Getting the Most out of Therapy: 

So often children who are diagnosed with a disability are provided a plethora of services which can be overwhelming to parents. This is especially true for younger children with recent diagnosis due to the proven efficiency of early intervention. Parents who are just learning about the needs their children have are given several referrals for services they have never heard of. This is such an emotional process for any parent of a child at any age and they are rarely given one person to make sense of it all. This series it meant to help explain the services your child may be receiving as they relate to ABA, how these services can be used to support an ABA program, and how to facilitate this collaboration between providers who can also be unfamiliar with each other’s specialties.

Part 1: Speech and Language Therapy and Applied Behavior Analysis 

Does your child receive speech and/or language services from a speech and language pathologist? What is speech and language pathology? How does this differ from ABA therapy? These are some of the most common questions that are asked during the establishment of new services. One of the most fundamental elements of language therapy is frequently not explained to parents: the difference between speech and language disorders. 

Speech disorders refer to difficulties producing speech sounds or problems with voice quality. They might be characterized by an interruption in the flow or rhythm of speech, such as stuttering, which is called dysfluency. Speech disorders may be problems with the way sounds are formed, called articulation or phonological disorders, or they may be difficulties with the pitch, volume or quality of the voice.

A language disorder is an impairment in the ability to understand and/or use words in context, both verbally and nonverbally. Some characteristics of language disorders include improper use of words and their meanings, inability to express ideas, inappropriate grammatical patterns, reduced vocabulary and inability to follow directions. 

(National Information Center for Children and Youth with Disabilities, 1996)

These are the two specific areas targeted by speech and language pathology and the sole focus of this therapy. Unlike ABA therapy, SLP services are usually provided on a weekly basis, ranging from 30 to 90-minute sessions. Some ABA programs can include services for 40 hours a week. This stark difference in exposure is mostly due to the specialized nature of SLP services compared to the broad range of goals addressed by ABA. Regardless of how often or how long the therapies are, both ABA and Language services are most efficient when they are implemented across your child’s entire day and various environments. The most common example this clinician uses to explain it is with a speech disorder. If your child is dropping a specific sound (phoneme) at a specific spot in a word. This is commonly seen with the initial /s/ sound in early speech development. Children will say “nake” instead of “snake” or “top” instead of “stop”. An SLP’s role would be to ensure your child can physically make the /s/ sound and then teach you how to correct them. This correction procedure will take effect the fastest if your child is corrected every time they say that word. This need for consistency aligns with the needs in ABA therapy implementation. 

Does ABA overlap with speech/language services? YES! They overlap in content of therapeutic targets, however they rarely work on the same goals for those targets. For example, your BCBA clinician may program for daily practice of letter sounds which is geared towards being able to identify a letter by its sound. An SLP may also focus on letter sounds, but the focus is much more about sound production and how to teach the mouth to produce that phoneme in speech centered therapy. For language focused therapy the SLP would focus on both the sound production and the process of learning individual sounds in order to produce them for communication purposes.  This targeted focus of therapy has one common theme, learning letter sounds, but two completely different focuses. 

Can these therapies support each other considering how different the focus is? Absolutely! Over years of providing services, this clinician has often utilized the talents of the SLP for ABA based program elements. Staying with the example of letter sounds, let’s say your child has all the letter sounds memorized besides a few that are just not happening. The SLP can point out that, from a speech only perspective, certain sounds (such as /h/ or soft vowels) rely on the position of the mouth and tongue to produce sound with air. This is different from sounds such as /k/ or /b/, which rely on a simpler mouth position and are produced from the voice box. The importance of this difference is seen in typical speech development of children, which is often referred to as ‘toddler talk’. By consulting with the SLP on the letter sounds your child is struggling with and providing them the data from the ABA program, they can provide insights and interventions that the BCBA can use to assist in those letter sounds being learned. A similar process can be done if there is a language delay. Often the children serviced by ABA therapy have both a speech and language disorder. Utilizing the SLP to support the language goals of the ABA therapy can prove an invaluable resource for your child. 

As a parent your role is to facilitate this communication between therapists. This is not always easy as these professionals rarely interact with each other or share knowledge since they are in different fields. Explaining to the SLP that they can also benefit from ABA behavior interventions, such as antecedent manipulations, to reduce problem behaviors and maximize therapy time can be a reciprocal way to start a bridge between these two services. This is advantageous for both sides because it is more implementation of the other interventions, which are equally proven as necessary. To often these services overlap and cause the different approaches to actually impede each other when there is such a potential for helping. The SLP can help the BCBA with language aspects of their program, while the BCBA can help the SLP with behavior related barriers to therapeutic goals. Explaining this and embracing each service will help make your child’s program one that gets the most out of each therapy. 

Author:

Sheila Panno, MEd, BCBA, LBA

BCBA Clinician

Works Cited:

National Information Center for Children and Youth with Disabilities. (1996). General Information About Speech and Language Disorders . Retrieved from LD OnLine: http://www.ldonline.org/article/6336/