Occupational Therapy (OT) vs Applied Behavior Analysis (ABA): What’s the difference?

Kyleigh Anderson, OTR/L

In a pediatric setting, OT and ABA may look similar. Both therapies can work together to address similar needs. Both OT and ABA involve play. Truly understanding the distinct processes and benefits of these therapies requires a closer look into what OT and ABA are.

What is occupational therapy?

The end goal of OT is function and well-being. The term “occupation” historically referred to everyday activities. The focus of occupational therapy is to promote quality of life by enabling successful participation in those meaningful daily activities. With children, examples of these activities may include: 

• activities of daily living (dressing, grooming/hygiene, eating, etc.)

• play

• school

• social participation

• leisure/hobbies

• participation with family and community

Considering how many factors may impact everyday life, it makes sense that OT addresses a wide variety of skills including:

• motor/movement skills (coordination, retained reflexes, neurological education, etc.)

• emotional regulation

• cognitive skills (attention, planning, memory, etc.)

• sensory regulation

• social skills

• self-advocating and adaptive skills 

What is applied behavior analysis?

ABA uses the science of behavior to improve lives via behavior change. The ABA approach focuses on increasing positive/functional behavior and decreasing maladaptive behavior. This commonly involves the use of reinforcement strategies and repetitive practice to master skills.  ABA therapy commonly addresses a variety of skills:

• social participation 

• functional communication

• play

• self-help and adaptive skills

• activities of daily living

• self-advocating and adaptive skills 

• movement skills for play

Similarities and differences:

Collaboration-

Both OT and ABA therapies are evidenced based approaches which can improve quality of life and function. Both therapies involve collaboration between the child, parents/caregivers, and therapists to identify and work toward meaningful goals. Parent/caregiver education is essential to each therapy in order to promote sustained change.

Timing-

Because ABA requires so much repetition and practice, sessions are generally longer (2-4 hours multiple times a week). OT, in contrast, addresses skills in sessions (1-2 times a week for 30-45 minutes) and then provides strategies for parents and children to practice those strategies throughout the week to promote independence.

Play-

Both therapies often involve play, though play may be utilized differently. ABA may seek to track and promote or discourage certain play skills/behaviors. ABA strategies may also use play as a reward or reinforcement to encourage growth and participation. OT generally uses play, especially child-directed play, as a teaching tool. OT uses play as a means to address life skills in a  motivating and engaging way. OT tends to focus more on intrinsic motivation, while ABA therapies utilize external reinforcement strategies.

Overall approach-

OT and ABA have some overlap in goals and skills addressed, but their approaches are generally different. ABA utilizes reinforcement and other behavior strategies through repeated, specific practice. OT addresses skills through functional, meaningful activities, with the OT subtly adapting tasks to address the necessary skill practice. 

These therapies work best in collaboration to meet goals and ensure continuity. Research supports both therapy styles.