What are the alternatives to ABA therapy?
Yes, ABA has real alternatives. The main ones are speech therapy, occupational therapy, developmental approaches like Floortime, and programs that coach parents directly.
The research behind them varies a lot. Here is a fair comparison, from a provider willing to tell you when ABA is not the right fit.
A 2020 national review found 28 practices with strong enough research to count as evidence based for autism, drawn from several therapy traditions.
On this page
What are the main alternatives to ABA?
Most families end up weighing the same short list. Speech work targets talking, occupational work targets sensory and daily living skills, developmental play models target connection, and parent coaching turns everyday routines into practice.
Combining them is normal. Picking one forever is not required.
For the wide view, a 2020 national review at UNC Chapel Hill identified 28 practices with strong enough research support for autism. By our own reading, about half are core behavior-analytic techniques, and the rest come from other traditions.
How do the alternatives compare?
| Approach | What the research shows |
|---|---|
| Speech-language therapy | Real, modest gains in spoken language. Strongest when parents and clinicians deliver it together. |
| Occupational therapy (Ayres Sensory Integration) | Meets evidence-based criteria for ages 4 to 12 with IQ above 65, based on two randomized trials. |
| DIR/Floortime | Only one randomized trial among 12 studies reviewed in 2023. The reviewers called the support "fragile." |
| Early Start Denver Model | Solid gains in cognition and language across 640 children, but no significant advantage on core autism symptoms. |
| PACT parent coaching | Significant reduction in symptom severity that emerged by the 6-year follow-up of its randomized trial. |
| Child-centered play therapy | Case studies only. Even play-therapy researchers call it too early to judge for autism. |
Every row above comes from the named studies listed in the sources at the bottom of this page.
Can you combine therapies?
Yes, and most families do. A common stack pairs weekly speech sessions, some OT, and behavioral work, with each piece doing a different job when the teams coordinate goals.
Budding Futures does not provide speech or OT in-house, so we coordinate with your child’s other providers rather than replacing them. If you are weighing the two most-compared options, our ABA vs speech therapy page breaks that choice down.
When is ABA not the right fit?
If your child is making steady progress with a speech therapist and an OT, adding ABA may not be worth the hours. A schedule your family cannot sustain is also a real reason to choose a lighter model.
Provider quality matters more than the name of the therapy. Whatever you choose, pick a team that measures progress and shows you the data. If they will not, walk away, including from an ABA provider.
How do you choose?
Start from the goal, because the goal picks the tool. A child who needs words fastest usually needs speech work and communication-focused behavioral teaching before anything else.
Then weigh what your family can actually sustain. A lighter program your child attends beats an intensive one your schedule breaks under.
We are glad to talk through the options even when the answer is not us. Clinical Director Rachel Blackburn, BCBA can tell you what an ABA plan would target, and our guide to whether ABA is effective lays out the research in the same plain terms as this page.
Frequently asked questions from parents
Q: What is better than ABA therapy?
A: Nothing beats it across the board. The honest answer depends on the goal your child needs most right now. For teaching specific skills and reducing dangerous behavior, behavioral approaches still carry the most research.
Q: Is Floortime better than ABA?
A: The research bases are not close in size. Floortime had one randomized trial among 12 studies in a 2023 review, against decades of controlled behavioral studies. Some families still prefer its style, and some children respond well to it.
Q: What about occupational therapy instead of ABA?
A: They target different things. OT, and specifically Ayres Sensory Integration, has support for sensory and daily-living goals in children 4 to 12. It does not replace communication or behavior teaching.
Q: Does Colorado Medicaid cover ABA and its alternatives?
A: Health First Colorado covers ABA for members under 21 through its Pediatric Behavioral Therapies benefit when medical necessity is documented. Coverage for other therapies runs through separate benefits, so ask each provider to verify yours.
ABA therapy support near you
In-Home ABA Therapy Across Colorado
How Budding Futures delivers BCBA-led, communication-first ABA at home.
ABA Therapy in Colorado Springs
In-home, BCBA-led ABA for Colorado Springs families.
ABA Therapy in Lakewood
In-home ABA therapy for families across Lakewood.
Sources
NCAEP, 2020
Evidence-based practices for children and youth with autism, UNC Chapel Hill.
Fuller et al., 2020
Effects of the Early Start Denver Model: a meta-analysis, Brain Sciences.
Divya et al., 2023
Effectiveness of DIR/Floortime: a systematic review, Iranian Journal of Nursing and Midwifery Research.
Pickles et al., 2016
PACT parent-mediated therapy: 6-year follow-up of a randomised trial, The Lancet.
Schoen et al., 2019
Ayres Sensory Integration for autism: a systematic review, Autism Research.
Health First Colorado
Pediatric Behavioral Therapies benefit, Colorado Dept. of Health Care Policy and Financing.
Want an honest read on what fits your child?
Tell us your child’s goals. We’ll tell you what an ABA plan would target, what we’d refer out, and how Medicaid or your insurance covers it in Colorado.