Autistic Neurodiversity: Overview Table of ABA vs Occupational Therapy Interventions

In the realm of therapeutic approaches for individuals on the autism spectrum, a profound distinction arises between Applied Behavior Analysis (ABA) and Occupational Therapy (OT) with Neurodiversity-Affirming Approaches. The table below illuminates the stark contrasts in philosophy, goals, communication focus, and various facets of intervention strategies employed by these two methodologies.

ABA often centers around behavior modification, striving to normalize perceived challenging behaviors through reinforcement strategies.

In contrast, OT, with its neurodiversity-affirming stance, embraces and celebrates the diversity of behaviors as valid expressions of individuality. This comprehensive exploration encapsulates their divergent approaches across key domains, shedding light on how each methodology navigates aspects such as sensory integration, social skills training, autonomy, and long-term therapeutic goals.

Understanding these differences is crucial in fostering an inclusive and respectful environment that recognizes and supports the unique strengths and challenges of neurodivergent individuals.

Applied Behavior Analysis (ABA) Occupational Therapy (OT) Neurodiversity-Affirming Approaches
Philosophy and Approach ABA focuses on behavior modification. Example: Using reinforcement to decrease a child’s hand-flapping. OT embraces neurodiversity, valuing and supporting a child’s hand-flapping as a self-soothing behavior. Example: Recognizing hand-flapping as a valid expression of the child’s emotions and sensory needs.
Goal of Therapy ABA often aims to make behaviors socially acceptable. Example: Teaching a child to use specific phrases during play to fit in with peers. OT focuses on supporting individual development. Example: Encouraging a child to communicate in ways comfortable for them, even if it differs from conventional norms.
Communication Focus ABA may prioritize verbal communication. Example: Using rewards to prompt a child to speak rather than using gestures. OT recognizes diverse communication styles. Example: Supporting non-verbal communication, such as gestures or picture-based communication, as valid forms of expression.
Sensory Integration ABA addresses sensory issues. Example: Using desensitization techniques to reduce reactions to specific sensory stimuli. OT incorporates sensory-informed interventions. Example: Creating a sensory-friendly environment to support a child’s sensory needs.
Individualization ABA often uses standardized treatment plans. Example: Applying the same behavior intervention plan to different individuals with similar behaviors. OT tailors interventions to the individual’s unique needs. Example: Designing activities based on an individual’s sensory preferences and strengths.
Social Skills Training ABA may emphasize training in conventional social norms. Example: Teaching a child to conform to expected social behaviors during group activities. OT focuses on supporting social development. Example: Facilitating social interactions that respect and accommodate the child’s unique social style.
Behavioral Interventions ABA uses reinforcement and consequences. Example: Offering rewards for completing specific tasks or following instructions. OT utilizes positive behavioral support. Example: Identifying triggers for challenging behaviors and implementing strategies to meet sensory or communication needs without relying on external rewards.
Autonomy and Consent ABA may have a prescriptive approach. Example: Implementing interventions without obtaining explicit consent from the individual. OT prioritizes autonomy and consent. Example: Collaboratively setting therapy goals and involving individuals in decision-making processes.
Cultural Competence ABA may lack cultural competence. Example: Viewing autism solely as a set of deficits to be corrected. OT promotes cultural competence. Example: Recognizing and respecting autism as a diverse and valid neurocultural identity.
Long-Term Goals ABA may focus on normalization. Example: Encouraging individuals to suppress stimming to appear less visibly autistic. OT aims to enhance overall well-being. Example: Fostering a positive self-image and supporting the development of skills that contribute to a fulfilling life, without prioritizing normalization.
Empowerment and Advocacy ABA may not inherently prioritize empowerment. Example: Deciding therapy goals without considering the individual’s aspirations or preferences. OT emphasizes empowerment. Example: Encouraging individuals to express their needs, preferences, and goals within the therapeutic process.
Family Collaboration ABA may involve families without prioritizing collaboration. Example: Implementing interventions without considering family input. OT actively collaborates with families. Example: Collaboratively setting goals with families based on their understanding of the individual’s needs and strengths.
Activities of Daily Living (ADLs) ABA may approach ADLs from a behavior modification standpoint. Example: Using behavior plans to encourage a child to follow a routine for self-care tasks. OT supports individuals in ADLs by considering sensory preferences. Example: Encouraging a child to explore different textures during self-care activities to address sensory needs.
Play ABA may guide play to conform to expected social norms. Example: Structuring play to encourage specific types of social interactions. OT embraces diverse play styles. Example: Allowing and encouraging stimming during play as a valid form of self-expression.
Rest and Sleep ABA may use behavior interventions for sleep difficulties. Example: Implementing a reward system for staying in bed during the night. OT addresses sleep difficulties by considering sensory needs. Example: Designing a sensory-friendly sleep environment to promote relaxation.
Masking ABA may inadvertently reinforce masking behaviors. Example: Rewarding a child for suppressing autistic traits in social situations. OT discourages masking. Example: Encouraging authenticity and self-expression, even if behaviors differ from societal norms.
Stimming ABA may attempt to decrease stimming behaviors. Example: Using redirection and consequences to discourage stimming in public settings. OT recognizes stimming as a valid and functional behavior. Example: Allowing and providing space for stimming activities as a self-regulatory strategy.
Fine Motor Skills ABA may address fine motor skills in a structured manner. Example: Using token systems to encourage fine motor activities. OT considers fine motor skills within a sensory-informed framework. Example: Providing various textures and tools for fine motor activities to accommodate sensory needs.
Hand Over Hand ABA may use hand-over-hand to guide individuals. Example: Physically assisting a child in completing a fine motor activity. OT, while recognizing the importance of fine motor skills, aims to minimize physical guidance. Example: Encouraging a child to explore and engage in fine motor activities independently, with minimal physical guidance.

Sources

Dallman, A. R., Williams, K. L., & Villa, L. (2022).. The Open Journal of Occupational Therapy10(2), 1-9.