They are different services, and a child may need both. A speech-language pathologist (SLP) evaluates and treats speech, language and feeding problems. ABA therapy, led by a Board Certified Behavior Analyst (BCBA), teaches communication and daily skills and reduces behaviors that get in the way of learning. Neither one replaces the other.
What does each professional do?
An SLP, often called a speech therapist, evaluates and treats communication. The American Speech-Language-Hearing Association (ASHA) says SLPs help autistic children with speech, language and social communication, and treat feeding problems when present. To serve Florida Medicaid members, an SLP needs a Florida license. Spanish-speaking relatives may call this professional a fonoaudiólogo or logopeda.
ABA (applied behavior analysis) is led by a lead analyst, usually a BCBA certified by the Behavior Analyst Certification Board (BACB), with technicians (RBTs) under supervision. It teaches skills like asking for what your child needs, following routines and getting dressed, and works on behaviors that put your child at risk or block learning.
How do I decide which one my child needs?
Decide with your pediatrician and your child's evaluations. The diagnostic evaluation may recommend one therapy or both. Some clues:
- If your child barely talks, does not understand what you say, or has trouble eating: ask for a speech and language evaluation.
- If your child hits, runs off, self-injures or struggles with daily routines: ask the pediatrician about ABA.
- If you see both, your child can receive both therapies at the same time.
Ask the two therapists to work as a team
ASHA says SLPs may collaborate with BCBAs. Ask them to share goals and use the same words, signs or pictures with your child. Some children use augmentative and alternative communication (AAC): gestures, signs, pictures or a talking tablet. The American Academy of Pediatrics (AAP) says starting AAC with children who do not yet talk does not keep them from learning to talk.
What does Florida Medicaid cover?
Florida Medicaid covers speech-language evaluations and therapy for members under 21, and ABA therapy with prior authorization, as separate services. Both policies cover only what is medically necessary and does not duplicate another service, so each therapist should have clear goals. Ask your plan what paperwork each therapy needs.
How can Paramount Behavior help?
Paramount Behavior is an ABA therapy agency serving Palm Beach County at home and at school, in English and Spanish. Today we serve Medicaid members of Molina Healthcare, Sunshine Health, Children's Medical Services Health Plan and Community Care Plan. For speech therapy, ask your pediatrician for a referral to a licensed SLP. Call (561) 421-0047 to check your child's plan.
Can ABA replace speech therapy?
No. They have different goals and different professionals. ABA can help build communication, but it does not take the place of an evaluation and treatment by a licensed SLP.
If my child uses pictures or a tablet, will they stop trying to talk?
The AAP says starting AAC with children who do not yet talk does not keep them from learning to talk. ASHA adds that early AAC use can help develop speech and language.
Where do I find a speech therapist?
Ask your pediatrician for a referral, and ask your Medicaid plan which SLPs are in its network.
General information, not medical advice for your child. If your child stops using words or skills they had, or often chokes or coughs while eating, talk to the pediatrician soon.
Sources
- Speech-Language Therapy for Autistic Children (last updated March 29, 2023). American Academy of Pediatrics (HealthyChildren.org), accessed October 30, 2026.
- Autism and Autism Spectrum Disorder (Practice Portal). American Speech-Language-Hearing Association (ASHA), accessed October 30, 2026.
- Augmentative and Alternative Communication (Practice Portal). American Speech-Language-Hearing Association (ASHA), accessed October 30, 2026.
- Florida Medicaid Speech-Language Pathology Services Coverage Policy, October 2016 (Rule 59G-4.324, F.A.C.). Florida Agency for Health Care Administration (AHCA), via Florida Administrative Register, accessed October 30, 2026.
- Florida Medicaid Behavior Analysis Services Coverage Policy, December 2024 (Rule 59G-4.125, F.A.C.). Florida Agency for Health Care Administration (AHCA), accessed October 30, 2026.