ABA vs. OT: Working Together — and When Each Makes the Difference
Welcome back to the Koi Wellness blog. I’m Aya Porté, pediatric occupational therapist and founder of Koi Wellness, where I partner with families, schools, and providers across cultural and neuro-diverse settings to build clarity, connection, and competence.
When a child is navigating challenges at home, in school, or in therapy, it’s common for everyone to pull in the same direction—but sometimes it doesn’t feel that way. You might hear phrases like “We need an ABA plan” or “Let’s get OT involved,” and wonder: What’s the difference? Who does what? Can they overlap? And most importantly: What does my child need right now?
This article aims to clarify the distinction between Applied Behavior Analysis (ABA) and Occupational Therapy (OT), highlight where they intersect, address common misconceptions among parents, RBTs (Registered Behavior Technicians) and BCBAs (Board Certified Behavior Analysts), and share how you can build a child-led, functional approach—with capacity-building, not just plan-execution.
What ABA Does
ABA is a behavior-based approach that uses data, reinforcement, and functional behaviour assessments (FBAs) to identify and change specific behaviours.
Typical goals: reducing challenging behaviours, increasing communication or social initiations, establishing routines and skills in highly structured formats.
ABA is often provided by BCBAs and implemented by RBTs, with an emphasis on measurable, observable behaviours: “if this happens, then we’ll reinforce that.”
What OT Does
Occupational Therapy takes a broader lens: it supports the child’s ability to engage in meaningful everyday activities (occupations)—self-care, play, school participation, sensory regulation, fine & gross motor skills, transitions, etc.
OT uses a client-centred and holistic frame: we look at what the child needs in the moment, what their routines and environment support (or hinder), and collaborate with caregivers, educators, and other providers to scaffold participation.
For example: if a child struggles to brush their teeth because their grip is weak, or because the sensory input of the toothbrush triggers discomfort, OT addresses that. It’s more than a behaviour to change—it’s building a skill, understanding the body, designing the environment.
Where the Overlap Happens and Where the Differences Matter
Because both ABA and OT work with children who have developmental or behavioural differences, and because both break tasks into smaller steps, there is natural overlap.
Both might work on self-care routines (e.g., dressing, toileting) and daily living skills.
Both may involve parent training and collaboration across settings.
However, the core difference lies in the focus and entry point:
Entry point: ABA often enters when a behaviour is interfering significantly (e.g., frequent meltdowns, escapes, aggression) and a structured behaviour plan is needed. OT often enters when participation is limited by motor, sensory, regulation, or environmental factors—even before behaviour becomes the headline. (E.g., a child avoids tasks because their body is tired, or sensory input is overwhelming.)
Focus: ABA = modifying behaviours via reinforcement and environment. OT = enabling meaningful occupations, building underlying skills, adapting the environment. For example: if a child refuses to join circle time because of gross motor fatigue, OT addresses the fatigue and body support; ABA might target the refusal behaviour and its antecedents.
Implementation lens: ABA plans may become very structured, data-driven and intensive; OT interventions may be more embedded in routines, play, context, less “sit-table”. For example, one resource notes ABA may be 20–40 hrs/week while OT session counts are fewer but embedded in daily life.
When a Functional Behaviour Plan “Falls Short”
You may see a functional behaviour plan (FBP) written by a BCBA and wonder: “This looks great on paper—but in the classroom or home it just isn’t sticking.” Why might that happen?
Because the skill part hasn’t been addressed: If the behaviour is a symptom of a sensory, motor, or regulation challenge, changing the behaviour alone may suppress without enabling.
Because environmental supports or participation routines aren’t aligned: If the plan doesn’t consider when the child is most vulnerable, or where the setting creates overload, the plan struggles.
Because implementation becomes adult-led rather than child-led: If the child doesn’t understand task expectations, isn’t engaged in the plan, or lacks the capacity, the plan can feel coercive rather than empowering.
This is where OT complements and strengthens the plan. OT brings the lens of “What does this child need in this moment to show up for the plan?” rather than only “What behaviour do we need to stop or teach?”
Building Capacity for Child-Led Implementation
Here are ways to build stronger, more sustainable implementation — whether you’re a parent, teacher, RBT, BCBA or OT:
Start with the child’s perspective
Ask: Where is the child in their body, regulation and environment before the plan kicks in? If they’re dys-regulated or sensory overloaded, the plan may not land.Collaborate across disciplines
Bridge the ABA plan with OT input: Are there motor, sensory or environmental barriers? For example: if the plan says “sit on carpet for 10 minutes,” OT might assess whether the floor or seating is preventing participation.Embed skill-building into routines
Instead of “you must do this task now,” build mini-skills (e.g., wrist support, core strength, sensory breaks) that support the task. The child should gradually own these skills.Make the plan fluid, not rigid
Data is important—but if data becomes the only focus, you lose the child. If a task fails repeatedly, pause: what’s the barrier? Ask “What’s the skill the child needs right now?” and adjust.Empower caregivers and educators
Whether you’re a parent, OT or RBT, you can build capacity by equipping others (teacher aides, siblings, home caregivers) with why the plan matters, when to adapt, and how to check in with the child’s regulation and readiness.
Why OT-Led Support Strengthens Functional Behaviour Plans
When Occupational Therapy leads the plan, the foundation for participation and regulation comes first. ABA can then provide reinforcement and structure—but only after the child’s sensory, motor, and emotional readiness is understood and supported.
One example that stays with me involved a student who struggled every day with transitions between classes. The team initially interpreted these challenges as “noncompliance” or “avoidance,” and a detailed behaviour plan was developed to increase compliance during transitions.
However, during my observations, I noticed something different. The child’s biggest reactions consistently happened before art class—a space full of strong smells, unpredictable sounds, and visual clutter. It wasn’t the transition itself that triggered distress; it was sensory overload in the art room.
After assessing the environment and the child’s sensory profile, I recommended several small adjustments: reducing visual stimuli near the work area, using noise-reducing headphones during setup, and changing the location of the art class. While not all of my suggestions were accepted at first, we eventually reached a compromise that allowed the child to stay regulated and participate more successfully.
That breakthrough didn’t come from enforcing the behaviour plan—it came from understanding the “why” behind the behaviour.
In this OT-led model, the occupational therapist identifies the underlying barriers that make tasks hard—sensory, motor, or environmental—so that ABA strategies can then build on a more stable foundation. Functional behaviour plans (FBP) support consistency and measurable progress, but OT ensures the child’s body, senses, and environment are aligned for success.
When OT leads and ABA supports, plans become more humane, sustainable, and effective—helping not only the child but the entire team see progress through a more compassionate, functional lens.
How I Can Support You
At Koi Wellness, I offer parent consultations, OT sessions, and collaborative planning with teachers and providers. Here’s how I can help:
For parents: I guide you through understanding how your child’s sensory, motor or regulation system might be influencing behaviour, and how to partner with RBTs/BCBAs to align plans with your child’s lived experience.
For schools and educators: I consult on how to embed OT-informed routines and supports that align with behaviour plans and classroom demands.
For RBTs/BCBAs seeking OT collaboration: I offer one-on-one mentoring to refine how OT and ABA can integrate, how to build capacity in caregivers and educators, and how to shift from “plan-execution” to “child-owned implementation.”
If you’re navigating an FBP (Functional behaviour plans) that feels stuck, or you want to ensure your child’s therapy is truly aligned with their sensory, motor and regulation needs—let’s work together.
Final Thoughts: The Gift of Time
Let’s set the groundwork for meaningful participation and ensure everyone on the team speaks the same language. When we shift from “everybody doing their thing” to “everybody on the same team,” the child steps into the centre with support, agency, and momentum.
You don’t have to navigate this alone. Whether you’re a parent wondering where to start, a teacher trying to coordinate support, or a practitioner looking for collaboration—I’d love to connect and bring clarity, confidence, and collaboration to your process.
Here’s to building teams that work—and children who thrive.