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Every child or adult with autism has unique strengths and challenges, so there is no one size fits all approach to autism treatment and intervention.

Each autism intervention or treatment plan should be tailored to address the person's specific needs. A person’s treatment plan can include behavioral interventions, other therapies, medicines or a combination of these.

The therapies described below are evidence based, Autism Speaks Canada encourages parents and adults to pursue treatments that are evidence based and informed.

Applied Behavior Analysis

Applied Behavior Analysis (ABA) is a therapy based on the science of learning and behavior. ABA therapy applies our understanding of how behavior works to real situations. The goal is to increase behaviors that are helpful and decrease behaviors that are harmful or affect learning.

Behavior analysis helps us to understand:

  • How behavior works
  • How behavior is affected by the environment
  • How learning takes place

ABA therapy programs can help:

  • Increase language and communication skills
  • Improve attention, focus, social skills, memory, and academics
  • Decrease problem behaviors

The methods of behavior analysis have been used and studied for decades. They have helped many kinds of learners gain different skills – from healthier lifestyles to learning a new language. Therapists have used ABA to help children with autism and related developmental disorders since the 1960s.

How ABA therapy works:

Applied Behavior Analysis involves many techniques for understanding and changing behavior. ABA is a flexible treatment:

  • Can be adapted to meet the needs of each unique person
  • Provided in many different locations – at home, at school, and in the community
  • Teaches skills that are useful in everyday life
  • Can involve one-to-one teaching or group instruction

Positive Reinforcement

Positive reinforcement is one of the main strategies used in ABA.

When a behavior is followed by something that is valued (a reward), a person is more likely to repeat that behavior. Over time, this encourages positive behavior change.

First, the therapist identifies a goal behavior. Each time the person uses the behavior or skill successfully, they get a reward. The reward is meaningful to the individual – examples include praise, a toy or book, watching a video, access to a playground or other location, and more.

Positive rewards encourage the person to continue using the skill. Over time this leads to meaningful behavior change.

Antecedent, Behavior, Consequence

Understanding antecedents (what happens before a behavior occurs) and consequences (what happens after the behavior) is another important part of any ABA program.

The following three steps – the “A-B-Cs” – help us teach and understand behavior:

  1. An antecedent: this is what occurs right before the target behavior. It can be verbal, such as a command or request. It can also be physical, such a toy or object, or a light, sound, or something else in the environment. An antecedent may come from the environment, from another person, or be internal (such as a thought or feeling).
  2. A resulting behavior: this is the person’s response or lack of response to the antecedent. It can be an action, a verbal response, or something else.
  3. A consequence: this is what comes directly after the behavior. It can include positive reinforcement of the desired behavior, or no reaction for incorrect/inappropriate responses.

Looking at A-B-Cs helps us understand:

  1. Why a behavior may be happening
  2. How different consequences could affect whether the behavior is likely to happen again


  • Antecedent: The teacher says “It’s time to clean up your toys” at the end of the day.
  • Behavior: The student yells “no!”
  • Consequence: The teacher removes the toys and says “Okay, toys are all done.”

How could ABA help the student learn a more appropriate behavior in this situation?

  • Antecedent: The teacher says “time to clean up” at the end of the day.
  • Behavior: The student is reminded to ask, “Can I have 5 more minutes?”
  • Consequence: The teacher says, “Of course you can have 5 more minutes!”

With continued practice, the student will be able to replace the inappropriate behavior with one that is more helpful. This is an easier way for the student to get what she needs!

Planning and Ongoing Assessment

A qualified and trained behavior analyst (BCBA) designs and directly oversees the program. They customize the ABA program to each learner’s skills, needs, interests, preferences and family situation.

The BCBA will start by doing a detailed assessment of each person’s skills and preferences. They will use this to write specific treatment goals. Family goals and preferences may be included, too.

Treatment goals are written based on the age and ability level of the person with autism. Goals can include many different skill areas, such as:

  • Communication and language
  • Social skills
  • Self-care (such as showering and toileting)
  • Play and leisure
  • Motor skills
  • Learning and academic skills

The instruction plan breaks down each of these skills into small, concrete steps. The therapist teaches each step one by one, from simple (e.g. imitating single sounds) to more complex (e.g. carrying on a conversation).

The BCBA and therapists measure progress by collecting data in each therapy session. Data helps them to monitor the person’s progress toward goals on an ongoing basis.

The behavior analyst regularly meets with family members and program staff to review information about progress. They can then plan ahead and adjust teaching plans and goals as needed.

ABA Techniques and Philosophy

The instructor uses a variety of ABA procedures. Some are directed by the instructor and others are directed by the person with autism.

Parents, family members and caregivers receive training so they can support learning and skill practice throughout the day.

The person with autism will have many opportunities to learn and practice skills each day. This can happen in both planned and naturally occurring situations. For instance, someone learning to greet others by saying “hello” may get the chance to practice this skill in the classroom with their teacher (planned) and on the playground at recess (naturally occurring).

The learner receives an abundance of positive reinforcement for demonstrating useful skills and socially appropriate behaviors. The emphasis is on positive social interactions and enjoyable learning.

The learner receives no reinforcement for behaviors that pose harm or prevent learning.

ABA is effective for people of all ages. It can be used from early childhood through adulthood!

ABA Service Providers

A board-certified behavior analyst (BCBA) provides ABA therapy services. To become a BCBA, the following is needed:

  • Earn a master’s degree or PhD in psychology or behavior analysis
  • Pass a national certification exam
  • Seek a license to practice

ABA therapy programs also involve therapists, or registered behavior technicians (RBTs). These therapists are trained and supervised by the BCBA. They work directly with children and adults with autism to practice skills and work toward the individual goals written by the BCBA. You may hear them referred to by a few different names: behavioral therapists, line therapists, behavior tech, etc.

Is ABA effective?

ABA is considered an evidence-based best practice treatment by the US Surgeon General and by the American Psychological Association.

“Evidence based” means that ABA has passed scientific tests of its usefulness, quality, and effectiveness. ABA therapy includes many different techniques. All of these techniques focus on antecedents (what happens before a behavior occurs) and on consequences (what happens after the behavior).

More than 20 studies have established that intensive and long-term therapy using ABA principles improves outcomes for many but not all children with autism. “Intensive” and “long term” refer to programs that provide 25 to 40 hours a week of therapy for 1 to 3 years. These studies show gains in intellectual functioning, language development, daily living skills and social functioning. Studies with adults using ABA principles, though fewer in number, show similar benefits.

What questions should I ask?

It’s important to find an ABA provider and therapists who are a good fit for your family. The first step is for therapists to establish a good relationship with your child. If your child trusts their therapists and enjoys spending time with them, therapy will be more successful – and fun!

The following questions can help you evaluate whether a provider will be a good fit for your family. Remember to trust your instincts, as well!

  1. How many BCBAs do you have on staff?
  2. How many behavioral therapists do you have?
  3. How many therapists will be working with my child?
  4. What sort of training do your therapists receive? How often?
  5. How much direct supervision do therapists receive from BCBAs weekly?
  6. How do you manage safety concerns?
  7. What does a typical ABA session look like?
  8. Do you offer home-based or clinic-based therapy?
  9. How do you determine goals for my child? Do you consider input from parents?
  10. How often do you re-evaluate goals?
  11. How is progress evaluated?
  12. How many hours per week can you provide?
  13. Do you have a wait list?

Early Start Denver Model

The Early Start Denver Model (ESDM) is a behavioral therapy for children with autism between the ages of 12-48 months. It is based on the methods of applied behavior analysis (ABA).

Parents and therapists use play to build positive and fun relationships. Through play and joint activities, the child is encouraged to boost language, social and cognitive skills.

  • Based on understanding of normal toddler learning and development
  • Focused on building positive relationships
  • Teaching occurs during natural play and everyday activities
  • Uses play to encourage interaction and communication

ESDM therapy can be used in many settings, including at home, at a clinic, or in school. Therapy is provided in both group settings and one-on-one.

It has been found to be effective for children with a wide range of learning styles and abilities. ESDM can help children make progress in their social skills, language skills, and cognitive skills. Children who have significant learning challenges can benefit just as much as those without learning challenges.

Parent involvement is a key part of the ESDM program. Therapists should explain and model the strategies they use so that families can practice them at home.

Early Start Denver Model Service Providers:

An ESDM therapist may be any of the following:

  • Psychologist
  • Behavior specialist (BCBA)
  • Occupational therapist
  • Speech and language pathologist
  • Early intervention specialist
  • Developmental pediatrician

All therapists must have specific training and certification in EDSM. This process requires them to:

  • Attend a training workshop
  • Submit video showing them using ESDM techniques in therapy sessions
  • Demonstrate they can use these techniques correctly and reliably

This ensures that a certified professional has the knowledge and skills to successfully use the teaching strategies with children with autism.

Visit the Early Start Denver Model website to learn more.

Autism Speaks Canada Autism Response Team – Home for the autism community in Canada

Autism Speaks Canada Autism Response Team is a helpful online community for anyone whose life has been impacted by autism – family members, peers, friends and autistic Canadians. Whether you’re looking for a certified therapist or trainer, or resources to help you through transitions, or need support from an inclusive, diverse community, this is the place for you. There is something for everyone. Try it out for free.

Join Autism Speaks Canada Autism Response Team

Is the Early Start Denver Model effective?

Over a dozen studies have demonstrated the benefits of ESDM as an early intervention for autism among children as young as 18 months. These studies included children across a wide range of learning abilities.

Many of these studies looked at ESDM delivered by trained therapists in one-on-one sessions with the child. One looked at ESDM delivered to groups of children in childcare. Others looked at the benefits of training parents to deliver ESDM therapy at home.

Benefits include improved learning and language abilities and adaptive behavior and reduced symptoms of autism. Research using brain scans suggests that ESDM improves brain activity associated with social and communication skills.

What questions should I ask?

The following questions can help you learn more about ESDM before you begin. It can also help you learn whether a particular therapist is a good fit for your family:

  1. Who will be working with my child?
  2. What training will you offer to parents?
  3. Where do you hold therapy sessions?
  4. How do you determine program goals?
  5. Are you trained to offer ESDM therapy?
  6. Can parents participate in therapy sessions?
  7. Will sessions be one-on-one, or held in a group?
  8. How do you handle challenging behavior?
  9. How do you measure progress?
  10. What type of progress should we expect?


Floortime is a relationship-based therapy for children with autism. The intervention is called Floortime because the parent gets down on the floor with the child to play and interact with the child at their level.

Floortime is an alternative to ABA and is sometimes used in combination with ABA therapies.

The goal is for adults to help children expand their “circles of communication.” They meet the child at their developmental level and build on their strengths.

Therapists and parents engage children through the activities each child enjoys. They enter the child’s games. They follow the child’s lead.

Six Key Milestones of Floortime

Floortime aims to help the child reach six key milestones that contribute to emotional and intellectual growth:

  • Self-regulation and interest in the world
  • Intimacy, or engagement in relationships
  • Two-way communication
  • Complex communication
  • Emotional ideas
  • Emotional thinking

Therapists teach parents how to direct their children into more and more complex interactions. This process, called “opening and closing circles of communication,” is central to the Floortime approach.

Floortime does not work on speech, motor or cognitive skills in isolation. It addresses these areas through its focus on emotional development.

Overall, this method encourages children with autism to push themselves to their full potential. It develops “who they are,” rather than “what their diagnosis says.”

How Floortime Works

Floortime takes place in a calm environment. This can be at home or in a professional setting.

Therapy sessions range from two to five hours a day. They include training for parents and caregivers as well as interaction with the child.

During a session, the parent or provider joins in the child’s activities and follows the child’s lead. The parent or provider then engages the child in increasingly complex interactions.

Floortime encourages inclusion with typically developing peers when used in a preschool setting.

Sessions emphasize back-and-forth play. This builds the foundation for shared attention, engagement and problem solving. Parents and therapists help the child maintain focus to sharpen interactions and abstract, logical thinking.


If the child is tapping a toy truck, the parent might tap a toy car in the same way. The parent might then put the car in front of the child’s truck or add language to the game. This encourages the child to respond and interact.

As children grow, therapists and parents match the strategies with their child’s developing interests. They encourage higher levels of interaction.

For example, instead of playing with toy trucks, parents can engage with model airplanes or even ideas and academic fields of special interest to their child.

Families are encouraged to use Floortime principals in their day-to-day lives.

The History of Floortime

Floortime was created by child psychiatrists Stanley Greenspan, M.D. and Serena Wieder, PhD. It is based on the Developmental Individual-difference Relationship-based model (DIR). Dr. Greenspan developed the DIR model as therapy for children with a variety of developmental delays and issues in the 1980s.

Floortime Training Providers

Different types of professionals seek special training in Floortime techniques, including:

  • Child psychologists
  • Special education teachers
  • Speech therapists
  • Occupational therapists

Parents and caregivers can also learn Floortime techniques through workshops, books and websites.

Is Floortime Effective?

In a 2003 study, Dr. Greenspan and Dr. Weider studied Joey, a child on the autism spectrum who spent three years engaging in Floortime with his father. Over that time, Joey enjoyed six daily Floortime sessions. He continuously improved, and the two scientists concluded that Floortime helped Joey progress.

In 2007, a pilot study conducted by independent researchers likewise showed a Floortime benefit for children with autism. Two other 2011 studies—one conducted in Thailand and one in Canada—further supported Floortime as significantly improving emotional development and reducing autism’s core symptoms.

What questions should I ask?

The following questions can help you learn more about Floortime before you begin. It can also help you learn whether a particular therapist is a good fit for your family:

  1. Who will be working directly with my child?
  2. How many years have you been working with people with autism?
  3. Where will services be provided?
  4. What does the initial assessment involve?
  5. Do you have a waiting list?
  6. How many hours of therapy per week?
  7. How long are therapy sessions?
  8. What training do you offer for parents?
  9. How are goals determined? Can clients and parents provide input?
  10. What does a typical program look like?
  11. How do you measure progress?
  12. What progress should we expect?

For more information…

Occupational Therapy (OT)

Occupational therapy (OT) helps people work on cognitive, physical, social, and motor skills. The goal is to improve everyday skills which allow people to become more independent and participate in a wide range of activities.

For people with autism, OT programs often focus on play skills, learning strategies, and self-care. OT strategies can also help to manage sensory issues.

The occupational therapist will begin by evaluating the person’s current level of ability. The evaluation looks at several areas, including how the person:

  • Learns
  • Plays
  • Cares for themselves
  • Interacts with their environment

The evaluation will also identify any obstacles that prevent the person from participating in any typical day-to-day activities.

Based on this evaluation, the therapist creates goals and strategies that will allow the person to work on key skills. Some examples of common goals include:

  • Independent dressing
  • Eating
  • Grooming
  • Using the bathroom
  • Fine motor skills like writing, colouring, and cutting with scissors

Occupational therapy usually involves half-hour to one-hour sessions. The number of sessions per week is based on individual needs.

The person with autism may also practice these strategies and skills outside of therapy sessions at home and in other settings including school.

Some OTs are specifically trained to address feeding and swallowing challenges in people with autism. They can evaluate the particular issue a person is dealing with and provide treatment plans for improving feeding-related challenges.

Occupational Therapy Providers

A licensed Occupational Therapist (OT) provides OT services. The accreditation standards set by the Canadian Association of Occupational Therapists (CAOT) accepts the master’s degree in occupational therapy as the minimal educational requirement. Applicants to every province other than Quebec must successfully complete the National Occupational Therapy Certification Exam (NOTCE), as a requirement of registration. In the Yukon, Northwest Territories and Nunavut, occupational therapists are not currently a regulated health profession and, as such, do not need to complete the NOTCE to practice in the Territories.

In some cases, therapy services are provided by an Occupational Therapy Assistant (OTA). This is a person with an associate’s or bachelor’s degree, who is trained and supervised by a certified OT. The assistant works directly with the person with autism to practice skills and work towards goals that are written by the OT in the clinical treatment plan.

What questions should I ask?

  1. Who will be working directly with my child?
  2. How many years have you been working as a OT?
  3. Where will services be provided?
  4. How often will therapy sessions be?
  5. What are the goals of this program?
  6. What real-life skills will therapy help with?
  7. How do you help with sensory issues?
  8. How do you measure progress?

Pivotal Response Treatment (PRT)

Pivotal Response Treatment (PRT) is a behavioral treatment for autism. This therapy is play-based and initiated by the child. PRT is based on the principles of Applied Behavior Analysis (ABA).

Goals of this approach include:

  • Development of communication and language skills
  • Increasing positive social behaviors
  • Relief from disruptive self-stimulatory behaviors

The PRT therapist targets “pivotal” areas of a child’s development instead of working on one specific behavior. By focusing on pivotal areas, PRT produces improvements across other areas of social skills, communication, behavior and learning.

Pivotal areas include:

  • Motivation
  • Response to multiple cues
  • Self-management
  • Initiation of social interactions

Motivation strategies are an important part of the PRT approach. These emphasize natural reinforcement.

For example, if a child makes a meaningful attempt to request a stuffed animal, the reward is the stuffed animal – not a candy or other unrelated reward. Children are rewarded for making a good attempt, even if it is not perfect.

PRT was developed by Dr. Robert L. Koegel and Dr. Lynn Kern Koegel of Stanford University. It was previously called the Natural Language Paradigm (NLP). This approach has been used since the 1970s.

PRT Providers

A variety of providers seek training in PRT methods, including:

  • Psychologists
  • Special education teachers
  • Speech therapists

What is a typical PRT therapy program like?

Each program is tailored to meet the goals and needs of the individual person and his or her everyday routines.

A session typically involves six segments. Language, play and social skills are targeted with both structured and unstructured interactions.

The focus of each session changes as the person makes progress to accommodate more advanced goals and needs.

PRT programs usually involve 25 or more hours per week.

Everyone involved in the child’s life is encouraged to use PRT methods consistently in every part of his or her life. PRT has been described as a lifestyle adopted by the whole family.

Is PRT effective?

PRT is one of the best studied and validated behavioral treatments for autism.

More than 20 studies suggest that PRT improves communication skills in many (though not all) children who have autism. Most of these studies looked at PRT delivered by trained therapists in one-on-one therapy sessions. Others looked at PRT delivered in group settings by school teachers and by trained parents in their homes. A 2017 review of brain imaging studies showed evidence that PRT improves brain activity associated with sociability and communication.

Relationship Development Intervention (RDI)

Relationship Development Intervention (RDI) is a family-based, behavioral treatment which addresses the core symptoms of autism. It focuses on building social and emotional skills. Parents are trained as the primary therapist in most RDI programs.

RDI helps people with autism form personal relationships by strengthening the building blocks of social connections. This includes the ability to form an emotional bond and share experiences with others.

RDI builds on the idea that “dynamic intelligence” is key to improving quality of life for individuals with autism.

Dynamic intelligence means the ability to think flexibly:

  • Understand different perspectives
  • Cope with change
  • Integrate information from multiple sources (e.g. sights and sounds)

Six Objectives of RDI

  1. Emotional Referencing: learning from the emotional and subjective experiences of others
  2. Social Coordination: observe and control behavior to successfully participate in social relationships
  3. Declarative Language: using language and non-verbal communication to express curiosity, invite others to interact, share perceptions and feelings and coordinate your actions with others
  4. Flexible Thinking: adapt and alter plans as circumstances change
  5. Relational Information Processing: putting things into context and solve problems that lack clear cut solutions and have no “right and wrong” solutions
  6. Foresight and Hindsight: thinking about past experiences and anticipate future possibilities based on past experiences

RDI involves a step-by-step approach to build motivation and teach skills. The teaching plan is based on the child’s current age and ability level. The parent or therapist uses a set of step-by-step, developmentally appropriate goals.

The initial goal is to build a “guided participation” relationship between parents and child, with the child as a “cognitive apprentice.” Once this relationship is in place, the family advances through a series of developmental goals for their child. The goal of this process is to improve “neural connectivity,” or brain function.

Parents, teachers and other caretakers continue to use the principles of RDI in the child’s daily life. They use positive reinforcement to help the child improve social skills, adaptability and self-awareness.

RDI Providers

Parents and caregivers of people with autism usually serve as the primary therapist in an RDI program. Parents can learn the techniques of RDI through training seminars, books and other materials. They may choose to work with an RDI-certified consultant, as well.

Classroom teachers and behavioral therapists may also use RDI. Some specialized schools offer RDI in a private school setting.

How RDI works

The RDI consultant may begin by doing an assessment to learn how the child interacts with parents or teachers. The consultant will then create a teaching plan and goals based on the person’s development and abilities. The plan will include working on communication styles that best suit the child.

At the start, RDI involves one-on-one work between the parent and child. The parent or therapist applies stepwise, developmentally appropriate objectives to everyday life situations.

For instance, at first parents may limit how much they use spoken language. This encourages the child and parent to focus on eye contact and non-verbal communication.

As the child’s abilities increase, the goals and teaching plan change to meet his/her needs.

Next, the child begins spending time with a peer who shares similar social and emotional skills. This may be referred to as forming a “dyad” (meaning two children).

Gradually, additional children join the group. They meet and play in a variety of settings with the guidance of a parent or therapist. This allows them to practice forming and maintaining relationships in different contexts.

What is the intensity of most RDI programs?

Families often use the principles of RDI in their day-to-day lives. Each family will make choices based on their child. Most families spend at least a few hours per week using RDI strategies.

Is RDI effective?

To date, no independent studies have been published on RDI. In 2007, the technique’s developer (Dr. Steven Gutstein) published a report in the journal Autism that found positive results of RDI in a study group of 16 children. Independent research is needed to confirm benefits.

For more information

RDIconnect is RDI’s official website and provides resources for finding consultants and connecting with other families who use RDI.

In 2001, Dr. Gutstein published his first book on RDI, Autism Aspergers: Solving the Relationship Puzzle. Since then, he has written several more books on RDI, including The RDI Book (2009).

Speech Therapy

Speech-language therapy addresses challenges with language and communication. It can help people with autism improve their verbal, nonverbal, and social communication. The overall goal is to help the person communicate in more useful and functional ways.

Communication and speech-related challenges vary from person to person. Some individuals on the autism spectrum are not able to speak. Others love to talk, but have difficulty holding a conversation or understanding body language and facial expressions when talking with others.

A speech therapy program begins with an evaluation by a speech-language pathologist (SLP) to assess the person’s communication strengths and challenges. From this evaluation, the SLP creates individual goals for therapy.

Common goals may include improving spoken language, learning nonverbal skills such as signs or gestures, or learning to communicate using an alternative method (such as pictures or technology).

Examples of the skills that speech therapy may work on include:

  • Strengthening the muscles in the mouth, jaw and neck
  • Making clearer speech sounds
  • Matching emotions with the correct facial expression
  • Understanding body language
  • Responding to questions
  • Matching a picture with its meaning
  • Using a speech app on an iPad to produce the correct word
  • Modulating tone of voice

Alternative Augmentative Communication (AAC)

Some people with autism find that using pictures or technology to communicate is more effective than speaking. This is known as Alternative Augmentative Communication (AAC). Examples of AAC methods include:

  • Sign language
  • Picture exchange communication system (PECS)
  • iPads
  • Speech output devices (such as Dynavox)

The speech-language pathologist can help to identify which AAC method (if any) is right for someone with autism and teach him/her how to use the method to communicate.

Learn more about AAC and autism.

You can also visit the American Speech-Language Hearing Association’s AAC webpage for more information.

Social Skills

Speech therapy can also help people work on goals related to social communication. Speech therapists sometimes offer social skills groups in addition to one-on-one therapy.

They may also work on coaching children and adults on communication in different settings. This can include how to communicate with friends, communicating in a relationship, appropriate behavior at work, and more.

Feeding Challenges

Some SLPs are specifically trained to address feeding and swallowing challenges in people with autism. They can evaluate the particular issue a person is dealing with and provide treatment plans for improving feeding-related challenges.

Where are services provided?

Speech therapy can take place in a variety of settings:

  • Private clinic setting
  • At school, through an Individualized Education Program (IEP)
  • At home, as part of an Early Intervention program for children under 3
  • In the community, to practice new skills in a natural environment

Services can be provided one-on-one, or in a group setting depending on what skill is being practiced.

Who provides the services?

Speech-Language Pathologists (SLP) provide speech therapy services. They have a master’s degree and are specially licensed to practice through the state.

You may notice that a speech therapist has the credentials “CCC-SLP” after their name. This stands for Certificate of Clinical Competence (CCC) and is a credential through the American Speech-Language Hearing Association (ASHA). It indicates that the speech therapist has achieved excellence in academic and professional standards. You can learn more on the ASHA website.

In some cases, a Speech Therapy Assistant provides direct speech therapy services. This is a person with an associate’s or bachelor’s degree, who is trained and supervised by a certified speech-language pathologist. The assistant works directly with the person with autism to practice skills and work towards goals that are written by the SLP in the clinical treatment plan.

What questions should I ask?

The following questions can help you learn more about speech therapy before you begin. It can also help you learn whether a particular speech therapist or clinic is a good fit for your family:

  1. Who will be working directly with my child?
  2. How many years have you been working with people with autism?
  3. Where will services be provided?
  4. What does the initial assessment involve?
  5. Do you have a waiting list?
  6. How many hours of therapy per week?
  7. How long are therapy sessions?
  8. Can I observe my child’s sessions?
  9. What is a typical caseload for each therapist?
  10. How are goals determined? Can clients and parents provide input?
  11. What does a typical program look like?
  12. How do you measure progress?
  13. What are some of the typical milestones for speech and language?
  14. What can we do to practice at home?
  15. What progress should we expect?


The TEACCH® Autism Program is a clinical, training, and research program based at the University of North Carolina – Chapel Hill. TEACCH was developed by Dr. Eric Schopler and Dr. Robert Reichler in the 1960s. It was established as a statewide program in 1972 and has become a model for other programs around the world.

TEACCH uses a method called “Structured TEACCHing.” This is based on the unique learning needs of people with autism, including:

  • Strengths in visual information processing
  • Difficulties with social communication, attention and executive function

Structured TEACCHing provides strategies and tools for teachers to use in the classroom. These help students with autism to achieve educational and therapeutic goals.  The Structured TEACCHing approach focuses on:

  • External organizational supports to address challenges with attention and executive function
  • Visual and/or written information to supplement verbal communication
  • Structured support for social communication

This method supports meaningful engagement in activities. It also works to increase students’ flexibility, independence, and self-efficacy.

Structured TEACCHing strategies can be used alongside other approaches and therapies.

TEACCH programs are usually applied in a classroom setting. TEACCH-based home programs are also available. Parents work with professionals as co-therapists for their children so that they can continue to use TEACCH techniques at home.

Structured TEACCHing uses organization and supports in the classroom environment to help students learn best. This includes:

  1. Physical organization
  2. Individualized schedules
  3. Work (Activity) systems
  4. Visual structure of materials in tasks and activities

TEACCH Service Providers

TEACCH methods are used by a variety of autism professionals:

  • Special education teachers
  • Residential care providers
  • Psychologists
  • Social workers
  • Speech therapists

To become trained, professionals must go through a certification program offered by the TEACCH Autism Program in North Carolina. Training is offered both online and in-person on the TEACCH campus.

The program includes two certification levels, Practitioner and Advanced Consultant.

Visit the TEACCH website for more information on training and certification.

Is TEACCH effective?

A 2011 review of more than 150 autism-intervention studies found that the TEACCH program had the strongest evidence of educational benefits of any recognized program. These benefits included improved learning (cognition) and motor skills.

Other studies found benefits of using TEACCH strategies in residential and employment programs for adults with autism.

Verbal Behavior Therapy

Verbal Behavior (VB) therapy teaches communication and language. It is based on the principles of Applied Behavior Analysis and the theories of behaviorist B.F. Skinner.

This approach encourages people with autism to learn language by connecting words with their purposes. The student learns that words can help them get desired objects or results.

Verbal Behavior therapy does not focus on words as labels only (cat, car, etc.). Rather, it teaches why we use words and how they are useful in making requests and communicating ideas.

Language is classified into types, called “operants.” Each operant has a different function. Verbal Behavior therapy focuses on four word types:

  • Mand: A request, such as saying “Cookie,” to ask for a cookie
  • Tact: A comment used to share an experience or draw attention, such as “airplane” to point out an airplane
  • Intraverbal: A word used to respond or answer a question, such as “Where do you go to school?” “Castle Park Elementary”
  • Echoic: A repeated, or echoed, word, such as “Cookie?” “Cookie!” This is important as imitating will help the student learn.

VB and classic ABA use similar techniques to work with children. VB methods may be combined with an ABA program to work towards communication goals.

How does Verbal Behavior work?

Verbal Behavior therapy begins by teaching mands (requests) as the most basic type of language. For example, the individual with autism learns that saying “cookie” can produce a cookie.

As soon as the student makes a request, the therapist repeats the word and presents the requested item. The therapist then uses the word again in the same context to reinforce the meaning.

The person does not have to say the actual word to receive the desired item. At first, he or she simply needs to make a request by any means (such as pointing). The person learns that communicating produces positive results.

The therapist then helps the student shape communication over time toward saying or signing the actual word.

In a typical session, the teacher asks a series of questions that combine easy and hard requests. This allows the student to be successful more often and reduces frustration. The teacher should vary the situations and instructions in ways that keep the student interested.

Errorless Learning

Verbal Behavior therapy uses a technique called “errorless learning.”

Errorless teaching means using immediate and frequent prompts to ensure the student provides the correct response each time. Over time, these prompts are reduced. Eventually the student no longer needs prompting to provide the correct response.


Step 1: The therapist holds a cookie in front of the student and says “cookie” to prompt a response from the child.

Step 2: The therapist holds the cookie and makes a “c” sound to prompt the response.

Step 3: The therapist holds the cookie in the child’s line of sight and waits for the request with no cue.

The ultimate goal is for the child to say “cookie” when he or she wants a cookie – without any prompting.

What is the intensity of most VB programs?

Most programs involve at least one to three hours of therapy per week. More intensive programs can involve many more hours.

Instructors train parents and other caregivers to use verbal-behavior strategies in their daily life.

Who can benefit from Verbal Behavior therapy?

Verbal Behavior Therapy can help:

  • Young children beginning to learn language
  • Older students with delayed or disordered language
  • Children and adults who sign or use visual supports or other forms of assisted communication

Verbal Behaviour therapy providers

A VB-trained therapist may be any of the following:

  • Psychologist
  • Behavior specialist (BCBA)
  • Special education teacher
  • Speech and language pathologist

Is Verbal Behavior effective?

A 2006 review of 60 published studies concluded that Verbal Behavior Therapy helps many children with autism develop spoken language. The same review noted a lack of evidence on whether the approach produces broader benefits in daily living skills and overall improved outcomes.

For more information…

B.F. Skinner published Verbal Behavior in 1957 to describe his functional analysis of language. In the 1970s, behavior analysts Vincent Carbone, Mark Sundberg and James Partington began adapting Skinner’s approach to create Verbal Behavior Therapy. Since 1982, the Association for Behavior Analysis International has published the annual, peer-reviewed journal The Analysis of Verbal Behavior.

For Information on VB, visit the Cambridge Center for Behavioral Studies website.

Related resources from our online community—Autism Speaks Canada