OT vs ABA therapy for autism: what’s the difference?

Occupational therapy (OT) for autistic children focuses on helping them participate in meaningful daily activities. An OT might work on sensory sensitivities (like managing loud noises or certain textures), self-care skills (dressing, eating, toileting), fine motor skills (handwriting, using cutlery), and play or school participation. Sessions typically run 45–60 minutes, weekly or fortnightly. Under the NDIS (2025–26 pricing), OT costs around $120–$180 per hour depending on your state and therapist qualifications. Many families also access OT through Medicare via a GP referral (up to 10 sessions per year under the Enhanced Primary Care scheme).

ABA (applied behaviour analysis) is a behavioural intervention based on learning theory. It uses structured techniques to increase desired behaviours and decrease unwanted ones, often through repetition and reward systems. ABA sessions are typically intensive (10–40 hours per week) and costly. Under NDIS, ABA funding varies significantly by state and individual plan, but can range from $150–$250+ per hour. However, it's important to know that many autistic self-advocates, neurodiversity-affirming professionals, and some Australian autism organisations have raised concerns about ABA's intensity and focus on compliance.

A growing number of OTs in Australia now practise neurodiversity-affirming OT, which supports autistic children's strengths and differences rather than trying to change core autistic traits. This approach aligns with how many Australian autistic adults and families view autism.

If you're considering therapy for your child, start by speaking with your GP or paediatrician about what would suit your child's needs. If you have NDIS funding, your planner can discuss which therapies are available in your plan. You can also ask potential therapists about their philosophy—whether they take a neurodiversity-affirming approach—and what outcomes matter most to your family.