There is no doubt that speech therapy and applied behavior analysis are a great combination for treating kids with autism, but when it comes time to choose your career, which path should you follow?
I started out earning my bachelor’s degree in Speech Language Pathology and Audiology from the University of Texas at Dallas with plans to get my master’s degree in Communication Disorders (which leads to becoming a fully licensed SLP). After earning my master’s degree, I spent the next 5 years working as a home health SLP-Assistant. Throughout this time, I realized I loved working with kids but did not want to spend over two years becoming an SLP. I went on to get a master’s degree in Applied Cognition and Neuroscience from the University of Texas at Dallas, then I completed the ABA certification program from the Florida Institute of Technology. I don’t want to persuade anyone away from becoming an SLP, but I will list the facts that I’ve found through my search and the reasons why I chose to become a BCBA instead.
There are enough programs for speech and ABA that finding a program shouldn’t pose a problem. A big bonus for ABA for me was the availability of 100% online programs. I wanted to continue working full time while in school, which would have been very difficult with the fulltime speech program plus their practicum requirements which I couldn’t get at my job despite working as an SLP-A. While the practicum requirements for speech are technically lower then ABA, those 400 hours are all/mostly face to face with clients and are unpaid placements through the school that you actually have to pay tuition for. In ABA, at least the online programs I’m familiar with, you can earn your hours at your place of employment while getting paid.
The range of hours, 750-1500 hrs, depends on if you are doing an intensive practicum or practicum through your school which has high rates of supervision, or if you are getting your hours independently with lower rates of supervision. I choose the independent fieldwork hours and completed the 1500 hrs in a year and a couple of weeks. Everything you do related to ABA counts towards your fieldwork hours, not just face to face time with clients.
The acceptance rates for speech were also disheartening, I only applied once to 1 school (UTD) for the master’s degree in SLP and didn’t get accepted, but I’ve heard of people applying every semester for several years and not getting in. Not all schools post their acceptance rates, but looking at one of the lowest ranked schools (according to US News), their pass rate was only 10%. Schools higher up on the list, including UTD which is ranked at #12, have even worse odds. In ABA I’ve not heard of someone struggling to getting into a program. While school acceptance rates are the barrier of entry to a career as an SLP, the exam pass rates are the barrier for BCBA’s. Rates differ from school to school, from 100% down to 13%, the average pass rate hovers around 60%. This is due to how they score the test, which I don’t fully understand so I’ve copied this from the BACB website:
“The BACB uses the modified Angoff method for establishing the passing score for each “base” exam form. Subsequent exam forms are statistically equated to the base exam form to ensure that any differences in difficulty level are taken into account. As a result of the equating process, the pass rates generally remain quite stable throughout the life span of each “base” exam form.”
The thought of going through 2 years of school then not passing the final hurdle is terrifying, but keep in mind that there are many study materials and you can re-take the test. But before choosing a school make sure to look at the pass rates by program. I attended Florida Institute of Technology’s online program and passed the test my first try.
The information obtained for the SLP career came from the Bureau of Labor Statistics, but they currently do not have a classification for BCBA’s so this information is not directly comparable. The information I did find for BCBA’s came from a report from the BACB (by Burning Glass) about career growth and from Payscale.com. In both fields there is huge growth potential and you should not have trouble finding a job. Depending on where you live, there are more SLP’s then BCBA’s, which means more SLP’s competing for a job, but even with that there are not enough SLP’s or BCBA’s to fill the demand.
The pay for both jobs is pretty even but that really depends on where you work. I worked for a short time in a clinic as an SLP-A and the fully licensed SLP’s only made $50,000 a year, which is less then I made as a home health SLP-A. That is another thing that lead me away from becoming an SLP, as an SLP-A in home health I was making $40/ 30-minute session while the SLP’s were only making $10 more than me per session and in clinics their salary was substantially less than mine. It didn’t make since to go to school where afterwards I would be in debt and get a pay cut if I wanted to work in a clinic.
Having worked in both fields, I find the overall work very similar. We both work in clinics, schools, home health, and private practice, but if you are very interested in doing more medical speech therapy (dysphagia, TBI, strokes, etc…) then you may not find satisfaction as a BCBA. Though both careers address language, social skills, communication, daily living skills, and feeding, ABA address these things from more of a behavioral aspect. ABA also gets to work with challenging behaviors such as aggression, pica, self-injurious behaviors, etc… which sound frightening to work with at first, and the first few times it is, but you get used to it and actually come to like working with those behaviors because that is where you can make the greatest impact in your clients and their families life. One of the things that I like in ABA over speech is that our scope of practice is behavior, which is basically everything. As a BCBA I can work on all the things that I did in speech, plus more. We work on things differently, but having seen the effects of both therapies, I prefer ABA for kids with autism and experience so much more success now than I did as an SLP-A.
If you’re coming from working in speech to working in ABA, the amount of time we spend in a session is shocking. I was used to fliting from visit to visit every 30 minutes for 8 hours all over Dallas, but when I provided the direct therapy as an RBT I would be in a visit from 2-5 hrs at a time. You might think, “what am I supposed to do in 5 hours?!”, but the time is a lot more flexible and there is plenty to do. For example, I might be with a client at their school or daycare prompting appropriate social interaction, managing challenging behaviors, prompting them to eat lunch appropriately, etc… It is not 5 hours of sitting on the floor labeling animals. As a BCBA Supervisor you will not be doing all of the direct therapy, so you time with the clients will still not be that long.
That is another difference between SLP’s and BCBA’s which could be a positive or negative thing depending on what you like to do. All BCBA positions are supervisor positions, there is no company that will hire a BCBA to provide direct therapy only. In fact, I have previously been discouraged from providing any direct therapy to my clients and only spend my time supervising. The reason for this is money; every time I see a client my company loses money. There are no limits to the number of RBT’s/BCaBA’s or clients that you can supervise, so your real function is to be a certificate that they can attach lower paid individuals to which can provide most of the therapy and make the company a profit. Getting this type of attitude will greatly depend on where you work, but even with ABA companies that are 100% ABA and very focused on client outcomes, it would be a huge waste of money and resources if you only did direct therapy and didn’t supervise. While as an SLP, supervising is completely optional and you are only allowed to supervise 4 SLP-Assistance at most. So if you like providing direct therapy and would hate supervising people, stick with speech.
Winner: It depends...
For me, it was BCBA, but for you it may be different. Are the things in the ‘It Depends’ column sound like pros or cons for you? If you’d get bored just doing speech, then maybe BCBA is for you too. If you don’t want to supervise or are uncomfortable working with possibly aggressive children, then maybe you’d prefer to be an SLP. From here, the choice is up to you.
Hopefully this information has been helpful and will help you decide which path to choose for your career. If you have any questions, don’t hesitate to email me and I’d be happy to answer.