Can ABA and Floortime be used together for a 3-year-old?

Yes, many families and clinicians find a combined approach beneficial. For example, you might use Floortime to build emotional connection and play skills while incorporating ABA techniques to teach specific communication or self-help goals. A competent provider can integrate elements from both models.

Is Floortime covered by insurance?

Insurance coverage for Floortime is less common than for ABA. Some plans may cover components like speech or occupational therapy that use Floortime principles, but pure Floortime sessions often need to be paid out-of-pocket. Contact your insurance provider to ask about behavioral health or developmental therapy coverage.

Does Medicaid pay for ABA therapy?

Yes, Medicaid covers ABA therapy in all states, but the specific benefits and the number of hours can vary. Many families use third-party billing companies of free matching services like ABA Therapy Now to find providers who accept their state's Medicaid plan.

How do I find a qualified BCBA near me for my 3-year-old?

You can start by asking your pediatrician or local early intervention program for recommendations. Another easy option is to use ABA Therapy Now's free matching service, which connects you with vetted BCBA-led providers in your area that accept your insurance.

At what age should I start ABA or Floortime for my child?

Early intervention is highly recommended, and 3 years old is a great age to begin either therapy. Research shows that starting before age 5 leads to the best outcomes for many children. It's never too early to seek an evaluation and start exploring options.

What if my child doesn't respond well to ABA?

It's important to monitor your child's engagement. If a child seems distressed or resistant, a skilled BCBA can adjust the approach to be more child-led and playful. Some children do better with a lower-intensity program or a hybrid model. You can also explore Floortime as an alternative or complement.

ABA vs Floortime for a 3-Year-Old: Which Is Right?

In short: ABA and Floortime are two common therapies for young children with autism. ABA focuses on teaching specific skills through structured reinforcement, while Floortime follows the child's lead to build emotional and social connections. Your choice depends on your child's needs and your family's values; many children benefit from a combined approach.

When you're exploring therapies for your 3-year-old with autism, two names often come up: ABA (Applied Behavior Analysis) and Floortime (also called DIR or DIRFloortime). Both can be valuable, but they take very different paths. Understanding these differences helps you make an informed decision that aligns with your child's needs and your family's values.

What Is ABA Therapy for 3-Year-Olds?

Core Principles of ABA

Applied Behavior Analysis is a structured, evidence-based therapy that focuses on teaching meaningful skills by breaking them down into small, teachable steps. A Board Certified Behavior Analyst (BCBA) designs and oversees the program, using positive reinforcement to encourage desired behaviors such as communication, social interaction, self-care, and play. For a 3-year-old, ABA goals might include initiating eye contact, requesting a favorite toy, or following simple instructions.

What to Expect in an ABA Session

Sessions are typically one-on-one with a trained therapist (a Registered Behavior Technician or RBT) who follows a detailed plan. The environment is often structured, with clear routines, visual schedules, and frequent opportunities for practice. Data is collected on each target skill so progress can be measured and the plan adjusted. Many ABA programs are delivered in-home, at a clinic, or in community settings, and they often recommend 20-40 hours per week for young children. Insurance and Medicaid frequently cover ABA therapy, making it accessible for many families.

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🔗 Related reading: Free & Low-Cost Autism Services in California · Local ABA Therapy

What Is Floortime (DIR) Therapy?

Philosophy and Approach

Floortime is part of the Developmental, Individual-differences, Relationship-based (DIR) model. Developed by Dr. Stanley Greenspan, Floortime emphasizes the child's emotional and relational development. The core idea is to follow the child's lead during play and gradually expand their circles of communication. Instead of focusing on discrete skills, Floortime aims to build foundational capacities like shared attention, two-way communication, complex social problem-solving, and emotional thinking.

What a Floortime Session Looks Like

A Floortime session is child-led and play-based. The parent or therapist gets down on the floor with the child, observes what the child is interested in, and gently encourages back-and-forth interactions. For example, if a child is lining up cars, the adult might join in and then create a playful obstacle to invite a response. Sessions are typically less intensive than ABA-often a few hours per week-and are usually guided by a trained professional (such as a speech-language pathologist, occupational therapist, or mental health professional) who coaches the family. Insurance coverage for Floortime varies; it is less often covered by private insurance, but some state-funded early intervention programs may include it.

Key Differences Between ABA and Floortime

Structure vs. child-led: ABA is structured and adult-directed; Floortime is flexible and follows the child's interests.
Goal focus: ABA targets specific observable skills; Floortime targets emotional and relational development.
Role of reinforcement: ABA uses systematic reinforcement; Floortime uses natural relationship rewards.
Data and measurement: ABA relies on frequent data collection; Floortime uses clinical observation and developmental profiles.
Intensity: ABA often requires 20-40 hours per week; Floortime typically recommends 15-25 hours across various contexts.
Provider credentials: ABA is led by a BCBA; Floortime does not have a single credentialing body but often involves specialists like SLP, OT, or psychologists trained in DIR.

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🔗 Related reading: Telehealth ABA in Ohio: Rules, Coverage & How It Works · Local ABA Therapy

Which Therapy Is More Effective? A Look at the Evidence

ABA has the strongest research base of any autism therapy. Numerous studies show significant gains in communication, social skills, and adaptive behavior, especially when started early (before age 4). The US Surgeon General and the CDC recognize ABA as an effective intervention.

Floortime has a smaller but growing evidence base. Some studies indicate improvements in social-emotional functioning, communication, and parent-child interaction. However, the overall body of research is less robust, and Floortime is not as widely covered by insurance. That said, many families and clinicians report positive outcomes, especially in areas of emotional connection and flexibility.

It's important to remember that every child is different. A therapy that works well for one child may not be ideal for another. Many professionals recommend considering a blended approach, using Floortime principles to build relationship and ABA techniques to teach specific skills.

Costs and Insurance Coverage for ABA and Floortime

ABA therapy is commonly covered by private health insurance, including employer plans and plans purchased through the Health Insurance Marketplace. Medicaid also covers ABA in all states, although specific benefits vary. Some families face copays or deductibles, but many plans cover a substantial portion. As a free referral service, ABA Therapy Now can help you find vetted BCBA-led providers who accept your insurance.

Floortime is less consistently covered by insurance. Some plans may reimburse for occupational therapy or speech therapy that incorporates Floortime, but pure Floortime services often require private pay. Costs range widely, from $75 to $200 per session depending on location and provider. Your state's early intervention program may offer some Floortime-like supports through Part C services (for children under 3) or preschool special education (ages 3-5).

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How to Choose Between ABA and Floortime for Your 3-Year-Old

Here are practical steps to help you decide:

Assess your child's primary challenges. If your child needs help with basic skills like toilet training, following directions, or reducing safety risks, ABA may be a strong fit. If your child struggles with social connection, emotional regulation, or flexibility, Floortime might be more appropriate.
Consider your family's lifestyle. ABA's intensive hours can be demanding; Floortime's lower intensity may fit better with a busy schedule. Some families start with one and add the other later.
Explore a hybrid model. Many professionals now combine approaches. For example, a BCBA might use child-led play to build rapport, or a Floortime practitioner might incorporate targeted skill teaching.
Look for qualified providers. For ABA, ensure the supervising therapist is a BCBA (Board Certified Behavior Analyst). For Floortime, seek providers trained through the Interdisciplinary Council on Development and Learning (ICDL) or DIR-certified professionals.
Check insurance coverage. Contact your insurance company to see what therapies are covered. ABA Therapy Now can assist with finding ABA providers who work with your plan, including Medicaid.

Common Mistakes to Avoid When Selecting Therapy

Choosing therapy based on popularity alone. Just because a therapy is well-known or a friend recommends it doesn't mean it's right for your child.
Ignoring your child's preferences. A highly structured program may cause distress for a child who needs more flexibility. Pay attention to how your child responds during initial sessions.
Not verifying provider credentials. For ABA, always ask if the supervisor is a BCBA. For Floortime, ask about DIR training and experience.
Overlooking the need for parent involvement. Both therapies require parents to be active participants. Ask about parent training and coaching opportunities.
Waiting too long to start. Early intervention (before age 5) makes a significant difference. Even if you're unsure of the exact therapy, starting some form of supportive intervention is better than delaying.
Not utilizing free support services. Services like ABA Therapy Now can save you time and help you find qualified providers at no cost. Don't hesitate to reach out.

Get Matched with a Vetted ABA Provider - Free

If you decide that ABA therapy is a good option for your 3-year-old, ABA Therapy Now can connect you with BCBA-led providers who are vetted and accept your insurance, including Medicaid. Our service is completely free for families. Simply tell us about your child's needs and your location, and we'll provide a personalized list of options. No obligation, no cost - just help finding the right support for your family.

ABA vs Floortime for Your 3-Year-Old: What Families Need to Know

Key takeaways