Part 1 of a 3-part series on interdisciplinary collaboration between Occupational Therapists and Behaviour Therapists*

There’s a particular kind of exhaustion that comes from running a paediatric OT session solo, juggling task demands, reading a child’s rising frustration, adjusting your prompts, and trying to hold the therapeutic thread together, all at once. If you’ve worked face-to-face with autistic children on skill-building goals, you know the feeling.

Since joining an ABA clinic and working alongside Board Certified Behaviour Analysts (BCBAs) and Behaviour Therapists (BTs), that exhausting solo act has become something else entirely: a shared performance, with each professional playing to their strengths.

1. Two Lenses, One Child

As an OT, my goal is usually about building independence, creating opportunities, then gradually increasing demands so a child can grow into new skills. That’s the work I’m trained for and love doing.

But there’s a gap that often opens up in solo practice: the moment when a child is technically completing a task, but not actually learning/developing skill from it. They’re going through the motions to make the demand disappear, not to build the skill. It looks like participation. It isn’t meaningful engagement.

This is exactly where a BT’s expertise becomes invaluable. Behaviour Therapists are remarkably skilled at spotting the early signs, the trigger moments, before they escalate. They can tell the difference between a child who is engaged and a child who is complying just to escape the task. In solo sessions, I’d often miss these cues, too focused on maintaining task perseverance and pushing through, encouraging “just one more” when a child needed something else entirely: a moment of regulation.

2. Working Smarter, Not Harder

In joint sessions, the BT takes on real-time activity analysis and grading, reading motivation, skill level, and engagement moment to moment, and adjusting the task accordingly. They support transitions and regulation, which frees me up to focus on what I do best: introducing and calibrating the actual OT task.

The result is what we call the “just right demand” a task pitched precisely at the edge of a child’s ability, challenging enough to build skill, achievable enough to keep them engaged. Finding that sweet spot alone, session after session, is genuinely difficult. Finding it with a BT reading the room alongside you is a different experience altogether.

This isn’t about handing over clinical responsibility. It’s role-sharing in its truest sense an intradisciplinary approach where joint assessment, joint intervention, and joint report writing mean the whole picture of a child’s functioning is captured more accurately than either discipline could manage alone.

3. What’s Coming Next

In the next post, I’ll walk through what actually changes in the room the shift from carrying the entire session on your own shoulders to working within a genuinely shared therapeutic dynamic, and why that shift matters not just for outcomes, but for practitioner sustainability too.

Next: “From Solo to Shared: What Changes in the Room”

Option 2:

Why Collaborative OT and Behaviour Therapy Sessions Can Strengthen Autism Intervention

Working as an occupational therapist within an ABA clinic has given me a unique opportunity to see how powerful collaborative practice can be for autistic children and their families. In joint sessions with behaviour therapists, occupational therapy goals are not addressed in isolation. Instead, the child is supported by a team that can simultaneously consider participation, regulation, behaviour, skill development and meaningful engagement.

From an OT perspective, the aim is to build functional skills by creating opportunities, gradually increasing demands in a way that supports success. In a joint OT–BT session, the behaviour therapist can help identify early signs of distress, adjust the way tasks are presented and support the child’s tolerance for participation. This means the OT can focus on activity analysis, motor planning, sensory processing, visual-motor skills, self-care routines and other occupation-based goals while the child remains more regulated and available for learning.

One of the most valuable parts of this approach is the shared ability to notice not just whether a child completes a task, but how and why they are participating. A child may finish an activity simply to escape the demand, rather than because the activity is meaningful or the skill is being learned. When OT and BT clinicians work together, they can identify these moments earlier and adjust the task so it becomes a “just right” challenge: achievable enough to support confidence, but demanding enough to promote growth.

Why collaboration matters

Best-practice early childhood intervention increasingly emphasises integrated, coordinated and family-centred support. The National Best Practice

Framework for Early Childhood Intervention highlights teamwork, participation, everyday settings, evidence-informed practice and outcomes-focused intervention as core elements of quality support. This aligns strongly with collaborative OT and behaviour therapy practice, where professionals share information, communicate regularly and work toward common goals that are meaningful for the child and family.

Research on collaboration between occupational therapists and behaviour analysts also recognises that both disciplines bring valuable but different perspectives. Occupational therapists contribute expertise in occupation, sensory processing, motor development, self-care, play, school readiness and environmental adaptation. Behaviour therapists contribute expertise in behaviour support, reinforcement, prompting, skill acquisition and reducing barriers to learning. When these perspectives are combined respectfully, intervention can become more consistent, functional and responsive to the child’s needs.

What this looks like in practice

In a joint session, the OT might introduce a structured activity of daily living, such as dressing, feeding, toileting preparation or a fine-motor task. The behaviour therapist may support the child’s readiness to engage by using familiar behavioural strategies, monitoring motivation and helping the team respond to early signs of dysregulation. Together, the clinicians can adjust the activity in real time by changing the prompt level, reducing or increasing task demands, modifying the environment or embedding reinforcement in a way that keeps participation meaningful.

This role-sharing can be especially helpful when working on skills that are difficult to practise when a child is overwhelmed, avoidant or unsure of what is expected. For example, core stability activities, visual-perceptual desktop tasks and self-care routines often require sustained attention, body awareness and persistence. With coordinated support, the child can experience the activity as manageable and purposeful rather than simply as another demand to escape.

The benefit for children and families

For children, collaborative sessions can support greater emotional regulation, more consistent participation and better opportunities to practise functional skills. For families, the benefit is a more coordinated team: goals are aligned, strategies are shared and intervention is less fragmented. Instead of each professional working separately, the team can build a shared understanding of what helps the child participate, learn and generalise skills across routines.

For clinicians, collaborative practice also reduces the pressure to “hold” every part of the session alone. The OT can remain focused on occupation-based analysis and therapeutic grading, while the BT supports behavioural readiness and engagement. This does not blur professional boundaries; rather, it strengthens them by allowing each practitioner to contribute their expertise within a shared plan.

Moving toward truly collaborative intervention

Collaborative OT and behaviour therapy is most effective when it is intentional. Teams need shared goals, regular communication, mutual respect and clear agreement about roles. When these foundations are in place, joint sessions can move beyond “two therapists in the same room” and become a genuinely integrated approach to supporting autistic children’s participation in everyday life.

For our practice, this approach reflects the heart of occupational therapy: helping children participate in meaningful occupations. By working alongside behaviour therapists, we can create sessions that are better regulated, better graded and more responsive to the child in front of us.

References and supporting literature

1. Gavidia-Payne, S., Rossell, R., Bull, K., & Forster, J. The changing narrative of early childhood intervention in Australia: service providers’ perspectives on the implementation of the National Disability Insurance Scheme.

2. Australian early childhood intervention practice promotes natural environments, transdisciplinary teamwork, blended practices and collaborative partnerships with families and community supports.

3. National Best Practice Framework for Early Childhood Intervention: Teamwork Practice Guideline.

• Practitioners are encouraged to work with other practitioners and service providers to foster integrated and collaborative service delivery based on the outcomes identified by parents, carers and families.
• Collaborative and coordinated teams help ensure that early childhood intervention services are integrated with wider community-based and specialist supports.
• Team members benefit from a shared understanding of communication processes, including update methods, meeting frequency and shared decision-making.

4. Lage, C. R., & Snider, J. Collaborative practices in early childhood intervention: the case for explicitly striving for maximal participation of families.

• Collaborative practice is a key component of successful early childhood intervention and supports family-centred, coordinated therapy planning.

5. Gasiewski, K., Weiss, M. J., Leaf, J. B., & Labowitz, J. (2021). Collaboration between behavior analysts and occupational therapists in autism service provision: Bridging the gap. Behavior Analysis in Practice, 14(4), 1209–1222.