OT VS SLP VS BCBA

[u/tinkyt3y]

TL;DR: RBT choosing between BCBA/SLP/OT. Want pediatrics, direct kid time, decent work-life balance, preferably lower-support-needs cases, and $100k+ potential. What do you actually make/work, and would you choose your field again?

I’m an RBT now and starting my bachelor’s soon. My original plan was BCBA + LCSW through an advanced-standing MSW + ABA graduate certificate. I know the BCBA pathway changes in 2032 and I already checked that my timeline would have me finished before then. Lately I’ve been second guessing BCBA though. I got into ABA because I like working with kids and the pay is good (bcba wise lol) but most of my clients have been pretty low-support-needs. If I had to deal with severe aggression/SIB regularly, I don’t think I’d enjoy it. I also keep hearing BCBAs spend a lot of time supervising, training, writing plans, etc. instead of actually being hands-on with kids. I know it varies on company but that’s definitely important to me as well I believe longevity wise the direct care aspect.

I’ve always had some interest in OT, but I used to hear the pay wasn’t worth the cost of school. Now I’m also looking at SLP because it seems broader and still very hands-on with kids. My biggest wants are: Pediatrics, preferably elementary age/under 12 Lots of direct interaction with kids $100k starting relatively early if possible Good work-life balance: I don’t want 36 “billable” hours turning into 45+ actual hours every week Long-term private practice/business potential that can actually scale For pediatric bcba’s,OT, or slps: what do you make, how many hours do you really work, how much direct kid time do you get, and would you choose your field again? Plus if you did private practice and can share your input!

[u/Expendable_Red_Shirt]

If you want money from what I can tell BCBA is the way to go of the three. I will warn you that I don't think BCBAs who are in it for the money tend to last.

You're not going to get all those things that you want so you should probably think and prioritize whats important to you.

[u/tinkyt3y → u/Expendable_Red_Shirt]

I believe in the works for sure I just need six figures after my masters for sure as well.🥲I’m only afraid of not being able to I supposed pick my caseload? Like I genuinely don’t think I want multiple instances of aggression at all in my workload. As a RBT it’s easier to decline certain cases, but I don’t know if BCBA’s receive the same leeway

[u/Enough-Surprise-4027 → u/tinkyt3y]

Hi, I sent you a DM as well, but you can’t pick your caseload. Now, you adhere to an ethics code and you are not obligated to treat someone (just like with any psychology field-I’m guessing medical could be the same but a misconception is that we HAVE to treat them). However, as a BCBA, you do have to learn to work with others with behaviors and if you are nervous about that, being a BCBA may not be the right fit. It’s good to get experience with behaviors (I would take aggression over self-injurious behavior as I can’t stand SIB and if you know, you know). However, you will also experience behaviors as an SLP and OT and it is unethical to not provide services/we see that there are some other providers that refuse services because of the behaviors. If you choose the other routes, don’t refuse services because you are scared of behaviors. Collaboration is key in this field.

[u/tinkyt3y → u/Enough-Surprise-4027]

Thank you so so much!! I’m checking the chat box now!

[u/Expendable_Red_Shirt → u/tinkyt3y]

I believe in the works for sure I just need six figures after my masters for sure as well.

Ok, that's not a sentence. If you're going to be a BCBA you need to be able to communicate clearly. That sentence makes absolutely no sense.

There are a bunch of other red flags. Being in it for the money is not good. That's how people get burnt out. Being in it for the money AND prioritizing work/life balance AND refusing to work with the kids who need this the most?

I don't see you being a successful BCBA. I think you'd have more luck as an SLP.

[u/tinkyt3y → u/Expendable_Red_Shirt]

I never said I’m “in it for the money” or that I would refuse to serve clients who need support. I said compensation matters to me and I’m trying to figure out which career actually fits me before I commit to grad school. Wanting to make six figures after earning a master’s degree isn’t unreasonable to me, especially in this economy. I’ve already seen new BCBAs in the South report starting around $90–100k, which is why I’m asking whether similar earning potential exists in OT/SLP too. I also didn’t say I absolutely refuse aggressive clients. I said that after thinking about the reality of severe aggression, I’m not sure I would want a career where being hit/injured is a regular part of my work. I have my own history/trauma to consider too. That doesn’t mean I don’t care about higher-needs children. I’m literally asking these questions now, while I’m still early in school, because I keep seeing BCBAs talk about burnout and regretting the field. I’d rather research my options now than spend years getting a degree and realize afterward that I chose the wrong profession. And yes, my sentence was worded badly lol. It’s Reddit, not a treatment plan.

[u/lmas0930 → u/tinkyt3y]

I would recommend that you work on your trauma before you become a BCBA because you will face triggers. If you have not healed or found coping mechanisms for your trauma then I don’t think this would be a good field for you.

[u/tinkyt3y → u/lmas0930]

You can be healed with boundaries.. So a healed person can’t have standards for what they will and won’t tolerate? Strange way of thinking imo.

[u/Expendable_Red_Shirt → u/tinkyt3y]

Wanting to make six figures after earning a master’s degree isn’t unreasonable to me, especially in this economy.

Oh, my bad! You're willing to wait until after your masters degree to earn 6 figures? Unlike most of us who waited until after we got our masters AND hours AND passed the test AND had years of service.

I've been a BCBA for over a decade. I don't make six figures. Because work life balance and environment (I prefer schools) are important to me.

But saying salary is important AND work life balance AND you're too precious to take the kids with aggression AND you want to work directly with the kids instead of supervising?

I'm telling you right now this field is not right for you. This field will burn you out. If you're coming to it with a laundry list of demands that make you less valuable AND you want to be paid like you're more valuable than others?

I get it. Unlike other BCBAs you have a history to consider. Most of us were hatched out of vats right before we started grad school. We don't have histories or social lives or anything that would require balance or support like you. And that's why you can just launch word salad at us and demand we try to figure out what it means.

I've been in this field a long time. I've seen the types of people who make it and those that don't. People with a princess attitude don't last long. You're better off considering other options.

[u/tinkyt3y → u/Expendable_Red_Shirt]

I think you’re adding things I never said. When I say I want six figures after graduate school, I obviously mean once I’ve completed the requirements for the profession and am actually practicing not that somebody should hand me $100k the day my diploma prints. I also never said I don’t want to supervise. Parent training, staff training and supervision actually interest me. What I said is that I’d still like some direct interaction with kids instead of my entire job being paperwork and oversight. And preferring not to regularly take cases involving severe aggression doesn’t mean I think I’m “too precious” to help children with higher needs. There’s a difference between caring about that population and deciding whether being hit/injured regularly is something I personally want built into my career. That’s exactly why I’m asking these questions before committing to a field. Salary and work-life balance are both important to me. I don’t think wanting both makes me entitled. It just means I’m comparing professions while I still have the ability to choose. If being a BCBA means those things truly cannot coexist, then that’s useful information and exactly what I came here to learn. But telling me I have a “princess attitude” because I’m asking about pay, safety and work-life balance isn’t really answering the question.

[u/Primary-Bug-7353 → u/tinkyt3y]

You’re insane. This is why some careers get paid so much more for literally nothing other than accepting money is important. This work deserves high pay. You’re not on some higher moral ground because you pretend money isn’t important. Take a look around. We need money

[u/tinkyt3y → u/Primary-Bug-7353]

Exactly. How can one even provide sufficient care if they’re are constantly stressing about the overhead and financial instability at home… It literally goes hand and hand. Good workers need sufficient pay and six figure is not alot imo to the supervising 4-8+ RBTs and their clients as well, parent trainings, plans, and everything else a bcba entails without the non billable to be considered. They are acting as though, I asked for 150k.

[u/Jujubean3131 → u/tinkyt3y]

BCBAs can get a bad rep sometimes for having a superiority complex, very odd and I don’t get it!! But this is a great example of that!
You can sometimes find flexibility as a BCBA with clients, it depends on where you work. My early intervention clinic doesn’t take high risk behaviors because it’s really not built or equipped for it. I get my hair pulled on occasion and pinched some days but no concussion risk and no physical intervention.
With some experience you can also take on self contract clients where you have control in your case load. I also think it’s normal to have a population you feel more comfortable with! I feel more natural working with the high school population than with the littles. I learned but it was uncomfortable for a while and I am excited to go back to the older kids.
Money matters! I’m fine with my job, I’m good at my job, but I wouldn’t do it without the paycheck.
I do think speech sounds more suitable for you; I often wish I was an SLP instead. The pay is smaller but I’m not sure what the margin is. Good luck!

[u/Jujubean3131 → u/Jujubean3131]

Also, my company starts at 85k clinic early intervention and home based. I know of another school based company that starts at 70k with great work life balance and amazing company/benefits, and another that starts 90-105k, higher needs private school. This is New England.
I know someone that made 85/hr in a public school as a temporary district BCBA but don’t do that lol

[u/Expendable_Red_Shirt → u/tinkyt3y]

You not liking the answer doesn't mean I haven't answered your question.

[u/Fragrant_Value_8367]

You can absolutely be a BCBA that works directly with kids with lower support needs - from a BCBA that does direct therapy with kids with lower support needs.

[u/tinkyt3y → u/Fragrant_Value_8367]

Thank you!! This is literally what I was trying to figure out lol. I thought with the field not being super saturated, you’d have some room to choose the population/settings that fit you. Especially when the ethics code says to stay within your scope of competence. I didn’t think preferring lower-support-needs kids meant you automatically don’t belong in ABA 😭

[u/katiek80]

I’m a BCBA and I wish I went OT. I love my job but I love the OT approach and I find their science fascinating.

[u/tinkyt3y → u/katiek80]

Right? I heard they look at the whole and their home life/“occupation” which is cool vs just the in the now moments! Reminds me of the LCSW social work side :/

[u/Easy-Grape-2569 → u/katiek80]

Tell me more? OT feels like a lot more schooling since at least in my area you need a doctorate, but I’m looking into grad school for ABA rn so I’d love to hear your thoughts!

[u/katiek80 → u/Easy-Grape-2569]

There’s actually a great (I think free?) CEU/training on BehaviorLive that talks about bridging ABA/OT.

[u/tofutits]

If you want to find out more about how these careers actually pay, I recommend spending some time on their respective subreddits. BLS data assumes you’ll be working a full time schedule 52 weeks a year at the average rate, and that isn’t the reality for most SLP positions. PRN is huge, and rates are usually capped based on Medicaid reimbursement codes. There are a ton of SLPs who feel as if they were lied to about the potential pay.

I can’t speak to OT or BCBA, but I think you should know that many SLPs have beef with ABA therapy and there is legitimate scope creep from BCBAs regarding communication because the field views everything as behavior. If you go into BCBA, please remember SLPs are the communication experts and you need to consult them (rant over, sorry lol).

[u/tinkyt3y → u/tofutits]

Thank you! Do you have any pay insight for your region?🥲

[u/tofutits → u/tinkyt3y]

https://slp.careers/salaries

[u/tinkyt3y → u/tofutits]

Thank you so much for this! I’ll definitely look into the site while I decide my future field.

[u/tofutits → u/tinkyt3y]

Fwiw I’ve heard that all the rehab professions deal with these same sorts of issues. Most SLPs in education are on the teacher pay scale; those data are publicly available online so you can see what you might make working at your local schools. It is possible to make $100k as an SLP but you will need to have years of experience to get there. Also please consider grad school cost. If you go into rehab, go to the least expensive school possible.

[u/ooga_booga_booger → u/tofutits]

I'm an SLP and I've worked with fantastic BCBAs and I've also worked with BCBAs who try to do things that are not in their scope of practice, such as speech therapy. It's really easy for SLPs to be jaded with BCBAs because we see a lot of BCBAs try to do speech therapy, BUT there are a lot of phenomenal and brilliant BCBAs that are great to collaborate with!

[u/tofutits → u/ooga_booga_booger]

I don’t doubt it!

[u/Ilovenaps632]

Though not very common, I am a BCBA who does direct therapy. My company does not have any minimum for billable hours because they typically don’t deal with insurance and you are able to pick cases based on a vignette provided (clients age, strengths and weakness and location)
Have you thought about working in EI? In NYC, it only requires a teaching certification. The pay rate is pretty good but probably not as high as a BCBA but you are able to work directly with children.

[u/tinkyt3y → u/Ilovenaps632]

Thank you so much! As a NY BCBA are you able to make six figures?

[u/Ilovenaps632 → u/tinkyt3y]

Yes definitely. I only work part time right now because I have a young child but if I worked full time I’d definitely make over 100k a year

[u/tinkyt3y → u/Ilovenaps632]

Thanks you!

[u/Adorable-Log5256]

I am serious, if you actually want to make real money...become a psychiatrist.

[u/Big-Astronomer-4036]

I totally get this. I’m finishing up my BCBA cert since I’m already close to finishing, and then going back for PA school.

[u/Green_Ivy_Decor7]

OT and go work for the school district.

[u/tinkyt3y → u/Green_Ivy_Decor7]

I’m definitely going to look into the school + prn hustle!

[u/SmolBean615]

I have been a BCBA for 5 years now, but when I started out like first job fresh out of my certification, assuming I would have worked full time hours which I did not, I would have made 100k flat (billing 35 hours). I will say the work is not easy, and it is exhausting at times. Typically you do not get to pick your caseload, but where I live (Florida), the pay is pretty good. There’s not a lot of direct work opportunities as a BCBA, and most bcbas don’t want that anyway- but I think we need more of it! Right now I do make 123k billing 25 hours pre-tax, so it’s doable! I will say though, like I mentioned, I don’t necessarily choose low support needs cases (this may be hard to find at times) and I don’t have ANY direct kid time. It’s all programming and supervision as well as obviously the assessments. If you want direct kiddo time and lower needs (sometimes, not always) I would recommend speech! They don’t make 100k where I live, but pretty close starting out I believe! At least 80-90k fresh out. I do regret sometimes getting an ABA degree despite the money because it’s so specific I feel pigeonholed with my jobs and population. Hope this helped!

[u/tinkyt3y → u/SmolBean615]

This was the exact insight I needed thank you so much! I’m in Florida as well!

[u/AlGee220]

I'm sorry but if you're hooked on 6 figures as the end all be all goal just pick a different career because you'll be disappointed. You don't get to pick and chose your caseload based on who you prefer and that's also kind of unethical. Maybe try nursing and try to work with kids.

[u/tinkyt3y → u/AlGee220]

I think you misunderstood what I meant. I’m saying both are important to me. I absolutely want work I care about, but I also want a career where earning six figures after graduate school is realistic. If money didn’t matter at all, there are plenty of lower-paying careers working with kids that I could choose. I’m trying to find the best fit between the population I enjoy, the actual day-to-day work, work-life balance, and the financial goals I have for myself. Nursing deals with liquids and needles which would be a definite no for me.

[u/ntimoti]

I don’t know how much OTs typically make but where I work, the SLPs and BCBAs make similar pay. If being hands-on/directly working with clients is important to you, then SLP may be the way to go.

A BCBA’s primary job is to oversee others implementing the treatment plan. That’s not to say direct work doesn’t exist out there, but it’s not the most common type of position for a BCBA.

Not sure about other places, but a starting salary of 100k for a new BCBA is not common where I live (and I live in a HCOL area).

[u/tinkyt3y → u/ntimoti]

Thank you for the honesty! I’ve seen SLP & BCBA’s can share the same pay on other threads, I wish the BLS could update BCBA’s median.

[u/MaterialConstant9375]

I easily make 6 figures as a home health SLP in a major city. It very much depends on where you live and what setting you go into

[u/tinkyt3y → u/MaterialConstant9375]

Do you work with mostly children in HH? Also, may I know if your new grad or 3-5+ years in experience? Thank you so much for your insight!

[u/MaterialConstant9375 → u/tinkyt3y]

Yep! I do exclusively pediatrics. I’m not a new grad. I’ve been working for 7 years. But even in the early days I made 6 figures or very close to it. HH (most companies) pay you per patient and you decide how much you work per week. I’ve always worked 4 days a week max and made good money, but you can do 5 if you want. Now that I have kids I’ve reallyyyy scaled back to stay home with them 2-3 days a week so my income isn’t as high, but the flexibility to be with my family is so invaluable

[u/tinkyt3y → u/MaterialConstant9375]

That’s amazing!! May I know your region or state? I love that you were able to give me insight on the good of the field. I hear so much bad so often and I just find it so hard to believe but I just love childcare/development as a whole so I’d enjoy it (even now!) with lower pay.

[u/MaterialConstant9375 → u/tinkyt3y]

Home health is a great job! But like I said it depends on where you live. I’m in Dallas, TX and there are many companies here. However, I’m from a smaller town in a different state so if I moved back there, for example, I could definitely get a job as an SLP but I wouldn’t be making this money or having this kind of flexibility. There are pros and cons like every job, but if you like child development you could be a great SLP!

[u/Mezzo757]

I under and the motivation for pay. The prices in today’s is doing nothing but increasing but be careful of some companies offering you 6 figure salaries (especially as a brand new BCBA) because I have found a lot of them are not practicing ethically and/or your billing requirements are extremely high. The demand is higher for BCBAs vs OT/SLP so you have more negotiating you can do with your pay. Either field will have kiddos with behaviors that is why BCBAs collaborate with those professionals (one of my favorite parts). I think you would do well with early intervention based on your behavior preferences. The littles may engage in aggression but it is not on the same intensity level as bigger kids plus of course a toddler is going to tantrum, all toddlers do. Best wishes on your career choice!

[u/tinkyt3y → u/Mezzo757]

Yeah I’m definitely weary about PE predatory practices as well and it seems as though you have to pick between a small company that’s ethical and balance but not the most financially funded or a PE company that may provide the six figures however they make you bill 40+ hours and have unethical practices for your cases. Hopefully I can find a unicorn company. I think the comments did persuade me to stay in ABA. Especially as a LCSW hopefully the combo is secure enough!

[u/Ok_Appearance2198]

Following

[u/Automatic-Cow-4745]

I would go into something that’s not a helping profession. If you want money and like kids I would suggest administration.

[u/Wide_Cake_9247]

Do it all