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Occupational Therapy vs Physical Therapy: What Does my Kid Need?
Occupational therapy vs physical therapy, an age-old question. When your child receives a diagnosis, the number of different medical services to consider can be overwhelming. Speech therapy, occupational therapy, physical therapy, ABA, visual therapy, on and on and on.
Despite all of the medical words floating around in your head, the two most prominent are likely occupational therapy and physical therapy. So, what’s the difference between them exactly and how do I decide which one is best for my child?
Let Me Warn You
I’m going to be describing OT and PT in a very cookie cutter fashion so that the differences between them are made very clear. That said, there’s a lot of overlap when considering these professions in real life. In fact, there can be so much overlap that a child’s OT or PT may decide to do joint sessions so as to get the most benefit.
Even though the waters can look murky in reality, OTs and PTs approach treatment from very different mindsets with very different goals in mind. Understanding each profession from its very basic foundation will help you understand how your child’s OT or PT is structuring their time with your child.
Pediatric Physical Therapy
Physical therapy is easier to understand as a solo profession, than it is to understand as a companion to occupational therapy. Because of that, we’ll keep this section short and elaborate on physical therapy more when we merge it with occupational therapy later in the post.
When looking at a very cookie cutter definition of physical therapy, take its name literally: therapy addressing someone’s physical abilities.
Physical therapists help us relearn to walk after an accident, push us to develop our core strength so we can sit up, teach us stretches to prevent tightness, etc.
Above all, physical therapists care about how your body mechanics are preventing you from doing your physical activities.
Pediatric Occupational Therapy
Almost everything you do every day qualifies as an occupation, from brushing your teeth to reading your newspaper and eating your dinner.
Yes, this means that occupational therapy encompasses almost everything and anything. This is why you can have a pediatric occupational therapist whose job seems completely opposite than their adult mental health occupational therapist co-worker.
While the wide range of skills OTs work on and populations OTs work with makes it seems as though there are no limits as far as occupational therapy is concerned, there’s a very important distinction from physical therapy.
As OTs, our minds are focused on helping people achieve success in their activities. If I’m helping you learn to brush your teeth, yes, I would ideally want you to be strong enough to stand at the sink, but my main focus in helping you achieve independence in that task. This may mean coming up with an adaptation so that you can sit and brush your teeth independently.
While we can practice standing so as to build your standing tolerance, I’m not going to wait until you can stand at the sink in order to come up with a way for you to brush your teeth independently. My main goal is to help you brush your teeth, not to have you stand at the sink.
When working with an OT, you’ll notice that you’re given a lot of strategies to try at home. This may include using different utensils while feeding your child, trying Velcro shoes, or develop a consistent night time routine. Your OT will constantly be adapting their own practice and their recommendations to accommodate what your child needs at that point in time.
The question they will always ask is, “how can I make xyz activity easier, more enjoyable, and independent for this child and their family?”
So, Do I Choose Occupational Therapy or Physical Therapy
It really depends on your child. Let’s run through a few scenarios. No matter what, check in with your kiddo’s doctor before making a decision. You will likely need a referral from them anyway. Every child is unique and will need a unique treatment plan. Be sure to connect with a medical professional about your own child’s circumstances before committing to either OT or PT.
My Child Has Physical Limitations
If your child is really physically limited, I’d suggest doing both physical therapy and occupational therapy. If you don’t have the resources for both, you may be only able to do physical therapy, but check with your physician before making this decision.
I mentioned earlier that OT and PT often have a great marriage. This is especially true for kids that have physical limitations. Let’s go back to my teeth brushing example to understand why.
As an OT, I’m going to help this child learn to go to the bathroom. In order to do so, I’m going to do what I need to do to help them achieve independence.
We may practice opening and closing the toilet seat, but my main focus will be on thinking about adaptations, such as adaptive toilet seats, that will facilitate the child’s success and independence. This is what I’m trained to do and what I’m good at.
Let’s say that this child is working with a physical therapist as well though. In the child’s physical therapy sessions, they work on core strength, standing tolerance, and all of the skills required to stay standing for a long time.
As the child’s physical skills progress, so too do my adaptations to their activities. If the child is now able to stand, I can help the child achieve independence brushing their teeth while standing at the sink.
The physical therapist develops the child’s physical skills and I, as the occupational therapist, apply them to an activity the child needs to do on a daily basis.
In some clinics, you may have the option to do PT and OT at the same time. This means that the PT would help the child stand at the sink, while the OT focused on teeth brushing. The benefits of working on these skills at the same time is why the two professions are such a great pair.
My Child Doesn't Have Physical Limitations
Again, every child is different and only a professional that knows your child personally can truly say what your child needs. This is a general description of what often occurs.
When your child doesn’t have physical limitations, there often isn’t a need for a physical therapist, as there are no physical goals to address.
In these cases, occupational therapists more so focus on the mental, developmental, or emotional barriers that are preventing success and independence in a task. From there, they consider what strategies and adaptations can be used to make these tasks within reach for the child.
To be clear, this doesn’t mean that occupational therapists don’t do anything physical. The brain-body connection is strong and something that OTs believe in quite a bit. The key difference between our movement and the type of movement PTs do is that we are using movement to achieve a mental or emotional outcome, not a physical outcome. While a PT may do stretches with a child to relieve tightness, we may do stretches to bring a child down from an agitated state.
If you want to read more about the benefits of movement, check out my post on heavy work and the benefits it can have for our kids with sensory challenges.
There really isn’t a clear-cut answer as to whether you should choose OT or PT. Generally, utilizing both can be a great choice if you can swing it. If you can’t, ask a professional which one they would advise and give it a try. You can always start out with OT and switch to PT and vice versa.
Even once you’ve decided on the type of therapy you want to pursue, finding the right therapist can be the next hurdle. If you want to learn more about picking your child’s therapist, check out my article on the most important factors to consider when choosing a therapist.
The most important thing to keep in mind is that your child’s entire healthcare journey is going to be ever adapting and growing. You’re going to make mistakes, win some victories, and eventually land on what’s right for your child.