Therapy 101

Cut through the confusion of PT, OT, and ST.

When my daughter was a toddler, I was told that she had ASD (autism spectrum disorder) and needed services. Subsequently, I became lost in the number of therapeutic options available. I discovered the letter combinations "PT," "OT," and "ST," and I noticed that each "T" offers a great many advantages and benefits. So, I embarked on a multi-year journey that included a vast amount of investigation and research, and I eventually came up with a plan that worked extremely well for my child. Today, my daughter is a well-adjusted, happy college student and a testimonial to the success of sensory integration therapies. Almost two decades after my family's research began, I'd like to share what I've learned.

A slew of research from the past 30 years has shown that a child's ability to function like all the other kids her age is largely based on her ability to receive, internalize, and process physical, mental, or sensory stimuli. This neuro-processing capability is an indication of a person's functional and cognitive abilities. Deficits in such areas are considered limitations, or "issues," that may require physical, occupational, or speech therapy (PT, OT, or ST). The purpose of these therapies is to maintain or increase skills and/ or adapt environments to meet the unique needs of an individual so that she may become as independent and functional as her peers.

So, what do physical therapy, occupational therapy, and speech therapy do, and how do they differ from one another?

Physical therapy, or PT, is the remediation of impairments and disabilities, as well as the promotion of mobility, functional ability, quality of life, and movement potential. Physical therapists help patients regain independence and function in their daily lives. They provide care in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, fitness facilities, and work settings. Physical therapists use a variety of exercise techniques and equipment to help patients move, reduce pain, restore function, and prevent disability. They also help prevent loss of mobility and motion by developing fitness and wellness programs tailored to each patient's specific needs.

Occupational therapy, or OT, is the therapeutic use of work, self-care, and play activities to increase development and prevent disability. It may include adaptation of a task or environment to create an accommodation that achieves maximum independence and to enhance the quality of life. Occupational therapist Lucy Miller defines "occupation" as the way in which one uses time to be productive in the community. Miller divides time into three categories of daily activities: self-care (sleeping, eating, grooming, dressing, etc.), work, and leisure. If a disability prevents a person from effectively or independently functioning in more than one of the three "occupational" areas, then OT is used.

Occupational therapists help patients with developmental delays related to autism, cerebral palsy, and Down syndrome. Developmental delays could include gross motor skills, such as crawling or walking, or fine motor skills, such as using fingers to grasp a spoon. Less obvious delays are the more silent disabilities, which may concern mental health and sensory processing disorders.

Both occupational and physical therapists strive to increase both the function and the independence of their patients. However, the occupational therapist only uses exercises that support the execution of a functional activity, while physical therapists seek to develop the muscle strength required to move the bones and joints.

Speech therapy, or ST, refers to the evaluation and treatment of communication and swallowing disorders. Infants and children with injuries due to complications at birth, as well as feeding and swallowing difficulties like dysphagia, should be cared for by a speech and language pathologist. Speech pathologists also help children with genetic and developmental disorders that adversely affect speech, language, and/or cognitive development. Children with the following disorders and conditions may benefit from ST: cleft palate, Down syndrome, DiGeorge syndrome, attention deficit hyperactivity disorder, autism, developmental delay, cranial nerve damage, hearing loss, craniofacial anomalies, language delay, specific language impairment, pediatric traumatic brain injury, developmental verbal dyspraxia, and more. In the United States, many public school systems offer speech therapy to eligible children.