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Physical Therapy and Occupational Therapy are Actually Different: Find Out if your Child Needs Both

Updated: Dec 21, 2022

If you are confused about the difference between physical therapists (PT) and occupational therapists (OT), you are not alone. Many misconceptions exist about their scope of work, such as:

· PT treats lower extremities; OT addresses upper extremities

· PT manages gross motor skills only; OT deals with fine motor only

· PT works in the outpatient setting; OT in hospitals and acute care facilities

· PT and OT only work with the elderly

Let’s take a look at some facts that can help debunk some false impressions about PT and OT. Foremost, licensed PT and OT can treat individuals in all age groups and create a profound impact in the growth of many children. As more children are diagnosed with neurodevelopmental disabilities, opportunities for PT and OT interventions are rising. Children who experience a temporary disability, like a fracture, also benefit from working with PT and OT. Therapies may be delivered in the short-term, life-long or at different time points in a child’s growth.

What does a Pediatric Occupational Therapist really do?

The operative word in occupational therapy is occupation; or more clearly stated: function. A pediatric OT focuses on a child’s ability to function within the appropriate environment and perform his or her activities of daily living. Depending on the age group, these tasks can include dressing, grooming, toileting, writing and playing skills. Another essential activity in younger children is feeding where an OT can help in teaching correct finger grasp, wrist movement and instrument holding. (Note: Early feeding therapy can overlap between OT and speech-language pathologists. The latter may have specialized training in evaluating children with more serious feeding and swallowing disorders.)

Other focus areas that a pediatric OT can address:

· Fine > gross motor skills

· Visual-motor function

· Sensory perception and processing

· Body awareness and coordination

· Executive functioning skills

· Equipment integration (e.g. assistive and augmentative devices)

· Socialization and independence

And what about a Pediatric Physical Therapist?

Think of a PT as an expert in the musculoskeletal system and movement. Whether the child is delayed in gross motor milestones or is recovering from major injury or surgery, a pediatric PT can help optimize function and reduce impairments. Because a key goal of PT is ideal mobility, interventions can also impact body posture, alignment and range of motion.

Other focus areas that a pediatric PT can address:

· Gross motor skills

· Strength and endurance building

· Balance and coordination

· Tone management

· Prevention of dysfunctional muscle compensation

· Gait training

· Orthotics, prosthetics and assistive equipment evaluation

Irrespective of the indication for therapy, a team-based approach is typically initiated by a pediatric care provider who confirms a diagnosis and makes a referral for PT and OT services. These therapies may be delivered in a variety of settings including hospitals, rehab facilities, as well as the child’s home, school or even virtually.

At the height of the COVID-19 pandemic, we got started with our daughter’s early intervention therapies through video conference. While telehealth (or teletherapy) may not be ideal for every family and medical condition, it allowed us to avoid further delays until we felt safer about meeting in person. Virtual PT and OT had their challenges that required a greater degree of involvement from us. My wife and I had to do more homework (i.e. making sure we did regular PT and OT exercises after our weekly video meetings), seek more feedback and read supplemental materials. We were privileged to partner with a PT and OT who were very skilled in family coaching. As we transitioned to face-to-face therapies, we learned a fundamental truth: the benefit a child derives from therapy is only as good the work parents put in it.


1. Houtrow A, Murphy N; COUNCIL ON CHILDREN WITH DISABILITIES. Prescribing Physical, Occupational, and Speech Therapy Services for Children With Disabilities. Pediatrics. 2019;143.

2. HongCS, Palmer K. Occupational therapy and physiotherapy for children with disabilities. J Fam Health Care. 2003; 13:38–40.

3. Hsu N, Monasterio E, Rolin O. Telehealth in Pediatric Rehabilitation. Phys Med Rehabil Clin N Am. 2021;32:307-317.

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