Occupational Therapy vs. Speech Therapy: Uses, Benefits, and More

Medically reviewed by Mohamad Hassan, PT

Occupational therapy (OT) and speech therapy (ST) both fall into the category of rehabilitation therapy. Although there is some overlap between the two therapies, each is a distinct field of practice with specific aims and purposes.

The goal of OT is to help people who are injured, ill, or disabled participate in the activities of daily life. Occupational therapists (OTs) offer tools and solutions to help improve one's ability to care for oneself independently and to overcome functional challenges at home, school, work, or social activities.

ST (also called speech-language pathology) focuses specifically on challenges with voice, speech, language, and communication as well as feeding or swallowing difficulties.

This article explains what occupational and speech therapy are, including their goals and techniques. It also looks at how occupational therapy and speech therapy can be used together for children and adults with complex speech, motor, voice, or swallowing difficulties.

What to Know About Occupational Therapy

OT looks at the whole person and finds ways to help them lead the lives they want to lead. Despite the name, occupational therapy does not refer to employment (though functioning on the job may be addressed if appropriate), but rather to functioning in a wide range of activities.

How Does Occupational Therapy Work?

OTs help people of all ages with the ability to participate in a variety of areas, including:

• Their jobs

• School

• Social activities

• Hobbies and leisure activities

• Mobility and "getting around"

• Self-care tasks, such as dressing and hygiene

• Caring for their home

• Anything else that is important to them

For example, OTs may help with:

• Children and teachers in a classroom setting on skills to help students thrive

• Assessing and treating cognitive impairment for people who are in the hospital following a stroke or brain injury

• Helping those in mental illness outpatient programs manage their conditions and live independently

• Helping people whose physical abilities have changed identify, acquire, and use equipment (such as mobility devices or safety equipment) needed to return to or remain at home

• Helping people determine and acquire what they need to perform daily activities following an injury

• Working with people who have experienced a change in their physical or mental abilities on reintegrating into the workplace

OTs may help a person develop the necessary skills to perform a task, and/or they may make the task/environment more accessible. Strategies used by OTs include:

• Activity-based interventions

• Adaptive techniques

• Assistive technology

• Environmental adaptations

The roles of an OT are to:

• Assess: What does the person want to do and what are the barriers to doing it?
  

• Plan: Short- and long-term treatment goals
  

• Initiate interventions: Teaching new techniques, providing adaptive equipment and resources, reducing environmental barriers, etc.
  

• Cooperate: Coordinating with other professionals, families, caregivers, etc.
  

Delivery of Occupational Therapy

Before starting treatment, an OT will assess:

• The person's physical and mental abilities

• The materials and devices a person uses to participate in activities

• The social and emotional support available to the person

• The physical setup of their environment (house, classroom, workplace, etc.)

When needs and goals have been established, an OT will:

• Help the person use, improve, or maintain the abilities they have

• Introduce adaptive materials and devices (such as shower chairs, playing card holders, or other equipment)

• Recommend changes to the environments in which the person engages in everyday activities, such as home or work

Where to Get Occupational Therapy

OTs offer services in a variety of settings, including:

• Private practice

• Home care

• Community centers and programs

• Hospitals

• Care facilities

• Schools

OT may be recommended as part of an established treatment plan for an injury or condition or following a hospital stay. You can also find an OT for yourself or your child by:

• Talking to your healthcare provider or another healthcare professional

• Asking for referrals from the school nurse or guidance counselor

• Contacting a local hospital or rehabilitation center

• Contacting your state's occupational therapy association

What to Know About Speech Therapy

Speech therapy addresses disorders affecting voice, speech, language, and swallowing.

According to the National Institute of Deafness and Other Communication Disorders, one in 12 children ages 3 to 17 in the United States have a condition related to voice, speech, language, or swallowing/feeding.

Moreover, no less than 9.4 million people in the United States (both children and adults) are affected by clinically significant short- or long-term voice or speech problems each year. Of these, two million experience aphasia (difficulties with communication) due to conditions like stroke or a brain injury.

Among adults, no less than one in 25 experience dysphagia (difficulties with swallowing), the risk of which increases with age. Not only does dysphagia affect eating and speech, but it can greatly diminish a person's overall quality of life

How Does Speech Therapy Work?

Speech-language pathologists (SLPs) work with both children and adults with speech, voice, and swallowing difficulties. They can help with:

• Articulation disorders: Difficulty making sounds in syllables, or saying words incorrectly

• Fluency disorders: Such as stuttering

• Resonance or voice disorders: Problems with pitch, volume, or quality of the voice

• Receptive disorders: Difficulty with understanding or processing language

• Expressive disorders: Problems with putting words together or vocabulary or using language in a socially appropriate way

• Pre-literacy and literacy skills: Such as decoding, reading comprehension, and writing

• Cognitive-communication disorders: Difficulty with communication skills involving memory, perception, attention, regulation, organization, problem-solving, and social communication

• Language delays and disorders: Such as oral and non-verbal expression and comprehension

• Swallowing and feeding disorders: Such as problems with chewing, swallowing, coughing, gagging, etc.

Aphasia and dysphagia are closely linked as they involve many of the same muscles and organs, including the larynx (voice box) and pharynx (throat). SLPs can help with speech and swallowing difficulties related to conditions such as:

• Dementia

• Stroke

• Intellectual disability

• Neurodevelopmental disorders like autism and cerebral palsy

• Neurodegenerative disorders like Parkinson's disease

• Motility problems like achalasia and esophageal atresia

• Traumatic brain injury

• Brain tumor, including brain cancer
  

Delivery of Speech Therapy

SLPs work with people one-on-one, in small groups, or a classroom setting. Strategies include:

• Language intervention activities involve stimulating language development and building language skills by modeling vocabulary and grammar and using repetition exercises. For children, this involves interactions such as playing, talking, the use of pictures/books/objects, etc.

• Articulation therapy involves modeling correct sounds and syllables in words/sentences (during play or other activities) and teaching the person to make specific sounds (such as showing them how to move their tongue).

• Oral-motor and swallowing therapy involves strengthening the muscles of the mouth using oral exercises (tongue, lips, jaw, etc.) and introducing different food textures and temperatures.

Where to Get Speech Therapy

To find an SLP:

• Talk to your healthcare provider

• Ask your child's teacher or guidance counselor

• Check local directories

• Search on the American Speech-Language-Hearing Association's website

Educational Requirements for Speech Therapists and Occupational Therapists?

OTs and SLPs are professionals, requiring:

• A master's degree

• State licensure (all states for SLPs, most states for OTs, but OTs have strong certification requirements in all states)
  

In addition, SLPs need a certificate of clinical competency from the American Speech-Language-Hearing Association (ASHA). OTs must take the national exam administered by the National Board for Certification in Occupational Therapy (NBCOT).

Which Treatment Is Best for You?

Which type of therapy to use depends on the goals of treatment.

Speech therapy focuses on communication and swallowing disorders. It's also more commonly for children than adults.

ST may be a good choice for addressing:

• Speech and language developmental milestones

• Speech fluency and articulation
  

• Literacy and vocabulary
  

• Feeding and oral motor skills

• Hearing impairments

• Weak oral muscles
  

• Chronic hoarseness

• Cleft lip or cleft palate

• Respiratory problems/breathing disorders

• Voice therapy for transgender individuals
  

• Other issues surrounding speech, language, feeding, or swallowing

OT takes a broader, more holistic approach. The goal of OT is to support independence and quality of life for the person's whole life rather than focusing on a specific area. OTs work with people of all ages but often choose a specialty such as pediatrics or gerontology.

An OT may be a good choice for addressing:

• Developmental delays and/or behavioral difficulties in children

• Play and social skills

• Academic and cognitive skills

• Self-care routines
  

• Fine motor and handwriting skills
  

• Sensory processing disorder

• Independent functioning in activities (work, school, leisure, home, etc.)

• The person's environment (evaluating and adapting)

• Adaptive equipment and care techniques

• Other issues surrounding the person's ability to do the things that are important to them
  

Which Treatment Should I Choose?

If you aren't sure which type of treatment to pursue, talk to your healthcare provider. They can help you tailor a treatment plan to your specific needs.

Can Occupational Therapy and Speech Therapy Be Used Together?

It's common for OTs and SLPs to collaborate or for a person to receive both types of therapies.

For example, an OT might help with a person's postural stability, improving the effectiveness of swallowing and/or speech therapy given by an SLP.

People with speech-language difficulties often have coexisting issues that could benefit from OT. For example, a person with an articulation disorder may also have fine-motor difficulties. A person who has had a stroke may need help reestablishing independence and regaining language skills.

Coordinating OT and ST can offer many benefits, including:

• Combining skill building within the same activities (such as sensory and/or motor activities while working on language or vice versa, increasing exposure to both)

• A more holistic experience
  

• Accommodation of specific needs with both treatments

• More enjoyable therapy sessions
  

Summary

Occupational therapy and speech therapy are distinct but complementary types of rehabilitation therapies used in children and adults

OT helps individuals engage in daily and social activities that are of importance to them, with a focus on independence. ST focuses specifically on speech, voice, language, communication, and swallowing challenges. OT and ST can be used on their own or in combination, depending on the person's needs.

Read the original article on Verywell Health.