Somewhere along the way - a school note, a relative's suggestion, a paediatrician's comment - someone said your child needs "therapy," and it wasn't entirely clear which kind. Occupational therapy and speech therapy get used almost interchangeably by well-meaning people who aren't entirely sure of the difference either. It's a genuinely confusing distinction, and it's worth sorting out properly.
Two different jobs
Occupational therapy is about function in daily life: motor skills, sensory processing, self-care, play, handwriting, and participating in a classroom. Speech-language therapy is about communication: understanding and using language, pronunciation and articulation, stammering, and sometimes feeding and swallowing mechanics. They're separate, distinctly trained professions, working toward different - often complementary - goals for a child.
Signs a child might need occupational therapy
- Difficulty with handwriting or holding a pencil comfortably
- Sensory sensitivities or sensory-seeking behaviour (avoiding certain textures, sounds, or clothing; constantly seeking movement or touch)
- Clumsiness, or difficulty with coordination-based tasks
- Struggling with self-care tasks like buttons, cutlery, or dressing independently
- Trouble sitting, attending, or managing transitions in a classroom or at home
Signs a child might need speech therapy
- Not using the words or phrases expected for their age
- Speech that's hard for familiar adults, or strangers, to understand
- Stammering or disfluency
- Difficulty following spoken instructions (though this can also overlap with attention, which is worth mentioning to whoever assesses your child)
- Feeding or swallowing difficulties
We should be direct here: this practice offers occupational therapy, not speech therapy, and we're not the right professionals for concerns that are purely speech and language. Speech-language pathology is a genuinely valuable, separate discipline, and if that's what your child needs, a qualified speech-language pathologist is exactly who to see.
When a child might need both
Plenty of children need both, and it's common. A toddler with limited spoken language might need a speech-language pathologist for communication and an occupational therapist for the sensory regulation and motor planning that often sit underneath communication difficulties - motor planning issues, for instance, can affect speech production itself, not just movement. Running both together, with the two providers coordinating, tends to work better than either alone.
This overlap comes up a lot with conditions like autism, global developmental delay, or apraxia of speech, where communication and sensory-motor development are genuinely intertwined rather than separate problems that happen to coexist. In those situations, trying to address just one side while ignoring the other often means progress in one area is held back by an unaddressed issue in the other - which is exactly why coordination between the two disciplines matters as much as the therapy itself.
How to figure out where to start
An honest OT assessment should be able to tell you whether OT is the right fit for what you're seeing - and, just as importantly, tell you plainly if your child's concerns look primarily speech-and-language-based, so you can be pointed toward a speech-language pathologist instead of being kept in the wrong therapy. If you're unsure where to start, an online consultation is a low-commitment way to get an initial, honest read before committing to travel or a longer plan. Our first assessment page also sets out exactly what that first session covers.
Frequently Asked Questions
My child isn't talking much yet - is that an OT issue or a speech issue?
Usually primarily a speech-and-language concern, but if there are also sensory or motor signs alongside it, OT may be relevant too. An assessment is the most reliable way to sort out which applies to your child.
Can one professional provide both occupational therapy and speech therapy?
They're distinct qualifications, so it depends on the individual provider. We offer occupational therapy specifically, and coordinate closely with speech-language pathologists when a child needs both.
If my child needs both OT and speech therapy, does the order matter?
Not usually strictly - many children run both in parallel. It's a decision best made case by case, alongside whoever is assessing your child.
