How is an Occupational Therapist different from a Physical Therapist?
An Occupational Therapist is commonly confused with a Physical Therapist as the two professions often work side-by-side. The main difference is that Occupational Therapy is centred on the person’s ability to perform activities of daily living, and Physical Therapy treats the person’s physical ability and focuses on movement and function.
For example: Sara is a 5-year-old girl diagnosed with cerebral palsy. She walks on her toes and has challenges with getting dressed. The Physical Therapist may give her orthotics to prevent toe walking, or work on muscle strengthening. The Occupational Therapist may provide her with aids such as adaptive zipper pulls that can help with her dressing challenges.
How is an Occupational Therapist different from a Behaviour Consultant?
Behaviour Consultants address complex behaviours by looking at a child across a variety of situations for patterns and the function of the child’s behaviour. This includes observing environmental factors including the relationships between the child and their caregivers.
In contrast, Occupational Therapists will look at the barriers limiting the child’s ability to engage in or perform their occupations. Occupational Therapists also consider a child’s behaviour, as well as sensory challenges, environmental factors, and motor skills impacting occupational performance.
For example: Jake is a 7-year-old boy with Autism Spectrum Disorder. He becomes stressed at unexpected, loud noises in his class at school. Also, when he gets frustrated with his tasks in school, he engages in screaming and throwing his pencils. The Occupational Therapist may provide him with large headphones to block out unsettling noise. Additionally, they may help him with emotional regulation skills for his frustration. The Behavioural Consultant will focus on establishing the cause and outcome of the child’s screaming and throwing of pencils. They will develop strategies to reduce or prevent this behaviour in all environments.
Despite the differences between Occupational Therapy, Physical Therapy, and Behavioural Consultation, the three professions have a lot of overlap. The chart below compares the areas of overlap between the professions.
| Challenges | Occupational Therapists (OTs) | Behaviour Consultants (BCs) | Physical Therapists (PTs) |
|---|---|---|---|
| Sensory Does the child avoid activities with certain textures, (gluing, finger-painting), have sensitivity to loud noises or smells, frequently pull, hit, seek touch (hugs, tight spaces), or avoid active games and slides? | ✅ OTs will help children find strategies to manage their sensory challenges. For example, they may suggest headphones to block out loud noises, or help children become tolerable of different sensory stimuli. | ❌ | ❌ |
| Behaviour Does the child display repetitive behaviours, restrictive interests, low frustration tolerance, difficulty with transitions, or impulsive behaviour? | ✅ OTs will assess aspects of the person, environment, or occupation to ultimately support the child’s ability to perform their occupations. | ✅ BCs can conduct assessments of the child and the environment to determine the triggers and responses to the challenging behaviours. They will develop strategies that will address the purpose of the behaviours by preventing future occurrences of challenging behaviours, teaching more appropriate behaviours to replace the problem behaviours, and responding to challenging behaviours in order to make them ineffective, inefficient, and irrelevant. | ❌ |
| Gross Motor Does the child have postural challenges, difficulty achieving motor milestones (walking, crawling, etc.), clumsiness, (often tripping and falling), difficulty with age-appropriate bicycle/tricycle riding, throwing a ball, kicking a ball, climbing stairs, or tire easily? | ✅ OTs can help with many of these areas with a focus on occupation. They may teach the steps required to ride a bike or throw a ball. They may suggest energy conservation strategies or provide strategies to increase coordination. The key is that they will focus on these challenges in relation to occupation. | ❌ | ✅ PTs frequently assist children with gross motor challenges, by providing specific exercises aimed at improving their physical abilities. |
| Fine Motor Does the child have difficulty with age appropriate dressing, the use of eating utensils, handwriting, colouring, cutting, using both hands together, or manipulating toys? | ✅ OTs will provide suggestions to develop and enhance fine motor skills or adaptive equipment such as a weighted spoon. | ❌ | ✅ PTs can help with improving physical strength and coordination for fine motor skills, especially handwriting. |
| Equipment Does the child have equipment needs including: prescribed equipment such as wheelchairs, walkers, standers? | ✅ OTs can prescribe and fit children for adaptive equipment. | ❌ | ✅ PTs can prescribe and fit children for adaptive equipment. |
| Oral Motor Does the child have difficulty chewing, keeping food in their mouth, swallowing, drinking from a cup? Are they very slow eaters? | ✅ OT’s will provide strategies for a child to learn to chew, swallow, and drink. The OT will first make sure that there are no medical or postural reasons for difficulty in eating and drinking. | ❌ | ❌ |
| Social Does the child have difficulty making and maintaining friends, making eye contact or using other non-verbal communication, playing with other children, or listening to and following instructions? | ✅ OT’s may conduct assessments to determine potential reasons for the social difficulties. OT’s will also assess how these difficulties are impacting the child’s occupations and will give strategies on how to include the child in play and help the child participate in activities. | ✅ BCs can conduct assessments and observations to determine supports in programming to develop the child’s social skills and have appropriate interactions with others. BCs will focus on changing socially significant behaviours that will support the child’s inclusion in all their environments. | ❌ |
| Cognitive Does the child have memory impairments, attention deficits, difficulty with decision making or problem solving, or difficulty following multi-step directions? | ✅ OT programming can also focus on cognitive skills to determine possible adaptive or remedial strategies for the challenges listed. | ✅ BCs assess the child’s current cognitive abilities and break down complex skills into smaller steps for the child to learn. BCs design individualized strategies/ adaptations to support skill development. | ❌ |