In my career thus far, I have been asked countless times, “What is the difference between physical therapy and occupational therapy?” My husband, a physical therapist (PT), frequently jokes in response, “A PT can help you get to the bathroom, but you better have an occupational therapist (OT) around to help you accomplish anything once you get there!” This sounds more applicable to his work with adults in a rehabilitation setting, but the idea is there for working with children as well.
Physical therapists focus on improving gross motor skills, which are those that need full body movement and involve the big muscles of the body to perform daily functions. These everyday functions include sitting upright, standing, walking, and running. It also includes hand-eye coordination and ball skills. Without gross motor skills, children will have trouble playing with friends at the playground, playing sports, or just moving around. Physical therapists are trained in the treatment of children who have difficulty moving as a result of an injury or disability. They will often develop a specialized treatment program based on the specific conditions of their patient. The treatment will be geared towards improving their patient’s ability to move and preventing worsening conditions from developing in the future. Physical therapy techniques can also decrease pain and restore the function of muscles. This type of therapy can even eliminate the need for expensive surgery or medication in the future.
When it comes to pediatric therapies, PTs often work more with a child’s physical mobility to move their body in order to do those activities of daily living, navigating safely through their environment, and getting to their destination. These movements use the large muscles of the body and are often referred to as gross motor skills.
A PT’s focus is for a child to be as mobile and independent as possible, while training caregivers on all aspects of their child’s physical development. This may include but is not limited to anything that effects the child’s movement, posture, alignment, and safety. PTs are often musculoskeletal and movement specialists who have an in-depth knowledge of the human musculoskeletal, neuromuscular, integumentary and cardiovascular systems. PTs are often able to analyze the child’s impairment from a biomechanical perspective and through exercise and play, improve the impairment itself by increasing mobility, aligning bones and joints and/or lessening pain.
On the other hand, occupational therapists focus on improving fine motor skills, which involve using the smaller muscle of the hands. Fine motor skills are vital for a child to perform their daily self-care and academic tasks. Self-care tasks can include brushing teeth, getting dressed, opening their lunchbox, and eating. Academic tasks include such things as using scissors, drawing, typing, and writing. The conditions requiring occupational therapy usually derive from physical or behavioral disabilities as well as injuries. Treatment will include functional activities, in an effort to enhance visual, cognitive, and coordination skills. The goal is to help your child flourish while doing activities associated with being a kid: learning, playing, and growing.
When OTs are working on the activities of daily living, functional tasks (e.g. school work, chores, etc.) and/or play skills that children participate in most, they may be using the small muscles of the body which is often referred to as fine motor skills while also incorporating postural control and balance.
An OT treats the whole child and the word occupation refers to all meaningful and purposeful activities. For children, these occupations include playing, learning, and socializing. Whether a child has developmental or cognitive disabilities or is recovering from an injury affecting their motor skills, emotions and/or behavior, OTs are helping them to fully engage in daily life.
Pediatric OTs may also be known as masters of activity analysis and adaptation. Finding the “Just Right Challenge” can be a large focus for OTs where we want to push a child to gain new skills, but also set them up for success. If a child’s impairment impacts their ability to participate in functional tasks, OTs will often find ways to adapt the task and/or materials to promote “abilitation”! OTs are also trained to help children organize and interpret information from the environment (sensory integration), so that they can just be kids!
Physical and occupational therapy are similar in that they are both recommended forms of treatment for a child living with a disability or suffering from an injury. For instance, both physical therapy and occupational therapy can help your child perform the self-care act of getting dressed. This is because physical therapy will improve balance, while occupational therapy will improve their ability to use their hands to put on their clothes.
In addition, gross motor skill development is essential to performing certain tasks requiring fine motor skills, such as writing or using scissors. To illustrate, your child will need to have the gross motor skill of sitting upright before completing these tasks. Both types of therapy also educate children on the healing process and tactics to avoid further injuries. It is important to work with a professional to figure out which form of therapy is right for your child or loved one.
Collaboration is key—we often work together and some may wonder why some children need both disciplines working as a team, and some need only one. Many factors can affect a child’s ability to participate in their daily life and it is important to have a comprehensive treatment approach. There is often overlap and similarities between what OTs & PTs work on with the same child, but more often we have come at it from different perspectives and contexts. We’re all just trying to help your child gain the skills required to perform everyday functions to the best of their ability, independently and safely. As they say, “teamwork makes the dream work”!
Occupational therapy and physical therapy are often wrongly considered the same thing. While they do share some similarities, they differ in their approach to treatment. If you are unsure which therapy is the best solution for your child or loved one, feel free to schedule a call with the team here at NAPA to begin your child’s journey to a customized therapy plan!
Courtney Shea is a pediatric occupational therapist at the NAPA Center in Boston. In her free time, she enjoys being outdoors with her family and their dog Kolana. She is often caught overpacking for weekend getaways and adventures. If staying local she enjoys long distance runs along the Charles River alongside her husband taking turns pushing their son in a jogging stroller!
At NAPA Center, we take an individualized approach to therapy because we understand that each child is unique with very specific needs. We embrace differences with an understanding that individualized programs work better. For this reason, no two therapeutic programs are alike and we offer multidisciplinary treatments integrating physical, occupational, speech, and feeding therapy. If your child needs our services, we will work closely with you to select the best therapies for them, creating a customized program specific to your child’s needs and your family’s goals. Let your child’s journey begin today by contacting us to learn more.