What’s the Difference Between Physical and Occupational Therapies in Early Intervention?

mom and son playing with blocks

Many people wonder what the difference is between a physical therapist (PT) or an occupational therapist (OT) working with babies and small children. It often looks like the same thing. The difference really depends on the age of the child and the child’s motor skills.

All children need to develop their bigger muscles first in order to hold their heads up, roll, sit, crawl, and walk. Until a child is sitting, both PTs and OTs do a lot of the same thing. We work on head control, purposeful reaching with hands, rolling over to get to toys, and sitting. Once a child is sitting, then we start to see a difference.

The PT will work more on the use of bigger muscles with an emphasis on transitional movements, such as getting into and out of a sitting position, getting onto hands and knees, pulling to stand, sitting to stand, and then walking.

The OT will work more on how children are using their hands to explore and play and how to manipulate toys to play as well as sensory experiences such as how things feel and how well the child can tolerate different textures.

Each therapist will try to incorporate activities that the other therapist is working on so a child gets more practice at different skills. For example, a PT will work on going from sitting to being on hands and knees and back to sitting by placing a toy just out of reach. An OT may use the same toy because it has a texture that is unfamiliar or needs to be activated by pushing a button or twisting a knob.

Once the child reaches the toy, the PT works on having the child play with that toy for a while before moving the toy again or changing to a different toy. Both therapists will look at whether a child needs adaptive equipment to play, sit, stand, or walk.

—Beth Bucker, EI physical therapist

Publication date: 2017
Originally published in the EIC Newsletter: Volume 29, Issue 4