Therapy guides explain what occupational, physical and speech therapy actually involve for a child — what a therapist works on, what a session looks like, and what the evidence supports. The guides are grouped four ways: by diagnosis, by cost and insurance, as side-by-side comparisons, and by the child’s age.
Key Takeaways
- The three disciplines address different things. Occupational therapy focuses on daily activities, fine motor skills, and sensory processing. Speech therapy covers communication, feeding, and swallowing. Physical therapy addresses movement, strength, balance, and mobility.
- Many children see more than one, and that isn’t duplication. The disciplines overlap — feeding is addressed by both OT and speech therapy, motor planning by both OT and PT — and working together is common.
- In the US, children under three can be referred to early intervention by a parent directly. No doctor’s referral, no cost, regardless of income.
- A diagnosis usually isn’t needed to start. Therapy is based on assessed need. Insurance coverage may depend on an associated diagnosis, so ask providers how they bill.
- Ask what the functional goals are. “Improve sensory processing” isn’t a goal. “Tolerate a haircut,” “climb stairs with alternating feet,” and “ask for what he wants using two words” are.
Frequently Asked Questions
What's the difference between occupational therapy and physical therapy for my child?
Physical therapy focuses on gross motor skills — walking, running, balance, strength, coordination, and mobility. Occupational therapy focuses on the activities a child does day to day: dressing, eating, handwriting, play, and managing sensory input. The two overlap around motor planning and postural control, and many children see both. As a rough guide: PT is about how a child moves through the world, OT is about what they do once they get there.
How much does pediatric therapy cost and will insurance cover it?
Costs vary considerably by region, setting, and whether therapy is private, school-based, or through early intervention. In the US, early intervention for children under three is free in most states, regardless of income, and school-based services are free where a child qualifies. Private therapy is paid or insurance-funded. Coverage differs by plan — many require a diagnosis and prior authorization, while Medicaid’s EPSDT benefit covers medically necessary services for children. Ask any provider directly how they bill and what they’ve seen covered.
What kinds of therapy can help an autistic child?
It depends on the individual child rather than the diagnosis. Occupational therapy commonly addresses sensory processing, daily living skills, and motor coordination. Speech therapy addresses communication — including augmentative and alternative communication where speech is limited — along with feeding and swallowing. Physical therapy is involved where motor differences affect movement or participation. Since 2022, ICD-11 has included sensory processing differences in the autism diagnostic criteria, so sensory assessment is now a reasonable thing to ask about specifically.
Is sensory integration therapy the same as occupational therapy?
No. Ayres Sensory Integration is a specific, manualized approach delivered by occupational therapists with additional training — not all occupational therapy is ASI, and not every sensory-based technique is ASI either. The distinction matters because the evidence differs: ASI has moderate-quality evidence for autistic children when delivered with fidelity, while individual sensory-based techniques such as weighted vests have repeatedly been found to have little or no effect. If sensory integration therapy is recommended, it’s reasonable to ask whether it’s Ayres Sensory Integration specifically and what training the therapist has.
Should I choose Early Intervention or private therapy for my young child?
For a child under three in the US, start with early intervention — it’s free in most states, regardless of income, you can refer your own child without a doctor, and there’s no reason to wait. It’s usually delivered at home and centered on coaching families rather than working with the child in isolation. Private therapy may offer more frequency, a specific approach, or shorter waits, and it costs. These aren’t mutually exclusive, and many families use both.
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Medical disclaimer. This page is for general educational purposes and does not constitute medical advice, diagnosis, or treatment.