Occupational Therapy vs. Physical Therapy vs. Speech Therapy

Occupational therapy, physical therapy, and speech therapy/speech-language pathology are often collectively referred to as “rehabilitation therapy.”

But wait—what, exactly, is rehabilitation therapy?

We’re so glad you asked!

In fact, there are so many questions around what rehabilitation is—and who does what within the rehabilitation team—that I teamed up with Stacie Delezene, M.S., CCC-SLP, and Rebeca Segraves, PT, DPT, WCS, CLT,  to write this article.

As firm believers that medicine works best with an interprofessional and collaborative approach, we want to help people understand not only what physical therapy (PT), occupational therapy (OT), and speech-language pathology (SLP) are, but also how they are similar and different.

Here’s what we’ll cover in this article:

• A simple explanation of OT vs. PT vs. SLP
• How do OT, PT and SLP fit into different types of therapy?
• OT, PT, and SLP similarities and differences
• Our salaries compared
• Common practice niches and settings
• OT vs. PT vs. SLP job outlook
• Our history

Without further ado, let’s dive in!

A simple explanation of OT vs. PT vs. SLP

We could talk for days about the intricacies and nuances of the rehabilitation therapy team, but here is the simplest breakdown of each team member’s role:

PTs are movement experts. (Learn more here.)
OTs are habit change experts. (Learn more here.)
SLPs are communication and swallowing experts. (Learn more here.)

Keep reading to see how we use our areas of expertise to provide both individual and collaborative treatment.

How do OTs, PTs, and SLPs fit into different types of therapy?

OT, PT, and SLP make up only a fraction of the different therapies out there. (In fact, we have an entire post on how each of these professions fits into the broader scope of all the different types of therapy.)

But, together, we are often referred to as the rehabilitation team.

“Rehabilitation therapy” refers to evaluations, interventions, and treatments that help patients regain function. We often work together to provide care to patients whose lives have been affected by disease, injury, or disability.

As a team, therapists address impairments in patients’ ability to move, speak, eat, walk, dress, and otherwise participate in daily life. According to the US Bureau of Labor Statistics, there are 187,400 SLP jobs, 160,000 OT jobs, and 267,200 PT jobs in the US as of 2024.

What is occupational therapy (OT)?

Being that this is an occupational therapy site, let’s start there. What, exactly, is occupational therapy?

The short version is that OTs are health professionals who work with people who’ve had illnesses, injuries, and disabilities that prevent them from participating in their normal daily activities.

OTs work with these individuals to help them regain agency over their own health in various ways, including helping them with cooking, bathing, dressing, toileting, and more. In some cases, that involves using assistive technology, splints, braces, or other devices.

Because OT is a very holistic profession, we approach each task with the big picture of the patient’s life in mind.

That’s the short version of what we do! If you want the long version, we have a whole article you can check out to learn more: “What is Occupational Therapy & How Can It Help You?”

What is physical therapy (PT)?

Simply put, physical therapists treat the effects of disease, injury, and disability by using exercise, manual therapy, education, and therapeutic activity. Physical therapy is considered a conservative care option because PTs use these less-invasive techniques to get results—rather than relying on medications or surgery.

A PT’s main goal is helping patients improve movement and function while reducing pain. Physical therapists often prescribe stretches, exercises, and functional mobility activities to help patients move more efficiently and effectively—with as little pain as possible. Physical therapists also look at patients through a holistic lens, but they generally focus more on providing specific interventions to improve particular movements.

What is speech-language pathology (SLP)?

A speech-language pathologist’s goal is to use speech, language, and swallowing skills safely and efficiently to enhance an individual’s overall health and quality of life.

SLPs can work on many aspects of communication with patients and their caregivers, including speech production, fluency (i.e., help with stuttering), expressive/receptive/written language, augmentative and alternative communication (AAC), health literacy, cognition, voice, resonance, and hearing. Swallowing evaluation and interventions can also address feeding.

SLPs work with individuals across the life span who may have a variety of medical diagnoses—ranging from stroke or dementia, to head and neck cancer, to traumatic brain injury or vocal fold nodules. Services provided by SLPs can be either rehabilitative (i.e., helping patients regain what they have lost/restoring and/or compensating for loss of skills) or habilitative (i.e., helping children and families reach developmental milestones, integrate strategies into daily routines, or improve communication and/or swallowing ability).

SLPs also strive to develop a holistic, individualized plan of care for each patient and their unique goals. Communicating effectively and swallowing safely can play a huge role in a patient’s ability to:

• participate in meaningful activities, daily tasks, and hobbies, such as socializing and mealtimes,
• make their wants and needs known,
• contribute to decisions about their care, 
• connect with their loved ones, or
• continue working in a specific vocation independently.

SLPs work with patients and their families to develop patient-centered goals based on each patient’s unique needs, underlying diagnosis, strengths/abilities, support systems, and opportunities to improve their quality of life. To learn more about speech-language pathology, check out this resource on the SLP scope of practice.

OT vs. PT. vs. SLP: similarities and differences

As noted above, physical, occupational, and speech therapists are all primarily concerned with improving patients’ function.

It’s how we each evaluate and treat a patient that sets us apart.

We’ll get into that in a moment, but let’s start with some similarities.

Similarities

Here are some of the ways the rehab therapy team’s roles overlap:

• We all follow a similar treatment trajectory involving initial comprehensive evaluations, progress notes, and discharge summaries.
• We all focus on caregiver training to help support a patient with their treatment goals.
• We often provide somewhat similar treatments (as noted above) and work toward similar end goals––though we each do so in our own unique manner.
• We all generally work in similar settings. For example, you’ll find all three of us in acute care, long-term acute care (LTAC), inpatient rehab, skilled nursing facilities (SNF), pediatric clinics, schools, home health, and outpatient settings.
• We are all key in making discharge recommendations after patients are hospitalized.
• We all participate in research and education.
• Our potential focus areas are similar (e.g., working specifically with children or older adults). PTs and OTs also share some subspecialties and niches (such as hand therapy and pelvic health), and OTs and SLPs both work on cognitive and mental health interventions, especially with patients who have dementia or those who have experienced brain injuries/diseases.

Differences

Here are some of the ways that each rehabilitation therapy profession is unique.

OTs are unique in how they use a holistic lens to focus on daily tasks. An OT’s goal is to help each individual become as involved as possible in the activities they love—from driving to cooking to playing with their children or grandchildren. Sometimes, that means getting quite creative with splinting or assistive technology! OTs can also pursue a niche in mental health.

SLPs are unique because they focus on the incredibly important functions of swallowing and communication across the lifespan, from infancy to end of life. From performing instrumental evaluations (e.g., Modified Barium Swallow Study or Flexible Endoscopic Evaluation of Swallow) for voice and swallowing, to using AAC technology to help patients facilitate communication, SLPs have limitless niches and specializations, including linking families to community resources and addressing social determinants of health that may impact recovery. Some SLPs even have the opportunity to focus on transgender voice and emerging literacy.

PTs are unique because they work everywhere movement matters, from professional sports and entertainment to hospitals, homes, and virtual care. PTs can specialize in pain science, recovery after birth, and neurologic conditions like stroke or brain injury. There are even PTs who work with animals (e.g., hippotherapy)!

An example of our team approach in action

Perhaps the best way to explain similarities and differences across the rehab therapies is to walk through a patient case study example.

Let’s consider the case of a young man who has chronic high blood pressure. The man then has a cerebrovascular accident (CVA), which is commonly referred to as a stroke. A stroke is sometimes informally called a “brain attack” because it involves the sudden deprivation of oxygen to the brain. This leads to areas of the brain losing function temporarily or permanently.

Here’s how each therapy discipline may treat this man:

An occupational therapist may focus primarily on how well this patient (or client) is able to function in his daily roles, based on the damage to various parts of his brain. For example:

• Can this man cook meals for his young daughter?
  • If not, an OT will provide coaching, exercises, and adaptive equipment to help the man return to cooking the meals he and his family love.

A physical therapist may look at that same young man and wonder how he is functioning from a movement standpoint. For example:

• Can the patient safely walk 50 feet so he can care for his daughter while his wife is at work?
  • If not, a PT will provide exercises, assistive devices (e.g., a cane or walker), training, and manual therapy to help the patient regain the ability to walk as independently as possible.

As you can see, there is already some overlap in PT and OT treatment. After all, that patient or client will need to walk to and from the pantry to get the supplies for cooking, too!

If the patient needs to stand up independently to cook, he will need strength and balance in his legs. So, the OT and PT may work on similar goals related to standing tolerance, which will help him become more independent. But while the PT looks at walking independently as the end goal, the OT looks at cooking meals as part of a normal daily life as the end goal.

A speech-language pathologist also looks at this same patient from a functional standpoint, but the SLP will focus primarily on speech, communication, cognition, and swallowing. In fact, there’s an overlap between SLPs and OTs in the area of cognitive interventions, especially in settings like acute care, inpatient rehab, and outpatient. So, ensuring collaboration to avoid duplication of services and carryover of skills is essential. For example:

• Can the patient speak to his wife without struggling to find the right words (a condition called expressive aphasia)? And can the patient move his mouth, jaw, and tongue to speak without struggling to produce intelligible speech (a condition called dysarthria) or safely eat/swallow (a condition called dysphagia)?

If not, the SLP might work with this patient to improve his ability to communicate, so his wife can purchase the foods he can safely eat for dinner.

Differences in education

In some ways, PTs and OTs have very similar educational curricula. Some schools even have us sitting in the same rooms for a few courses!

The SLP curriculum is probably the most different of the three, but we do all share some core commonalities.

Before we jump into the coursework itself, keep in mind that occupational therapists and speech-language pathologists need master’s degrees to practice, while the entry-level requirement for physical therapists is a doctorate degree. WebPT has a comprehensive article about all the nuances of becoming a PT. We also have a post that walks you through what it takes to become an OT. And, the American Speech-Language-Hearing Association (ASHA) provides several great resources for those pursuing an SLP degree.

Programs for all three rehab therapy disciplines include coursework in human anatomy, physiology, and neuroscience. Occupational and physical therapists receive additional education on orthopedics, neurological interventions, geriatrics, and pediatrics. OTs branch off to focus on activity analysis, cognitive function, mental health, and research. PTs spend extended time on joint mobilization, therapeutic exercise, and pain science, as well as the cardiac, pulmonary, digestive, and integumentary (skin) systems (and other body systems that impact movement).

Speech-language pathology curricula emphasize typical and atypical speech, voice, cognitive-communication, language throughout the lifespan, and the neurological basis of communication. A significant portion of training also focuses on swallowing and feeding, including pediatric feeding challenges and adult dysphagia related to stroke or progressive neurological conditions. Coursework also covers audiology basics to understand the impact of hearing on speech and language, as well as strategies for collaboration with audiologists. 

While all three professions emphasize evidence-based practice, outcome measurement, and interprofessional collaboration, their curricula reflect their unique roles in promoting independence, mobility, and communication for individuals in diverse settings.

To get a better sense of the educational focus areas for each profession, check out the curriculum for each program at NYU:

• Occupational therapy curriculum
• Speech-language pathology curriculum
• Physical therapy curriculum

Differences in licensure

All new physical therapy students in the US must complete a Doctor of Physical Therapy (DPT) degree at one of the accredited institutions across the country. In order to practice, they must also pass the NPTE (National Physical Therapy Exam) and apply for and receive a state license.

In order to become an occupational therapist in the US, one must obtain a master’s or doctorate degree from an accredited OT school, then pass the NBCOT (National Board for Certification of Occupational Therapists).

In the US, speech-language pathologists must complete a master’s degree-level program, pass the Praxis exam, maintain continuing education requirements, and obtain state licensure in order to practice in an individual state. Many speech-language pathology positions also require SLPs to earn (or to be working toward earning) and maintain their Certificate of Clinical Competence (CCCs) through the American Speech-Language-Hearing Association (ASHA). This certification requires the SLP to complete a clinical fellowship year with an experienced SLP mentor (among other requirements).

Each state has different requirements for PTs, OTs, and SLPs to obtain and maintain licensure, so therapists must consider individual state laws—regardless of whether they have been educated on US soil or elsewhere.

OT vs. PT vs. SLP salary

According to the Bureau of Labor Statistics, PTs, OTs, and SLPs have somewhat similar salaries.

The largest gap seems to be between PT and SLP.

According to the BLS site, as of May 2024, the median annual wage was $101,020 for physical therapists and $95,410 for speech-language pathologists. The median wage for occupational therapists fell in between that range, at $98,340. As this is an OT website, we have our own guide to OT salary, in case you want to dive deeper into that particular data.

Keep in mind that “median wage” denotes the wage at which half the workers in an occupation earn more, and half earn less.

Another thing to keep in mind is saturation. Certain cities have several PT, OT, or SLP schools within the area (or at least nearby), so there is more competition for jobs—ultimately lowering overall wages.

Also, more “desirable” cities will often pay lower rates, because more people are vying for jobs there.

Aside from location, the setting in which you practice—as well as your employer—will play a big role in how much you earn.

If you are deciding which rehab therapy profession to pursue, our advice is to consider the field that appeals the most to you—rather than looking at salary alone.

Common practice niches and settings

One of the best things about being a therapist is the ability to explore all sorts of settings and patient populations, allowing you to dive deeper and expand your expertise in the areas that interest you most!

PTs, OTs, and SLPs can focus on treating infants, children, or adults—in either an inpatient or outpatient setting. OTs, PTs, and SLPs can also opt to work in the school system.

Physical therapists commonly choose to specialize in geriatrics, pediatrics, hand therapy, sports, or pelvic health therapy. A newer specialty is animal therapy, particularly with dogs. More and more PTs are entering the realm of pain science these days, too, which is great considering the opioid crisis in the US!

Occupational therapists often opt for specialized training in driving rehab, low vision, hand therapy, and mental health.

Speech-language pathologists frequently choose to focus on fluency, swallowing disorders, communication, and/or voice/resonance disorders within specific populations.

OT vs. PT vs. SLP job outlook

According to the Bureau of Labor Statistics (BLS), all three rehab therapy professions have an excellent employment outlook.

Employment of occupational therapists is projected to grow 14% from 2024 to 2034, which is much faster than the average for all occupations. Occupational therapy will continue to be an important part of treatment for people with various illnesses and disabilities, such as Alzheimer’s disease, cerebral palsy, autism, or the loss of a limb.

Employment of physical therapists is projected to grow 11% from 2024 to 2034, which is also much faster than the average for all occupations. A lot of the demand for physical therapy will come from aging baby boomers, who are not only staying active later in life, but are also more susceptible to age-related health conditions that may require physical therapy. Additionally, physical therapists will be needed to treat people with mobility issues stemming from chronic conditions, such as diabetes or obesity.

Employment of SLPs is projected to grow 15% from 2024 to 2034, which again, is much faster than the average for all occupations. With baby boomers continuing to age, there will be an increased need for SLPs to treat speech and language impairments caused by strokes and age-related brain injuries.

No matter which path you choose, you’re in good shape.

The rehab therapy professions are constantly making various lists of the top careers in America.

And while these lists should always be taken with a grain of salt, it’s still nice to see our wonderful professions represented positively by mainstream media!

Here are just a few of our bragging rights:

• Glassdoor’s 2018’s 50 Best Jobs in America (OT #4, SLP #35)
• US News and World Report’s Best Healthcare Jobs (OT #8, PT #7, SLP #3)
• US News and World Report’s 100 Best Jobs (OT # 23, PT #21, SLP #9)

The history of OT, PT, and SLP

We thought a brief overview of our professions’ histories was important to include, because it emphasizes two things:

1. All three professions are around a century old, making them relatively new.
2. Though distinct in their own ways, our professions have a lot in common throughout their history.

All three professions were established around the same time, with two major factors influencing their founding:

• World War I
• The entrance of women into the workforce

We look forward to seeing how all three professions continue to grow, evolve, and interact with one another.

Conclusion: We are all one big, happy rehab family!

At the end of the day, our differences and similarities are what make us such a fantastic team.

One of the reasons we love each other so much is that we understand the joys and pains involved in rehabilitating patients to achieve their goals.

We hope that this article has helped un-muddy the waters by clarifying what the rehabilitation therapy disciplines do—and how we work together and separately to help patients regain the ability to communicate, eat, move, and participate in the activities that mean the most to them.

And if you’re trying to decide which path to pursue, we hope this article has helped you make that choice!

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About the authors:

Rebeca Segraves, PT, DPT, WCS, is a physical therapist who specializes in early recovery after birth, pelvic surgery, and cancer treatment. She trains rehab professionals to treat women’s health patients across hospital, home, and virtual settings. Outside of work, she loves mountain biking and hiking trails across Colorado.

Stacie Delezene, CCC-SLP, is an SLP with more than 15 years of experience helping children, patients, and families thrive across a variety of therapy settings—outpatient clinics, skilled nursing, hospitals, home health, and community programs. Stacie works closely with occupational therapists, physical therapists, and speech-language pathologists to ensure every patient receives care that is evidence-based, family/patient-centered, and focused on meaningful outcomes. Her passion is creating strong partnerships—between therapists, caregivers, and families—so that therapy feels like a team effort.

Sarah Lyon, OTR/L, is the owner of OT Potential. Sarah worked in an acute trauma center, a rural hospital, and a state psychiatric hospital before transitioning to helping fellow OTs full-time—by creating resources such as this one.

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