In honor of BETTER Speech & Hearing Month, I am tackling some answers for BETTER questions we can be asking each other as a profession. Imagine if we started asking some of these thoughtful questions that could elevate and inform how we practice, in contrast with questions that oversimplify what we do such as “What’s your favorite game to play for memory?” Let’s crowd-source our knowledge here! I’d LOVE to hear your thoughts in a comment below or email me: [email protected]

First up: Does Functional Speech Therapy Overlap With Occupational Therapy? (Also: Will My OT CoWorker Think I’m Stepping On Her Toes If I Use A Functional Approach? and… Will Insurance Still Cover What I’m Doing If OT Is Also On The Case?)

Here are my thoughts in 3 key words expanded:

Complement: As therapy coworkers, OT and SLP can look at the same patient need through a different lens. Together, with different primary focuses, we are able to wholly address the ways a patient may function optimally. OT and SLP are able to complement each other in creating solutions for patients. In my experience, the OT lens tends to focus on environment and safety modifications, while SLP focuses on how specific cognitive or communication functions are working within each environment. Yes, there can be overlap in what environments we look at, but our methods and solutions are meant to complement each other.

I’m going to use an analogy here: Why do professional sports have a whole coaching staff? Because even with the same primary goal (winning the game), each coach looks at how to do that in a complementary way. Suggestions may include moving to a different spot on the basketball court, trying a different play, forcing a certain player to go to the left side, or using a better foul-through with free throws. Each coach offers a unique, complementary view in contributing to the greater, complex goal of winning the basketball game. To me, this matches how OT and SLP can work together on a single focus, but with a unique vantage point that is within their area of training.

Collaborate: In some cases, we may decide to collaborate on the same activities. So the participation goal may be better safety and functioning for kitchen tasks, and OT will take the physical environment using task-specific strategies like moving items to a different shelf, or adding labels or a timer. SLP may give input on what type of labels would work best, and then work with patient on specific memory strategies for how to use the timer. Or they may work on language-based tasks like re-sizing recipes so they are more readable. SLP is uniquely trained in the cognitive strategies such as systematic instruction or Goal-Plan-Do-Review framework. So you can see how introducing those strategies that apply to a specific situation but then may also be used in other situations is a slice of the pie of how someone can improve at a certain activity or participation level.

Divide & Conquer: In other cases, we may decide to divide and conquer. OT will take the cooking / kitchen safety environment and handle that aspect, where SLP will take medication list and paying the bills. 

In my experience, open communication and using OT as a teammate for various situations has allowed us to best serve the patient rather than getting caught up in rigid roles. I’ve never had reimbursement issues across the multiple settings I’ve worked in! 

I’d love to hear from you! What are your thoughts to the question?

2 Responses

  1. This article is exactly what I’m looking for and I’d love to get more input! I am struggling with making a clear distinction between OT and ST cognitive treatment. My facility is encouraging ST to be more involved in the IL community. Currently OT is targeting cognition but I’m concerned about duplication of services. However, our OT is utilizing some of my workbooks and not approaching it in more “ADL” terms. I’d love some more resources to help us both navigate through our roles in cognitive treatment.

  2. OT definitely addresses the cognitive and praxis deficits involved in accomplishing occupations. They will select training techniques such as chaining, modeling, error-based learning etc. based on the cognitive level. The CO-OP model you reference was originally developed to treat children with Developmental Coordination Disorder and is certainly not unique to speech therapy. Environmental modification is used to increase performance if remediation is not possible.

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