The specialty decoder: what the words inside speech, OT, PT, and ABA mean

Avery spent most of her first four months in the hospital. She learned how to drink from a bottle in the NICU, and that’s where my husband and I first started learning a second language — the medical one. Replogle. TPN. Gavage. PO (per os, by mouth). PRN (pro re nata, as needed). It was as if we had to learn another language just to take care of our new baby.

After 49 days we were discharged. But after a short stint at home, she went back to the hospital — this time to the PICU, for congestive heart failure. (NICU, PICU: same idea, different floor. Newborns on one, older babies and children on the other.)

Once she was admitted, they wanted to check whether she was aspirating (new word to me!), so she was wheeled down on a gurney for a swallow study (also new to me). She hadn’t eaten since she’d been admitted, so she was absolutely ravenous and drank more than half the bottle before she realized… it wasn’t milk. Then she screamed her head off, furious that she’d been handed a bottle of what is essentially liquid chalk while the machine recorded her throat and airway on every swallow.

I remember saying something to the speech therapist, the doctor, and the radiology techs like, “Let me translate for you: This restaurant is terrible! ZERO stars!” They laughed (I don’t think they laugh a lot at work). I don’t even know why I said it. I think it was a coping mechanism for the stress of having a baby in the hospital.

She wasn’t aspirating, thankfully — no food was getting into her lungs. But she was in heart failure, and we were at the hospital until she had her heart surgery. Most of that time she was tube-fed again, and all the work she’d done to take a bottle in the NICU was lost. We left after one more surgery, to place a g-tube.

Then she was discharged, and I got her set up with in-home therapy as soon as I could: feeding therapy, physical therapy, and occupational therapy.

And then we had to learn even more terminology — from the therapists.

I wrote this guide so that the words you see in session notes, or hear at handoff when a session ends, won’t be a foreign language to you. Think of it like a pocket translator.

Our terminology decoder covers the words you hear in the first year: ST and OT and PT, in-home versus center-based, ECI and IEP and ARD. This guide is the next layer down — the words your child’s therapist uses about the actual work. They’re not trying to lose you. These are just the ordinary working vocabulary of each field, and nobody hands parents the glossary.

Two rules for reading this. First, a definition is not a diagnosis: knowing what hypotonia means tells you nothing about whether it applies to your child — that’s your evaluating provider’s call, always. Second, you’re allowed to ask. A good therapist can explain any word here in plain terms in thirty seconds, and asking is one of the best ways to tell whether you’re in the right place (our guide to choosing a clinic has the whole test).

What do speech therapy terms mean?

Speech therapy covers more than speech. Most of these words sort into a few buckets: the sounds, the language, the social use of language, and the mouth itself.

• Expressive vs. receptive language. Receptive is what your child understands — following directions, pointing to the right picture. Expressive is what your child produces — words, sentences, gestures, signs. They develop separately, and a child can be strong in one and behind in the other, which is why an evaluation reports them separately.
• Articulation. Producing individual speech sounds — the r in rabbit, the s in sun. An articulation goal targets specific sounds.
• Phonological processes. Patterns of sound simplification, rather than trouble with one sound — leaving off final consonants, or replacing back sounds with front ones (“tat” for “cat”). Most are normal at certain ages; a phonological goal targets a pattern that has stuck around past the usual window.
• Childhood apraxia of speech (CAS). A motor-planning difficulty: the child knows what they want to say but the brain has trouble sequencing the mouth movements to say it. Distinct from articulation and from a muscle-weakness problem, and treated differently, which is why the label matters — and why it’s a call for an SLP with CAS experience, not a checklist.
• Stuttering / fluency. Fluency is the clinical word for the rhythm and flow of speech, and a fluency goal almost always means stuttering — repeated sounds or syllables, stretched sounds, or silent blocks where a word gets stuck. Disfluency is the general term for any break in flow; many preschoolers go through a stretch of developmental disfluency that resolves on its own, which is why an SLP looks at the type, frequency, and how long it has lasted before calling it stuttering. Cluttering is a related but different pattern — fast, irregular, jumbled speech — that’s sometimes confused with it.
• Pragmatics / social communication. Pragmatics is the unwritten rules of using language with other people — taking turns, staying on topic, reading tone, knowing how close to stand. Social communication is the wider skill set it belongs to. A social-skills group is usually working on both.
• Late talker. A descriptive term, not a diagnosis, for a toddler whose spoken vocabulary is behind with no other identified cause. Whether a late talker needs therapy or monitoring is exactly the question an evaluation answers.
• Echolalia. Repeating words or phrases heard from others — a line from a show, a question asked back. It’s common in early language and in autism, and it isn’t meaningless; the next term is about that.
• Gestalt language processing (GLP). A framework describing children who learn language in whole chunks (“gestalts” — scripts, phrases, song lines) and later break them into parts, rather than building up from single words. You may hear Natural Language Acquisition (NLA), a staged model some SLPs use to describe and support this path. It’s a framework, not a diagnosis, and views on it differ among SLPs; if an evaluator used the term about your child, ask a prospective SLP directly whether they work from it — it changes what therapy looks like.
• Oral-motor. The strength, coordination, and range of motion of the lips, tongue, jaw, and cheeks — the hardware of both speech and eating.
• Tongue lateralization. Moving the tongue side to side. It sounds trivial; it’s how a child moves food onto the molars to chew, and it’s a common feeding-therapy target.
• Myofunctional / orofacial myofunctional disorder (OMD). The pattern of how the tongue, lips, and jaw rest and move — tongue resting low or forward, lips apart at rest, a “tongue thrust” swallow. Myofunctional therapy works on these resting and swallowing patterns. Some SLPs (and some dental professionals) specialize in it; ask.
• Tongue tie / lip tie (ankyloglossia). A band of tissue under the tongue or lip that restricts movement. Whether it’s affecting feeding or speech, and whether anything should be done about it, is a medical and dental question — a therapist may flag it, but the decision isn’t theirs.
• AAC — and its classes. The general decoder defines AAC (augmentative and alternative communication). The words inside it: low-tech / light-tech means picture boards, communication books, and picture-exchange systems (PECS is one branded, structured version); high-tech means electronic — a dedicated speech-generating device (SGD) or a tablet or phone running a communication app. (When insurance says “SGD,” it usually means the dedicated device; that distinction matters for coverage.) Core vocabulary is the small set of high-frequency words (“more,” “go,” “stop,” “want”) most AAC systems build around. Modeling (or aided language input) is the adult using the device while talking, so the child sees the words in use — you’ll likely be asked to do it at home.

Feeding words, the short version — the feeding therapy guide goes deeper:

• Dysphagia is difficulty swallowing.
• Aspiration is food or liquid getting into the airway — past the vocal cords, toward the lungs — instead of going down to the stomach. A swallow study is the instrumental test that checks for it, usually an X-ray study with barium (a VFSS or “modified barium swallow”), sometimes a small camera passed through the nose (FEES). This is the one feeding word that’s always a doctor-now question, never a wait-and-see.
• Texture progression is the planned move from purees toward mixed and chewable foods. Food chaining (a named program) builds from foods a child already accepts toward similar new ones.
• Oral aversion is a strong avoidance of things in or near the mouth, common after early medical experiences.
• ARFID (avoidant/restrictive food intake disorder) is a formal diagnosis — eating so limited in amount or variety that it affects growth, nutrition, or daily life, without the body-image concerns of other eating disorders — made by a physician or a mental-health clinician (a psychologist or psychiatrist), not a feeding therapist. Feeding therapists don’t diagnose or treat ARFID itself, but they may be part of the care team, working on the feeding-skill pieces alongside it. A child whose main problem is a swallowing or oral-skill deficit gets a different label, pediatric feeding disorder (PFD) — and that one is squarely the feeding therapist’s territory.
• Tube weaning is the supervised process of moving from tube feeding toward eating by mouth, always under medical oversight.

What do occupational therapy terms mean?

Pediatric OT vocabulary confuses parents more than any other, because half of it is about senses you were never taught you had.

• Sensory processing / sensory integration. How the brain takes in information from the senses and organizes it into a usable response. Ayres Sensory Integration is also the name of a specific, trademarked treatment approach with its own training and certification, so “we do sensory integration” can mean the general idea or the formal method — worth asking which.
• The senses beyond the five. Proprioception is the body-position sense — information from muscles and joints that tells you where your limbs are without looking. Vestibular is the movement-and-balance sense, from the inner ear. Interoception is the sense of internal signals — hunger, thirst, needing the bathroom, a racing heart. A lot of OT goals that sound mysterious are about one of these three.
• Over-responsive, under-responsive, sensory-seeking. Descriptions of how a child tends to react to sensory input — reacting strongly and steering away from it (covering ears, refusing textures), barely registering it, or craving more of it (crashing, spinning, chewing). Different assessments group these a little differently, and most kids are a mix, by sense and by day.
• Sensory diet. Not about food. A planned schedule of sensory activities across the day — swinging, heavy work, quiet breaks — designed to help a child stay regulated. If your OT gives you one, it’s meant for home and school, not just the clinic.
• Heavy work. Activities that push or pull against resistance — carrying, pushing a cart, animal walks. It’s proprioceptive input, and it’s often used because it tends to be organizing.
• Self-regulation. The ability to manage one’s own alertness, emotions, and behavior to match the situation. Co-regulation is an adult helping a child get there. Many OT programs teach a shared vocabulary for this (colors, engines, zones — several are branded programs).
• Fine motor. Small-muscle skills, mostly hands and fingers — grasping, cutting, buttoning, writing. Pincer grasp (thumb and index finger) is the milestone you’ll hear about first.
• Bilateral coordination. Using both sides of the body together — one hand stabilizing the paper while the other writes, or catching a ball.
• Crossing midline. Reaching across the center of the body with a hand or foot. Kids who avoid it will switch hands rather than reach across; it’s tied to hand dominance and to a lot of classroom tasks.
• Visual-motor integration. Coordinating what the eyes see with what the hands do — copying shapes, cutting on a line, handwriting.
• Praxis / motor planning. The ability to think of, plan, and carry out an unfamiliar movement. Dyspraxia is difficulty with it. (Note the overlap with apraxia of speech above — same root idea, different system. Dyspraxia is the descriptive OT term; the diagnostic label for persistent coordination difficulty is DCD, in the PT section below.)
• Executive function. The mental management skills — starting a task, holding a plan in mind, shifting between steps, checking your work. A common OT focus for older kids and teens.
• ADLs / self-care. Activities of daily living — dressing, toileting, feeding yourself, hygiene. When an OT says “we’re working on ADLs,” they mean the everyday independence skills.
• Handwriting programs. A common OT goal at school age; several branded programs exist. Whether handwriting belongs in OT or in a school accommodation (a keyboard, a 504 plan) is a fair question to ask your team.

What do physical therapy terms mean?

PT vocabulary is the most physical and, for babies, the most likely to arrive before you were ready for any therapy at all.

• Gross motor. Big-muscle skills — head control, rolling, sitting, crawling, walking, running, jumping, climbing.
• Muscle tone — hypotonia and hypertonia. Tone is the resting tension in a muscle, not its strength. Hypotonia (low tone) can look floppy or loose-jointed; hypertonia (high tone) looks stiff or tight. A child can have low tone and normal strength. Tone is a description a clinician makes, not something you can judge from a photo.
• Torticollis. A tightened neck muscle that tilts or turns a baby’s head to one side. One of the most common reasons an infant is referred to PT.
• Plagiocephaly. A flattened area on a baby’s head, often alongside torticollis, on the side the baby’s head keeps turning toward. PT addresses the positioning and the neck; a helmet, if one is discussed, is a separate medical decision.
• Developmental milestones. The typical age windows for skills — in PT, the gross-motor ones. Milestone lists are guidance, not deadlines — the range is wide, and your PT will tell you what actually matters for your child.
• Tummy time. Awake time on the stomach, building the neck, shoulder, and core strength that everything after it depends on. If a PT is involved with an infant, expect this word constantly.
• Range of motion (ROM). How far a joint can move. Stretching goals target it.
• Core strength / postural control. The trunk stability that sitting, standing, and every hand skill rests on. Explains why an OT and a PT may both mention it.
• Shoulder girdle. The shoulder blades, collarbones, and the muscles around them — the platform the arms work from. “Strengthening the shoulder girdle” is a common goal for babies and young kids because head control, pushing up in tummy time, crawling, and later reaching and handwriting all load through it. Another term you may hear from both a PT and an OT.
• Gait. How a child walks. Toe walking — walking on the balls of the feet — is common in toddlers; when it persists, PT is often involved, and the reason behind it is a clinical question.
• Orthotics — AFO, SMO. Braces, often custom-molded. An AFO (ankle-foot orthosis) supports the ankle and foot and comes up the lower leg; an SMO (supramalleolar orthosis) is a shorter brace just above the ankle bones, used for milder support. Serial casting is a series of casts used to gradually lengthen a tight muscle, sometimes before or instead of bracing.
• Balance and coordination. Exactly what they sound like; a PT may describe these separately from strength. Developmental coordination disorder (DCD) is a diagnostic term you may hear for persistent, significant coordination difficulty — a diagnosis, so it comes from a provider, not a checklist.
• Adaptive equipment. Walkers, standers, gait trainers, adapted strollers or seating. A PT often recommends and fits these; funding them is its own process, which your PT and your insurance will walk you through.

What do ABA terms mean?

ABA has the most jargon of the four, because the field is built on describing behavior precisely. None of these words tells you whether a program is a good one — but knowing them lets you ask.

• FBA — functional behavior assessment. Figuring out what a behavior does for the child — what it gets them, or gets them out of. The plan is built on the answer.
• ABC data. Antecedent (what happened before), Behavior, Consequence (what happened after). The basic observation format; you may be asked to keep some at home.
• Reinforcement. Anything that follows a behavior and makes it more likely to happen again. Positive reinforcement adds something (praise, a preferred item); negative reinforcement removes something unpleasant — it is not punishment, despite the name.
• Prompting and prompt fading. A prompt is the help given to get a response (a gesture, a model, hand-over-hand). Fading is the planned reduction of that help until the child does it independently. “Prompt-dependent” means the help hasn’t faded yet.
• DTT — discrete trial training. A structured teaching format: a clear instruction, a response, a consequence, repeated in short trials, often at a table. Precise and data-heavy.
• NET — natural environment teaching. Teaching within play and everyday routines, following the child’s motivation, with the same principles running underneath. Programs that call themselves play-based or naturalistic are usually describing a NET-heavy approach or one of several related named approaches — worth asking which. Most programs use both DTT and NET in some proportion; asking what the proportion looks like for your child is a fair question.
• Assent-based / PFA and SBT. Assent means the child’s own willingness to participate, shown in whatever way the child can show it — and respecting it is an ethics obligation for every behavior analyst, not a program feature. An assent-based program treats withdrawal of assent as information to respond to rather than resistance to push through. PFA (practical functional assessment) and SBT (skills-based treatment) are one specific, named approach to understanding and treating challenging behavior, designed to keep the child happy, relaxed, and engaged throughout — which is why it’s often described as assent-based. A program can be assent-based without using PFA/SBT, and using PFA/SBT isn’t the same as a program-wide assent policy. Other programs run a more traditional model. No label guarantees anything; ask what happens in the room when a child is distressed or refuses.
• Mand / tact. A mand is a request (“juice,” pointing at the cup); a tact is a label or comment (“dog!”). Early language programs often build mands first, because requesting is the most motivating thing to say.
• Generalization and maintenance. Generalization is the skill showing up outside the teaching setting — with a different person, place, or material. Maintenance is the skill sticking over time. A skill that only works at the clinic table hasn’t finished being learned.
• Extinction. Stopping the reinforcement a behavior was getting, so the behavior fades. It’s a technical term with a specific meaning and it’s sometimes misunderstood as “ignoring the child”; how and whether a program uses it is a reasonable thing to ask about directly.
• Treatment plan, recommended hours, and authorization. The BCBA’s written plan sets goals and a recommended weekly hours number; insurance authorizes a number of hours, which may differ. The general decoder covers comprehensive vs. focused — the industry words behind big and small hours numbers.
• Parent training / caregiver training. A standard, often insurance-required part of the plan: sessions where the BCBA teaches you the strategies. If it’s missing from a plan, ask why.
• Supervision. The BCBA overseeing the RBTs delivering the hours — a required ratio, and the reason you’ll see the BCBA less often than the technician. Asking how much direct BCBA time your child gets is a fair question.
• Assessment names. You may see acronyms like VB-MAPP, ABLLS-R, or Vineland on a report. The first two are skill inventories used to set and track goals; the Vineland is a standardized rating of everyday adaptive skills, usually done by interviewing you, that compares your child to same-age peers — and it’s the one schools and insurers often ask for. The acronym matters less than the BCBA’s ability to walk you through what it found.

What do you do with a word you don’t recognize?

Ask, in the moment: “Can you say that in plain terms?” Then ask the follow-up that matters more: “And why is that the goal for her right now?” Any therapist worth their license lights up at the second question — it’s the fit test from our choosing-a-clinic guide, and it works for every word on this page.

And if the word is one your child’s therapist doesn’t work with — a specialty they’d refer out for — the word itself is your search term. Ask the clinic directly: “Does anyone here do [the word]?” A clinic that doesn’t usually knows who does. Our guide to finding a therapist with a specific specialty covers how to search by the word itself.

Finding pediatric therapy in Central Texas

Every word on this page is easier to learn from a therapist who explains things well — and finding that clinic starts with a short list: which ones near you do the therapy your child needs, work with your child’s age, take your insurance, and offer in-clinic, in-home, or telehealth care. That’s what Care Connect Kids is for. It’s free for parents, always, and it’s one place to find the speech, OT, PT, and ABA clinics in your area by therapy type, age, insurance, and location. Care Connect Kids will find matches and send your inquiry to participating clinics for you. We never ask for a diagnosis or medical details — only what’s needed to match.

See what’s near you at /coverage, or start with the Austin metro page.