The therapy-terminology decoder: what all those letters actually mean

When your child is referred to therapy for the first time, everyone around you starts speaking a new language. The pediatrician says “ST and OT.” The clinic asks whether you want “center-based or in-home.” The school mentions an “ARD meeting.” Nobody stops to translate.

I’ve been the parent nodding along in those conversations while quietly keeping a list of things to look up in the car afterward. This guide is that list, translated — the words you’ll actually hear in your first year of pediatric therapy, in plain English.

One thing this guide is not: advice about which therapy your child needs. That answer comes from your child’s doctor and from evaluations — not from a glossary, including this one.

What are the four main types of pediatric therapy?

Speech, occupational, physical, and ABA therapy — and each name means more (or something different) than it sounds like.

Speech therapy (ST). Speech therapy, speech-language therapy, and “ST” are all the same thing. It covers more than speech sounds: language (understanding words and putting them together), social communication, alternative ways to communicate like AAC devices (more on that below) — and, to many parents’ surprise, feeding and swallowing. If a clinic offers “feeding therapy,” it is usually a speech therapist (sometimes an occupational therapist) providing it.

Occupational therapy (OT). The “occupational” throws every new parent — no, it is not about jobs. A child’s occupation is childhood: playing, getting dressed, eating with utensils, holding a pencil, managing big feelings. Pediatric OT works on fine motor skills, sensory processing, and the daily living skills a child’s day is built from.

Physical therapy (PT). The big movements — sitting, crawling, walking, running, jumping, balance, and strength. If OT is the hands and the senses, PT is the trunk and the legs. (Plenty of children do both, because the two overlap in real life.)

ABA therapy. Applied Behavior Analysis — a therapy approach used most often with autistic children. Skills are broken into small teachable steps and progress is tracked closely with data. ABA is structured differently from the other three: a board-certified analyst designs the program, technicians deliver most of the day-to-day sessions, and programs are measured in hours per week rather than a weekly 30- or 60-minute session. Because of that, ABA vocabulary gets its own entries below.

Who are all the people on your child’s team?

The letters after the names describe training and role — here is the decoder.

• SLP — speech-language pathologist. Master’s-level provider of speech therapy. CCC-SLP after a name is their national clinical certification. An SLPA is a speech-language pathology assistant, who works under an SLP’s supervision.
• OTR/L — a registered, licensed occupational therapist. A COTA is a certified occupational therapy assistant, working under the OT’s supervision.
• PT / DPT — a licensed physical therapist; DPT means Doctor of Physical Therapy, the standard degree for newer graduates. A PTA is a physical therapist assistant.
• BCBA — Board Certified Behavior Analyst, the master’s-level professional who assesses your child and designs and supervises an ABA program. An RBT — Registered Behavior Technician — delivers most of the hands-on session time, under the BCBA’s supervision.

Seeing an assistant’s title on your child’s schedule is normal and common — assistants always work under a supervising therapist’s plan. If you want to know how supervision works at a particular clinic, that is a completely fair question to ask.

What’s the difference between an evaluation and treatment?

The evaluation is the map; treatment is the trip — and they are often scheduled (and waitlisted) separately.

An evaluation (or “assessment”) usually comes first: a therapist observes your child, often uses standardized tests, and writes a report. That report becomes the plan of care — the goals your child will work on and the recommended frequency, like “twice a week for 45 minutes.” Treatment is the recurring weekly sessions that follow. Along the way you will hear about goals being met, periodic re-evaluations to update the plan, and eventually discharge — clinic language for graduating from services, which is the happy ending everyone is working toward.

Two practical notes. First, the wait for an evaluation and the wait for a treatment slot can be different — some clinics can evaluate soon and place you on a list for recurring sessions, which means you are ready to start the day something opens. In ABA, the assessment and ongoing treatment often have separate waits too. Our waitlist survival guide covers how to ask about this. Second, in ABA you may hear comprehensive versus focused — industry words for the shape of the program, roughly many hours per week across many skill areas versus fewer hours aimed at specific goals. Which shape fits your child is the BCBA’s assessment conversation, not a menu you order from.

What do center-based, in-home, push-in, and telehealth mean?

Where the therapy physically happens — and the words clinics use for each.

• In-clinic / outpatient / center-based. You drive to them. All three words mean the therapist’s own space; “center-based” is the word you will hear most in the ABA world.
• In-home. The therapist comes to you — your house, sometimes your child’s daycare or another community setting. Some practices call this mobile therapy (or a mobile clinic) — same idea. Some private clinics offer it directly, especially for younger children and for ABA.
• Home health. Often the very same visit as in-home — families and providers use the two terms interchangeably at least some of the time. The real difference is usually how it’s billed: home health is its own insurance benefit category, and whether your child’s in-home or in-community services fall under it can depend on the diagnosis and on the doctor’s prescription for services. Home-health care usually comes through an agency, and which therapist you get often depends on who covers your part of town — so ask about the specific therapist’s pediatric experience, not just the agency’s. Not sure which category applies to your child? Ask the provider how the services will be billed.
• Push-in. The therapist comes to your child’s daycare or preschool and works with them during the normal day. Parents often first hear this one as “push-in OT at daycare.”
• Telehealth / teletherapy. Sessions over video. For some children and some goals — speech especially, and parent-coaching models — it works well and draws on a different pool of scheduling availability. Ask the clinic whether your child is a good candidate.

What are ECI, IEP, 504 — and an ARD meeting?

These are the public-system words — the therapy your child may receive through the state or the school, on a separate track from any private clinic.

ECI — Early Childhood Intervention. Texas’s program for babies and toddlers from birth up to age three with delays or disabilities. Anyone can refer a child — you do not need a doctor’s order to ask for an evaluation, and the evaluation itself is at no cost to the family (some ongoing services may have an income-based cost share; the program will walk you through it). Services often happen in your home or your child’s daycare.

The age-3 transition. ECI ends at a child’s third birthday. If your child still needs support, the handoff is to your local school district, which runs its own evaluation — this is the moment many families first meet the school-side vocabulary below. It is worth starting that conversation months before the birthday, not after.

IEP — Individualized Education Program. The formal special-education plan a school district writes for an eligible child, which can include speech, OT, or PT at school when the child needs them to make progress at school. 504 plan is the lighter-weight cousin: accommodations (like extra time or sensory breaks) without specialized instruction.

ARD meeting. Texas’s name for the meeting where the IEP is written and reviewed — it stands for Admission, Review, and Dismissal. If someone schedules “an ARD,” that is the IEP meeting; the rest of the country just calls it that.

“Outside therapy.” What school teams call your private clinic therapy. The two tracks are separate on purpose: school therapy targets what a child needs to access their education, while private therapy can target anything in your child’s life — and many children do both at the same time. (Fitting outside therapy around a school day is its own puzzle — our kindergarten transition guide covers it.)

AAC — augmentative and alternative communication. Not a program but a term you will hear in both systems: the tools that supplement or stand in for speech, from picture boards to speech-generating devices (“AAC devices”). If your child uses or is evaluated for AAC, ask any prospective clinic how comfortable their therapists are with it — comfort levels genuinely vary.

What do the insurance and payment words mean?

Five terms cover most of what you will hear on the phone.

• In-network / out-of-network. Whether the clinic has a contract with your insurance plan. “Do you take my insurance?” is really asking this.
• Prior authorization. Your insurance approving therapy before it starts (or before it continues). Clinics usually handle the paperwork, but it is a common source of start-date delays.
• Visit cap. A plan-imposed limit on covered sessions per year. Worth asking your plan about up front, since recurring weekly therapy meets a cap faster than you would think.
• Private pay / self-pay. Paying the clinic directly instead of billing insurance. Practices that work this way are often the least crowded, because nearly every family searches in-network first.
• Superbill. An itemized receipt with the codes your insurance needs, so you can seek reimbursement yourself for out-of-network care. Many clinics provide them — ask.

How families actually put these together — including HSA and FSA money — is its own guide: paying for your child’s therapy.

Finding pediatric therapy in Central Texas

Care Connect Kids is free for families. Always. Clinics pay for the platform, and speech, occupational, physical, and ABA therapy all live in one place — so once you know which words apply to your child, you do not need a separate search for each one.

Not sure whether we reach your family yet? Check your zip code. If you are in Central Texas, the Austin metro page shows where we cover today.