Occupational Therapy vs Paediatric Physiotherapy for Children

What each therapy addresses

Occupational therapy (OT) helps children build the skills they need for everyday activities — the 'occupations' of childhood like playing, dressing, eating, learning and socialising. Paediatric OTs commonly work on:

• Fine motor skills (holding a pencil, using scissors, doing up buttons)
• Sensory processing (how a child responds to sounds, textures, movement or light)
• Daily-living skills (toileting, dressing, feeding themselves)
• Play, attention and emotional regulation
• Handwriting and school readiness

Paediatric physiotherapy focuses on how a child moves. Physios support gross motor development — the larger movements involving the whole body. They commonly work on:

• Gross motor milestones (rolling, crawling, walking, running, jumping)
• Coordination, balance and posture
• Muscle strength and joint movement
• Mobility, walking patterns and use of equipment where needed
• Sport and playground participation

A simple way to think about it: OT often focuses on the hands, the senses and daily tasks, while physiotherapy often focuses on the body's larger movements and mobility.

Signs a child might benefit from each

These are general observations only — not a diagnosis. Always check concerns with your GP or paediatrician.

A child might benefit from OT if they:

• Struggle with pencil grip, drawing or handwriting
• Find dressing, using cutlery or toileting harder than peers
• Are very sensitive to (or seek out) certain sounds, textures or movement
• Have trouble with attention, focus or managing big feelings
• Avoid activities involving hands or fiddly tasks

A child might benefit from paediatric physiotherapy if they:

• Are late reaching movement milestones like sitting, crawling or walking
• Seem clumsy, trip often or tire quickly during physical play
• Have an unusual walking pattern or difficulty with balance
• Avoid stairs, climbing or ball games
• Have low or high muscle tone noted by a health professional

Suitable ages

Both therapies work with children from infancy through the teenage years. Physiotherapy often starts very early — even with babies — for movement and milestone concerns. OT is frequently sought once fine motor, sensory or school-readiness challenges become noticeable, often in the toddler-to-primary-school years, though it can begin earlier too. Earlier support is generally helpful, but there's no strict cut-off, and it's never 'too late' to seek help.

What a typical session looks like

Both therapies are play-based for younger children — the work looks like fun, which keeps kids engaged.

• OT session: Might involve obstacle courses, threading, drawing games, messy play or practising a daily task like getting dressed. The therapist often coaches parents on strategies to use at home.
• Physio session: Might involve crawling games, balance activities, climbing, jumping, stretches or exercises, sometimes with equipment. Home exercises are usually part of the plan.

Sessions typically run 45–60 minutes and may happen in a clinic, at home, at school or at daycare.

Key differences at a glance

Feature	Occupational Therapy	Paediatric Physiotherapy
Main focus	Fine motor, sensory, daily-living skills	Gross motor, coordination, mobility
Common goals	Handwriting, dressing, sensory regulation	Walking, balance, strength, milestones
Body focus	Hands, senses, everyday tasks	Whole-body movement
Professional body	Occupational Therapy Australia / AHPRA	Australian Physiotherapy Association / AHPRA
Typical setting	Clinic, home, school	Clinic, home, school

Typical AU costs and NDIS funding

As a general guide, private therapy sessions in Australia commonly range from around $180 to $220+ per hour for both OT and physiotherapy. The NDIS publishes price caps in its Pricing Arrangements and Price Limits, which set maximum rates providers can charge NDIS participants — these are updated periodically. Prices vary by location, provider and session length, so always confirm current fees directly with the provider.

Under the NDIS, both OT and physiotherapy usually sit within the Capacity Building — Improved Daily Living support budget. If your child has an NDIS plan, funding may cover eligible therapy, assessments and reports. It's worth asking a provider how their fees align with the current NDIS price caps and what's included (travel, report writing, non-face-to-face time). If you're not on the NDIS, some costs may attract a Medicare rebate under a GP-referred plan or private health extras — check with your GP and insurer.

Who each therapy suits

Choose based on the skills your child is finding hard, not on which sounds 'better':

• OT suits children whose challenges show up in hands-on tasks, sensory responses, self-care or focus and regulation.
• Physiotherapy suits children whose challenges show up in movement, strength, balance, coordination or mobility.

If you're unsure, a GP, paediatrician or the therapist's initial assessment can help point you in the right direction.

Can children do both?

Yes — and many do. A child's needs often overlap. For example, a child working on coordination with a physio might also see an OT for handwriting or sensory support. When both are involved, good therapists usually communicate and set aligned, family-friendly goals so you're not doubling up. If your child is on the NDIS, this can be built into the plan.

Before you book

Whatever you choose, do a few checks:

• Confirm the therapist's registration — OTs and physios must be registered with AHPRA, and many OTs are also members of Occupational Therapy Australia (physios often with the Australian Physiotherapy Association).
• Ask whether they're an NDIS-registered provider if you plan to use NDIS funding.
• Ask about their experience with children and your area of concern.
• Ask about waitlists early — paediatric therapy waitlists can be long, so it's worth enquiring at several providers.