Many children benefit from speech therapy or occupational therapy on their own, but sometimes progress feels slower than parents expect. A child may be struggling with both communication needs and sensory or motor challenges at the same time. Addressing one without the other can lead to frustration.

I’m Poonam, an occupational therapist at Joy & Laughter Developmental Therapy. In this article, I’ll explain what co-treatment is, why therapists use it, and how combining speech and occupational therapy in one session can help your child stay engaged, regulated, and on track.

What Is Co-Treatment in Pediatric Therapy?

“Co-treatment” means two or more therapists from different fields, such as occupational therapy and speech therapy, work with your child together in a single session. This joint approach allows therapists to address different developmental goals at the same time.

In pediatric therapy, the most common pairing is speech and occupational therapy (OT). Speech therapists may also co-treat with physical therapists (PTs), but OTs typically do not co-treat with physical therapists because of insurance guidelines.

How Speech and OT Work Together in a Session

When speech and OT work together, both bring their expertise into the same activity. For example, we often use an AAC (augmentative and alternative communication) device — a tablet with TouchChat software — to help children communicate. 

A speech therapist teaches the OT how to incorporate this tool so the child can press icons to say things like “I want” or “I want to play.” Then they can choose what kind of play, such as Legos or the swing in the gym. Using first person language helps the child express their own wants and needs.

While the speech therapist supports language development, the occupational therapist works on fine motor skills needed to point at the icons and helps the child regulate their body so they can follow through with their chosen activity.

How Co-Treatment Helps Kids Stay Engaged

When children come into a pediatric clinic, it’s a brand-new environment with new people. That alone can feel overwhelming. If one therapist works on communication while another supports regulation, the session becomes more manageable and child-led.

For example, if a child chooses “swing” on the AAC device to indicate they want time on the sensory swing, the OT can help them stay calm and organized as they swing, while the speech therapist encourages them to use words or icons like “swing,” “yes,” “no,” or “more.”

During games, we might work on turn-taking. The speech therapist can model, “my turn” and “your turn,” while the OT supports regulation so the child stays engaged. If the environment is too noisy, the child can learn to communicate “stop” or “I don’t want it.” Communication helps us understand when the child is ready to move on instead of forcing an activity that will only cause frustration.

We also look at basic needs. Using the ACC device, a child can tell us “I’m hungry,” “I’m thirsty,” or “I need the bathroom.” Meeting those needs right away makes the therapy meaningful. There is no point in asking a child to complete activities if they are hungry, thirsty, or uncomfortable. They will only get more upset, and we want them calm enough to learn.

How Co-Treatment Makes Therapy Easier For Kids

When different therapy sessions are separate, children can become frustrated. In speech therapy, a child may want sensory input like swinging or bouncing, but without an OT there, it may be harder for them to regulate. In OT, a child may want to communicate their choices, but without speech support, it can be harder to know what they need.

Co-treatment solves this by letting therapists respond in the moment. For example, if a child is overstimulated and the speech therapist is struggling to keep them engaged, the OT can step in with sensory strategies. We might dim the lights, speak in a softer voice, offer a weighted lap belt or blanket, or let the child bounce on a therapy ball. With the child calmer, the speech therapist can continue working on language goals.

OTs can also ask speech therapists to add co-regulation or self-regulation strategies to a session. That might include giving the child a break, using a dark room, offering a beanbag, or building in more choices. These supports help children settle down so they are ready to learn.

How Co-Treatment Leads to Better Outcomes

Not every child needs co-treatment, but it is especially helpful for kids who have trouble sitting still, staying calm, or tolerating longer sessions. In those cases, shorter, shared sessions can be more productive than longer, separate ones.

When speech and OT collaborate, they can:

  • Teach children to identify and express emotions, such as saying “I feel good” or “I feel bad.”
  • Incorporate co-regulation strategies, like asking for a break, sitting in a beanbag, or using a quiet space.
  • Help children express preferences and dislikes, such as “I don’t like yogurt; I want ice cream.”
  • Combine skills in feeding sessions, where OT supports utensil use and speech supports communication about food choices.

 

This teamwork makes therapy more engaging, more personalized, and more effective for the child. It is also helpful for parents, who learn more about their child’s preferences and needs.

Learn More About Co-Treatment at JLD Therapy

Co-treatment is not about forcing children into therapy tasks. It is about creating a supportive, engaging environment where children feel understood and motivated. By combining goals, speech and occupational therapy can help children make steady progress in ways that feel natural and meaningful.

If you’d like to learn more about how co-treatment could support your child, contact Joy & Laughter Developmental Therapy today at (408) 337-2727 or via our website.