Your child's IFSP lists three therapies: speech, occupational, and physical. You've got therapists coming to your home twice a week, sometimes three times. But when you watch the sessions, you're not always sure what each person is working on or why your child needs all three. The disciplines overlap in ways that aren't obvious at first. A speech therapist might work on feeding. An occupational therapist might focus on play. A physical therapist might spend most of the session on the floor with toys, guiding your child through a movement they haven't quite figured out yet.

Here's what each discipline does, how they work together, and what to look for during sessions so you can carry the work forward at home.

What Speech Therapy Addresses in Early Intervention

Speech therapy in early intervention focuses on communication and feeding, not just talking.

If your child isn't babbling by 6 months, isn't using gestures like pointing or waving by 12 months, or isn't combining words by 24 months, speech therapy targets those milestones. But it also addresses how your child uses sounds and gestures to communicate needs before words develop.

A speech-language pathologist (SLP) works on:

• Pre-language skills: eye contact, joint attention, turn-taking in play, responding to their name
• Expressive communication: babbling, first words, word combinations, using gestures to request or comment
• Receptive language: following simple directions, understanding questions, recognizing familiar words
• Feeding and swallowing: latching, moving food from front to back of mouth, transitioning to solid textures, drinking from a cup

Speech therapy goals for a 10-month-old might include babbling with consonant-vowel combinations (ba-ba, da-da) and using gestures to show or request objects. For a 20-month-old, goals might target a 50-word vocabulary and combining two words together (more milk, bye-bye dog).

The SLP teaches you strategies to use during daily routines. Narrating what you're doing during diaper changes, pausing during songs to give your child time to fill in a word, or modeling simple words during play all count as language intervention. The therapist shows you how; you practice it all week.

What Occupational Therapy Addresses in Early Intervention

Occupational therapy focuses on fine motor skills, sensory processing, self-care, and play.

If your child struggles with grasping small objects, tolerating different textures, feeding themselves, or engaging with toys, OT addresses those areas.

An occupational therapist works on:

• Fine motor skills: reaching, grasping, transferring objects hand to hand, pincer grasp, using utensils, stacking blocks
• Sensory processing: tolerating different textures (grass, sand, food), regulating responses to sound or light, seeking or avoiding movement
• Self-care skills: self-feeding, drinking from a cup, participating in dressing
• Play skills: exploring toys appropriately, cause-and-effect play, pretend play

OT goals for a 9-month-old might include reaching for and grasping toys with both hands and transferring objects from one hand to the other. For an 18-month-old, goals might include self-feeding with a spoon, stacking three blocks, or tolerating messy textures during mealtime and play.

OT sessions often look like play. The therapist might bring textured balls, stacking cups, or finger foods. What looks like simple play is targeting specific motor skills or sensory responses. When the therapist encourages your child to reach for a toy across their body, that builds crossing midline. When they offer yogurt on a spoon, they're working on self-feeding and oral motor coordination.

The therapist coaches you on how to set up opportunities for these skills during your day. Putting toys slightly out of reach encourages reaching. Offering finger foods at every meal builds self-feeding. You become the primary teacher; the therapist shows you what to practice.

What Physical Therapy Addresses in Early Intervention

Physical therapy targets gross motor skills: rolling, sitting, crawling, walking, strength, and coordination.

If your child isn't rolling by 6 months, sitting independently by 9 months, crawling by 12 months, or walking by 18 months, PT addresses those delays.

A physical therapist works on:

• Gross motor milestones: head control, rolling, sitting, crawling, pulling to stand, cruising, walking
• Strength and endurance: core strength, leg strength, stamina for movement
• Balance and coordination: weight shifting, maintaining balance during movement, coordinating arms and legs
• Mobility: moving through space, transitioning between positions (floor to sitting, sitting to standing)

PT goals for a 7-month-old might include sitting independently for 30 seconds and rolling from back to stomach in both directions. For a 14-month-old, goals might include walking 10 feet independently and climbing onto furniture safely.

PT sessions happen on the floor. The therapist positions your child to encourage movement, uses toys to motivate reaching or crawling, and guides your child through transitions between positions. When they place a toy just out of reach while your child is sitting, they're working on balance and reaching without falling. When they hold your child's hands while they walk, they're building strength and coordination.

The therapist shows you how to position your child during play, what movements to encourage, and how to create opportunities for practice. Tummy time isn't just lying on the floor; it's a chance to build neck and shoulder strength. Floor play isn't just for fun; it's how your child learns to move.

How the Therapies Work Together

Your child's development doesn't happen in separate boxes. Communication requires motor skills. Self-feeding requires coordination. Play requires attention and movement. When therapists design goals that intersect, they're working with how your child grows, not how development looks on an evaluation checklist.

An 18-month-old working on self-feeding might have goals across all three disciplines:

• Speech therapy: using words to request food (more, please, milk)
• Occupational therapy: using a spoon independently, tolerating different food textures
• Physical therapy: sitting upright in a chair with trunk control

The goals overlap. The SLP might work on requesting during snack time. The OT might focus on the mechanics of scooping and bringing the spoon to the mouth. The PT might address the postural stability that makes self-feeding possible. They're all working on the same mealtime routine from different angles.

Or take a 10-month-old learning to crawl:

• Physical therapy: building core strength, practicing weight shifting and reciprocal movement
• Occupational therapy: reaching for toys to motivate movement, using both hands during play
• Speech therapy: using sounds to express excitement or frustration during movement, responding to your encouragement

The team coordinates goals so they support each other. Your child practices the same skills across sessions and routines, with each therapist targeting a different piece of the same developmental task.

Service Frequency and Delivery Models

Early intervention services are documented in your child's IFSP, which specifies how often each therapy occurs and where.

Typical frequencies range from:

• Weekly sessions: one 45-60 minute session per week per discipline
• Bi-weekly sessions: two sessions per month
• Monthly consultative sessions: therapist works with you to create strategies, not directly with your child

Frequency depends on your child's needs and your state's guidelines. A child with significant delays across multiple areas might receive three therapies weekly. A child with needs in one area might receive one therapy bi-weekly.

Home-based services are the most common model for birth-to-3 programs. The therapist comes to your home, works with your child in their natural environment, and coaches you on strategies to use between sessions. Home-based doesn't mean isolated. The therapist is part of a coordinated team.

Clinic-based services are less common in Part C early intervention but may be offered for specific needs like feeding therapy or intensive motor intervention. Clinic-based sessions provide access to specialized equipment but may feel less connected to your daily routines.

Consultative services involve the therapist meeting with you to develop strategies, observe your child, and adjust the plan without providing direct therapy each visit. This model works when your child is making progress and you need guidance more than hands-on intervention.

What to Look for During Sessions

You're not just watching therapy; you're learning it so you can continue the work all week.

During a session, notice:

• What the therapist is doing differently than you would: How are they positioning your child? What cues are they giving? What words are they using? Those are the strategies you'll practice.
• What motivates your child: Which toys hold their attention? What makes them reach or move? You'll use those same motivators between sessions.
• What the goal looks like: When the therapist says "we're working on sitting balance," watch what that means in practice. Are they removing hand support? Placing toys to the side? That's the skill being built.

After the session, ask:

• What should I practice this week?
• What does success look like for this goal right now?
• How do I know if this strategy is working?

Your child's therapists aren't there to "fix" your child in a 45-minute session once a week. They're there to teach you what to do the other 167 hours. The more you understand what they're targeting and how they're doing it, the more effective your child's intervention becomes.

Common Questions Parents Ask

Why does my child need multiple therapies?

Because development is interconnected. A child who isn't sitting yet (PT) may struggle with self-feeding (OT) and may not have the postural support for clear speech sounds (ST). Addressing all three areas together produces better outcomes than focusing on just one.

How long will my child need therapy?

That depends on your child's progress and ongoing needs. Some children catch up within a year and exit services. Others continue through age three and transition to preschool special education. Progress is reviewed every six months through IFSP updates.

What if I don't see progress?

Bring it up at the next IFSP meeting or before if you're concerned. Goals should be adjusted based on what's working. If a strategy isn't producing change after several weeks, the team revises the approach or increases intensity.

Can I request a different therapist?

Yes. If the relationship isn't working or you feel the therapist isn't a good fit, you can request a change. Your service coordinator can help facilitate that.

What happens when my child turns three?

Part C early intervention ends at your child's third birthday. If your child still has delays that impact their education, they may qualify for preschool special education under Part B of IDEA. The transition process begins 90 days before their third birthday.

Moving Forward

You don't need to become an expert in child development to support your child's therapy. You need to know what each therapist is targeting, what to practice at home, and how the pieces fit together.

Watch sessions with intent. Ask questions when you don't understand why the therapist is doing something. Request written strategies you can reference during the week. The therapists are there once or twice a week. You're there every hour in between.

The small moments you create at home count more than they might seem: the extra reach for a toy just out of range, the waiting beat during a familiar song, the messy meal where they practice with a spoon. Your child's therapists are helping you see what to do with those moments. That's the whole point of early intervention.