Plain English
What all the letters mean
Nobody hands you a translation when your child is referred to therapy. Here is one — every abbreviation on this site, and the paperwork words that go with them.
A therapist’s credentials are not decoration. They are the difference between a doctorate and a two-year degree, between board-certified and not, between someone who specializes in autism and someone who does not. You are entitled to know which is which before you hand over your child’s care — so here are all 30 of them.
If a word is holding up your child’s care and it is not here, tell us and we will add it.
Letters after a name
These are degrees and certifications. They are not interchangeable, and the difference matters when you are deciding who works with your child.
- OTDDoctor of Occupational Therapy
The doctoral degree in occupational therapy — the highest clinical degree in the field. An OTD has done several years of study beyond the master’s that used to be the standard.
Claudia Yagel earned hers at Texas Tech Health Sciences Center in 2022.
- MOTMaster of Occupational Therapy
The master’s degree in occupational therapy. For years this was the entry-level degree required to practice.
- OTROccupational Therapist, Registered
National board certification. It means the therapist passed the national exam and keeps the certification current — separate from, and in addition to, the state license required to practice in Texas.
Issued by: NBCOT — the National Board for Certification in Occupational Therapy
- OTAOccupational Therapy Assistant
A therapy professional with their own two-year degree who delivers treatment under an occupational therapist’s supervision. The OT writes the plan; the OTA is very often the person your child actually sees each week.
- COTACertified Occupational Therapy Assistant
An occupational therapy assistant who has passed the national certification exam. The C is the certification, not a separate job.
Issued by: NBCOT — the National Board for Certification in Occupational Therapy
Shelley, Silvia and Samantha hold this credential.
- CASCertified Autism Specialist
A certification for professionals who work specifically with autistic people. It requires a qualifying degree, documented experience, and continuing education to keep.
Issued by: IBCCES — the International Board of Credentialing and Continuing Education Standards
- IBCCESInternational Board of Credentialing and Continuing Education Standards
The body that issues the Certified Autism Specialist credential and related certifications for clinicians, educators, and organizations.
- NBCOTNational Board for Certification in Occupational Therapy
The national body that certifies occupational therapists (OTR) and occupational therapy assistants (COTA) in the United States.
The three therapies
Children are often referred for more than one. They overlap, and a good team talks to each other about your child rather than working in three separate lanes.
- OTOccupational therapy
The “occupation” of a child is being a child — dressing, eating, writing, playing, coping with a noisy room. Occupational therapy builds the everyday skills that let a child take part.
More on our occupational therapy page.
- PTPhysical therapy
Movement: strength, balance, coordination, walking, and the gross motor skills a child needs to keep up with other children.
- PTAPhysical Therapist Assistant
A licensed professional who delivers physical therapy under a physical therapist’s supervision — the same relationship an OTA has to an OT.
- DPTDoctor of Physical Therapy
The doctoral degree in physical therapy, and now the standard entry-level degree for new physical therapists in the United States.
- SLPSpeech-Language Pathologist
The formal title for a speech therapist. The work covers far more than pronunciation — understanding language, being understood, social communication, and often feeding and swallowing.
- SLP-ASpeech-Language Pathology Assistant
A therapy professional with their own degree who delivers speech therapy under a speech-language pathologist’s supervision — the same relationship an OTA has to an OT.
Marie holds this credential.
- STSpeech therapy
The everyday name for the work a speech-language pathologist does. You will see both terms used for the same thing.
Words you will hear in a session
These come up in evaluations, progress notes, and school meetings. None of them are as technical as they sound.
- ASDAutism Spectrum Disorder
The clinical name for autism. “Spectrum” means it presents differently in every person — which is why a plan built for one autistic child is not the plan for another.
- SPDSensory Processing Disorder
Difficulty taking in and organizing everyday sensory information — sound, light, texture, movement. A child may be overwhelmed by a noisy classroom, or may seek out constant motion.
- Sensory regulation
Staying in a state where you can pay attention and take part. When a child is over- or under-stimulated, learning stops until the body settles — so therapists work on settling first.
- ADLsActivities of Daily Living
The ordinary self-care tasks of a day: dressing, bathing, brushing teeth, using utensils, using the bathroom. Progress is usually measured here rather than in abstract skills.
- Fine motorFine motor skills
The small, precise movements — holding a pencil, doing up buttons, using scissors, turning a page.
- Gross motorGross motor skills
The big movements — sitting up, walking, running, climbing, throwing, keeping balance.
- Evaluation
The first full appointment. A therapist works with your child, asks you a lot of questions, and writes up what they find. It is where a plan of care comes from — nothing is decided before it.
- Plan of care
The written plan after an evaluation: the goals, how often your child is seen, and for how long. It is reviewed and updated as your child changes.
Insurance and paperwork
The part nobody explains. If a term here is holding up your child’s care, call us and ask — we would rather answer it than have you guess.
- Referral
A note from your child’s doctor saying therapy is medically needed. Most insurance plans require one before they will pay, and Texas Medicaid requires a physician referral.
You do not need one to call and ask a question.
- MCOManaged Care Organization
The private health plan that runs your Texas Medicaid benefit day to day. Your card usually shows the MCO’s name rather than the word Medicaid, which is why families often are not sure what they have.
- CHIPChildren’s Health Insurance Program
Texas health coverage for children in families that earn too much for Medicaid but cannot readily afford private insurance.
- ECIEarly Childhood Intervention
The Texas program serving children from birth to age three with developmental delays or disabilities. Many families meet therapy for the first time through ECI, and then need a provider once a child turns three and ages out.
- IEPIndividualized Education Program
The legal document a public school writes for a student who qualifies for special education. It sets goals and the services the school provides — school therapy and private therapy are separate things, and a child can have both.
- Home health
Therapy delivered in your home rather than at a clinic. The therapist comes to you, and works on skills in the room where your child actually needs them.
Still not sure what you are looking at?
Bring the letter, the referral, or the insurance card to the phone with you and read it to us. Working out what a document means is not a service we charge for — it is just the first thing that has to happen.
Now that the letters make sense
If you are ready to talk about your child, we can start with an evaluation — or just a question.