Other OT-Related Information Can you help me decide Speech Pathology and OT?

[BubbleGumDreams]

It's great to find this forum because it is notoriously difficult to find OT forums on the internet! I am hoping that some of you OTs and OTs-to-be can give me some guidance about the career and the application process. I've flip-flopped between SLP and OT for quite a long time but I want to make sure I pick the right path before I spend more money on potentially-unnecessary schooling.

Why did I choose speech pathology? I graduated with degree in Spanish Education and I was fascinated by my courses in linguistics, child development, special education, etc. I am currently taking pre-requisite courses online as I teach English abroad, and although I only have two completed, I am taking three this semester. From what I see in my courses, there is a lot of carry-over from my undergraduate degree. I also enjoy helping children communicate because communication is so crucial to quality of life. My heart feels in the right place with this degree but some of the things that make me very apprehensive about the field. First, I am very nervous about job settings. I know that speech pathology is known for being in-demand, but most of these jobs are with schools or SNFs. I know that there are pros and cons to anywhere you work, but speech pathologists in the schools seem overworked and stressed out to the max. Our accrediting body recommends a maximum caseload of 40 students, but I've seen SLPs giving therapy to 70-90 students. I don't mind paperwork but the demands of the paperwork on top of planning for lessons to give therapy to such a large caseload are enough to stress anyone out. While some school-based SLPs thoroughly enjoy their jobs, there are constant complaints of this issue on SLP message boards.

As for SNFs, I enjoy working with the elderly but I don't think I would enjoy swallow therapy, which is what most of the job is! And while I enjoy language in theory, I'm not sure if I would enjoy therapy. I want to keep my creative side but have things be a little more 'cut and dry'. Speech can be hard to quantify or put into measurable units and progress for some children can be slow. It's exciting to be part of a relatively new field, but that also means that there isn't a huge research base for SLP. There's a big focus on evidence-based practice but there's so much that we don't know about yet. Does this happen with OT as well? I would guess no, since a lot of the job deals with knowing anatomy to complete meaningful activities or ADLs. I do know that there is a lot of controversy about sensory integration and lacking evidence to support it, however. Another issue that frustrates me about speech is the path to specialization. There are certain certifications that you can get such as PECs and Floortime, but there are a limited number of certifications to specialize in other areas. It seems like with OT, there are more.

However, there are some perks to speech- opening up your private practice seems much easier, and teletherapy is growing as a service model for people who would like to work at home. But OT has been in the back of my mind for a long time and it seems like the OTs that I know thoroughly enjoy their jobs and don't have the same complaints as SLPs. Am I living in a Utopia or is job satisfaction fairly high among OTs? It also seems like a great career for work-life balance. People say the same about SLP but I know several SLPs who take sizable amounts of paperwork home and prep lessons on their off hours. OT seems to have all the things that I like about SLP (autonomy, creativity, in-demand, helping others) while providing a better work-life balance and more day-to-day variety. Plus, the salary seems better too.

Applying and taking courses
If I decide to go into OT, I know that I need shadowing hours. I had observed some OTs at the speech clinics that I went to, but they were very brief. Is cold-calling the best way to observe? What places should I call? Speech clinics, hospitals, etc.? I have also tried to watch OT sessions on Youtube but it's hard to get a feel for the profession that way.

Is it possible to take pre-requisite courses online? I will be teaching in Brazil next year and it would be great to observe some OTs there, and it would look great on a statement of purpose. I will be 24 years old when I get back from Brazil and I really don't want to wait another year to take the pre-reqs. If I could find a steady job while taking those courses on the side, it wouldn't be too bad, but I am nervous about wasting too much time. I haven't taken A&P, which I am hesitant about because I have no background in science. I've taken abnormal psychology and stats, and also child development (but I need lifespan development, I think). It's a bit confusing because graduate school pre-reqs seem different for every school. If you applied to multiple graduate schools, how did you handle the discrepancies in pre-reqs needed?

I'm also nervous about the GRE (especially math) and pre-req letters. I had a 4.0 in my undergraduate and speech courses, and I know lots of people who could write me recommendation letters for SLP but not for OT.

So to wrap this up, do you think that OT sounds like a better fit for me, and how do I go about planning to get into graduate school? Also if any of you considered SLP before or have worked with SLPs, I would love to hear your perspectives about some similarities and differences between our fields. Thanks so much!

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[c2902]

To touch on a few points in your post:
With regard to things being more "cut and dry" in OT - that's not always the case. OT is not just focused on ADLs and biomechanics; as it originated in the mental health world, we focus on the client (not "patient") as a holistic being. It's not just looking at their physical limitations and seeing how much movement they've lost, but how that loss impacts their ability to be independent, how their home/work/community environment supports or prohibits meaningful participation, how their own self-concept and motivation informs how they perform an activity, etc. So depending on your setting, it won't just be about taking measurements with a goniometer and writing down how many degrees of shoulder flexion they've achieved since the last time you saw them. Similarly, the body of OT-specific literature is smallish, as much of our research is culled from other disciplines, so there aren't always tons and tons of systematic reviews for every single intervention. That being said, the profession is pushing for more evidence-based practice and focus on doing more high-level research, so things may change. Sensory Integration has more research to back it up than it did 10 years ago, though it's still not where the bulk of high-level studies are (for a number of reasons), but this is not to say that it's invalid as a frame of reference for treatment. insurance companies love measurable results, but parents may not care, as long as it works for their child (and for many, it does).

With regard to prereqs, most, though not all OT programs will accept online work, with the exception of A&P, which nearly all of them want as a live class. When I was looking at programs, I applied to schools that had similar requirements in order to keep from spending thousands of dollars on classes I may not need. I worked full time while I took classes, and did A&P at night at the local community college (I am a career-changer, so I had a ton of classes to take and did them all a CC - most programs don't mind).

With regard to shadowing an OT, call private clinics, hospitals, skilled nursing facilities and other long-term or post-acute rehab settings, and schools (though some schools won't allow observers, but it's worth a call). Cold calling is fine, but be prepared to be persistent and call back multiple times. Many places get tons of requests so you have to be a little bit pushy (but polite) in order to get through. Some places won't be able to give you all of the hours your applications require, but take what they offer, even if it's just a day. Try to observe with kids and adults, if you can. OT is much more than just ADLs and fine motor skills, even if in some settings, it may feel that way.

Hope this helps some!

 

[brisa2004]

I'm not sure where you're at in the decision-making process since your post is a few months old but thought that I would share my experience. I have practice as an OTR for 6 years and really enjoy my job/field. There are definitely some similarities between speech and OT. You have the focus of helping others, being creative and there is a cognitive focus in each field. However, OT is a mixture between physical and cognitive which I love--I wouldn't want to do just the physical element like PT or just cognitive like SLP. It's been my experience that if you are looking to do the straight cognitive part of someone's rehab, then speech is the way to go because they go with more depth into memory, sequencing etc with the use of worksheets, oral motor exercises and memory strategies. You could work on all of this but in a practical way, such as see if the person can go through the sequencing and memory of how to get dressed in the morning which is more practical in my opinion. It sounds like you really enjoy the communication piece of things--that would be primarily a speech area. OT does not focus on helping people pronounce words correctly. However, I should mention that in some settings, including pediatrics, OT can also work with people who have trouble swallowing. When a person has trouble eating, OT would help with getting the food to their mouth while speech would generally help with actual mastication and swallowing.

I've worked in the transitional care units (short term rehab after a hospitalization), long term care and home health. I do not have any experience in the schools for have a few OTR friends who work in the schools. The OTs in the schools also have big caseloads and they have a lot of paperwork too. I believe the term is an IEP plan for each student that they must maintain and like you said, progress is slow. Home health can also have take home paperwork, whether you are OT or SLP. I do not have any take home paperwork when I work in the transitional care units and when I was a fieldwork student at a hospital, it also involved much less paperwork.

It seems to be my experience that jobs are more plentiful for OTs than SLP. Private practice almost always has both OT and SLP as well as PT. But jobs seems more available in OT because there are more specializations that you can do as an OT. There is hand therapy, sensory integration, wheelchairs/assistive technology, driving safety, ergonomics and Lymphedema to name just a few. I just became certified in Lymphedema in 2013 and now I'm doing some overlap with PT as I wrap people's legs and have them do leg exercises! I like that if I wish to change areas, I can go to another specialization without having to go back to school for another degree. My current employer paid completely for me to get the Lymphedema certification including refresher/advanced courses.

With regard to shadowing, try to shadow as much as possible in whatever settings interest you. Try to network with anyone you might know who could help you set up shadowing. Try to find places that hire floats because if you can shadow a float, you will see the vast variety of diagnoses that they treat. I work as a full time float in physical disabilities and see anything from strokes to hip surgeries to cardiovascular problems to dementia.

I wouldn't worry about the academic part. I am not good at math and all I needed to take to get in was statistics which made sense to me because it is practical math. I never did trigonometry and calculus. Anatomy will be easy for you if you are a visual learner. Physiology is a good preparation for seeing the big picture that you need to do as a clinician. If you work hard, you can be successful at those subjects because psychology can be very difficult too. I wouldn't discount your academic background.

Talk to as many OTs and SLPs as possible and the answer will gradually come to you. Good luck on your decision!

 

[Osillyphilly]

You should volunteer with both. This is your future don't have us decide. You need to decide for yourself and the only way you will find out if it is right for you is by dipping in and experiencing what's it's like.