Choosing Between Speech Pathology or Occupational Therapy

For those with a desire to help others develop, improve, recover, or find alternatives to the skills needed in everyday life, speech pathology and occupational therapy are both excellent career choices. Because these careers help others in similar ways, many aspiring healthcare professionals struggle to decide which field to pursue. While there are many similarities between the two fields in terms of how both professionals work with patients, this article will talk about some of the differences that may help you decide which path to choose.

Sponsored online speech pathology programs

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Speech@Emerson enables you to earn an MS online and pursue SLP certification in as few as 20 mos. Learn the same curriculum as the on-campus program. Study FT or PT.

• Prepares you to pursue certification as an SLP generalist
• In-person clinical placements at faculty-approved partner sites
• As few as 20 months to complete

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Online MS in Speech-Language Pathology from Pepperdine University

Pepperdine University’s online Master of Science in Speech-Language Pathology program combines a robust, innovative curriculum rooted in Christian values with a full-time or part-time option that features online learning, on-campus intensive experiences, and comprehensive clinical field practicums to prepare skilled, compassionate students for careers as speech-language pathologists. 

• Full-time (five trimesters) or part-time (eight trimesters) options available.
• No GRE scores required.
• 400+ supervised, clinical learning hours are done at schools/clinics local to students
• Three onsite experiences build a sense of camaraderie and community throughout the program

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Want to Become an SLP? Earn an MS Online at NYU

NYU Steinhardt’s online master of science program in Communicative Sciences and Disorders prepares aspiring speech-language pathologists with a comprehensive professional education.

• Prepares students to pursue SLP licensure 
• Accredited by ASHA’s Council on Academic Accreditation 
• As few as six terms to complete 
• Full-time and part-time plans of study

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Occupational therapists (OTs) use everyday activities as therapy to treat disability, illness, or injury. The goal of occupational therapy is to optimize a patient’s daily living and working experience, either through the improvement, development, or recovery of skills or through the adaptation of the patient’s environment. Occupational Therapists help patients across the lifespan, from children with developmental disabilities to seniors undergoing cognitive change. Since occupational therapists work on whole-body movements and activities, they are more likely to be physically active during the workday as they demonstrate exercises and move equipment.

Speech-language pathologists (SLPs) treat patients with a wide range of speech, language, swallowing, fluency, voice, and cognitive disorders to help them communicate more effectively. Like OT’s, the goal of SLPs is to optimize their patient’s living experience, either through the improvement of their ability to communicate or by providing them with alternative ways of communicating so that they can be heard. SLPs also treat across age groups in a variety of settings. 

So, if you are interested in helping people improve their ability to communicate, speech pathology careers may be of interest to you. If you are more interested in helping others develop the skills needed to complete physical tasks, occupational therapy may be the best fit.

While speech-language pathologists and occupational therapists work with patients on different sets of issues, there are many similarities in the approach to helping patients in both careers:

Evaluation: Assessing and evaluating patients for issues and disorders is a key responsibility for both SLPs and OTs

Treatment and Treatment Plans: Both OTs and SLPs must use what they have learned from evaluating their patients to develop treatment plans and execute them. Both professions are highly evidenced based, utilizing research to implement proven treatments

Evaluate Treatment Effectiveness: Once speech pathology or occupational therapy treatment plans are in place, it is important to be able to evaluate whether or not they are working, so that those plans can be adjusted to optimize outcomes for patients

Family Education: Many therapy patients either have disabilities that require help from caregivers, are young children who need help continuing treatment outside of therapy sessions, or have other needs that require family education. SLPs and OTs are charged with educating families about injuries and disorders, including what families can do to help patients benefit from therapy as much as possible, and with improving patients’ home environments for their condition.

Both speech pathology careers and occupational therapy careers require master’s degrees and state certification. Here is some more information on the path to becoming each.

Before applying to a speech pathology master’s program, students must meet prerequisite requirements. While some programs allow students to complete foundational speech pathology coursework in the early semesters of the program, most require students to complete several foundational courses before applying. Some programs will also require that the student has spent a certain number of hours observing speech pathologists before applying.

Speech pathologists must earn a master’s degree, which typically takes 2-3 years to complete. As part of this degree, students will complete the coursework needed to prepare to become speech pathologists and will also complete clinical and field requirements required by most states for certification or licensure.  Speech-language pathology master’s programs are typically designed to meet ASHA certification requirements, which include at least 400 hours of supervised clinical experience.

Sponsored online speech pathology programs

Online MS: Pursue SLP Certification. Study FT/PT

Speech@Emerson enables you to earn an MS online and pursue SLP certification in as few as 20 mos. Learn the same curriculum as the on-campus program. Study FT or PT.

• Prepares you to pursue certification as an SLP generalist
• In-person clinical placements at faculty-approved partner sites
• As few as 20 months to complete

Request more info from Emerson College.

info AD

Online MS in Speech-Language Pathology from Pepperdine University

Pepperdine University’s online Master of Science in Speech-Language Pathology program combines a robust, innovative curriculum rooted in Christian values with a full-time or part-time option that features online learning, on-campus intensive experiences, and comprehensive clinical field practicums to prepare skilled, compassionate students for careers as speech-language pathologists. 

• Full-time (five trimesters) or part-time (eight trimesters) options available.
• No GRE scores required.
• 400+ supervised, clinical learning hours are done at schools/clinics local to students
• Three onsite experiences build a sense of camaraderie and community throughout the program

Request more info from Pepperdine University.

info AD

Want to Become an SLP? Earn an MS Online at NYU

NYU Steinhardt’s online master of science program in Communicative Sciences and Disorders prepares aspiring speech-language pathologists with a comprehensive professional education.

• Prepares students to pursue SLP licensure 
• Accredited by ASHA’s Council on Academic Accreditation 
• As few as six terms to complete 
• Full-time and part-time plans of study

Request more info from New York University.

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Speech pathologists do not need a doctoral degree to become certified and practice in any state.

After completing a speech-language pathology graduate program, new SLPs typically complete a post-graduate Clinical Fellowship (CF) to qualify for ASHA certification (CCC-SLP) and to meet many states’ licensure requirements.  ASHA requires the CF to include at least 36 weeks and 1,260 hours of mentored professional experience, completed under a qualified ASHA-certified CF mentor (CCC-SLP). During the CF, fellows build independent-practice skills with structured mentorship. ASHA expects the CF to be completed in three segments, with required observation and mentorship activities in each segment. 

The current passing score for the Praxis Speech-Language Pathology exam (5331) for ASHA certification is 162, as confirmed by the American Speech-Language-Hearing Association (ASHA). 

Speech-language pathologists (SLPs) generally must be licensed by the state to practice. In addition, many SLPs pursue ASHA’s Certificate of Clinical Competence (CCC-SLP), a widely recognized national credential. While ASHA offers a national certification, it is not required in all states (though most states have equivalent standards). For state licensure, you’ll apply through your state’s speech-language pathology licensing board and follow that state’s rules. For ASHA certification (CCC-SLP), you apply through ASHA and must meet ASHA’s certification standards. Once you’re licensed, you can practice in that state as long as you keep your license active and meet renewal requirements. If you also hold the CCC-SLP, you’ll need to meet ASHA’s certification maintenance requirements to keep that credential in good standing.

The American Occupational Therapy Association (AOTA) does not prescribe one universal set of prerequisite courses for all programs. Instead, each program sets and publishes its own admissions criteria, including any required prerequisites, such as education or work experience.

Occupational therapy master’s programs typically take 2-3 years to complete. In addition to required coursework, students must complete Level I and Level II Fieldwork as part of the program. OT programs include Level I and Level II Fieldwork. For Level I Fieldwork, AOTA does not require a minimum number of hours, so the structure is set by each program. For Level II Fieldwork, ACOTE standards require a minimum of 24 weeks of full-time equivalent, which may be completed full-time or part-time (as permitted by the program and site policies).

Although a master’s degree will suffice for earning certification at this time, AOTA/Accreditation Council for Occupational Therapy Education (ACOTE) will require all entry-level OTs to have a doctorate from July 1, 2027 onward.

To become NBCOT-certified as an occupational therapist, you must pass the NBCOT certification exam. You must apply through NBCOT and submit your official final transcript (or a Degree Verification Form, when applicable). First-time applicants also complete a character review as part of the application (including required character questions and, in many cases, a background check). Once your application is approved, NBCOT will issue an Authorization to Test (ATT) so you can schedule your exam. If you pass, you become NBCOT-certified (national certification). You’ll still need to meet your state’s licensure requirements to practice.

After earning your national certification, make sure to check with your state on occupational therapy licensure requirements so that you can become licensed to practice in that state. After receiving state licensure, continue to follow all state and national renewal requirements.

Speech pathology and occupational therapy are both high-growth fields with strong earning opportunities:

Although both SLPs and OTs are needed in many different settings and provide services to a variety of populations, there are some differences in where these professionals typically work. According to the BLS, 40% of speech pathologists work in educational services, compared to 13% of OTs. There are certainly many occupational therapists in educational settings, but one who aims to work in a school may want to keep this in mind.

BLS data show that occupational therapists most commonly work in hospitals (28%), followed by offices of physical, occupational and speech therapists, and audiologists (27%), educational services (13%), home healthcare services (8%), and nursing care facilities (7%). For speech-language pathologists, the largest employers are educational services (40%), therapy offices (26%), hospitals (14%), and nursing and residential care facilities (4%). SLPs and OTs are similarly likely to work in therapy offices: BLS lists 26% of speech-language pathologists and 27% of occupational therapists in offices of physical, occupational and speech therapists, and audiologists.

Information last updated: February 2026