Which kind of help do we need?

Speech-language pathologist (SLP)

What the profession does

SLPs work with communication and swallowing across the whole lifespan — speech therapy is not limited to how clearly someone pronounces words.

Concerns it may help with

Understanding and using language, speech-sound production, motor speech (including apraxia), AAC, social communication, literacy, stuttering and voice, cognitive-communication, and feeding or swallowing when the SLP has that specific training.

Training or licensure background

A master’s degree, supervised clinical fellowship, and national exam lead to ASHA certification (CCC-SLP). Tennessee licenses SLPs through the Board of Communication Disorders and Sciences.

The lens it commonly brings

Communication and swallowing — how understanding, expression, or eating safety affects someone’s ability to take part in daily life.

What an evaluation may involve

Standardized testing, informal observation, a case history, and sometimes an instrumental swallowing study.

What treatment may look like

Individual or group sessions building specific skills, AAC trials and setup, caregiver coaching, and collaboration with school or medical teams.

What it does not automatically provide

Fine-motor or sensory-processing treatment, gross-motor treatment, a medical diagnosis, or medication.

When another professional may be needed

Suspected hearing loss (an audiologist), oral-motor or sensory feeding concerns beyond communication (OT or a feeding team), or a broader diagnostic question (a psychologist or developmental pediatrician).

Questions to ask before starting

• Do you have specific training in AAC, feeding, or [the exact concern]?
• How will you know my child understands, even before they can show it?

Red flags

• Treats a nonspeaking person as though they can’t understand.
• Withholds AAC as a reward, or takes it away as a consequence.

Occupational therapist (OT)

What the profession does

OTs help people participate in the everyday activities — “occupations” — that make up their lives, from dressing to school to work. OT is not limited to handwriting.

Concerns it may help with

Dressing, toileting, eating, play, school and work participation, sensory processing, self-regulation, fine and visual-motor skills, adaptive equipment, and environmental access.

Training or licensure background

A master’s or doctoral degree plus a national exam lead to the OTR credential. Tennessee licenses OTs through the Board of Occupational Therapy.

The lens it commonly brings

The fit between the person, the activity, and the environment — sometimes the person builds a skill, and sometimes the task or environment changes instead.

What an evaluation may involve

An occupational profile built from the person’s own goals, observation of daily tasks, and standardized testing when it’s useful.

What treatment may look like

Activity-based sessions, sensory strategies, adaptive equipment and training in its use, and coaching for family or school staff.

What it does not automatically provide

Speech or language treatment, gross-motor conditioning at a PT’s intensity, or a medical diagnosis.

When another professional may be needed

A communication concern beyond what supports the OT goal (SLP), a strength or mobility concern beyond fine motor (PT), or a feeding concern that’s primarily medical (a feeding team or physician).

Questions to ask before starting

• Is handwriting the actual goal, or one piece of something bigger?
• How will you involve me in choosing which daily activities matter most?

Red flags

• Reduces OT to handwriting practice alone.
• No mention of sensory or regulation needs when they’re clearly part of the picture.

Physical therapist (PT)

What the profession does

PTs address how the body moves — strength, endurance, balance, coordination, and the mechanics of movement and pain.

Concerns it may help with

Gross motor delays, walking and gait, transfers, balance, coordination, chronic or post-injury pain, mobility equipment, positioning, and safe access to spaces.

Training or licensure background

Since 2016, U.S. PTs complete a Doctor of Physical Therapy (DPT) degree and a national licensing exam. Tennessee licenses PTs through the Board of Physical Therapy; PTs can be seen without a referral.

The lens it commonly brings

Movement and mechanics — what’s limiting the body physically, and how to build strength or work around it safely.

What an evaluation may involve

Observation of movement, strength and range-of-motion testing, and a plan built around functional goals like walking further or transferring more safely.

What treatment may look like

Exercise, movement practice, gait training, equipment fitting (walkers, wheelchairs, orthotics), and family or caregiver training.

What it does not automatically provide

Communication, feeding, or sensory and emotional-regulation treatment — those sit with other professions, even when movement overlaps with those needs.

When another professional may be needed

Pain with an unclear medical cause (a physician), equipment-funding questions (see the Resource Directory’s equipment categories), or movement avoidance that’s really about sensory needs (OT).

Questions to ask before starting

• What does “progress” look like in terms I’d actually notice at home?
• Will you train me or the school so the plan continues outside sessions?

Red flags

• Pushes through clear pain or fear without adjusting.
• No functional, everyday-life goal behind the exercises.

Feeding and swallowing team

What the profession does

Feeding difficulties can be medical, developmental, sensory, or some mix of all three — a feeding team exists to sort out which, because treating the wrong one doesn’t help.

Concerns it may help with

Swallowing safety, growth concerns tied to eating, extremely limited diets, oral-motor skills, sensory food aversions, and mealtime stress.

Training or licensure background

Not one credential — typically an SLP or OT for oral-motor/sensory skills, a dietitian for nutrition, and a physician or GI specialist for medical causes, sometimes in one clinic and sometimes coordinated separately.

The lens it commonly brings

Is this medical, developmental, sensory, or behavioral first — and often, it’s more than one at once.

What an evaluation may involve

A swallow-safety screening or instrumental study when indicated, a feeding and mealtime history, a growth and nutrition review, and observation of an actual meal.

What treatment may look like

Oral-motor and sensory-based feeding therapy, structured mealtime approaches, nutrition support, and caregiver coaching — rarely one piece alone.

What it does not automatically provide

A single fix from a single provider — expect referrals across SLP, OT, dietitian, GI, and primary care rather than one appointment solving everything.

When another professional may be needed

Any sign of choking, coughing or a wet voice with liquids, or poor weight gain — see a physician first, not last.

Questions to ask before starting

• Has swallowing safety been ruled in or out?
• Who is tracking nutrition while we work on skills?

Red flags

• Treats all feeding difficulty as purely behavioral without checking medical or sensory causes.
• Uses pressure, force, or punishment around eating.

Counselor or psychotherapist

What the profession does

Talk-based mental-health treatment for anxiety, depression, trauma, grief, relationships, and coping — for the person themselves, a family, or both.

Concerns it may help with

Anxiety, depression, trauma, grief, identity, self-esteem, adjustment to a diagnosis or life change, family relationships, and parent or caregiver support.

Training or licensure background

Credentials differ by license, each needing a graduate degree, supervised clinical hours, and an exam. Tennessee licenses LPC-MHSPs, LMFTs, and clinical pastoral therapists through one counseling and family therapy board; LCSWs through the Board of Social Worker Licensure; psychologists separately (see below).

The lens it commonly brings

How the person feels, copes, and relates — and how the people around them are doing too.

What an evaluation may involve

An intake interview covering history, current concerns, and goals, sometimes alongside brief questionnaires.

What treatment may look like

Regular talk-therapy sessions using an approach suited to the person’s age and concern, occasionally with family sessions included.

What it does not automatically provide

Medication (most counselors can’t prescribe), a medical or psychological diagnosis that requires testing, or play therapy unless separately trained and credentialed.

When another professional may be needed

Symptoms with a possible medical cause, a formal diagnostic question (a psychologist), or medication under consideration (psychiatry).

Questions to ask before starting

• What’s your experience with this specific concern — autism, trauma, grief, or otherwise?
• How do you work with family members alongside the person themselves?

Red flags

• Pathologizes ordinary autistic traits as something to eliminate.
• No clear sense of whose goals are actually being worked toward.

Play therapist

What the profession does

Play therapy is psychotherapy that uses play as its language, delivered by a trained mental-health professional — not simply “using toys” inside another kind of session. Play-based speech, OT, or PT sessions use play to reach that profession’s own functional goals, and the two are not interchangeable.

Concerns it may help with

The same ground as counseling — anxiety, trauma, grief, behavior that communicates distress, and family relationships — worked through a medium that fits how a child naturally processes experience.

Training or licensure background

A play therapist must already hold a clinical mental-health license (counseling, marriage and family therapy, psychiatry, psychology, or social work). The Association for Play Therapy’s Registered Play Therapist (RPT) credential then adds a qualifying degree, specific coursework, at least 150 hours of play-therapy instruction, supervised experience, and ongoing supervision.

The lens it commonly brings

The same emotional lens as counseling, expressed through play instead of conversation.

What an evaluation may involve

An intake similar to any counseling relationship, often including observation of the person’s play itself.

What treatment may look like

Regular sessions using play, toys, and creative materials with therapeutic intent — not free play, and not the same as play used inside speech or OT sessions.

What it does not automatically provide

A medical evaluation, and it is not a stand-in for any session that merely happens to involve toys.

When another professional may be needed

A diagnostic question (a psychologist), medication (psychiatry), or the concern turns out to be primarily developmental rather than emotional.

Questions to ask before starting

• Are you an RPT, or working toward it under supervision?
• What underlying clinical mental-health license do you hold?

Red flags

• Calls any toy-filled session “play therapy” without the credential or a mental-health license behind it.
• No communication with family about what’s happening in sessions.

Psychologist and neuropsychologist

What the profession does

Psychologists assess, diagnose, and sometimes treat. Testing is often the main event here, not a side step before the “real” treatment.

Concerns it may help with

Diagnostic and learning evaluation, cognitive and academic testing, autism and ADHD evaluation, emotional and behavioral assessment, and psychotherapy when the psychologist offers it.

Training or licensure background

A doctoral degree (PhD or PsyD), a supervised internship, and a national licensing exam. Tennessee licenses psychologists through the Board of Examiners in Psychology. Neuropsychology is a specialty focused on brain-behavior relationships, sometimes board-certified through the American Board of Professional Psychology. School psychologists typically add the NCSP credential and work through an education, not health, credential — see “School-based services” below.

The lens it commonly brings

Measurement — turning “something feels off” into standardized, comparable data with a written interpretation.

What an evaluation may involve

A battery of standardized tests, interviews, and questionnaires, usually across more than one visit, ending in a written report with scores and recommendations.

What treatment may look like

Psychotherapy when the same psychologist offers it; otherwise, the report’s recommendations point toward other services.

What it does not automatically provide

Ongoing weekly therapy — testing produces a report and recommendations, not a treatment plan by itself, unless therapy is separately arranged.

When another professional may be needed

Medication under consideration (psychiatry), or the recommendations point toward speech, OT, PT, or counseling.

Questions to ask before starting

• What exactly will this evaluation answer?
• How long until we get the written report, and will you walk through it with us?

Red flags

• A report with scores but no functional recommendations attached.
• Pressure to buy a specific therapy package alongside the testing.

Psychiatrist or psychiatric prescriber

What the profession does

Medical evaluation and treatment of mental-health conditions, centered on diagnosis, medication, and monitoring rather than weekly talk therapy.

Concerns it may help with

Diagnostic questions with a medical component, medication decisions, monitoring side effects and effectiveness, and coordinating care with therapists, schools, and other physicians.

Training or licensure background

A psychiatrist is a physician (MD or DO); a child and adolescent psychiatrist completes “at least five years of additional training beyond medical school in general (adult) and child and adolescent psychiatry,” per the American Academy of Child and Adolescent Psychiatry. Tennessee licenses physicians through its medical boards. A psychiatric nurse practitioner instead completes a nursing degree plus a psychiatric specialty, licensed through the Board of Nursing.

The lens it commonly brings

Medical and biological — whether a diagnosis, a medication, or a medical condition is part of the picture.

What an evaluation may involve

A comprehensive history covering health, development, family, and school, leading to a shared explanation of what’s going on before any medication is discussed.

What treatment may look like

Medication when appropriate, with regular follow-up visits to monitor effect and side effects; many prescribers do not also provide therapy, and pair with a separate therapist instead.

What it does not automatically provide

Ongoing therapy or skill-building — most visits are shorter and medication-focused, with therapy happening elsewhere.

When another professional may be needed

Therapy itself (a counselor or psychologist), a diagnostic evaluation that hasn’t happened yet (a psychologist), or a concern that turns out to be primarily behavioral or environmental.

Questions to ask before starting

• What will we watch for, and when do we follow up?
• What’s the plan if this medication doesn’t help or causes side effects?

Red flags

• Prescribes without a clear diagnostic conversation.
• No follow-up plan or monitoring offered.

Behavior analyst or behavioral provider

What the profession does

Behavior analysts study why a behavior happens — its function — and build supports around that, working with the family. This is a neutral lens, not a claim that behavioral services are required, or harmful, for everyone.

Concerns it may help with

Functional assessment of challenging or unsafe behavior, skill-building, environmental supports, caregiver collaboration, and ongoing measurement of progress.

Training or licensure background

The Behavior Analyst Certification Board (BACB) certifies BCBAs (graduate level), BCaBAs (bachelor’s level), and supervised Registered Behavior Technicians (RBTs), to “protect consumers of behavior-analytic services.” Tennessee separately licenses Behavior Analysts (LBA) and Assistant Behavior Analysts (LABA) through its Applied Behavior Analyst Licensing Committee. Verify any specific provider’s license status directly with the board.

The lens it commonly brings

Function — what purpose this behavior currently serves for this person, rather than only whether it’s inconvenient for others.

What an evaluation may involve

A functional behavior assessment combining interviews, direct observation, and sometimes structured testing of what triggers and maintains a behavior.

What treatment may look like

A written behavior plan built around specific goals, delivered through direct sessions, caregiver training, or both, with data collected over time.

What it does not automatically provide

Communication evaluation or AAC expertise — a BCBA is not automatically qualified to design a communication system, so a plan addressing communication-related behavior works best with a communication professional involved too.

When another professional may be needed

Any time a behavior may reflect pain, a medical issue, sensory overload, or an unmet communication need — involve a physician, OT, or SLP before assuming the behavior itself is the whole story.

Questions to ask before starting

These questions matter enough that we’d encourage every family to ask them, of any provider:

• Are the goals meaningful to the person, not just convenient for adults?
• Is communication treated as communication, even when it looks like “behavior”?
• Are sensory, medical, trauma, and relationship factors considered?
• Is assent and refusal respected, including the right to request a break?
• Is the goal safety and access, or just appearing compliant?
• Are AAC or communication professionals involved when needed?
• Are restrictive or aversive methods explicitly prohibited?

Red flags

• Goals are about looking typical rather than living well.
• Any unwillingness to discuss the questions above openly.

Registered dietitian

What the profession does

RDNs handle the nutrition side of eating — what the body needs, and how to meet that need, regardless of how food gets in.

Concerns it may help with

Growth and weight trends, nutrient needs, formula selection, food allergies, GI-related coordination, extremely selective eating, and tube-feeding nutrition.

Training or licensure background

Per the Academy of Nutrition and Dietetics, RDNs hold “a minimum of a graduate degree from an accredited dietetics program,” plus supervised practice and a national exam. Tennessee licenses dietitian/nutritionists through the Board of Dietitian/Nutritionist Examiners.

The lens it commonly brings

Nutrition and growth — is the body getting what it needs.

What an evaluation may involve

A nutrition history, a growth-chart review, and sometimes a review of lab work done alongside a physician.

What treatment may look like

A nutrition plan, formula or supplement recommendations, and ongoing monitoring of growth and labs.

What it does not automatically provide

Feeding-skill therapy for the physical or sensory mechanics of eating — that’s the SLP or OT side of a feeding team, not the dietitian’s.

When another professional may be needed

Oral-motor or sensory obstacles to eating (a feeding team), or a possible underlying medical cause (a physician or GI specialist).

Questions to ask before starting

• How will you coordinate with our other providers?
• How often will you check in as needs change?

Red flags

• A plan with no connection to an actual growth or lab concern.
• No coordination with the medical or feeding team.

Developmental-behavioral pediatrician or other medical specialist

What the profession does

A physician who looks at the whole medical and developmental picture, sorts out what’s driving it, and coordinates the team.

Concerns it may help with

Complex or overlapping developmental concerns, ruling medical causes in or out, differential diagnosis, and referrals to the right next professional.

Training or licensure background

A developmental-behavioral pediatrician is a physician with roughly a decade of training beyond a bachelor’s degree, board-certified in both general pediatrics and developmental-behavioral pediatrics. Tennessee licenses all physicians through its medical boards; specialty board certification comes from national medical boards, not the state.

The lens it commonly brings

The whole-child medical and developmental picture, including ruling out other explanations before settling on one.

What an evaluation may involve

A detailed developmental and medical history, a direct examination, and often coordination or review of testing done elsewhere.

What treatment may look like

Not usually weekly therapy — expect diagnosis, medical oversight, and a referral plan, with the actual therapy happening through SLP, OT, PT, counseling, or other services.

What it does not automatically provide

Ongoing weekly intervention. Waits for an appointment can also be long, so this is often a “start the referral early” step rather than a first stop for an urgent concern.

When another professional may be needed

Almost always — this profession organizes the picture, and other professions carry out much of the day-to-day work.

Questions to ask before starting

• What specifically will this visit help us understand or decide?
• What should we do while we wait for the appointment?

Red flags

• Promises a definitive answer to every question in one visit.
• Dismisses concerns your other providers have already documented.

Executive-function or ADHD coach

What the profession does

Practical, forward-looking support for planning, organization, routines, and follow-through — coaching, not medical or mental-health treatment.

Concerns it may help with

Time management, organization systems, breaking down tasks, building routines, and staying accountable to goals the person themselves sets.

Training or licensure background

Coaching is not licensed or state-regulated, so credentials vary widely. Some coaches train through the International Coaching Federation (ICF), which defines coaching as “partnering with clients… to maximize their personal and professional potential.” ADHD-specific coaches may also belong to the ADHD Coaches Organization (ACO). With no license behind the title, ask directly about training.

The lens it commonly brings

Forward-looking systems and follow-through — less “why is this happening,” more “what’s the plan, and who’s checking in.”

What an evaluation may involve

Usually an intake conversation about goals and current systems, not standardized testing.

What treatment may look like

Regular coaching sessions, often by phone or video, building and adjusting systems between meetings.

What it does not automatically provide

Medical or mental-health treatment, diagnosis, crisis support, or medication guidance — coaching complements those, and is not a substitute for them.

When another professional may be needed

Symptoms of anxiety, depression, or a crisis (a counselor or psychiatry), or a diagnostic question that hasn’t been answered yet (a psychologist).

Questions to ask before starting

• What training do you have, and is it accredited?
• How do you handle it if something comes up that’s outside coaching’s scope?

Red flags

• Implies coaching can replace medication or therapy for a diagnosed condition.
• No clear training or credentialing background offered when asked.

School-based services

What the profession does

Services delivered at school are determined by educational impact — whether a difference gets in the way of learning or school participation — not by diagnosis alone.

Concerns it may help with

Any of the concerns above when they affect school participation: communication, literacy, motor skills, attention, behavior, or emotional regulation at school.

Training or licensure background

School-based providers hold the same state professional licenses as their clinic-based counterparts, often alongside a Tennessee Department of Education endorsement. Eligibility and services are decided by an IEP or 504 team under IDEA, the federal special-education law.

The lens it commonly brings

Educational access — not “does this person have a diagnosis,” but “does this get in the way of learning or participating.”

What an evaluation may involve

A school-based evaluation looking specifically at educational impact, which can reach a different conclusion than a medical or private evaluation of the same concern.

What treatment may look like

Services written into an IEP or 504 plan, delivered during the school day, tied to specific educational goals.

What it does not automatically provide

The same intensity or scope as private or medical therapy — school services are legally tied to educational benefit, not to maximizing every possible skill.

When another professional may be needed

A concern with real impact outside school — at home or in the community — often benefits from a private provider alongside school services, not instead of them.

Questions to ask before starting

• How was “educational impact” decided here?
• How do school and outside providers share information?

Red flags

• Denies services solely because a private provider already treats the same concern.
• No written plan or measurable goals.

• What concerns are you qualified to assess?
• What does your evaluation include?
• How will goals relate to everyday life?
• How will you include the child or adult in goal-setting?
• How will you support communication, including AAC?
• How do you respond to distress, refusal, or requests for a break?
• How are parents, caregivers, schools, or other providers involved?
• What would make you refer to another professional?
• How will we know whether this is helping?
• When will we reconsider, reduce, or end therapy?
• What will this cost?
• What insurance or funding do you accept?
• What records or referrals are required?