Special educator vs occupational therapist: who does what in your child’s team

The Indian Academy of Pediatrics (IAP), in its 2017 consensus statement on autism, describes management as the work of an interdisciplinary team coordinated by a developmental paediatrician or paediatrician, which can include a child neurologist or psychiatrist, a clinical psychologist, an occupational therapist, a speech-language therapist, a special educator, a nutritionist and a social worker. Its 2024 consensus statement adds that the diagnosis is confirmed by a developmental paediatrician, developmental neurologist or child psychiatrist.

Not every autistic child needs every professional, and the doctor leading the assessment is the person to say which ones yours needs. The table sets out the roles side by side, including two that families meet often but that no Indian register covers: the behaviour analyst and the shadow teacher.

A developmental paediatrician is a doctor: a paediatrician with further training in child development, a small field in India where the IAP’s neurodevelopmental chapter runs a one-year fellowship at accredited centres. They lead the assessment, look for medical causes, arrange hearing and vision checks, confirm the diagnosis, can prescribe, and bring in other specialists: a paediatric neurologist for regression or seizures, a child psychiatrist for anxiety or aggression, a psychologist for psychoeducational and behavioural assessment.

A child psychologist is not a doctor and does not prescribe. The title to look for is clinical psychologist, a profession registered by RCI and defined in the Mental Healthcare Act, 2017 by its qualifications: a recognised clinical psychology qualification from an RCI-approved institution, or a postgraduate degree in psychology plus a two-year M.Phil in clinical psychology with supervised clinical training. A child psychiatrist, by contrast, is a doctor with a postgraduate qualification in psychiatry.

We found no separate statutory title or register for developmental paediatricians or child psychiatrists, so check them as doctors, with the State Medical Council or on the National Medical Commission’s registers. NMC’s Indian Medical Register covers doctors registered with State Medical Councils up to 2021, with gaps for a few states in that year, and NMC also runs a newer National Medical Register portal.

The route into clinical psychology is changing. UGC letters of 29 January 2024 and 13 August 2024 allow admissions to the M.Phil in Clinical Psychology only up to the 2025-26 session, and RCI introduced a two-year Master in Clinical Psychology (M.Clin.Psy.) from 2024-25 in place of the M.Phil. A clinical psychologist who assesses your child might hold either, and should be on RCI’s register whichever it is.

Graduates of the new four-year Bachelor in Clinical Psychology are a supervised first tier, not independent clinical psychologists, and may not carry out complex or certification assessments on their own. Holders of the one-year Professional Diploma in Clinical Psychology register as “Clinical Psychologist (Associate)”. Rehabilitation psychologists are a separate RCI category, and holders of the PG Diploma in Rehabilitation Psychology under the syllabus used since 2018-19 register as rehabilitation counsellors. Counselling psychology in general is not an RCI category.

Speech-language pathologists and audiologists are registered by RCI as “Audiologist and Speech Therapist”. RCI’s scope of practice document, approved in 2015 and posted on its website in July 2026, says “speech therapist” and “speech-language pathologist” mean the same thing, that only RCI-registered people with a recognised degree may practise, and that holders of the Diploma in Hearing, Language and Speech may work only under a graduate professional’s supervision. The usual degree is the four-year BASLP, including a one-year internship.

The speech-language pathologist owns the assessment, the targets, the method and any alternative communication system the child uses, and the same document says no other professional prescribes or supervises their work. The special educator’s part is to put the current targets into meals, play, reading and the school run, use the communication system everywhere, and keep a record the therapist can use. Carrying the speech-language pathologist’s targets into the day shows how that works. The IAP also recommends a hearing check for every child with autism.

The occupational therapist assesses how a child manages movement, handwriting, self-care and sensory input, and writes the plan: the sensory adjustments at home and in class, the daily activities, the equipment. The special educator and the shadow teacher do not assess or treat; they make the plan part of every day, notice what works and tell the therapist. A written recommendation from the occupational therapist also helps a school agree to headphones in assembly or a movement break.

Occupational therapists are not registered by RCI. The National Commission for Allied and Healthcare Professions Act, 2021 lists “Occupational Therapy Professional” as a category requiring at least a bachelor’s degree and provides for national and state registers, but in September 2025 the Madras High Court found that the Commission was not yet functioning, and at the time of writing we could find no evidence that its registers are live.

In Maharashtra, which covers Mumbai and Pune, the State Council for Occupational Therapy and Physiotherapy Act, 2002 allows only therapists on the council’s register to practise. Elsewhere, ask where the therapist trained and which council, if any, they are registered with, and confirm the degree with the institution. Sensory processing at home and school shows how the plan is carried through a day.

Applied behaviour analysis (ABA) is a behaviour-analytic approach delivered through programmes that a behaviour analyst designs and supervises. Special education is teaching: literacy, number, routines, independence and the curriculum, planned by a special educator. Some professionals have trained in both, but they are different disciplines. Whether any programme suits your child is a question for the developmental paediatrician and clinical team; this guide recommends no therapy.

The regulation is the part families rarely hear. ABA is not regulated by RCI: there is no RCI-approved course in behaviour analysis and no behaviour analyst category on the register. The US-based Behavior Analyst Certification Board (BACB) has, since 1 January 2023, accepted certification applications only from residents of authorised countries, currently the US, Canada and Australia, so a resident of India cannot apply for a new BCBA, BCaBA or RBT. Existing certificants living in India keep their certification for now, but cannot requalify from here if it lapses.

Other international bodies offer behaviour-analysis credentials, and none is an Indian statutory licence. Ask a behaviour analyst which credential they hold and check it on that body’s public registry; the BACB’s registry shows certification status and any reportable disciplinary action. Ask who supervises their work, and whether they hold an RCI registration in another capacity, such as special educator or clinical psychologist. The glossary entry on ABA explains the terms.

A special educator holds an RCI-recognised qualification, usually a D.Ed. or B.Ed. in special education, and is registered on RCI’s Central Rehabilitation Register. They plan and run structured learning at home or in school: routines, visual schedules, early literacy and number, daily-living skills, and the therapists’ plans carried into ordinary moments. They keep records the clinicians can use. They do not diagnose, carry out clinical assessments, write therapy programmes or advise on medication.

A shadow teacher supports one child through the school day, at the school’s invitation, helping them follow the lesson, manage transitions and take part. There is no licence or registration for shadow teachers in India, so families judge them on a verified qualification, references they have spoken to and a scenario interview. Many hold a special education qualification and, where they do, should be on the register. In both roles the plan comes from the clinicians and the school.

A team works when one person coordinates and everyone else knows the plan. The developmental paediatrician or paediatrician usually leads the clinical side, the school’s inclusion coordinator leads the school side, and the family decides what is shared between them. Give written consent for the therapists and the school to talk, and ask each professional for a short plan the others can read.

The special educator or shadow teacher is often the one adult who sees the child in more than one setting. They carry the speech-language pathologist’s targets into the classroom and the occupational therapist’s plan into the morning routine, keep a daily note, and bring what they see back to the clinicians. Autism support at home between therapy sessions describes that work, and the first weeks after an autism diagnosis covers how families put the team together.

Watch for gaps and overlaps. Two professionals setting different targets for the same skill, a special educator writing therapy goals, or a therapist who never hears what happens at school are all signs that the team needs a meeting. Special Minds introduces special educators and shadow teachers who work to the clinicians’ plans; it does not diagnose or provide speech or occupational therapy, and the one therapy it provides is ABA, designed and supervised by a BCBA.

Checking takes minutes and is worth doing for every professional who works with your child, however they were introduced to you. At the time of writing (September 2026), these are the checks for each role. Registers and rules change, so confirm with the body concerned if anything does not match.

• Developmental paediatricians and child psychiatrists: the State Medical Council, NMC’s Indian Medical Register or its National Medical Register.
• Clinical psychologists, rehabilitation psychologists, speech-language pathologists, audiologists and special educators: RCI’s Central Rehabilitation Register, searchable by CRR number or name, as explained in how to check RCI registration.
• Occupational therapists: the Maharashtra council’s register in Mumbai and Pune; elsewhere, the degree confirmed with the institution and any state council registration.
• Behaviour analysts: the credentialing body’s public registry, and any RCI registration they hold in another capacity.
• Shadow teachers: the qualification confirmed with the institution, references spoken to, and a safeguarding interview.

One caution. An advisory of 5 September 2026 (R-13014/28/2022-Ethics) from the National Medical Commission, citing a Supreme Court order of 30 January 2026, says stem-cell therapy for autism cannot be offered as routine commercial treatment outside the clinical-trial framework; it may be standard care only for indications approved by ICMR, the Department of Health Research or the Health Ministry. If it is offered to your family, take the advisory to your child’s developmental paediatrician first.