Occupational therapists help people functionally succeed in their environments.
Although we tend to use the term “occupation” as a synonym for “job” or “career,” OTs conceive of “occupation” in the sense of an everyday activity or action — that is, how you occupy yourself.
OTs utilize everyday activities as therapeutic tools to enhance the skills and fine motor control of their clients, and thereby increase their clients’ independence. For example, if someone has trouble tying her shoes, an occupational therapist might find similar common fine motor tasks that involve this activity — perhaps tying a bow on a package or a piece of clothing — to help that student progress toward independently tying her shoes. Likewise, OTs might provide someone with adaptive equipment, such as a pencil grip to aid writing or an augmentative and alternative communication (AAC) device to facilitate communication.
Education and Licensure
OTs must hold an associate’s, bachelor’s, master’s, or doctoral degree in occupational therapy from an institution accredited by the American Occupational Therapy Association (AOTA). They must also sit for an intensive, comprehensive exam administered by the National Board for Certification in Occupational Therapy (NBCOT). Moreover, recently-certified OTs must spend a six-month training period working under the supervision of an experienced licensed occupational therapist.
Because of a present shortage of qualified OTs, states also allow Occupational Therapy Assistants (OT-As), who must hold an associate’s degree from an AOTA-accredited Occupational Therapy Assistant Program, to provide certain services under the supervision of a licensed OT.
Follow this link to discover which colleges offer occupational therapy programs.
OTs who have national certification can add “OTR” to their signatures (the “R” stands for “registered nationally”). Those who also possess a state license can add an “L” (for “license”) so you’ll often see OTR/L following their signatures. OTs who only have a state license can add OT/L after their signature. The process of obtaining national registration and state licensure both demonstrate that a professional has received a formal education in occupational therapy; has the requisite number of hours of work experience; and has passed a national exam of best practices in occupational therapy. OTs maintain their licensure by attending professional development courses on a regular basis so that they stay abreast of current evidence-based approaches in the field.
Work and Settings
Occupational Therapists are trained to work with children or adults on a range of skills, including the following:
- Fine motor skills (such as writing by hand, getting dressed, tying shoes)
- Executive functions and organizational skills (such as getting ready in the morning or completing nighttime routines)
- Coordinated movements (such as playing catch)
- Sophisticated play skills
- Social skills
In schools, occupational therapists collaborate with other professionals and teachers to help children succeed in the classroom. If a student has an Individualized Education Plan (IEP), she may be entitled to individual or group support from an OT either in or outside of the classroom.
OTs may also fulfill any portion of the IEP that relates to adaptive equipment (e.g., AAC devices, special seating arrangements, and so on). Children who have IEPs and attend schools without an on-staff OT will typically receive free occupational therapy at a clinic or other school through a mechanism known as a “Related Service Authorization,” or RSA. RSAs are district mandates that enable children to receive disability supports at other schools or in the community free of charge. (The New York City form is an example of a RSA.)
Families also have the option of paying out-of-pocket to work with an OT privately. Some health insurance plans cover occupational therapy, although there may be limits on the number of sessions or the types of disorders included. It’s important to note that many occupational therapy programs focus on working with adults, and while there may be commonalities between adults and children, the needs of children differ in significant ways. For this reason, choosing a professional with training and experience in pediatrics will provide greater benefits to your child.
Questions to Ask an OT
When you meet your child’s OT, you’ll want to be prepared with questions to help you better understand the supports your child will get. Here are four important sets of questions to ask your child’s OT:
- What types of classroom supports would you recommend for my child?
- Should we focus on handwriting, keyboarding, or both? Why?
- What should my child’s teachers and I be looking for in her growth?
- What is the balance between encouraging independence and providing supports? What will help my child become most independent without limiting her progress as a result of too much frustration or physical strain?
Further Reading for You: Other Members of the Team
Your child may also work with other specialists in addition to an OT. Find out more about the other members of your child’s support team by reading these comprehensive articles:
- Speech-Language Pathologists
- Physical Therapists
- Special Education Itinerant Teachers or Special Education Teacher Support Service Providers
- Assistive Technologists
Further Reading for Your Child
- Going to an Occupational Therapist
- What Is Occupational Therapy? A Video from the NHS
- Getting Organized for Back to School: Children with Special Needs
American Occupational Therapy Association. (2014). State OT Statutes and Regulations. Retrieved from AOTA.
American Occupational Therapy Association. Children and Youth. Retrieved from AOTA.
New York State Education Department, Office of the Professions. (2013, April 5). Occupational Therapy. Retrieved from NYSED.