How to Become a Pediatric Occupational Therapist

What is occupational therapy?

Occupational therapy (OT) is the use of hands-on treatment and therapeutic activities to help individuals improve their ability to participate in everyday life. Therapists work with people who have conditions that affect cognitive function, mobility, strength, vision, hearing, language, and communication skills. Treatment will help them improve their daily life skills as well as set goals for those individuals with health issues like depression or anxiety. Occupational therapists work with people who have injuries or illnesses that affect their ability to function in daily life activities like dressing, cooking, bathing, and eating. They also work with individuals who suffer from developmental disabilities such as autism spectrum disorders (ASD).

A Day in the Life of an Occupational Therapist

What does an occupational therapist do? The tasks performed by occupational therapists may differ based on the position they hold and their work environment. Some therapists practice in hospitals while others may be employed by schools, nursing homes, or rehab centers. Generally, occupational therapists spend a significant amount of time conducting evaluations with patients to determine what type of treatment intervention may be necessary. Therapists also develop treatment plans for patients to help them improve their ability to complete daily tasks and participate in activities that are meaningful to them.

Occupational therapists may start their day with team meetings or meetings with other professionals or families early in the morning. Then they usually spend time planning and setting up for their sessions. After that, they will see patients or clients back to back for varying lengths of time. For those who work in pediatrics, these sessions usually are 30, 45, or 60 minutes. Some places of employment require therapists to complete treatment notes during sessions (called point of service documentation). Or treatment notes are completed at the end of the day.

Other OTs travel from home to home during the day. This is common not only if you are employed in home health (pediatric or adult) but also in early intervention. If a therapist works within the school district, they often travel from school to school.

Pediatric occupational therapists

Pediatric occupational therapists work in many pediatric settings. These include schools, hospitals, homes, outpatient clinics, and even the NICU. The children pediatric OTs see can have extremely varied difficulties and challenges including developmental delays, premature infants, and cerebral palsy and be of all ages. Pediatric OT works on a child's ability to complete daily activities by improving their fine motor skills, social skills, visual motor skills, and any other underlying deficits. We become experts in child development.

Steps to becoming a pediatric occupational therapist

• Earn a Bachelor’s undergraduate degree in a pre-occupational therapy program or a related field.
• Complete prerequisite classes and requirements – observation hours, certain classes, GRE
• Decide between a master's or doctorate program
• Apply and get accepted and complete Master's or Doctorate program in occupational therapy from an accredited occupational therapy program.
• Complete required fieldwork – 24 week total (usually 12 weeks in two different settings) as required by your OT school
• One fieldwork placement preferably should be in a pediatric occupational therapy setting.
• Take and pass the national licensure exam by NBCOT in the United States
• Apply to become a licensed occupational therapist in your state

Steps to becoming a pediatric occupational therapy assistant

• Apply and get accepted and complete an associates program in occupational therapy from an accredited occupational therapy program
• Complete required Fieldwork – 16 weeks (usually 8 weeks in two different settings) as required by your OT school
• One fieldwork placement preferably should be in a pediatric occupational therapy setting.
• Take and pass the national licensure exam by NBCOT in the United States
• Apply to become a licensed occupational therapist in your state

Occupational Therapist Education Requirements

Since 2007 to become a registered OT the field requires a master's degree from an accredited program. Previously a university college bachelor's degree was required and some practicing therapists are still grandfathered into that requirement. There was talk of requiring a doctorate degree to become a newly licensed OTR, however, this change in educational requirements has been postponed.

Occupational therapy students take courses such as psychology, biology, anatomy, and physiology to learn about the human body and its functions. Students also take specialized courses in treatment techniques for different practice settings. Such as OT with older adults and occupational therapy with children.

Professional requirements for Occupational Therapists

Occupational therapists must be licensed to practice in the state where they reside or plan on working. Each state such as Florida or California has its own licensing requirements however the first step is to pass the national NBCOT exam. Occupational therapists must also complete fieldwork programs to gain clinical experience working with patients in various settings.

What is the difference between an OTR and COTA?

An occupational therapist registered, or OTR, is an occupational therapist who has completed a master's or doctorate degree from an accredited school, required a minimum of 24 weeks of fieldwork, and passed the National Board for Certification in Occupational Therapy (NBCOT exam) certification exam. OTRs complete the initial evaluations, re-evaluations and write the goals and treatment plan for occupational therapy recipients.

A certified occupational therapy assistant, or COTA, is a therapist who has completed an associate degree from an accredited school, required a minimum of 16 weeks of fieldwork, and passed the National Board for Certification in Occupational Therapy (NBCOT) certification exam. A COTA works in coordination with an OTR and is responsible for carrying out the treatment plan written by the OTR.

What is the difference between occupational therapy and physical therapy?

This is a common question for those considering both OT and PT school. There are many differences and I encourage you to read more in my article: What’s the Difference Between Occupational Therapy and Physical Therapy?

How much schooling is required to become an OTR?

Becoming an occupational therapist requires at minimum a master's degree. Some universities offer this as a combined BS/MS program. These programs take 5 years of schooling and 6 months of fieldwork to complete. Schools have also started offering entry-level doctorate degrees.

What is the difference between an entry-level doctorate degree and post-professional doctorate degree?

An entry-level doctorate degree is the first degree in occupational therapy a professional obtain to become certified as an occupational therapist. Other occupational therapists who have previously obtained schooling and certification an occupational therapist can continue their education with a post-professional doctorate degree.

How much schooling is required to become an occupational therapy assistant (COTA)?

To become an occupational therapy assistant requires an associate degree and 4 months of fieldwork.

What is the best undergraduate major for OT school?

The best undergraduate major for an OT student to have is one that will help them gain a strong foundation in the sciences.

What prerequisite classes are required to get into OT school?

Each university has its own requirements. Prerequisite classes usually include developmental and abnormal psychology, biology, anatomy and physiology, and statistics. Make sure you check the individual schools you are interested in.

What are some tips on getting accepted into occupational therapy school?

Undergraduate applicants should create solid resumes that highlight their work experience, activities, and volunteerism. Applicants should also be aware of the entrance requirements for OT programs and complete any necessary prerequisites before applying to avoid unnecessary delays in the application process. Make sure to complete the required observation hours.

Demonstrating a strong understanding of the occupational therapy profession such as observing in multiple settings and letters of recommendation from occupational therapists may help strengthen your application.

How much does an occupational therapist make?

The average annual salary of a registered occupational therapist is $86,280 according to the Bureau of Labor Statistics (BLS). There are several factors that can affect a therapist's salary, with the biggest factors usually employment setting and geographic location.

According to the BLS, therapists who work in-home health care services earn an average annual salary of $91,830 while those employed by nursing facilities average about $92,260 per year. Therapists who work in hospitals make slightly more than the national average with salaries averaging around $86,910 annually.

Occupational therapists employed in schools average $76,560 per year.

The average annual salary of an occupational therapist assistant is $62,940 according to the Bureau of Labor Statistics (BLS). According to the BLS, therapists who work in-home health care services earn an average annual salary of $67,760 while those employed by nursing facilities average about $67,460 per year. Occupational therapists assistants employed in schools average $51,520 per year.

Occupational Therapist Job Growth

The U.S. Bureau of Labor Statistics (BLS) projects that occupational therapy jobs will grow by around 17% between 2020 and 2030.

My Experience as an Occupational Therapist

My personal experience as an occupational therapist has been mostly positive. I absolutely love what I do. As an OT I was employed full time in multiple different states and settings than was able to move to a part-time basis by choice. I have also been a private practice owner.

There have been many changes in the OT profession over the years. The most drastic has been the shift to a focus on productivity and also employment structures.

While many OTs are still employed as full-time W-2 employees and paid via salary, many are now paid hourly, per treatment visit, or as independent contractors.

Becoming an occupational therapist is a fulfilling career choice but it has changed a lot over the years. I recommend making sure it is the career you want to pursue by talking to several OTs and shadowing in several different occupational therapy settings.