Pediatric occupational therapists are healthcare specialists whose role is to help children whose developmental conditions or disabilities affect their ability to perform everyday activities participate more independently at home, in school, and in other environments.
Qualifying for professional practice in this highly regulated field is a rigorous process that requires completing advanced education, supervised clinical training, and passing standardized examinations before entering the workforce.
If you are interested in learning how to become a pediatric occupational therapist, the article below will walk you through this process step by step and explain the qualifications, training, and optional advanced credentials involved.
Understanding the Pediatric Occupational Therapist Role
Pediatric occupational therapists are licensed healthcare professionals who specialize in working with infants, children, and adolescents whose developmental conditions, physical disabilities, or other physical limitations affect their ability to perform everyday activities independently.
Depending on the child’s age and stage of development, pediatric OTs may help patients improve their ability to eat, get dressed, play, complete school-related tasks, interact with others, and participate more successfully in routines at home and in the community.
The exact type of support a pediatric OT can provide also depends on the needs of the child they are working with. Some patients may need help developing fine motor skills or improving coordination, while others may experience difficulties with sensory processing, feeding, attention, social participation, or other areas that interfere with their ability to function independently.
To address these challenges, pediatric occupational therapists assess the child’s abilities and limitations, identify the activities they are having difficulty performing, and develop an individualized treatment plan around those findings.
These plans often incorporate a range of therapeutic techniques, including play‑based activities, sensory integration exercises, adaptive equipment training, and task‑specific practice.
As the children’s needs evolve over time, OTs continually monitor progress and make the necessary adjustments to make sure that interventions remain relevant and effective.
Occupational Therapists vs Pediatric Occupational Therapists
Before we move on to exploring the OT profession in greater detail, we thought it’d be a good idea to clarify the differences between occupational therapists who work with broader patient populations and those who specialize in pediatrics, just so you can have a clearer understanding of how these roles differ.
While both occupational therapists and pediatric OTs help patients improve their ability to perform everyday activities and function more independently, the differences in the client populations they serve can have a major impact on the type of care they provide and create several important distinctions in their day-to-day work.
Namely, occupational therapists can work with patients of all ages and may help them develop, regain, or maintain the skills they need for self-care, work, household tasks, and other everyday activities. Pediatric OTs also help their patients improve their ability to perform daily activities, but they do so with a much stronger focus on childhood development and the skills children need as they grow.
As such, their treatment may place greater emphasis on areas such as play, feeding, dressing, handwriting, fine motor development, sensory processing, and school participation. What’s more, pediatric OTs also adapt their assessments and interventions to the child’s age, developmental stage, individual abilities, and the environments in which they spend most of their time.
Work Settings, Responsibilities, and Skills Needed
Pediatric occupational therapists work in a variety of settings, including children’s hospitals, occupational therapy clinics, schools, early intervention programs, rehabilitation facilities, and home- or community-based environments. Naturally, the setting in which they practice can influence both the types of patients they see and the responsibilities they take on.
When working with a child, pediatric OTs typically assess their functional abilities and use the findings to develop an individualized treatment plan targeting areas such as fine motor development, self-care, feeding, school participation, and sensory processing.
As the therapy continues, they monitor the child’s progress, adjust their approach when necessary, and coordinate with parents, caregivers, teachers, and other professionals so the strategies used during treatment can also support the child in everyday environments.
Given the nature of this work, pediatric OTs also need strong communication, observation, problem-solving, and interpersonal skills. Patience and adaptability are equally important, as younger patients may respond differently to treatment and often require therapists to modify activities according to their age, developmental stage, and individual abilities.
Qualification Requirements for Becoming a Pediatric OT
Now that we understand the pediatric OT role a bit better, we can take a look at the qualifications aspiring professionals need to meet before they can begin working in this area of practice. To become eligible for practicing this role in a professional capacity, aspiring candidates need to:
- Complete a bachelor’s degree and the prerequisite coursework required for admission to an occupational therapy program
- Earn an entry-level master’s or doctoral degree from an ACOTE-accredited occupational therapy program
- Meet the required Level I and Level II fieldwork requirements
- Achieve a passing score on the NBCOT Occupational Therapist examination
- Secure an occupational therapy license in the state where they intend to practice
- Gain professional experience working with pediatric patients
- Obtain Board Certification in Pediatrics for advanced specialization
To put it in simple terms, pediatric OTs first need to meet all the eligibility criteria to qualify as licensed occupational therapists and then move on to developing their specialization by working with children and gaining pediatric experience.
How to Become a Pediatric Occupational Therapist: Step by Step
Having outlined the main qualifications required to become a pediatric occupational therapist, we can now move on to the practical part of the guide and take a closer look at each step in the process.
Complete a Bachelor’s Degree and Meet OT Program Prerequisites
The first step toward becoming a pediatric occupational therapist is enrolling in a bachelor’s degree program. Even though there is no specific undergraduate major aspiring professionals are required to pursue to qualify for this profession, choosing a field related to healthcare, human development, or the sciences can provide a useful foundation for occupational therapy studies.
However, while students may have some flexibility when choosing their major, they still need to complete the prerequisite coursework required to become eligible for enrollment in a professional occupational therapy program.
We should point out that every OT program has its own admission requirements and prerequisites, though generally, most ACOTE-accredited OT programs require coursework in subjects such as anatomy, physiology, biology, psychology, statistics, and other science or behavioral science areas.
During their undergraduate studies, aspiring OTs attend lectures and laboratory classes, complete assignments and examinations, and participate in projects related to their chosen field.
That said, students interested in pediatric occupational therapy can tailor this stage of their education toward working with children by choosing electives in child development and developmental psychology and seeking relevant volunteer or observational opportunities.
Earn an Accredited Occupational Therapy Degree
After earning their undergraduate degree, aspiring pediatric occupational therapists need to continue their academic journey by enrolling in an entry-level ACOTE-accredited occupational therapy program.
At this stage of their occupational therapy education, they have two pathways they can choose from:
- Master’s Degree Program in Occupational Therapy: This is the more traditional graduate-level route and generally takes around two to three years to complete
- Entry-Level Doctor of Occupational Therapy Degree: This pathway provides the same entry into professional OT practice but typically includes additional advanced coursework and a doctoral capstone experience
It is important to note that both of these degree options prepare students for entry-level occupational therapy practice, so aspiring pediatric OTs should not feel obligated to pursue the doctorate degree simply because it represents the more advanced academic credential.
Instead, they can choose the pathway that better aligns with their academic preferences and long-term professional goals.
Meet Your Occupational Therapy Fieldwork Requirements
In addition to completing the academic portion of their occupational therapy degree, students also need to satisfy the fieldwork requirements included in their program.
These requirements are typically divided into Level I and Level II fieldwork, which are designed to gradually introduce students to occupational therapy practice.
More specifically, Level I fieldwork is primarily intended to reinforce classroom learning through observation and introductory experiences, whereas Level II places students in more intensive clinical settings where they assume greater responsibility for providing occupational therapy services under supervision.
Students enrolled in entry-level master’s and doctoral programs need to complete the equivalent of at least 24 weeks of full-time Level II fieldwork before graduating, while those pursuing a doctoral degree have the additional requirement of completing a doctoral capstone experience lasting at least 14 full-time weeks after their coursework and Level II fieldwork are finished.
While fulfilling these requirements is necessary to complete their degree, students interested in pediatric occupational therapy should make strategic use of their placements by seeking opportunities to work with children and adolescents and gain experience relevant to their future specialization.
Achieve a Passing Score on the NBCOT Exam
After completing their fieldwork requirements and earning their graduate degrees, graduates can take the national certification examination administered by the National Board for Certification in Occupational Therapy (NBCOT).
This exam is designed to assess whether candidates have the knowledge and clinical reasoning skills needed to practice occupational therapy safely and effectively at the entry level. It contains 180 items, including multiple-choice questions and multi-select scenario sets, and candidates have four hours to complete it.
While the NBCOT exam is not specific to pediatric practice, passing it is an important part of becoming professionally qualified as an occupational therapist and allows graduates to demonstrate that they have met the national standards expected of entry-level practitioners.
Those who achieve a passing score earn the Occupational Therapist Registered credential, commonly abbreviated as OTR.
Secure Your Professional Occupational Therapy License
Once they pass the NBCOT exam and earn their OTR credential, candidates can move on to the licensing stage and apply for authorization to practice occupational therapy in the state where they intend to work.
Since occupational therapy is a regulated profession, candidates need to obtain a professional license before they can begin practicing. This requirement applies across all 50 states, as well as the District of Columbia, Puerto Rico, and Guam, although the exact licensing process can vary by jurisdiction.
To secure their occupational therapy license, candidates generally need to have passed the NBCOT examination, submit a licensure application, and pay the applicable fee. Depending on the state, they may also need to undergo a criminal background check, submit official transcripts, or pass an examination covering state occupational therapy laws and regulations.
We should make it clear that pediatric occupational therapists do not need to obtain a separate pediatric license, and the same professional OT license allows qualified practitioners to work with children.
Start Working as a Professional Occupational Therapist
The moment candidates secure their occupational therapy license, they become qualified to enter the workforce and begin practicing as professional occupational therapists.
Under this status, they’re fully authorized to assess patients from all age groups, develop individualized treatment plans, provide therapeutic interventions, monitor progress, and help clients improve their ability to perform everyday activities more independently.
Depending on their interests and the opportunities available to them, newly licensed OTs may work in hospitals, outpatient clinics, rehabilitation facilities, schools, nursing facilities, home healthcare, and other settings where occupational therapy services are provided.
We should point out that OTs interested in specializing in pediatrics do not need to spend several years working with other patient populations before entering this area of practice.
If they meet an employer’s requirements, even newly licensed OTs can begin working with children early in their careers and start building the professional experience needed to develop greater expertise in pediatric occupational therapy.
Pursue an AOTA-Accredited Pediatric Fellowship Program
Licensed occupational therapists who want to receive more structured training in pediatric practice can choose to pursue a pediatric fellowship accredited by the American Occupational Therapy Association.
These postprofessional programs are designed to help OTs develop more advanced knowledge and clinical skills in a focused area of practice through a combination of hands-on experience, mentorship, and professional education.
To qualify for an AOTA-accredited fellowship, applicants generally need to graduate from an ACOTE- or WFOT-recognized occupational therapy program and hold a professional license in the jurisdiction where the fellowship is offered.
During a pediatric fellowship, OTs work with children while receiving guidance from experienced practitioners and developing their clinical reasoning, evidence-based practice, and other skills relevant to pediatric care.
Please note that completing a pediatric fellowship is not required to work as a pediatric occupational therapist, but rather an optional form of advanced training for professionals who want to deepen their expertise through a more structured and mentored learning experience.
Obtain Board Certification in Pediatric Occupational Therapy
OTs who want to make their pediatric expertise more formal and demonstrate their specialization in this area more clearly to employers, colleagues, and patients can consider pursuing Board Certification in Pediatrics.
To qualify for this credential, candidates need to hold an occupational therapy certification or license in good standing, have at least three years of professional experience as an OT, and have accumulated at least 3,000 hours of pediatric experience within the previous five years.
Those who complete an AOTA-accredited fellowship can become eligible after two years of professional experience instead of three, provided they also have the required pediatric experience hours.
Applicants who satisfy these eligibility criteria can then take the pediatric board certification examination, which assesses the advanced knowledge and clinical reasoning expected of experienced pediatric OTs.
Those who achieve a passing score earn the BCP designation and can formally identify themselves as board-certified pediatric occupational therapists. The certification remains valid for five years before renewal is required.
Job Outlook and Salary for Pediatric Occupational Therapists
Having covered the entire process of becoming a pediatric occupational therapist, we can now take a look at the earning potential and employment outlook associated with this area of practice.
Since the Bureau of Labor Statistics does not report salary figures specifically for pediatric occupational therapists, we can use ZipRecruiter’s pediatric-specific estimates to get a better idea of their earning potential. According to its current data, these professionals earn an average annual salary of $86,665, or approximately $41.67 per hour.
Naturally, this figure only provides a general indication of their earning potential and does not reflect what every pediatric OT makes. Most salaries currently fall between $70,000 and $94,500 per year, while those around the 90th percentile earn approximately $120,500.
Furthermore, the job’s location can also make a noticeable difference, with pediatric occupational therapists earning an average of $98,156 in Washington and $94,814 in New York, compared with $80,742 in Texas and $64,764 in Florida.
As for the employment outlook, there are no separate projections available specifically for pediatric occupational therapists. However, O*NET recognizes pediatric occupational therapist as a professional title within the broader occupational therapist occupation, for which CareerOneStop projects employment to increase from approximately 160,000 jobs in 2024 to 182,100 by 2034.
This represents growth of about 14%, with roughly 10,200 new occupational therapy jobs expected each year, although these figures apply to occupational therapists as a whole rather than the pediatric specialty specifically.
(ZipRecruiter, CareerOneStop, ONET)
Final Words
Children who experience developmental conditions, disabilities, injuries, or other challenges may need additional support to participate more independently in everyday activities. Pediatric occupational therapists can provide this support by helping younger patients develop the functional skills they need at home, in school, and in other environments.
Becoming a pediatric occupational therapist is a multi-stage process that requires completing the qualification process for becoming a generalist OT and then developing specialized experience working with children. For professionals interested in supporting children to become more independent and confident in their everyday lives, this can be a very fulfilling career.
FAQs
What is the best undergraduate major for a pediatric occupational therapist?
There is no single undergraduate major that aspiring pediatric occupational therapists need to pursue, as occupational therapy programs generally accept students from a variety of academic backgrounds. However, majors such as psychology, biology, kinesiology, health science, and human development can provide a particularly relevant foundation for graduate OT education.
More importantly, students should choose a degree that allows them to complete the prerequisite coursework required by the occupational therapy school programs they plan to apply to.
What is the difference between pediatric physical therapy and pediatric OT?
Pediatric OT and physical therapy differ mainly in the types of functional challenges they are designed to address. Pediatric occupational therapists focus more heavily on helping children perform everyday activities, which may involve improving fine motor skills, self-care, feeding, sensory processing, handwriting, and school participation.
A pediatric physical therapist, on the other hand, concentrates primarily on movement and physical function. Pediatric physical therapists commonly help children improve gross motor skills, strength, balance, coordination, mobility, and other abilities involved in moving safely and independently.
Although the two professions can overlap, each approaches the child’s needs from a different functional perspective.
How long does it take to become a pediatric occupational therapist?
Becoming a pediatric occupational therapist typically takes around six to seven years from the start of undergraduate education. This timeframe generally accounts for about four years of bachelor’s-level study followed by another two to three years in an entry-level occupational therapy master’s program.
Students also complete the required fieldwork as part of their professional OT education, so this does not usually add a separate period after graduation. Once they finish their degree, they still need to pass the NBCOT exam and secure state licensure before they can begin practicing.
Those who later pursue a pediatric fellowship or Board Certification in Pediatrics will need additional time, although neither is required to begin working as a pediatric occupational therapist.