Occupational therapist assistants are healthcare professionals who help people whose injuries, health conditions, disabilities, or developmental challenges make everyday activities more difficult to perform independently. Working under the supervision of occupational therapists, they play an important role in carrying out treatment interventions and supporting patients throughout the rehabilitation process.
If you’re interested in pursuing a career in this profession and want to know how to become an occupational therapist assistant, this article will walk you through the qualification process from completing your preliminary education to obtaining professional licensure and entering the field.
It will also take a closer look at the nature and responsibilities of the profession, explain how occupational therapist assistants differ from occupational therapists and occupational therapy aides, and explore the opportunities available for advancing your career after becoming licensed.
Understanding the Occupational Therapy Assistant (OTA) Role
Occupational therapist assistants are healthcare professionals who work alongside occupational therapists to help patients with injuries, illnesses, and developmental disabilities improve their ability to perform everyday activities and function more independently.
While OTs are the responsible professionals who evaluate patients and direct the overall course of their treatment, OTAs are the supporting practitioners who work under their supervision and help carry out the interventions included in those treatment plans.
Their specific job duties depend on the patient and treatment plan, but most involve helping patients put the occupational therapist’s interventions into practice.
When working with patients, OTAs may guide patients with their therapeutic activities, help them perform specific exercises, teach them how to use adaptive equipment, or help them practice alternative ways of completing the tasks that have become difficult.
As they carry out these interventions, occupational therapist assistants also observe how patients respond and document any changes in their abilities. They then communicate this information to the supervising OT, who can use it to determine whether the treatment plan needs to be adjusted.
Occupational Therapist Assistant vs Occupational Therapist
Even though occupational therapist assistants and occupational therapists work closely together and provide care to the same patients, these two professions come with different levels of responsibility within the occupational therapy process.
Namely, OTs operate as the lead practitioners who hold the primary responsibility for evaluating patients, identifying their occupational needs, establishing the treatment goals, and developing the intervention plans used to guide their care.
OTAs, on the other hand, work under the direction of OTs and help carry out the interventions included in those plans. As they work with patients, OTAs also observe their progress, document relevant changes, and communicate this information to the supervising therapist, who remains responsible for directing the overall course of treatment.
The difference between these two therapist roles is also reflected in the education required to enter each profession. While OTs need to complete a graduate degree in occupational therapy, aspiring OTAs can qualify through an ACOTE-accredited occupational therapy assistant program, most commonly at the associate-degree level.
Occupational Therapist Assistant vs Occupational Therapy Aide
Another related position within the field of occupational therapy is that of the occupational therapy aide. And given that both aides and OTAs work under the supervision of OTs, some people may confuse their responsibilities, so we decided to take a moment to explain how these two roles differ.
As we just established, PTAs work directly with patients and help carry out the interventions included in their treatment plans. OT aides, on the other hand, do not provide occupational therapy interventions themselves and instead perform supportive duties that help OTs and OTAs provide care more efficiently.
Depending on the setting, these duties may include preparing treatment areas and equipment, cleaning and organizing supplies, helping patients move between treatment spaces, and completing routine administrative tasks.
Naturally, OT aides do not need to complete formal occupational therapy education before entering the field. While OTAs need to graduate from an ACOTE-accredited occupational therapy assistant program, pass the NBCOT examination, and obtain state licensure, aides typically need only a high school diploma or equivalent and receive most of their training on the job.
Requirements for Becoming an Occupational Therapist Assistant
Now that we have a better understanding of the occupational therapist assistant profession and how it differs from related occupational therapy roles, we can turn our attention to outlining the qualifications aspiring OTAs need to meet before they can begin practicing professionally.
To qualify for entry into this regulated healthcare profession, candidates need to:
- Earn a high school diploma or equivalent
- Graduate from an ACOTE-accredited program in occupational therapy
- Complete the supervised fieldwork required as part of their professional education
- Pass the NBCOT certification examination for occupational therapy assistants
- Obtain an occupational therapy assistant license in the state where they intend to practice
These requirements are designed to make sure that aspiring OTAs possess the appropriate academic and clinical preparation to provide occupational therapy services safely and effectively under the supervision of an occupational therapist.
How to Become an Occupational Therapist Assistant: Step By Step
Having outlined the main qualifications required to enter the profession, we can now take a closer look at the steps that aspiring OTAs need to take to become eligible for professional practice.
Finish High School or Obtain an Equivalent Credential
The first step toward becoming an occupational therapy assistant is to finish high school or earn an equivalent credential, such as a GED. This foundational level of education is required for admission to occupational therapy assistant degree programs and provides the academic preparation students need to continue into postsecondary education.
Students who are interested in pursuing this career can use their time in high school to develop a stronger foundation in subjects related to health and human function. In particular, courses in biology, anatomy, psychology, and health science can help prepare them for some of the material they will encounter during their occupational therapy assistant education.
However, a high school diploma alone is not enough to qualify for professional OTA practice. After graduating, aspiring occupational therapy assistants need to continue into an ACOTE-accredited degree program, which is where they receive the formal academic and clinical preparation required to enter the profession.
Earn an ACOTE-Accredited Occupational Therapy Assistant Degree
After finishing high school, aspiring OTAs can move on to the main stage of their professional education and enroll in an occupational therapy assistant degree program.
These degree programs are most commonly offered at the associate’s level and generally take around two years of full-time study to complete. However, students can also enter the profession through an accredited bachelor’s-level OTA program, although these programs are considerably less common.
Throughout their education, OTA students complete coursework that introduces them to the scientific and practical foundations of occupational therapy. Their curriculum commonly covers subjects such as anatomy, physiology, psychology, kinesiology, therapeutic techniques, and the different ways occupational therapy can be used to help patients improve their ability to function more independently.
One important consideration students need to keep in mind when choosing a program is accreditation. To remain eligible for the NBCOT certification examination after graduation, aspiring OTAs need to complete a program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE).
Complete the Required Fieldwork
In addition to their classroom education, aspiring occupational therapist assistants also need to complete a practical component as a part of their studies. This experience comes in the form of supervised fieldwork and allows students to apply what they have learned in the classroom in real occupational therapy settings.
The first part of the clinical practice is Level I fieldwork, which introduces students to occupational therapy practice and gives them opportunities to observe how the concepts and techniques covered in class are applied when working with patients.
After completing this introductory experience, students move on to Level II fieldwork, where they take on a more active role in providing occupational therapy services under appropriate supervision. In total, OTA students need to complete at least 16 weeks of full-time Level II fieldwork, or its part-time equivalent.
By the time they finish their fieldwork, students are expected to demonstrate greater competence in carrying out occupational therapy interventions, communicating with patients and supervising therapists, and performing the responsibilities associated with entry-level OTA practice.
Pass the NBCOT COTA Examination
With their education and practical experience requirements complete, aspiring OTAs can move on to the examination stage of the qualification process.
Their main challenge at this phase is to pass the national certification examination administered by the National Board for Certification in Occupational Therapy (NBCOT), commonly referred to as the COTA exam.
This examination is designed to assess whether or not candidates can apply the knowledge and clinical reasoning developed during their OTA education to situations they are likely to encounter in professional practice.
Once they pass the national certification exam, candidates earn the Certified Occupational Therapy Assistant (COTA) credential and become eligible to continue toward state licensure. However, NBCOT certification alone does not authorize them to begin practicing, as OTAs must also obtain a professional license from the state in which they intend to work.
Obtain an Occupational Therapy Assistant License
Candidates who have passed the NBCOT COTA examination can move on to the final stage of the qualification process and apply for an occupational therapy assistant license in the state where they intend to practice.
Since every state regulates the occupational therapy profession independently, aspiring OTAs need to secure a valid state license before they can legally begin providing occupational therapy services.
To apply for their license, applicants generally need to submit an application to the appropriate state licensing authority and provide documentation showing that they have graduated from an ACOTE-accredited occupational therapy assistant program and passed the NBCOT examination.
Depending on the jurisdiction, they may also need to complete a criminal background check, pass a state law or jurisprudence examination, pay the required licensing fees, or satisfy other state-specific requirements.
Once the licensing authority verifies that the applicant has met all applicable requirements, it can issue the professional license needed to begin practicing as an occupational therapy assistant within that state.
Start Working as a Certified Occupational Therapy Assistant
The moment an occupational therapy assistant candidate receives their license, they officially become qualified to enter the field in a professional capacity. At this point, they can start applying for positions in settings that align with their interests and the types of patients they would like to work with.
Depending on the opportunities available to them, newly licensed OTAs may find employment in hospitals, outpatient therapy offices, assisted living facilities, nursing care facilities, home health care services, and other environments where occupational therapy care is provided.
It is worth pointing out that some employers may also require them to hold additional credentials, such as basic life support certification, before beginning work.
As they continue to gain experience, certified occupational therapy assistants can become increasingly familiar with carrying out different types of interventions and potentially identify areas of occupational therapy that they might be interested in pursuing further education.
For those who decide that they do want to advance their careers, there are several pathways that they can take to develop new skills and qualify for more advanced roles.
Advancing Your Career as an Occupational Therapist Assistant
Occupational therapist assistants with enough experience in professional practice may begin looking for ways to expand their skills and take the next step in their careers.
Depending on their professional goals, this may involve pursuing additional training and continuing education to develop greater expertise in a particular area of occupational therapy practice.
Alternatively, OTAs who want to take on the broader responsibilities associated with evaluating patients and directing their treatment can continue their education and work toward becoming an occupational therapist.
Pursue Additional Training and Professional Development
Beyond the experience they develop through everyday practice, certified occupational therapy assistants can also pursue additional education and training to expand their knowledge in the areas of occupational therapy that interest them most.
One way they can do this is by pursuing continuing education opportunities that focus on specific patient populations, treatment approaches, or areas of practice. These programs allow them to build on their existing knowledge and develop more specialized skills.
OTAs who want to have their additional training be formally recognized can also pursue professional certificates and microcredentials offered by the American Occupational Therapy Association.
Unlike AOTA’s exam-based advanced certifications, which are currently designed for occupational therapists, these professional-development credentials are available to occupational therapy assistants and allow them to demonstrate additional knowledge and skills in focused areas of practice.
Continuing professional development is also important for maintaining the COTA credential. NBCOT-certified OTAs generally need to renew their certification every three years and complete the required professional-development activities during each renewal cycle.
Transition From OTA to Occupational Therapist
For occupational therapist assistants who want to take on greater responsibility within the occupational therapy process, there is also the option to continue their education and work toward becoming an occupational therapist.
Naturally, the experience they gain while working as OTAs can provide a strong practical foundation for making this transition, though it will not replace the additional professional education required for OT practice.
This means that OTAs who want to move into the occupational therapist role still need to complete an ACOTE-accredited occupational therapy program at the master’s or doctoral level.
After completing the required OT education and fieldwork, graduates must also pass the NBCOT examination for occupational therapists and obtain a state occupational therapy license before they can begin practicing in their new role.
Job Outlook and Salary for Occupational Therapist Assistants
Having explored the qualification process for becoming a licensed occupational therapist assistant, we can now take a look at the earning potential and employment outlook associated with this profession.
According to the Bureau of Labor Statistics, OTAs earn a median annual wage of $68,340. However, this figure represents the midpoint for the profession as a whole and does not reflect what every OTA earns.
For example, occupational therapist assistants working in home healthcare services earn a median annual salary of $76,800, compared with $59,240 for those employed in educational services. OTAs working in skilled nursing facilities also earn a notably higher median salary of $75,860 per year.
Looking beyond earnings, the job outlook for occupational therapist assistants is also positive. The BLS projects employment in the profession to grow by 19% between 2024 and 2034, increasing from approximately 49,200 jobs to 58,700.
This represents around 9,500 additional positions over the decade, while approximately 7,200 openings are expected each year on average when employment growth and the need to replace workers leaving the occupation are taken into account.
Much of this demand is expected to come from the healthcare needs of an aging population, as older adults are more likely to experience conditions that can affect their ability to perform everyday activities.
In addition, healthcare providers, particularly those specializing in long-term care, are expected to continue relying on occupational therapy assistants to help provide occupational therapy services more efficiently. (BLS, BLS)
Closing Words
Difficulties with everyday activities can significantly affect a person’s independence and ability to function comfortably in daily life. Occupational therapy assistants play an important role in the rehabilitation process by helping patients carry out the interventions designed to improve these abilities and supporting their progress toward greater independence.
Becoming an occupational therapist assistant requires completing the appropriate education and securing a professional license. For those willing to complete these requirements, the profession can offer a rewarding healthcare career centered on helping people improve their ability to manage the activities that matter most in their everyday lives.
FAQs
How long does it take to become an occupational therapy assistant?
Becoming an occupational therapy assistant typically takes around two years from the start of your postsecondary education, although the exact timeframe can vary depending on the program you attend.
Most aspiring OTAs spend about two years completing an ACOTE-accredited associate degree program. The required Level I and Level II fieldwork is completed as part of that program, including at least 16 weeks of Level II fieldwork, so it does not normally add another separate period to the timeline.
After graduation, candidates still need to pass the NBCOT COTA examination and obtain state licensure. These final steps generally take additional weeks or months, depending on how quickly candidates schedule the exam and how long their state licensing authority takes to process the application.
What degree do you need to become an occupational therapist assistant?
Most occupational therapist assistants need an associate degree from an ACOTE-accredited occupational therapy assistant program. These programs generally take around two years of full-time study and include both classroom instruction and the supervised fieldwork required for entry into the profession.
However, an associate degree is not the only option. Some schools also offer ACOTE-accredited bachelor’s-level OTA programs, although these are considerably less common.
Regardless of the degree level, aspiring OTAs need to make sure the program they choose is accredited by ACOTE, as graduating from an accredited program is necessary for continuing toward NBCOT certification and state licensure.
Do occupational therapist assistants need a license?
Yes, occupational therapist assistants need to be licensed before they can provide occupational therapy services professionally in all states across the US.
To qualify for a license, candidates generally need to graduate from an ACOTE-accredited occupational therapy assistant program, complete the required fieldwork, and pass the NBCOT COTA examination.
However, individual states may also require applicants to complete a criminal background check, pass a jurisprudence examination, submit an official transcript, or meet other state-specific requirements.