How to Become an Occupational Therapy Assistant

By: Dr. April McDowell, MFT

Last Updated: Dec 12, 2018

Occupational therapy assistants enjoy a greatly satisfying career working directly with patients of all ages to help them grow and develop positive skills, rehabilitate after injury, manage a multitude of chronic illnesses and conditions, and improve their quality of life dramatically in many other ways. An occupational therapy assistant (OTA) works under the direction of an occupational therapist to guide patients in prescribed therapeutic activities and exercises.

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Often using specialized equipment, OTAs help patients achieve or recover their full, independent and healthy lifestyles in spite of injury or disability. While an occupational therapist may diagnose and prescribe certain treatments, occupational therapy assistants are mostly responsible for directly working with the patient to achieve the treatment goals. It’s important to note, OT assistants (or OTAs) are different than OT aides – aides generally do not assist with exercises or treatment.

Workplace Details

Since occupational therapy assistants work under the direction of the therapists, they work wherever the OTs work. And since there are many different specialties in occupational therapy, the assistants enjoy a variety of potential workplace environments. Traditionally OTAs worked in hospitals but increasingly they are employed in private practice offices (approximately one third of all assistants). Other venues include schools and nursing care facilities. Ten percent of OTAs provide direct in-home care to patients.

The assistants work a 40-hour workweek or more, which may involve weekends, early morning and/or early evening schedules.

Hover over any state to explore local income and job growth data.

The Bureau of Labor Statistics states that the median income for occupational therapy assistants is $57,870. Those who work in nursing facilities, private practitioners’ offices and home health agencies earn more than those who work in hospitals or schools.

Job growth is projected to increase at a much higher rate than average. The Bureau of Labor Statistics estimates a whopping 43% increase in jobs from 2014 to 2024. Also worth noting: this rate of growth is unchanged from the previous BLS projection a couple years earlier, another indication of the strength of the employment outlook for occupational therapy assistants.

The minimum education requirement for an occupational therapy assistant is a two-year associate’s degree. The degree should be from a program accredited by the American Occupational Therapy Association. Courses vary by school, but will generally include coursework in biology, psychology, kinesiology (the science of movement) and a variety of occupational therapy courses.

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Most often, a school that grants associate degrees will provide a formal practicum in which students work under the supervision of a licensed occupational therapist. When it is not part of the formal curriculum, students must arrange to obtain this supervised training separately. The required length of this fieldwork varies by state, but is at least eight weeks in duration. The practicum offered in most schools may last longer than minimum requirements.

Graduates must pass the National Board for Certification in Occupational Therapy (NBCOT) certification examination. OTAs take the Certified Occupational Therapist Assistant (COTA) exam. Once candidates have their associate degree, documented fieldwork experience, and passing COTA exam grade in hand, they may apply to their state for licensure, which is essentially a verification process for the above qualifications.

Because licensure allows occupational therapy assistants to work for OTs only, career advancement depends greatly on solid job performance in support of the therapist. Assistants who demonstrate that they can be trusted, follow treatment instructions and provide excellent care are rewarded with job security, promotions and higher pay. Though not prevalent, there are “bridge” programs that provide a good pathway for OTAs to gain additional education in order to advance their career by becoming occupational therapists.

To become an occupational therapy assistant (OTA), you’ll need to earn an associate degree (typically an A.S. or A.A.S.) from an accredited training program. OTA associate degrees take about two years of full-time study to complete and are commonly found in community colleges and technical schools.

To ensure you’ll be eligible for licensure, choose a program accredited by the American Occupational Therapy Association. The good news: there are currently over 250 AOTA-accredited programs across the United States.

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As part of your program, you’ll study the movement and function of the human body. You’ll also delve into the role the mind plays in the tasks of work and daily living. Expect coursework in the following subjects, among others:

In addition to coursework, most OTA associate degree programs require at least 16 weeks of hands-on clinical training with a licensed occupational therapist. Your school may arrange this for you, or you may need to reach out to therapists on your own. The amount of fieldwork needed for licensure can vary by state, so check the requirements for your location.

Taking high school classes in biology and the physical sciences can improve your chances of getting into an OTA program.

After completing an associate degree program, OTA candidates pursue national certification. This requires passage of the Certified Occupational Therapy Assistant (COTA) exam, which is administered by the National Board for Certification in Occupational Therapy (NBCOT).

AOTA offers OTAs voluntary certification in five specialties. These credentials are most appropriate for experienced OTAs who have clinical and research interests in a specific condition or patient population. Options include:

• Driving and community mobility
• Environmental modification
• Feeding, eating and swallowing
• Low vision
• School systems

To obtain specialty certification, applicants must submit a portfolio, self-assessment, and professional development plan to AOTA’s peer review committee. The application should demonstrate high standards of ethics, critical reasoning, clinical knowledge, and interpersonal skills.