An Occupational Therapy Assistant (OTA) is a healthcare professional who works under the supervision of an Occupational Therapist. OTAs help patients of all ages recovering from injuries, illnesses, or developmental disabilities regain independence. They assist patients in participating in activities meaningful to them. Becoming a Certified Occupational Therapy Assistant (COTA) offers a strong career path, with an employment outlook projected to be much faster than the national average.
What Occupational Therapy Assistants Do
Occupational therapy assistants implement the treatment plan created by the occupational therapist after the initial evaluation. This involves working directly with patients through therapeutic activities and exercises. The goal is to improve motor functions, cognitive abilities, and self-care skills, enabling the patient to perform daily tasks like dressing or cooking by adapting the task or environment.
Daily duties involve teaching patients how to use adaptive equipment, such as splints or modified utensils, and instructing them in home programs to reinforce skills. OTAs monitor the patient’s progress and behavior during sessions and must document all observations in the patient’s record. They communicate continuously with the supervising occupational therapist to ensure the treatment plan remains effective and can be adjusted.
OTAs and OTs work side-by-side, but their responsibilities are distinct. The occupational therapist develops the intervention plan, while the OTA focuses on the hands-on delivery of treatment. Common work environments include hospitals, skilled nursing facilities, rehabilitation centers, schools, and outpatient clinics.
Meeting the Educational Requirements
The first step toward becoming an OTA is completing an associate’s degree, typically an Associate of Applied Science (AAS) or an Associate of Occupational Studies (AOS). This degree takes about two years of full-time study and provides foundational knowledge. The program must be accredited by the Accreditation Council for Occupational Therapy Education (ACOTE).
Graduation from an ACOTE-accredited program is required to sit for the national certification exam and obtain state licensure. The curriculum includes scientific and therapeutic courses. Students study human anatomy, physiology, kinesiology, and psychology to understand the physical and emotional components of occupational performance.
Coursework covers occupational therapy principles, therapeutic techniques, professional ethics, and clinical reasoning. This prepares students for patient care and clinical decision-making. Students must maintain a required grade point average to remain eligible for fieldwork.
Completing Fieldwork and Practical Experience
After completing academic requirements, students must complete hands-on training known as fieldwork. This experience is integrated into the associate’s degree program and is required for national certification eligibility. ACOTE mandates a structured approach to this clinical training, which is separated into two levels.
Level I Fieldwork is introductory, often concurrent with academic coursework. It focuses on observation and participation, exposing students to different practice settings and client populations.
Level II requires a minimum of 16 weeks of full-time work, which may be completed across two separate placements. This stage involves direct patient care under the supervision of a qualified occupational therapist or assistant. During Level II fieldwork, students apply academic knowledge, refine technical skills, and take on professional responsibilities.
Passing the National Certification Exam
After completing the academic and fieldwork requirements, graduates apply for the national certification examination. This exam is administered by the National Board for Certification in Occupational Therapy (NBCOT). Passing this standardized test of entry-level competence is necessary to earn the title of Certified Occupational Therapy Assistant (COTA).
The NBCOT exam is a four-hour, computer-based test consisting of 190 items, including multiple-choice and multi-select questions. The content covers the knowledge and skills required for safe practice. Candidates must use the MyNBCOT portal to apply and receive their Authorization to Test (ATT) to schedule the appointment.
National certification protects the public by ensuring practitioners have foundational knowledge of occupational therapy principles. Achieving a passing score grants the COTA credential. This certification is a separate step from the state-specific license required to practice legally.
Obtaining State Licensure
National certification is a prerequisite, but nearly all states require OTAs to obtain a separate state license to practice legally. The license grants the privilege to provide occupational therapy services within that specific jurisdiction. This process is managed by the state’s occupational therapy board, which verifies the candidate’s education, fieldwork, and NBCOT certification.
Licensure requirements vary, often including a background check, application fees, and sometimes a state-specific jurisprudence exam testing local laws. The state board must receive official documentation, such as transcripts and NBCOT exam scores, directly from the source.
Continuing competence ensures the OTA stays current with evolving standards of practice and new therapeutic techniques. State boards monitor and regulate OTA practice, enforcing ethical standards and supervision requirements. Practitioners must know that a license from one state does not automatically allow them to practice in another.
Career Outlook and Next Steps
The career outlook for Occupational Therapy Assistants is strong, driven by increasing demand for healthcare services for the aging population and people with chronic conditions. The Bureau of Labor Statistics projects employment for OTAs to grow by 18 percent from 2024 to 2034. This growth rate is significantly faster than the average for all occupations, suggesting a steady supply of job openings.
The median annual wage for occupational therapy assistants was $68,340 in May 2024, with the highest earners making over $86,930 annually. Salary fluctuates based on employment setting, geographic location, and years of experience. Opportunities for advancement are available through specialization in areas such as pediatrics, geriatrics, or low vision, pursued through continuing education.
Aspiring OTAs should research ACOTE-accredited programs in their area and contact admissions offices regarding deadlines and prerequisites. The first step is enrolling in an associate’s degree program. This positions an individual to enter a rewarding and secure healthcare profession within a few years.