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How to Become an Occupational Therapy Assistant (OTA)
Quick answer: how to become an Occupational Therapy assistant
Complete an accredited occupational therapy assistant associate degree program (2 years), pass the NBCOT certification exam to earn the COTA credential, obtain state licensure, and apply for positions in hospitals, rehabilitation centers, or schools. Most occupational therapy assistants can begin their career within 2-2.5 years of starting their education.
What does an Occupational Therapy assistant do?
Occupational therapy assistants (OTAs) work under the supervision of occupational therapists to help patients develop, recover, or maintain daily living and work skills. They help people of all ages overcome physical, developmental, or emotional challenges to live more independent and fulfilling lives.
Primary Responsibilities
Direct Patient Treatment:
- Implement treatment plans designed by occupational therapists
- Lead patients through therapeutic exercises and activities
- Help patients practice daily living skills (dressing, cooking, bathing)
- Teach adaptive techniques for daily tasks
- Guide patients in using assistive devices and equipment
- Provide hands-on assistance during therapy sessions
Patient Assessment and Documentation:
- Observe and record patient progress
- Report changes in patient condition to supervising OT
- Document treatment sessions and outcomes
- Contribute to patient care conferences
- Help develop treatment goals
- Track patient attendance and participation
Specialized Interventions:
- Provide sensory integration activities
- Lead fine and gross motor skill development exercises
- Implement cognitive rehabilitation activities
- Teach energy conservation techniques
- Support work-related skill development
- Provide community integration training
Equipment and Environment:
- Set up treatment areas and equipment
- Fabricate and modify adaptive equipment
- Recommend environmental modifications
- Maintain therapy supplies and materials
- Ensure safe treatment environments
- Train patients and caregivers on equipment use
Work Environment
Occupational therapy assistants work in various settings:
- Hospitals and acute care facilities
- Skilled nursing facilities
- Outpatient rehabilitation clinics
- Schools and early intervention programs
- Home health agencies
- Mental health facilities
- Pediatric therapy centers
Licensure and Certification for Occupational Therapy Assistants
Certification and state licensure are required to practice as an OTA.
NBCOT Certification (COTA)
Issuing Organization: NBCOT (National Board for Certification in Occupational Therapy)
Requirements:
- Graduate from ACOTE-accredited OTA program
- Complete all fieldwork requirements
- Pass background check
Exam Details:
- 200 multiple-choice questions
- 4 hours time limit
- Computer-based testing
- Covers all areas of OT practice
- $535 exam fee
Designation: Certified Occupational Therapy Assistant (COTA)
Renewal: Every 3 years with professional development units
State Licensure
Requirement: All 50 states require OTA licensure or registration
Common Requirements:
- NBCOT certification
- State application and fee
- Background check
- Continuing education for renewal
Supervision Requirements: OTAs must work under the supervision of a licensed occupational therapist; supervision levels vary by state
Step-by-step path to becoming an Occupational Therapy assistant
Step 1: meet basic requirements
Education: High school diploma or GED required
Recommended Preparation:
- Biology and anatomy courses
- Psychology classes
- Health or human development courses
- Volunteer experience in healthcare
Personal Qualities:
- Patience and empathy
- Creativity and adaptability
- Strong communication skills
- Physical stamina
- Attention to detail
- Desire to help others
Step 2: complete an accredited OTA program
Associate Degree (2 years)
- Required for NBCOT certification
- Must be accredited by ACOTE
- Includes classroom and fieldwork components
- Available at community colleges and technical schools
Program Components:
- Anatomy and physiology
- Kinesiology and neuroscience
- Occupational therapy theory and practice
- Developmental psychology
- Therapeutic activity analysis
- Physical and psychosocial conditions
- Documentation and professional ethics
Fieldwork Requirements:
- Level I Fieldwork: Observation and introductory experiences
- Level II Fieldwork: 16 weeks of supervised clinical practice
- Rotations in various treatment settings
Step 3: complete fieldwork
Fieldwork is integrated into the OTA program:
- Level I: Introductory experiences during coursework
- Level II: Two 8-week full-time clinical rotations
- Settings: Hospitals, schools, SNFs, outpatient clinics, pediatric centers
- Supervision: Direct supervision by licensed OT or OTA
Step 4: Pass the NBCOT Exam
- Apply for NBCOT exam after program completion
- Complete background check
- Schedule exam at testing center
- Study using NBCOT prep materials
- Pass exam to earn COTA designation
Step 5: obtain state licensure
- Apply to state occupational therapy board
- Submit NBCOT certification verification
- Complete background check
- Pay licensure fee
- Meet any additional state requirements
Step 6: begin your career
Entry-Level Positions:
- Occupational therapy assistant
- Certified occupational therapy assistant (COTA)
- Rehab aide (while pursuing OTA education)
- Therapy technician
Common First Employers:
- Skilled nursing facilities
- Hospital rehabilitation departments
- School districts
- Home health agencies
- Outpatient rehabilitation clinics
Training programs and education options
Program types comparison
| Program Type | Duration | Cost Range | Best For |
|---|---|---|---|
| Associate Degree | 2 years | $8,000-$25,000 | Standard pathway |
| Accelerated Program | 18-20 months | $15,000-$30,000 | Quick completion |
| Bridge Program | 12-18 months | $12,000-$20,000 | PTAs or healthcare workers |
What to look for in a program
ACOTE Accreditation: Required for NBCOT exam eligibility
Pass Rates: NBCOT first-time pass rates (80%+ is strong)
Fieldwork Partnerships: Established clinical site relationships
Faculty: Experienced OT practitioners as instructors
Job Placement: High graduate employment rates
Accreditation is Essential
ACOTE (Accreditation Council for Occupational Therapy Education):
- Only ACOTE-accredited programs qualify for NBCOT exam
- Ensures program meets quality standards
- Verify accreditation status before enrolling
- Check for any probation or warnings
Program Curriculum
Year 1:
- Anatomy and physiology
- Medical terminology
- Introduction to occupational therapy
- Human development
- Level I fieldwork
Year 2:
- Physical dysfunction treatment
- Psychosocial conditions
- Pediatric OT
- Geriatric OT
- Level II fieldwork (16 weeks)
Cost breakdown: Occupational Therapy assistant training
Tuition and Fees
| Program Type | Tuition Range | Additional Fees |
|---|---|---|
| Community College | $8,000-$15,000 | $500-$1,000 |
| Technical School | $15,000-$25,000 | $800-$1,500 |
| Private College | $25,000-$40,000 | $1,000-$2,000 |
Additional Expenses
| Item | Estimated Cost |
|---|---|
| NBCOT exam fee | $535 |
| State licensure | $50-$200 |
| Background check | $50-$100 |
| Textbooks | $500-$1,000 |
| Fieldwork costs (travel, housing) | $500-$2,000 |
| Uniforms/scrubs | $100-$200 |
| CPR certification | $50-$100 |
Financial aid options
- Federal Financial Aid: Pell Grants, student loans (FAFSA)
- State Grants: Many states offer healthcare workforce grants
- Scholarships: AOTA and state OT associations offer scholarships
- Employer Tuition Assistance: Some healthcare employers fund education
- Veterans Benefits: GI Bill covers approved programs
Occupational Therapy assistant salary and job outlook
National salary data
Salary by Experience Level
| Experience | Typical Annual Salary |
|---|---|
| Entry-Level (0-1 year) | $48,000-$55,000 |
| Early Career (1-3 years) | $55,000-$65,000 |
| Mid-Career (4-7 years) | $65,000-$75,000 |
| Experienced (8+ years) | $75,000-$85,000 |
Salary by Work Setting
| Setting | Median Annual Salary |
|---|---|
| Home Health Services | $72,000-$82,000 |
| Hospitals | $68,000-$78,000 |
| Nursing Facilities | $65,000-$75,000 |
| Schools | $58,000-$68,000 |
| Outpatient Clinics | $62,000-$72,000 |
Job Outlook
- Current Employment: Over 47,000 occupational therapy assistants nationwide
- Projected Growth (2022-2032): 24% (much faster than average)
- Annual Job Openings: 7,500 positions
- Growth Factors: Aging population, increased rehabilitation needs, school-based therapy expansion
Salary by State
Career advancement opportunities
Specialization Options
Practice Areas:
- Pediatric occupational therapy
- Geriatric rehabilitation
- Hand therapy assistance
- Mental health/behavioral health
- School-based practice
- Work rehabilitation
Advanced Skills:
- Splinting and orthotics
- Sensory integration
- Driving rehabilitation assistance
- Low vision rehabilitation
- Lymphedema management
Advanced Certifications
| Certification | Focus | Requirements |
|---|---|---|
| AOTA Board Certifications | Various specialty areas | Experience + portfolio |
| PAMs Certification | Physical agent modalities | State-specific training |
| Specialty Training | Hand therapy, pediatrics | Additional coursework |
Career Paths
| Role | Additional Requirements | Salary Range |
|---|---|---|
| Senior OTA | 3-5 years experience | $70,000-$80,000 |
| OTA Fieldwork Educator | AOTA training | $68,000-$78,000 |
| Rehab Department Supervisor | Management experience | $75,000-$90,000 |
| Occupational Therapist | Master’s degree | $85,000-$100,000+ |
| OTA Program Instructor | Master’s degree + experience | $60,000-$80,000 |
Educational Advancement
- Bachelor’s Degree Completion: Some schools offer OTA-to-BS pathways
- Master’s in Occupational Therapy: Become a licensed OT
- Related Master’s Degrees: Healthcare administration, rehabilitation counseling
Pros and challenges of this career
Benefits
- Exceptional job growth (24% - much faster than average)
- Meaningful work helping people regain independence
- Excellent salary for associate degree ($66,650 median)
- Multiple work settings available
- Creative, hands-on work environment
- Strong job security in healthcare
- Pathway to becoming an occupational therapist
- Work with diverse patient populations
Challenges
- Requires 2-year degree (longer than some healthcare roles)
- NBCOT exam can be challenging
- Must work under OT supervision
- Physically demanding work
- Emotionally challenging patient situations
- Continuing education required for licensure
- Documentation requirements can be extensive
Frequently asked questions
How long does it take to become an occupational therapy assistant?
OTA programs take 2 years to complete. This includes classroom instruction, lab work, and 16 weeks of Level II fieldwork. After graduation, passing the NBCOT exam and obtaining state licensure adds 1-2 months.
How much does OTA training cost?
Community college programs cost $8,000-$15,000 for the full program. Technical schools range from $15,000-$25,000. Private colleges can cost $25,000-$40,000. Additional expenses include exam fees, licensure, and fieldwork costs.
Is occupational therapy assistant a good career choice?
OTA is an excellent career with 24% job growth (much faster than average) and strong median salary ($66,650). The combination of meaningful work, job security, and advancement opportunities makes it highly attractive for healthcare careers.
What is the difference between an OTA and an OT?
Occupational therapists (OTs) have master’s or doctoral degrees, evaluate patients, and develop treatment plans. OTAs have associate degrees, implement treatment plans, and work under OT supervision. Both are licensed healthcare professionals.
Do OTAs need to be licensed?
Yes, all 50 states require OTA licensure or registration. You must first pass the NBCOT exam to earn COTA certification, then apply for state licensure. Continuing education is required for renewal.
Can OTAs specialize in a particular area?
Yes, OTAs can specialize through work experience and additional training. Common specializations include pediatrics, geriatrics, hand therapy, mental health, and school-based practice. Some states allow additional certifications for physical agent modalities.
Where do occupational therapy assistants earn the most?
OTAs in home health settings typically earn the highest salaries. Geographic location also matters, with states like California, New Jersey, and Nevada offering higher wages. Urban areas generally pay more than rural settings.
How much do OTAs make per hour?
Based on national averages, OTAs earn approximately $32-$35 per hour at the median level. Entry-level positions start around $23-$27 per hour, while experienced OTAs can earn $36-$42 per hour in high-paying settings.
Is the NBCOT exam difficult?
The NBCOT exam is challenging and requires thorough preparation. National first-time pass rates vary by program, with well-prepared students from accredited programs typically passing at rates of 80-90%. Study courses and practice exams are highly recommended.
Can I become an OT after working as an OTA?
Yes, many OTAs pursue master’s degrees to become occupational therapists. Some programs offer OTA-to-OT bridge pathways. Your OTA experience provides valuable clinical foundation, though you’ll need to complete the full OT curriculum.
What is the job outlook for occupational therapy assistants?
The BLS projects 24% growth for OTAs through 2032, with 7,500 annual job openings. This is much faster than average, driven by aging populations and increased recognition of occupational therapy benefits.
Do OTAs work with children?
Yes, many OTAs work in pediatric settings including schools, early intervention programs, and pediatric clinics. They help children with developmental delays, autism, sensory processing issues, and physical disabilities develop skills for daily life.
How to get started today
Ready to begin your occupational therapy assistant career? Follow these steps:
- Research Programs: Use the search tool below to find ACOTE-accredited OTA programs in your area
- Verify Accreditation: Confirm programs are accredited by ACOTE
- Check Prerequisites: Many programs require anatomy, psychology, or healthcare experience
- Plan for Fieldwork: Understand the 16-week fieldwork commitment
- Apply and Enroll: Start your OTA program
Additional Resources
Certification and Licensure
- NBCOT: nbcot.org – National certification
- State Licensure Boards: Contact your state’s OT regulatory board
Professional Organizations
- AOTA: aota.org – American Occupational Therapy Association
- State OT Associations: Local networking and continuing education
Accreditation
- ACOTE: acoteonline.org – Program accreditation verification
Career Development
- Continuing Education: Required for licensure renewal
- Specialty Certifications: AOTA specialty training
- OT Graduate Programs: Pathways to become an occupational therapist