Pediatric Therapeutic Services


Female school-based COTA kneels beside schoolboy sitting on medicine ball in sensory room during therapeutic intervention.

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Certified Occupational Therapy Assistant (COTA) - School Based. 19801 Wilmington DE


Are you a persistent and creative problem solver? Do you want to help people improve their daily lives in tangible ways? A career as a Certified Occupational Therapy Assistant (COTA®) may be right for you.

Like an Occupational Therapist Registered (OTR®), the COTA is trained in holistic approaches, “helping people participate in the meaningful activities they need and want to do.”

Unlike the OTR, the COTA doesn’t perform research or evaluate clients. Under the OTR’s supervision, the COTA implements and documents therapeutic interventions. The COTA also provides the OTR feedback about the client’s progress.

COTAs in school jobs largely help students with physical or developmental disabilities who receive special education do the tasks (the “occupations”) they must to access their education. They can help children make progress in everything from literacy and behavior management to making their way around the school building, to playing with their peers at recess, and more.

Where schools have adopted a Multi-Tier Systems of Support (MTSS) approach to related services, COTAs can also assist students struggling in general education. 

COTAs on the Pediatric Therapeutic Services (PTS) team make practical, powerful differences in students’ lives every day. Here’s what you need to know about getting started in this rewarding career.

An Overview of Occupational Therapy Education for COTAs

 Female school-based Certified Occupational Therapy Assistant models talking on phone for young school girl during session.The American Occupational Therapy Association (AOTA) established the role of Certified Occupational Therapy Assistant to meet a shortage of occupational therapists in psychiatric hospitals during the 1950s. In 1960, the first two classes of COTAs began work after completing a 12-week training program.

Currently, aspiring COTAs must successfully complete what is usually a two-year degree program (some only take 16 or 18 months) accredited by the ACOTE (Accreditation Council for Occupational Therapy Education). The program leads to an associate’s degree, usually an Associate of Applied Science (A.A.S.). (By July 1, 2027, the entry-level OTA degree will be a bachelor’s degree.) 

Classroom work generally fills your first year—medical terminology, neuroscience concepts, kinesiology, physical rehabilitation, intervention techniques, pediatrics, gerontology, and more. Fieldwork or clinical practice occupies your second year.

AOTA recognizes two levels of fieldwork:

  • Level I Fieldwork is Introductory

It will orient you to occupational therapy through directed observation and participation. Each degree program sets its own Level I requirements; no minimum AOTA requirement exists.

  • Level II Fieldwork is In-Depth

It is “designed to promote clinical reasoning and reflective practice.” It will nurture your independent expertise and professional identity. AOTA requires that OTAs complete at least 16 full-time weeks of Level II fieldwork.

What You Must Master to Pass the National Certification Exam

To become a Certified Occupational Therapy Assistant, you’ll also have to pass the NBCOT® Certification Examination. (NBCOT is the National Board for Certification in Occupational Therapy, and it administers a similar, separate exam for OTRs.) 

Candidates take the test in electronic format at a Prometric Test Center. The COTA exam consists of 200 multiple-choice questions you’ll have four hours to answer. Most are single-response items. Six are multi-select items (in other words, you select the three best options out of six.)

The test measures your entry-level competence in these three domains:

  • Collaborating and Gathering Information (28% of the exam)
  • Selecting and Implementing Interventions (55% of the exam)
  • Upholding Professional Standards and Responsibilities (17% of the exam)

A passing score on the certification exam is 450 points. In 2019, the national pass rate was 61%. Fortunately, study guides and practice tests abound. Using these test preparation resources can greatly increase the odds of passing the NBCOT exam on your first attempt.

The COTA Jobs Outlook: Growing Strong Through 2029

As you’ve seen, the requirements are many. But once you meet the requirements, so are your job possibilities!

Employers of Occupational Therapy Assistants will be looking for people with your skills and education. In fact, about 80% of OTAs get a job within six months of graduating from their degree program.

According to the Bureau of Labor Statistics (BLS), demand for occupational therapy assistants should grow 35% through 2029, much faster than all occupations’ average. 

The U.S. population of aging baby boomers accounts for much of the anticipated demand for Occupational Therapy. Many OTA positions in hospitals, residential care facilities, home health care agencies, and similar clinical settings will be available.

But the BLS specifically notes OT “will also continue to be used to treat children and young adults with developmental disabilities, such as autism.” And, AOTA identifies children and youth “as a key practice area for the 21st century.”

Find Great COTA Jobs Near You When You Work with PTS

Overall, Certified Occupational Therapy Assistants are “highly satisfied” with their job, according to a PayScale survey

Ready to kick off your career as a school-based COTA? Browse PTS’ currently available COTA jobs in Pennsylvania, New Jersey, and Delaware.

Send us your information and submit your resume. We’ll help you find a perfect placement where you can do more good for more students. You’ll find satisfaction in the steps you help them take toward a fuller and more fulfilling educational experience!

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