Occupational therapist assistants and aides work under the supervision of occupational therapists to provide rehabilitative services to persons with mental, physical, emotional, or developmental impairments. The ultimate goal is to improve clients' quality of life and ability to perform daily activities. For example, occupational therapist assistants help injured workers re-enter the labor force by teaching them how to compensate for lost motor skills or help individuals with learning disabilities increase their independence.
Occupational therapist assistants help clients with rehabilitative activities and exercises outlined in a treatment plan developed in collaboration with an occupational therapist. Activities range from teaching the proper method of moving from a bed into a wheelchair to the best way to stretch and limber the muscles of the hand. Assistants monitor an individual's activities to make sure that they are performed correctly and to provide encouragement. They also record their client's progress for the occupational therapist. If the treatment is not having the intended effect, or the client is not improving as expected, the therapist may alter the treatment program in hopes of obtaining better results. In addition, occupational therapist assistants document the billing of the client's health insurance provider.
Occupational therapist aides typically prepare materials and assemble equipment used during treatment. They are responsible for a range of clerical tasks, including scheduling appointments, answering the telephone, restocking or ordering depleted supplies, and filling out insurance forms or other paperwork. Aides are not regulated by States, so the law does not allow them to perform as wide a range of tasks as occupational therapist assistants.
Work Environment
Occupational therapy aides held about 5,800 jobs in 2020. The largest employers of occupational therapy aides were as follows:
- Offices of other health practitioners - 45%
- Hospitals; state, local, and private - 27%
- Nursing care facilities (skilled nursing facilities) - 13%
Occupational therapy assistants held about 43,300 jobs in 2020. The largest employers of occupational therapy assistants were as follows:
- Offices of physical, occupational and speech therapists, and audiologists - 45%
- Nursing care facilities (skilled nursing facilities) - 17%
- Hospitals; state, local, and private - 16%
- Home healthcare services - 7%
- Educational services; state, local, and private - 5%
Occupational therapy assistants and aides spend much of their time on their feet while setting up equipment and, in the case of assistants, providing therapy to patients. Constant kneeling and stooping are part of the job, as is the occasional need to lift patients.
Injuries and Illnesses
Occupational therapy aides have one of the highest rates of injuries and illnesses of all occupations. Their work may require physically demanding tasks, such as lifting patients, which can cause injuries.
Work Schedules
Most occupational therapy assistants and aides work full time. Occupational therapy assistants and aides may work during evenings or on weekends to accommodate patients’ schedules.
Education & Training Required
Occupational therapist assistants must attend a school accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) in order to sit for the national certifying exam for occupational therapist assistants. There were 135 ACOTE accredited occupational therapist assistant programs in 2009.
The first year of study typically involves an introduction to healthcare, basic medical terminology, anatomy, and physiology. In the second year, courses are more rigorous and usually include occupational therapy courses in areas such as mental health, adult physical disabilities, gerontology, and pediatrics. Students also must complete at least 16 weeks of supervised fieldwork in a clinic or community setting.
Applicants to occupational therapist assistant programs can improve their chances of admission by taking high school courses in biology and health and by performing volunteer work in nursing care facilities, occupational or physical therapists' offices, or other healthcare settings.
Occupational therapist aides usually receive most of their training on the job. Qualified applicants must have a high school diploma, strong interpersonal skills, and a desire to help people in need. Applicants may increase their chances of getting a job by volunteering their services, thus displaying initiative and aptitude to the employer.
Certifications Needed
Forty States, Guam, Puerto Rico, and the District of Columbia regulate the practice of occupational therapist assistants either by licensing, registration, or certification. In addition, eligibility requirements vary by State. Contact your State’s licensing board for specific regulatory requirements on occupational therapist assistants.
Some States have additional requirements for therapist assistants who work in schools or early intervention programs. These requirements may include education-related classes, an education practice certificate, or early intervention certification.
Other Skills Required
Certification is voluntary. The National Board for Certifying Occupational Therapy certifies occupational therapist assistants through a national certifying exam. Those who pass the test are awarded the title Certified Occupational Therapy Assistant (COTA). In some States, the national certifying exam meets requirements for regulation, but other States have their own licensing exam.
Occupational therapist assistants are expected to continue their professional development by participating in continuing education courses and workshops in order to maintain certification. A number of States require continuing education as a condition of maintaining licensure.
Assistants and aides must be responsible, patient, and willing to take directions and work as part of a team. Furthermore, they should be caring and want to help people who are not able to help themselves.
How to Advance
Occupational therapist assistants may advance into administration positions. They might organize all the assistants in a large occupational therapy department or act as the director for a specific department such as sports medicine. Some assistants go on to teach classes in accredited occupational therapist assistant academic programs or lead health risk reduction classes for the elderly.
With proper formal education, occupational therapist aides can become occupational therapist assistants.
Job Outlook
Overall employment of occupational therapy assistants and aides is projected to grow 34 percent from 2020 to 2030, much faster than the average for all occupations.
About 8,800 openings for occupational therapy assistants and aides are projected each year, on average, over the decade. Many of those openings are expected to result from the need to replace workers who transfer to different occupations or exit the labor force, such as to retire.
Employment
Demand for occupational therapy is likely to grow over the coming decade in response to the health needs of a growing number of older adults. However, because occupational therapy aides is a small occupation, the fast growth is expected to result in only about 1,200 new jobs over the decade.
Older adults are more prone than young people to conditions and ailments, such as arthritis and strokes, that may affect the ability to do everyday activities. Occupational therapy assistants and aides will be needed to help occupational therapists in caring for these patients. Occupational therapy also will continue to be used to treat children and young adults with developmental disabilities, such as autism.
Healthcare providers, especially those specializing in long-term care, will continue to employ these assistants to reduce the cost of occupational therapy services. After the therapist has evaluated a patient and designed a treatment plan, the occupational therapy assistant provides many aspects of the treatment that the therapist prescribed.
Earnings
The median annual wage for occupational therapy aides was $33,560 in May 2021. The median wage is the wage at which half the workers in an occupation earned more than that amount and half earned less. The lowest 10 percent earned less than $23,860, and the highest 10 percent earned more than $61,960.
The median annual wage for occupational therapy assistants was $61,730 in May 2021. The lowest 10 percent earned less than $46,810, and the highest 10 percent earned more than $80,210.
In May 2021, the median annual wages for occupational therapy aides in the top industries in which they worked were as follows:
- Nursing care facilities (skilled nursing facilities) - $38,220
- Hospitals; state, local, and private - $36,060
- Offices of other health practitioners - $28,910
In May 2021, the median annual wages for occupational therapy assistants in the top industries in which they worked were as follows:
- Home healthcare services - $75,070
- Nursing care facilities (skilled nursing facilities) - $64,670
- Hospitals; state, local, and private - $61,570
- Offices of physical, occupational and speech therapists, and audiologists - $61,320
- Educational services; state, local, and private - $49,920
Most occupational therapy assistants and aides work full time. Occupational therapy assistants and aides may work during evenings or on weekends to accommodate patients’ schedules.
