How to Become a Pediatric Occupational Therapist

If you’ve ever wondered how to become a pediatric occupational therapist or how to become a child occupational therapist, this article is for you. 

Occupational therapists (OTs) have many options to specialize in specific audiences and demographics, one of which is pediatrics. 

Whether you’re a new grad or a seasoned therapist looking to make a change, pediatrics can be a rewarding practice area. 

Understanding how to become a pediatric occupational therapist and developing an awareness of the qualifications and steps can help you to pursue this career path.

What does a pediatric occupational therapist do? 

Before we dive into how to become a pediatric occupational therapist, let’s take a look at what the job encompasses. 

Simply put, pediatric occupational therapists work with children and their families, to improve their daily lives by helping children reach developmental milestones through play and other treatment methods.

Treatment areas can include fine and visual motor skills, sensory processing, self-help skills, and academic-related skills such as executive function.

Pediatric OTs work with children from birth to age 21. Treatment can look different in different settings and based on the child’s age. 

There are a variety of different settings pediatric occupational therapists work in, including outpatient clinics, schools, early intervention, private practice clinics, and hospitals. 

Here are examples of pediatric occupational therapists’ roles in various settings. 

Early Intervention (0-3 or 0-5 years old, depending on which state you practice in)

Early intervention OTs work with young children. They can address feeding, self-soothing, play skills, and activities of daily living, such as putting on a coat or feeding skills. 

Schools (pre-kindergarten through high school)

School-based occupational therapists work inside schools, helping children function in the school environment. They can address fine and visual motor skills, handwriting, sensory processing, technology, feeding, and other academic skills. 

Outpatient clinics

As you might expect from the name, outpatient pediatric occupational therapists typically see kids in outpatient clinics. Outpatient OTs cover many skills, including medical needs, fine and visual motor skills, activities of daily living, self-help, and sensory regulation. Some outpatient OTs also work with physical therapists (PTs) for seating and mobility or to do things like splinting.

Private practice clinics

Private practice occupational therapists see kids in their clinics. Here, OTs can treat many different issues, including fine and visual motor skills, self-help, sensory processing, and activities of daily living. Some OTs also do splinting, seating, mobility, assistive technology, or behavioral health. Many private practice occupational therapists have sensory gyms to address sensory processing difficulties. 

Hospitals

Pediatric occupational therapists work in hospitals to help children recover from surgery or illness. They can work with babies in the Neonatal Intensive Care Unit (NICU), general hospital, or behavioral health unit. They address various areas, including sensory, feeding, seating, splinting, and recovery from medical issues. 

How many years does it take to become an occupational therapist?

When thinking about how to become a child occupational therapist, you’re probably wanting to know how many years of school to become a pediatric occupational therapist?

Understanding the educational requirements is essential. 

Becoming an occupational therapist requires a master’s degree or higher. There is more than one avenue to becoming an OT, which can determine the time it takes to become one. 

There are entry-level programs, and there are also bridge programs for certified occupational therapy assistants (COTAs). 

The short answer is it takes about 6-7 years to become an occupational therapist. 

First, you must complete your bachelor’s degree. Your degree does not have to be in occupational therapy, but having a bachelor’s in a related field may be helpful. In general, a bachelor’s degree takes 4 years. 

Then, you need to continue your coursework in a master’s program for occupational therapy. This can range from 2-3 years. Coursework includes fieldwork (level 1 and 2) where you learn practical skills in various occupational therapy settings.

Currently, pursuing a doctorate degree in occupational therapy is optional. 

However, as of July 1, 2027, occupational therapy will become a doctorate-level program, meaning you must have your doctorate to practice occupational therapy. This new rule will only apply to new therapists. 

If you are already a practicing OT before this time, you will not need to return to school and get your doctorate. 

After completing your degrees, you must pass the National Board Certification for Occupational Therapists (NBCOT) exam (a score of 450 is required to pass the exam). 

Finally, once you have passed certification and become licensed in the state you wish to prcatice in, you can begin practicing as an occupational therapist. 

Steps to become a pediatric occupational therapist

Next, for those wondering how to become a pediatric occupational therapist, here are the steps to take. There are several different ways you can become an occupational therapist. The steps you take can depend on when and where you decide to begin your journey. 

Here are a few of the different journeys to becoming a pediatric OT.

Starting in high school 

Volunteering or shadowing a pediatric OT can be a great way to find out if it is a career path you want to pursue. Researching different schools and programs can help you make an informed decision. 

College 

Be selective in choosing your major for your undergraduate degree, as occupational therapy is a master’s level program. 

There are a few things you should consider when deciding on an undergraduate major:

• A degree in a relevant field (from an accredited university) will give you a leg up when entering a master’s level OT program. Examples of relevant fields include kinesiology, athletic training, psychology, biology, or physiology. 
• Be sure to take the prerequisite classes you will need to take to apply to an occupational therapy program. Many OT programs require a specific grade in the pre-requisite classes (usually a B- or higher) and an overall GPA (usually a 3.0 or higher). Lastly, programs may also require that you take the pre-requisite classes within a certain time frame, such as 5-10 years from the time of your application.

Master’s level 

Here are the steps you must complete to get your master’s degree in occupational therapy:

• Once you have applied and been accepted to a program, you must complete the coursework to receive your degree. Part of the coursework includes level 1 and 2 fieldwork (unpaid).
  
• After receiving your master’s degree, the next step is passing the National Occupational Therapy Board exam through NBCOT.
  
• You must apply for a state license once you have passed the board exam. Depending on your state, the application process can take approximately 2-8 weeks. You will also need to pay a fee to get your state license. You can not practice occupational therapy if you are not licensed in the state (this includes teletherapy). 

Doctorate level

Here are the steps you will need to take to receive your doctorate degree:

• You can apply to a doctorate program once you have a bachelor’s degree.
  
• Coursework takes 2 to 3 years, and then you are awarded your degree.
  
• Just like at the master’s level, you will need to take your national board exam through NBCOT and get licensed in the state in which you will practice.

What’s the difference between pediatric OTs and occupational therapy assistants?

The primary difference between a pediatric OT and a certified occupational therapy assistant (COTA) is their specific responsibilities. 

Whereas OTs perform evaluations, make treatment plans, and complete discharge paperwork, COTAs do not. 

How to become a pediatric occupational therapy assistant

For those who may be wondering, how to become a pediatric occupational therapist assistant, becoming a certified pediatric occupational therapy assistant is similar to becoming an OT. For instance, both COTAs and OTs complete similar coursework and take the national board exam.

To become a COTA, you must have an associate’s degree, which generally takes 2 years. 

Here are the steps you will need to take to become an occupational therapy assistant:

1. Apply to an accredited occupational therapy assistant program (this includes level 1 and level 2 fieldwork)
   
2. Once you have completed the COTA program, you must take the NBCOT exam.
   
3. Once you have passed the exam, you can apply for licensure in the state where you wish to practice.

Here is some other important information about how to become a child occupational therapist:

• The American Occupational Therapy Association (AOTA) and the National Board Certification for Occupational Therapists (NBCOT) are working on a state licensing compact agreement allowing therapists to practice in any state participating in the compact. (Click here to learn more)
  
• Beginning July 1, 2027, all new occupational therapists will be required to have a doctorate in occupational therapy. If you have a bachelor’s or master’s before this date, you will not need to get a doctorate.
  
• To maintain your license, you must take continuing education courses. Each state may have different requirements, but typically, you must take about 12 continuing education credits a year and pay a fee to renew your license.
  
• You must also renew your NBCOT certification, including a fee every 3 years.
  
• Becoming familiar with the non-treatment side of occupational therapy can be helpful. Knowledge of occupational therapy EHR (electronic health records) and an occupational therapist’s schedule can make a smoother transition into your job. 

Working as a pediatric occupational therapist can be a rewarding experience. You can work in various settings, and working with children and families can be fun and fulfilling. 

Hopefully this article has helped you to better understand how to become a pediatric occupational therapist, including the education, steps, and certifications involved. 

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