What Does an Occupational Therapy Assistant (OTA) Do?

An occupational therapy assistant, or OTA, works under the supervision of a licensed occupational therapist to help patients regain the skills they need for daily life. Occupational therapy assistants implement treatment plans that restore independence in everyday tasks like dressing, bathing, grooming, and mobility across various settings. If you are exploring the career path to become an occupational therapy professional and want to understand what the role involves, this guide covers the day-to-day work, scope of practice, credential pathway, and job outlook.

Table of Contents

1. What You Should Know Before You Start
2. What Does an OTA Do Day to Day?
3. OTA vs. OT: Where the Line Is
4. Where OTAs Work
5. The Skill That Separates Good OTAs from Great Ones
6. Sean Valdez Miller, OTA Student at Keiser University Video
7. What New Students Get Wrong
8. How to Become a Certified Occupational Therapy Assistant (COTA)
9. OTA Career Outlook and Salary
10. From OTA to OT: The Career Ladder at Keiser
11. Why Keiser University
12. Frequently Asked Questions

What You Should Know Before You Start

Is OTA a good career?

• Employment for occupational therapy assistants is projected to grow 18 percent from 2024 to 2034, far outpacing the 3 percent national average.
• Median annual wage for occupational therapy assistants: $68,340 as of May 2024 (BLS).
• Requires a two-year associate degree — one of the faster entry-level credentials into health care.
• OTA roles account for approximately 24% of occupational therapy professional jobs in the U.S.

What is the difference between an OTA and an OT?

• The occupational therapist evaluates patients, sets goals, and creates the treatment plan.
• Occupational therapy assistants implement treatment plans and document the client’s progress.
• OTAs practice under the supervising OT; the occupational therapist co-signs clinical notes.
• Occupational therapists hold a master’s or clinical doctorate; occupational therapy assistants most commonly hold an associate’s degree.

Do OTAs need to be licensed?

While specific regulations vary by jurisdiction, all 50 U.S. states and several territories require OTAs to be licensed. The main requirements generally include:

• Education: Licensure requires graduating from an ACOTE-accredited OTA program.
• Fieldwork: Completion of clinical fieldwork requirements.
• National Certification: passing the NBCOT® Certification Examination in Occupational Therapy. Note: the NBCOT certification and state licensure are two separate steps; passing the national certification exam does not automatically grant a state license.
• State Application: Submitting an application and paying a fee to the regulatory board in every state where you intend to practice. Some states may also require additional forms or exams covering local laws.

What Does an OTA Do Day to Day?

The daily rhythm of an OTA begins before the first patient arrives. Chart review comes first: reading prior notes, reviewing the occupational therapist’s evaluation for new clients, and planning for the session ahead.

Barbara Porter, OTA Program Director at Keiser University Jacksonville, describes the process:

“A typical day begins by reviewing your patient schedule. Before your first appointment, you’ll examine the patient’s chart, review their progress, and read notes from previous therapy sessions to understand their current status and prepare for treatment.” 

Before each session, the OTA also prepares the therapy space to ensure safety and organization. Each patient gets roughly 30 minutes to an hour of direct treatment time. The OTA introduces themselves, explains the session goals, and gets the patient’s input on where to start. Porter notes: “With occupational therapy, everything starts with the patient because if it’s not important to them, they’re not going to do it.”

The therapeutic use of activities varies by patient. Some patients work on upper-body strength or hand grip after surgery. Others focus on mobility, grooming, cooking, or using assistive devices to support daily living. Patients managing chronic illnesses or recovering from injury may work on energy conservation and adaptive strategies. The OTA applies therapeutic interventions throughout the treatment session, adapts based on the patient’s response, and ends each encounter with documentation. What gets written and when it is due depends on the facility’s accreditation and credentialing requirements.

Hannah V., Occupational Therapy Assistant Student in Class

OTA vs. OT: Where the Line Is

Both occupational therapists and occupational therapy assistants provide patient care, often side by side. But the professional boundary is clear.

Porter explains: “They evaluate, they create the goals together, both the OT and OTA can adjust the plan of care, and they’re going to make the initial plan of care for the patient, document what needs to be done and why. Now you’re going to come in as an OTA, and you are going to implement the interventions or the specific tasks and activities that you’re going to do to work towards those goals, and you’re going to document the progress on those goals.”

OTAs collaborate closely with occupational therapists (OTs) on every program of care, and that collaboration is governed by professional standards set at both the national and facility levels. Patients benefit most when the OTA and occupational therapist maintain clear communication about patient goals and patient progress throughout treatment. This division of responsibilities is not a limitation — it is what allows occupational therapy assistants and occupational therapy aides to deliver safe, consistent care across program after program while the occupational therapist retains evaluative oversight.

Occupational therapy assistants (OTAs) can assist with portions of a standardized assessment, but interpreting those results belongs to the occupational therapist. Occupational therapy aides, a distinct and lower-credentialed role compared to the OTA, typically support the therapy environment rather than delivering direct patient treatment.

Where OTAs Work

Occupational therapy assistants work across a wide range of settings, and OTA jobs exist in far more places than most prospective students expect. Common environments where occupational therapy assistants and occupational therapy aides serve clients include:

• Skilled nursing facilities (SNFs) and nursing homes: The highest-volume employer for OTA graduates in most local areas; clients here typically include older adults recovering from falls, strokes, or surgery.
• Outpatient rehabilitation clinics and hospitals: Strong demand is driven by regional hospital systems and rehabilitation networks; clients in these settings receive occupational therapy (OT) services for injuries, surgeries, and neurological conditions.
• School systems: Occupational therapy assistants work with students who have developmental delays, learning differences, or physical disabilities; clients in this setting are children and adolescents.
• Pediatric home health and outpatient pediatric clinics: Play activities and sensory integration therapy with younger clients.
• Acute care hospitals: Post-surgical recovery, early mobilization, and care for clients with complex disabilities.
• Home health, inpatient rehabilitation, and mental health settings

Porter also notes emerging practice areas: “We’ve had a lot of aquatic therapy opportunities here recently, and we have one student pursuing a hippotherapy idea, occupational and physical therapy with horses.”

The breadth of settings where OTAs work is a career-long advantage. As Porter puts it, “OTAs can have a really rich career and still have that same work-life satisfaction without having to keep going back to the drawing board.” An occupational therapy assistant (OTA) who starts in pediatrics can later transition to geriatric or outpatient care without additional licensing.

The Skill that Separates Good OTAs from Great Ones

The skills needed to succeed as an occupational therapy assistant go beyond clinical technique. Porter is clear about what matters most in practice:

“I think the biggest soft skill that I see making people successful, happy, and satisfied in their job is their ability to be flexible, that flexibility in their thinking. Anyone can learn the skills needed to do the job, but if you can apply clinical reasoning in a flexible way during each session, you’ll be much more successful in helping patients achieve positive outcomes.“

– Barbara Porter, OTA Program Director, Keiser University

Successful OTAs also possess strong communication, empathy, and problem-solving skills. Physical stamina matters too, particularly in settings involving patient transfers or hands-on mobility training with patients recovering from surgery or neurological events. The OTA must adapt physical demands to the environment, whether working bedside in a skilled nursing facility or on the floor of a pediatric clinic.

Clients and patients rarely follow a script. A planned gym session may shift because a patient arrives with orthostatic hypotension. The OTA who can pivot, adapt the intervention in the moment, and still document clear clinical justification is the one who produces consistent results and upholds the quality of care patients and their families depend on.

Sean Valdez Miller, OTA Student at Keiser University

What New Students Get Wrong

Many students who decide to become occupational therapy assistants assume the role is similar to nursing because early OTA training covers diagnoses, blood pressure, and clinical vitals. Porter describes the shift: “It starts to shift a little when they start to realize that, yes, we do all these same physical things, but we’re different, we’re holistic. We’re starting with the patient first, not the disease process first.” That shift becomes fully real during the first Level I clinical rotations.

How to Become a Certified Occupational Therapy Assistant (COTA)

Step 1: Complete an ACOTE-accredited OTA program

The Accreditation Council for Occupational Therapy Education (ACOTE) is the body within the American Occupational Therapy Association (AOTA) that accredits OTA and occupational therapy education programs. Graduating from an ACOTE-accredited program is required to sit for the national certification examination. Porter is direct: “You can’t sit for the NBCOT exam if you don’t graduate from an accredited program.”

To become an occupational therapy assistant (OTA), students complete a degree program covering applied science coursework, including anatomy, therapeutic technique, human development, and activity analysis. No high school diploma in specialized sciences is required beyond standard prerequisites; this is not a liberal arts program and does not demand advanced math or chemistry. Most entry-level applicants enter with a standard high school diploma. The program is designed to be accessible — not easy, but achievable — and it prepares graduates for entry-level clinical practice from day one.

Step 2: Complete Level I and Level II fieldwork experiences

OTA training requires completing both levels of supervised fieldwork. Candidates typically log 640 hours of supervised practice, building the entry-level competence required to sit for the national board examination. Patients encountered during fieldwork expose those entering the field to the full range of conditions occupational therapy assistants treat in practice. Porter describes the milestone OTA students consistently reference: “I think the first moment on their first Level 2 placement that they’re asked to go take a patient by themselves… It’s that moment where it hits you, you’re like, okay, I’m this. This is me. I’m an OTA. I can do this.”

Step 3: Pass the national certification examination (NBCOT)

The National Board for Certification in Occupational Therapy administers the national certification exam. Passing the NBCOT examination earns the entry-level COTA credential. Most employers expect it. According to Porter, “You go through that stack of resumes, you want that, you want to have that C there, and if you don’t have it, you’re probably not looking very hard at that resume.”

Step 4: Obtain state licensing

State licensing is a separate legal requirement from national certification. All 50 states require it, and processes vary by state.

Step 5: Maintain licensing through continuing education

OTAs must finish continuing education hours each licensing cycle. The supervising occupational therapist can help guide newer occupational therapy assistants toward relevant professional development that benefits the patients they serve. 

Very Important – Keep this in Mind: National certification and state licensing are two separate steps. Passing the national certification exam qualifies you to apply for a state license, but the state license requires its own application. Both are required before an OTA can treat patients independently under supervision.

OTA Career Outlook and Salary

The job outlook for occupational therapy assistants and occupational therapy aides is strong. According to the Bureau of Labor Statistics (May 2024):

• Median annual wage for occupational therapy assistants: $68,340
• Overall employment growth rate, 2024-2034: 18 percent (“much faster than average”)
• Projected annual job openings: approximately 7,900 per year

OTA roles account for approximately 24% of occupational therapy professional jobs in the U.S. Entry-level occupational therapy assistant OTA positions are available across virtually every local area in Florida and nationally. Patients in hospitals, schools, skilled nursing facilities, and home health settings receive care from OTAs, and the program of care OTAs deliver is directly tied to patient outcomes measured by the supervising occupational therapist. Overall employment demand is driven by an aging population, growing recognition of occupational therapy in mental health, and the sheer volume of patients across settings who require entry-level OTA services to regain independence. A two-year associate’s degree program trains graduates for entry-level practice, and most employers in the local area actively hire from ACOTE-accredited occupational therapy programs.

The growth rate reflects sustained demand drivers: an aging population, expanding occupational therapy in school systems and mental health settings, and broader recognition of occupational therapy services. According to previous projections from the Bureau of Labor Statistics (BLS) (2019-2029), the COTA job outlook was expected to grow by 32 percent, reflecting long-term demand for occupational therapy assistants who become occupational therapy professionals through a qualifying program.

From OTA to OT: The Career Ladder at Keiser

The Master of Science in Occupational Therapy (MSOT) at Keiser includes a Bridge Program for working COTAs. Graduates who maintain a qualifying GPA and complete one clinical year of practice can enter the MSOT without a traditional bachelor’s degree. Porter describes it: “You graduate here from our OTA program, and you can go out into the community and work for a year. They know Keiser, they feel like they’re at home, and they know the people in the halls who can still be here to support them.”

This OTA degree-to-MSOT pathway is a genuine differentiator. Most institutions cannot offer this connected career path because they offer only one level of occupational therapy education.

Why Keiser University

Keiser University’s OTA program builds preparation for the national certification examination into training from day one, distinguishing it from programs that address exam readiness only at the end of the curriculum. Students take the Occupational Therapy Knowledge Exam (OTKE) three times and must score 60 or above, a strong predictor of first-time NBCOT pass rates. Access to AOTA exam prep and NBCOT study materials is included, and the initial national certification exam fee is built into tuition.

• The one-class-at-a-time format delivers focused immersion in each course of the occupational therapy assistant curriculum. 
• Financial aid and dedicated student services support traditional students, working adults, military-affiliated students, and first-generation college learners throughout their studies.
• ACOTE Accredited: Keiser University’s Occupational Therapy Assistant program, Daytona, Fort Myers, Jacksonville, Melbourne, Miami, Pembroke Pines, Tallahassee, Tampa, and West Palm Beach campuses are fully accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) of the American Occupational Therapy Association (AOTA). 
• Keiser University is a private, nonprofit university accredited by SACSCOC, with programs across multiple Florida campuses, three international campuses, and international education centers.

Final Thoughts

An occupational therapist assistant (OTA) helps people get back to what matters to them, whether that is dressing independently after a stroke or participating in school with a disability. To learn more, visit our Occupational Therapy Assistant program page or connect with an admissions counselor.

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OTA Program Frequently Asked Questions

What does an occupational therapy assistant actually do?

An occupational therapy assistant implements treatment plans designed by a licensed occupational therapist, helping patients build or rebuild the skills they need to function independently. This includes dressing, bathing, grooming, mobility, and cooking. OTAs document the patient’s progress and communicate regularly with the occupational therapist they work under.

How long does it take to become an occupational therapy assistant?

Most ACOTE-accredited OTA programs take approximately two years at the associate’s degree level, including Level I and Level II fieldwork. Candidates then pass the national certification examination (NBCOT) and apply for state licensing. The full timeline from entry-level enrollment to licensed practice typically falls between two and three years.

What is the OTA job outlook?

The job outlook for occupational therapy assistants and occupational therapy aides is strong, with projected employment growth of 18 percent from 2024 to 2034 (August 28, 2025, Bureau of Labor Statistics), far outpacing the national average. Approximately 7,900 annual job openings are projected over the decade. Occupational therapy assistants who complete an accredited program gain entry-level licensure and can work across multiple care environments without returning to school for additional licensing.

Can an OTA become a full occupational therapist?

Yes. To become an occupational therapist after working as a COTA, Keiser University’s MSOT Bridge Program offers a direct career path for experienced occupational therapy assistants. Graduates who finish the OTA program, earn their COTA, and complete one clinical year may qualify to enter the MSOT without a traditional bachelor’s degree. Patients with disabilities or chronic conditions benefit when their OTA pursues this additional clinical training to become a fully licensed occupational therapist.

What does ACOTE accreditation mean and why does it matter?

ACOTE is the Accreditation Council for Occupational Therapy Education, the body within the American Occupational Therapy Association that accredits occupational therapy education programs. Graduating from an ACOTE-accredited program is required to sit for the national certification examination and to obtain licensure. A program without ACOTE accreditation disqualifies graduates from certification and employment as a COTA.

What skills are needed to succeed as an OTA?

The skills needed to succeed include strong communication, empathy, and problem-solving skills alongside clinical competence. Physical stamina matters in many settings, particularly where patients require transfers or mobility training. Flexibility in clinical reasoning is a unique skill that effective occupational therapy assistants possess because patients and conditions rarely follow a planned script.

Is there a related program for students interested in physical therapy?

Yes. Keiser University also offers a Physical Therapist Assistant program for students interested in the physical therapist assistant career path.

About Keiser University

Keiser University is about to celebrate 50 years of empowering students through career-focused education. Since opening its doors in 1977, the university has remained committed to preparing graduates with the knowledge, skills, and hands-on experience needed to succeed in today’s workforce. As Keiser approaches this milestone anniversary, it continues to build on its legacy of academic excellence, innovation, and student success while helping shape the future of higher education. 

As a Keiser University student, you’ll benefit from:

• One of Florida’s largest private, non-profit universities, Keiser is institutionally accredited by SACSCOC, ensuring degrees are respected by employers and other institutions nationwide
• Over 100 degree levels, from associate, bachelor’s, master’s, and doctoral degree programs aligned with today’s workforce.
• Flexible learning options, including on-campus, online, hybrid, and one-class-at-a-time formats.
• Personalized academic and career support, with dedicated faculty and career services.
• Financial aid, scholarships, and tuition guidance to help make education more accessible.
• Recognition as the No. 1 university in the U.S. for Social Mobility by U.S. News & World Report (2023).
• Proud membership in the Hispanic Association of Colleges and Universities (HACU).
• Almost 50 years of educational excellence with a proven focus on student success and outcomes.

Don’t wait to start building your future. Contact Keiser University today to learn how our accredited programs, financial aid options, and career-focused approach can help you move forward with confidence.

Call toll-free 888-KEISER-9, contact a Keiser campus near you, or schedule a campus tour to take the first step toward your dream career.

Contributing Author:

Barbara Porter, MS, BS, AOS, has served as the OTA Program Director at Keiser University since 2024. Before her current role at Keiser University, Barbara Porter held a leadership position as the Chief Operating Officer for Arbor Therapy. Her transition to OTA Program Director aligns with her extensive experience in healthcare operations and therapy services.