What is Occupational therapy Assistant (OTA) or Certified occupational therapy Assistant (COTA)?
The certified occupational therapy assistant is defined as an individual who works under the guidance and supervision of the registered occupational therapist (OTR) and may provide assistance in the evaluation, program planning, and treatment processes (AOTA, 1981).
Occupational therapist (OT), Occupational therapy Assistant (OTA), and Occupational therapy Aides come under the occupational therapy domain.
An OTA is nothing but a COTA. People use these terms interchangeably. OTA is a qualified person but he/she cannot use the term COTA until he/she clears the certification exam. COTA use the term “certified” because they are certified by the National Board for Certification in Occupational Therapy (NBCOT).
NBCOT holds the copyright to the designations Certified Occupational Therapy Assistant (COTA) and Occupational Therapy Registered (OTR). Individuals not certified by NBCOT cannot use these credentials.
Due to implementation of the voluntary NBCOT certification renewal program, all OT may not be OTR and all OTA may not be COTA.
Read more… What is Occupational therapy?
Occupational therapy assistants are graduates of the Accreditation Council for Occupational Therapy Education (ACOTE) accredited Associate’s degree programs, which are generally 2 years in duration.
An OTA can expand their role by establishing service competency-
- Service competency is the ability to use the specified intervention in a safe, effective, and reliable manner. (i.e., the OT and OTA can perform the same or equivalent procedure and obtain the same results)
- OT Assistants who establish service competency do not become independent; they continue to work under the minimal supervision of occupational therapist.
Job Description of Occupational Therapy Assistant–
Stress level – Average
according to the bureau of labor statistics, the median salary of a certified occupational therapy assistant is $57,871.
The salary depends upon the level of experience, and work setting.
- Help patient to do therapeutic activities.
- Encourage patient to complete the activity.
- Teach patient how to use the special equipment.
- Perform evaluation of a patient.
- Provide treatment to the patient.
- Duties regarding patient progress, reporting, and other administrative works.
The minimum required educational qualification for the post of OT assistant is an Associate degree.
This degree program offered by many institutes in all over the United States. The duration of the program is 2 years.
Occupational therapy assistants are eligible for certification by the American Occupational Therapy Certification Board (AOTCB). But they have to follow some sequence –
- Complete the accredited educational program of OTA, this program must include 12 weeks or 440 hours of level II fieldwork.
- Submit the application for the certification examination.
- Pass the certification examination to become certified occupational therapy assistant (COTA).
Occupational therapy assistants work in a variety of health care settings. The OT assistants are in good demands in the following practice areas – Skilled care nursing homes, intermediate care facilities, schools, Rehabilitation centers, general hospital, and psychiatric hospitals.
The most frequent cases seen by the OT assistants are – stroke/hemiplegia, Autism, developmental delay, schizophrenic disorders and cerebral palsy.
Occupational therapist supervises occupational therapy assistant in evaluation and intervention. This supervision must be collaborative in nature and not be differentiating them.
The document, “supervision guidelines for Certified Occupational Therapy Assistants,” stress the following points (AOTA, 1990c)
- Implementation of treatment under the supervision of OTR is the COTAs primary role.
- A COTA may not conduct an evaluation or begin treatment independently before an OTR’s evaluation.
- The COTA contributes to the evaluation process by reporting observations, the current level of functioning, impairment, and gathering related data.
- The OTR (supervisor) is legally responsible for the outcomes of all occupational therapy services provided by the COTA.
- The frequency, amount, and type of supervision required may vary with the experience of the COTA.
The most important things between the OTR and COTA are a nature of collaboration and ongoing efforts between them. It must be active and interactive. A good collaboration and team building contribute to the professional growth of both parties.
Team building helps to improve the mutual respect between OT and OTA. It leads to effective performance and personal/professional growth.
Transition from OTA to OT–
If OT assistant wants to become an occupational therapist, he/she can join transition or bridge program. Working OTA’s can also do this through distance learning or by attending weekend classes.
Specific OTA roles-
Occupational therapy assistant can perform many roles in the field of occupational therapy.
These are some roles can be performed by the OTA (under the supervision of OT) –
Functions to provide quality OT services to assigned individuals under the supervision of occupational therapist.
It can range from entry level to advanced level depending on the experience, education, and practical skills.
OTA’s can provide education or training related to Occupational therapy domain to the patient, caretaker, and community groups.
- Fieldwork Supervisor –
The OTA can function as a manager of level 1 and or 2 fieldwork in a practice setting, providing students with opportunities to practice. –
- Entry level OTA’s may supervise Level 1 fieldwork students.
- Intermediate or advanced level OTA’s may supervise Level 2 fieldwork students.
- Manager –
The OTA can function as a manager of the overall daily operation of OT services in a defined practice area.
- Consultant –
The OTA can provide occupational therapy consultation to individuals, groups, or organizations. This is the primary job of an OTR, but advanced level OTA may provide consultation.
OTA may eligible to provide formal academic education to OT or OTA students. OTA must have an appropriate advanced professional degree and intermediate to advanced skills in teaching. General supervision may be recommended by the academic program director.
- Researcher –
OTA’s can contribute to the research process. Additional academic qualification is required for OTA’s to be the principal investigator. OTA’s frequently perform scholarly work of the profession.
OTA may be partially or fully self-employed individual who provides occupational therapy services. If they satisfy the state regulatory requirements.
OTA’s who provide direct service have the responsibility to obtain appropriate supervision from a registered occupational therapist.
Independent practice –
American Occupational Therapy Association (AOTA) supports the independent practice of OT assistants with advanced level of skills who work for independent living centers. But state licensure laws and scope of practice legislation may supersede this recommendation.
COTA career ladder –
COTA works under the supervision of OTR. But how much of supervision required by OTR depends upon the level of expertise and experience. Entry level COTA needs more and direct supervision, while experienced COTA needs minimal supervision.
COTA’s Responsibility – Entry Level
An entry level COTA has less knowledge about the particular work setting. So, the amount of responsibility is less while the amount of supervision is more.
Initial orientation of workplace and nature of work may be provided by the colleagues. Interaction and observation are the key elements to enhance professional performance as an occupational therapy assistant.
Some responsibilities are –
- Provide patient education.
- Carries out treatment regime established by the therapist such as cognitive and self-care training.
- Learn the practical things from the OTR and others.
- Determine the focus of the activity and how the activity must be adapted to the needs of practical patients.
- Learn independent problem solving on a specific assignment.
COTA’s responsibility – Intermediate level
After the one year of practice as an OT assistant, the assistant is considered as an experienced one (beyond entry level).
- Level of supervision is shifted from close to routine or general supervision.
- Evaluation and treatment can be done more independently.
- Perform general evaluation required in a specific setting.
- OTA may provide supervision to OTA fieldwork students.
COTA’s Responsibility – Advanced level
After the improved technical competency in a specific area of practice, the OTA may assume greater responsibility for program planning and implementation.
At this stage, they may consider as a senior staff member (OTA II)
- They may assist in research paper presentation along with OTR in conferences.
- They may help in the modification of adaptive devices or making a new device.
- At this level, the role and responsibilities of a COTA are nearly equal to OTR. But officially OTR has the complete responsibility for work.
Necessary Skills and qualities-
Physical fitness –
OTA has to support and transfer the patient, which needs lots of energy. A good physical strength helps OTA to do their work with ease.
The OT assistant must have this skill; they may improve their problem-solving skills with guidance from OTR. During therapy treatment, OTA has to take some decision regarding the patient issues.
Just obey the instruction is not a cup of tea for the COTA’s. They must think about the patient care and their improvement. They may suggest better activities for patients and discuss with OTR for the betterment of patient and profession.
Rehabilitation of a patient takes time; we can’t expect complete/partial recovery in a month or two. Patience is the key factor to remain hopeful and positive regarding improvement.
An OT assistant should be good in communication. They have to deal with the patient, caretaker, colleagues, doctors, and more.
Future Growth –
The occupational therapy profession is in good demand. The 40% increased demand is expected in next 10 years. The Occupational therapist will have increasingly more responsibilities for consultation, supervision, program development, and research, which will greatly influence the roles of occupational therapy assistants.
The role of the OT Assistant is continuously evolving. More effective collaboration and teamwork will result in the solution of personnel shortages and the provision of quality, cost-effective services to an ever-increasing demand for occupational therapy intervention.
- Karen Sladyk. Ryan’s occupational therapy Assistant: principles, practice issues, and techniques (2014). 5th Slack Incorporated.
- Jerry A. Johnson. Certified Occupational Therapy Assistants: Opportunities and challenges (2013). 1st Routledge Publication.