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What To Know About Occupational Therapy Certifications & Specialties

Learn more about the various certifications and specialties you can pursue as an OT, including the requirements, costs, and earning potential for each.

February 21, 2020

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For those interested in becoming an occupational therapist, the sheer diversity of choices for advanced certification is an exciting draw to the field. Whether you dream of working in a certain setting or serving a specific population, there’s a specialization that exists to help you get there and, most importantly, stand out from the pack.

However, more options can also mean more confusion. So we’ve compiled a comprehensive list of what OT students and recent grads should know about the specialties and certifications available to them.

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Why Pursue a Specialty Certification?

When you’re fresh out of school, you may not be thinking about pursuing a certification right away. However, it’s definitely something worth having on your radar, says Jeremy Furniss, OTD, OTR/L, BCG, and current director of quality at the American Occupational Therapy Association.

Furniss encourages young OTs to look toward advanced certification as an organizing factor for continuing education, as well as “the other requirements that are needed to meet licensure anyway.”

“Why not have an end goal in mind that really helps to structure those efforts and develop you as an advanced practitioner in an area you’re passionate about?” he says. “A specialty certification signifies to potential clients and employers that you’re an expert in your field and committed to staying up-to-date on best practices.”

For those who are unsure what direction to take, Furniss believes fieldwork settings can prove useful in narrowing your options, even if it’s simply by helping you realize what you’re not interested in.

Laura Ramsey, a recent OT grad based in Connecticut, says per diem work is another great way to gain exposure to different settings and explore potential certifications. In fact, it was a per diem position in a hospital that reinforced her passion for working with clients in a home care setting. This realization led her to pursue a certification in home modifications and start her own business with her friend Ashley Marino, called Livable Spaces. Ramsey and Marino conduct home evaluations and develop custom designs catered to their clients’ specific abilities and lifestyles, which has been invaluable in setting them apart from other OTs in the area.

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What Can You Specialize in as an Occupational Therapist?

Now that we’ve established the benefits, what are the options available for OTs? The short answer is: A whole heck of a lot! The AOTA offers a number of board and specialty certifications, but they aren’t the only certifying organization in town.

AOTA Board & Specialty Certifications

There are nine board certifications and specialties offered by the AOTA:

  1. Gerontology (BCG)
  2. Mental Health (BCMH)
  3. Pediatrics (BCP)
  4. Physical Rehabilitation (BCPR)
  5. Driving and Community Mobility (SCDCM or SCDCM-A)
  6. Environmental Modifications (SCEM or SCEM-A)
  7. Feeding, Eating, & Swallowing (SCEFAS or SCEFAS-A)
  8. Low Vision (SCLVA or SCLVA-A)
  9. School Systems (SCSS or SCSS-A)

Other OT Specialty Certifications Available

These are other specialty certifications available to OTs that are offered through various specialty associations:

  • Assistive Technology Professional (ATP)
  • Aquatic Therapeutic Exercise Certification (ATRIC)
  • Basic DIRFloortime Certification
  • Certified Hand Therapist (CHT)
  • Certified Lymphedema Specialist (CLT)
  • Certified Stroke Rehabilitation Specialist (CSRS)
  • Certified Aging In Place Specialist (CAPS)
  • Certified Autism Specialist (CAS)
  • Certified Hippotherapy Clinical Specialist (HPSC)
  • Certified Brain Injury Specialist (CBIST)
  • Certified Diabetes Educator (CDE)
  • Certified Industrial Economic Evaluator (CIEE)
  • Certified Kinesio Taping Practitioner (CKTP)
  • Certified Low Vision Therapist (CLVT)
  • Certified Psychiatric Rehabilitation Practitioner (CPRP)
  • Certified Stroke Rehabilitation Specialist (CSRS)
  • Certified Driver Rehabilitation Specialist (CRDS)
  • Lee Silverman Voice Treatment- BIG (LSVT BIG)
  • Neuro-Developmental Treatment Certification (C/NDT)
  • Saebo Certified Therapist
  • Seating and Mobility Specialist (ATP/SMS)

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What’s the Highest Paying Occupational Therapy Specialty Overall?

According to the Bureau of Labor Statistics (BLS), the mean annual wage for OTs is $85,350. The highest paid OTs work in management positions within companies and enterprises, with an average annual wage of $94,170. However, it’s important to note that your income as an OT varies depending on a wide range of factors, such as your location, experience, market saturation, etc.

Kate Washa Boyd, MS, OTR/L, CLT, LSVT BIG, founded OTSalary.com to increase transparency around OT compensation in various work settings. Boyd says her research efforts have found that skilled nursing is one of the highest-paying specialties, and she names hand therapy as one of the more lucrative specializations. Still, she says, “It depends on so many variables, as well as an individual’s willingness to negotiate their salary.”

Boyd recently earned her third certification. She says this professional level expertise is the best way OTs can expand their skill set and make themselves more marketable in different settings, thus increasing their salary potential.

“The great thing about OT is that it’s so broad and there’s so many different certifications you can go for,” Boyd says. “Don’t be afraid to move jobs to find the perfect fit. Every time you do so, you have another option to negotiate your salary.”

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Breakdown of the AOTA Board Certifications

Now for some more details on the board certifications offered by the AOTA.

1) Gerontology

With the number of senior citizens on the rise, gerontology is one of the most popular specialties and involves working with the aging population in a variety of settings, such as hospitals, outpatient settings, skilled nursing facilities, and in-home healthcare.

2) Mental Health

This OT specialty focuses on mental health treatment and prevention services for those with severe and persistent mental illness, with a focus on function and independence.

3) Pediatrics

OTs who specialize in pediatrics help children succeed in daily activities such as learning, socializing, and playing, as well as general functioning skills.

4) Physical Rehabilitation

This specialty gives OTs the ability to “design and implement physical rehabilitation interventions that are client-centered, contextually relevant, and evidence-based to facilitate optimal occupational engagement,” according to the AOTA.

AOTA Board Certification Requirements

At the moment, the requirements for board certification include:

  • Five years’ experience as an OT
  • 5,000 hours in any capacity in the certification area in the past five years
  • 500 hours of delivering OT services as an OT in the certification area
  • A peer-reviewed reflective portfolio application process ($525)
  • Renewal after five years

However, it’s essential to note that the AOTA recently announced that the traditional application process will be changed to an exam-based certification in late 2020. The current portfolio process will accept submissions through December 2019.

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Breakdown of the AOTA Specialty Certifications

Obtaining a specialty certification is a less intense process than getting board-certified.

The AOTA offers specialty certifications in the following areas:

1) Driving and Community Mobility (SCDCM or SCDCM-A)

Expertise in helping clients adjust to challenges that impact the ability to drive safely, such as physical, mental, and sensory abilities.

2) Environmental Modifications(SCEM or SCEM-A)

Expertise in modifying or adapting environments (e.g., home, school, work, etc.) to meet the needs of their clients and maximize their safety and independence.

3) Feeding, Eating, and Swallowing (SCEFAS or SCEFAS-A)

Expertise in working with clients who have difficulties with feeding, eating, and swallowing.

4) Low Vision (SCLVA or SCLVA-A)

Expertise in working with adults who have deficiencies in acuity and visual field as a result of eye disease/conditions or brain injury.

5) School Systems (SCSS or SCSS-A)

Expertise in providing and promoting occupational therapy in public or private school settings.

AOTA Specialty Certification Requirements

As we mentioned above with the boards, exam-based advanced certifications will replace the current peer-reviewed reflective portfolio application process in late 2020. Here are the current requirements for the specialty certifications offered through the AOTA:

  • 2,000 hours in any capacity in the certification area in the past five years
  • 600 hours of delivering OT services as an OT in the certification area
  • A peer-reviewed reflective portfolio application process ($375)
  • Renewal after five years

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Breakdown of Other OT Specialty Certifications Available

Here’s a comprehensive breakdown of other specialty certifications you can pursue to advance your knowledge as an OT.

1) Assistive Technology Professional

ATP professionals analyze the technology needs of consumers with all types of disabilities, helping them to select and properly use adaptive devices from hearing aids to augmentative communication.

2) Aquatic Therapeutic Exercise Certification

This certification is just what it sounds like, and it’s ideal for OTs who have a desire to help clients improve functional activities through water-based therapeutic exercises.

3) DIRFloortime Certification

DIR, which stands for the developmental, individual-differences, and relationship-based model, is a framework that enables OTs to promote and understand the positive development of children with autism spectrum disorders (ASD). This certification allows OTs to better construct a program tailored to a child’s unique challenges and strengths.

  • Requirements: A bachelor’s degree in OT is the sole requirement. There are four tiers of certification; these courses can be completed online or in-person, and you must successfully complete one course at a time with a passing assessment score in order to progress to the next.
  • Cost: Certifications range from $179 to $789, depending on the level
  • Salary: No data found
  • Certifying Organization: Interdisciplinary Council on Development and Learning (ICDL)
  • Credential: DIR-Basic, DIR-Proficient, DIR-Advanced, DIR-Expert Training Leader

4) Certified Hand Therapist

Earning a CHT certification is a process more rigorous than most, but one that’s known to be well-paying within the OT field. This specialty is ideal for OTs seeking advanced clinical knowledge and skills to help clients regain manual skills and resume functional activities with their hands and upper extremities.

  • Requirements: Three years’ clinical experience; 4,000 direct practice hours in hand therapy; pass the certification exam; renewal every five years ($450)
  • Cost: $500 certification exam
  • Salary: An average of $80,051, according to Payscale.com
  • Certifying Organization: Hand Therapy Certification Commission (HTCC)
  • Credential: CHT

5) Certified Lymphedema Specialist

The lymphedema certification is for OTs who wish to specialize in successfully treating and managing clients affected by lymphedema and other related conditions.

6) Certified Aging-In-Place Specialist

A Certified Aging-in-Place Specialist helps older individuals live in their homes safely as they age, recommending home modifications and solutions based on safety and functional needs.

7) Certified Autism Specialist

This certification is a natural fit for OTs who wish to advance their skill set, knowledge, and confidence in working with both children and adults with autism.

8) Certified Hippotherapy Clinical Specialist

For OTs who love working with humans and horses, a hippotherapy certification enables them to incorporate equines and equine movement in treatment.

  • Requirements: Three years’ experience in OT; 100 hours of one-on-one direct treatment in hippotherapy practice within the three years prior to the certification application deadline; experienced and comfortable with horses; independent, skilled riding ability; pass the certification exam; renewal every five years
  • Cost: $455 certification fee ($355 for AHA members)
  • Salary: An average of $79,649, according to SimplyHired.com
  • Certifying Organization: American Hippotherapy Certification Board (AHCB)
  • Credential: HPSC

9) Certified Brain Injury Specialist

This certification allows OTs to deepen their knowledge of caring for clients who have experienced a brain injury.

10) Certified Diabetes Educator

This certification is a worthwhile endeavor for OTs who wish to improve the outcomes for clients with diabetes in both inpatient and outpatient settings.

11) Certified Industrial Economic Evaluator

This certification enables OTs to specialize in the areas of industrial rehabilitation, work injury, and work hardening/conditioning.

  • Requirements: Three-day course completed in-person or online; submit application within one year of completing the course; renewal every four years ($250)
  • Cost: $350 application fee; $900 course fee
  • Salary: No data found
  • Certifying Organization: Occupro
  • Credential: CIEE

12) Certified Kinesio Taping Practitioner

This certification is ideal for OTs wishing to expand their toolkit with kinesio taping, a rehabilitative taping technique designed to facilitate the body’s natural healing process.

  • Requirements: Completion of four eight-hour courses; pass the exam with a score of 80 percent or higher; annual membership in the Kinesio Taping Association International ($49)
  • Cost: $1,049
  • Salary: No data found
  • Certifying Organization: Kinesio
  • Credential: CKTP

13) Certified Low Vision Therapist

OTs with this certification have expertise in improving the function of clients who have vision impairments.

14) Certified Psychiatric Rehabilitation Practitioner

OTs who want to better serve adults with severe mental illness can benefit from having the CPRP credential.

  • Requirements: Work experience in psychiatric rehabilitation/recovery-oriented environment, serving adults and transition-age youth with serious and persistent mental illness; 45 training hours; pass the certification exam; renewal every three years ($245)
  • Cost: $495 for exam fees
  • Salary: An average of $52,000, according to Payscale.com
  • Certifying Organization: Psychiatric Rehabilitation Association (PRA)
  • Credential: CPRP

15) Certified Stroke Rehabilitation Specialist

A CSRS certification is a great option for OTs who want to work in rehabilitation settings with clients who’ve experienced strokes.

  • Requirements: Four eight-hour seminars; pass the online certification exam with a score of 80 percent or higher; renewal every two years ($75 for ASA members; $100 for non-members)
  • Cost: $800 for the seminars; $175 application fee for the online certification exam
  • Salary: No data found
  • Certifying Organization: American Stroke Organization
  • Credential: CSRS

16) Certified Driver Rehabilitation Specialist

Driver rehabilitation specialists work with clients who are dealing with injuries, disabilities, or the effects of aging to help improve their function and independence behind the wheel.

17) Lee Silverman Voice Treatment BIG

OTs certified in LSVT BIG help clients with Parkinson’s disease and other neurological conditions to improve their functioning.

18) Neuro-Developmental Treatment Certification

NDT is a hands-on treatment approach to enhance the functioning of children and adults who have difficulty controlling movement due to neurological challenges, such as stroke, brain injury, and cerebral palsy.

  • Requirements: NDTA membership ($105 per year), successful completion of certification course
  • Cost: $155 membership fee; up to $3,000 in course fees
  • Salary: No data found
  • Certifying Organization: Neuro-Developmental Treatment Association (NDTA)
  • Credential: C/NDT

19) Saebo Certified Therapist

This certification is ideal for OTs who seek a deeper understanding of Saebo’s Functional Dynamic Orthoses and Saebo Arm Training Program, which allows them to help clients who have experienced a neurological injury.

  • Requirements: Eight-hour self-study course
  • Cost: $195 course
  • Salary: No data found
  • Certifying Organization: Saebo
  • Credential: Saebo

Image courtesy of iStock.com/Gemalbarra


The views expressed in this article are those of the author and do not necessarily reflect those of Berxi™ or Berkshire Hathaway Specialty Insurance Company. This article (subject to change without notice) is for informational purposes only, and does not constitute professional advice.

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