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Texas Occupational Therapy — Requirements & Free Practice

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Occupational Therapist License

Regular Texas occupational therapist license issued by the Texas Board of Occupational Therapy Examiners under Occupations Code Chapter 454.

Licensing authority: Texas Board of Occupational Therapy Examiners · Application information

Licensure by endorsement
Application And Photo
Submit the application form, the non-refundable application fee and a current color U.S.-passport-standard photograph (40 TAC §364.1(a)(1)-(2)).
Education
Completion of the academic and supervised field work requirements of an ACOTE-accredited occupational therapist educational program, or substantially equivalent requirements if foreign-trained (40 TAC §364.1(a)(4); Tex. Occ. Code §§454.203-454.205).
Eligibility
Passed the NBCOT certification examination and either currently licensed as an OT or OTA in another U.S. state or territory with substantially equivalent requirements, or, if not currently licensed, applying from the U.S. military or a non-licensing state or territory and able to substantiate at least two years of occupational therapy employment immediately preceding application (40 TAC §§364.1(c), 364.4(a)).
Fingerprints
Submit a complete and legible set of fingerprints for a DPS/FBI criminal history record check (40 TAC §364.1(a)(5); Tex. Occ. Code §454.217).
Jurisprudence Exam
Pass the Board jurisprudence examination on the Act and Rules (Tex. Occ. Code §454.216(a)(3); 40 TAC §364.1(a)(3)).
License Verification
Submit an original license verification for any occupational therapy license the Board cannot verify, or a verification of employment form when applying from the U.S. military or a non-licensing jurisdiction (40 TAC §364.4(a)(3)).
Military Applicants
Military service members, veterans and spouses holding a current license in good standing in another state may request alternative licensing and expedited services under 40 TAC §364.1(d)(3).
Nbcot Score
NBCOT sends the certification examination score report directly to the Board; applicants examined before 1986 may instead have NBCOT send a Verification of Certification form (40 TAC §364.4(a)(2)).
Prior Texas Licensees
Previous Texas licensees are not eligible for licensure by endorsement (40 TAC §364.4(a)).
Initial license by examination
Application And Photo
Submit the application form, the non-refundable application fee and a current color U.S.-passport-standard photograph (40 TAC §364.1(a)(1)-(2)).
Education
Completion of the academic and supervised field work requirements of an ACOTE-accredited occupational therapist educational program, or substantially equivalent requirements if foreign-trained (40 TAC §364.1(a)(4); Tex. Occ. Code §§454.203-454.205).
Eligibility
Apply by examination if the applicant has not passed the NBCOT certification examination, or has passed it but is not currently licensed in another U.S. state or territory and cannot substantiate at least two years of occupational therapy employment immediately preceding application when applying from the U.S. military or a non-licensing state or territory (40 TAC §364.1(b)).
Exam Score Age
The application must be received no later than two years after the date of the passing NBCOT examination; otherwise the applicant must request Board approval and pass the NBCOT examination again for licensure purposes only (40 TAC §364.2(b)).
Fingerprints
Submit a complete and legible set of fingerprints for a DPS/FBI criminal history record check (40 TAC §364.1(a)(5); Tex. Occ. Code §454.217).
Jurisprudence Exam
Pass the Board jurisprudence examination on the Act and Rules with at least 70% of questions answered correctly (40 TAC §§362.1(7), 364.1(a)(3)).
License History
Submit an original license verification for any occupational therapy license history the Board cannot verify, including disciplinary action (40 TAC §364.2(d)).
Nbcot Exam
Pass the NBCOT Occupational Therapist Registered (OTR) Certification Examination with the score set by NBCOT; the score report must be sent directly to the Board by NBCOT (40 TAC §364.2(a)(2)).
Prior Texas Licensees
Previous Texas licensees are not eligible for initial license by examination (40 TAC §364.2(e)).
Placing or renewing a license on inactive status
jurisprudence examination
Eligibility
Licensee in good standing not actively practicing; inactive status is initiated only at renewal and may last no more than three consecutive renewal cycles or six consecutive years (40 TAC §371.1(a)).
Items
Application documenting the required continuing education, the inactive status fee and any late fees, and a passing jurisprudence examination score (40 TAC §371.1(c)).
Return from inactive to active status
jurisprudence examination
Expired Inactive
If the inactive license has been expired one year or more, the restoration procedures of 40 TAC §370.3 apply instead (40 TAC §371.1(e)).
Items
Application form, active status renewal fee and any late fees, passing jurisprudence examination score, proof of required continuing education if required, and fingerprints unless previously submitted (40 TAC §371.1(d)).
License renewal (on time or less than one year expired)
jurisprudence examination
Continuing Education
Complete 24 contact hours of continuing education every two years, including an HHSC-approved human trafficking training course (40 TAC §367.1(b)).
Fees
Renewal fee and any late fee set by the Executive Council (40 TAC §370.1(a)(1)(B)).
Fingerprints
Fingerprints unless previously submitted under Chapters 364, 370 or 371 (40 TAC §370.1(a)(1)(E)).
Jurisprudence Exam
A passing score on the jurisprudence examination (40 TAC §370.1(a)(1)(C)).
Timing
Renew every two years by the end of the birth month; a license expired less than one year may be renewed with the late fee (40 TAC §§370.1(a), 370.2(b)).
Restoration of a license expired one year or more (current license elsewhere or two years of employment)
jurisprudence examination
Deadline
Restoration requirements must be met within one year of the Board receiving the application (40 TAC §370.3(g)).
Eligibility
Texas license expired one year or more; currently licensed and unrestricted in another U.S. state or territory, or applying from the U.S. military or a non-licensing jurisdiction with at least two years of occupational therapy employment immediately preceding application (40 TAC §370.3(a)(1)).
Items
Restoration application, passport-standard photograph, human trafficking training documentation, license or employment verification, jurisprudence examination, restoration fee and fingerprints (40 TAC §370.3(a)(2)).
Restoration of a license expired at least one but less than two years (no current license or employment)
jurisprudence examination
Continuing Education
Submit 36 hours of continuing education including human trafficking training (40 TAC §370.3(b)(2)(C)).
Deadline
Restoration requirements must be met within one year of the Board receiving the application (40 TAC §370.3(g)).
Eligibility
Texas license expired at least one year but less than two years; not currently licensed elsewhere and unable to substantiate two years of occupational therapy employment (40 TAC §370.3(b)(1)).
Items
Restoration application, passport-standard photograph, license verification, jurisprudence examination, restoration fee and fingerprints (40 TAC §370.3(b)(2)).
Restoration of a license expired two years or more (no current license or employment)
Deadline
Restoration requirements must be met within one year of the Board receiving the application (40 TAC §370.3(g)).
Eligibility
Texas license expired two years or more; not currently licensed elsewhere and unable to substantiate two years of occupational therapy employment (40 TAC §370.3(c)(1)).
Items
Restoration application, passport-standard photograph, human trafficking training documentation, license verification, jurisprudence examination, restoration fee and fingerprints (40 TAC §370.3(c)(2)).
Nbcot Alternatives
Within two years before applying, satisfy one of: complete a re-entry course through an accredited college or university; obtain an advanced or post-professional occupational therapy degree; or, after requesting Board approval, take and pass the NBCOT examination for licensure purposes only with the score reported directly by NBCOT. An applicant who completes either of the first two need not sit the NBCOT examination (40 TAC §370.3(c)(2)(H)).
Placing or renewing a license on retired status (voluntary charity care)
jurisprudence examination
Eligibility
Practice limited to voluntary charity care without compensation; license current on active or inactive status or expired less than one year; retired status is initiated only at renewal (40 TAC §371.2(a)-(b)).
Items
Application form, passing jurisprudence examination score, 6 hours of continuing education including human trafficking training, the retired status fee and any late fees, and fingerprints unless previously submitted (40 TAC §371.2(d)).

provisional license

Provisional occupational therapist license for applicants licensed in good standing in another state with substantially equivalent requirements who have passed a national or other board-recognized examination. Valid until the board approves or denies the license application.

Licensing authority: Texas Board of Occupational Therapy Examiners · Application information

Provisional license for an endorsement applicant facing a documentation delay
Eligibility
Applicant for licensure by endorsement with an unwarranted delay in submitting required documentation outside the applicant's control; not available with disciplinary action in the license history or pending (40 TAC §364.4(b)).
Other Requirements
All other requirements for licensure by endorsement must be met, and the Provisional License fee paid; the provisional license lasts 180 days (40 TAC §364.4(b)).

Occupational Therapist Temporary License

Temporary Texas occupational therapist license for an applicant for licensure by examination taking the NBCOT exam for the first time.

Licensing authority: Texas Board of Occupational Therapy Examiners · Application information

Temporary license while taking the NBCOT examination for the first time
Application
Temporary license application and non-refundable temporary license fee (40 TAC §364.3(c)(6)).
Eligibility
Applicant for licensure by examination taking the NBCOT certification examination for the first time; not available to applicants previously licensed as an OT practitioner in any U.S. state or territory or with two years of occupational therapy employment from the U.S. military or a non-licensing jurisdiction, subject to the OT/OTA cross-level exception (40 TAC §364.3(a)-(b)).
Nbcot Registration
NBCOT sends the Confirmation of Exam Registration and Eligibility to Examine form directly to the Board, and the applicant submits a receipt showing an NBCOT score report was ordered for the Board (40 TAC §364.3(c)(3)-(4)).
Supervision
Submit a completed verification of supervision form; the temporary licensee practices under supervision by a regular licensee on the premises (40 TAC §§364.3(c)(5), 373.2; Tex. Occ. Code §454.211(b)).
Voidance
The temporary license is void if the applicant fails the examination, does not test within the NBCOT eligibility window or fails to have the score reported; it is valid no longer than 180 days and is not issued twice (40 TAC §364.3(d)-(f)).

Occupational Therapy Assistant License

Regular Texas occupational therapy assistant license issued by the Texas Board of Occupational Therapy Examiners under Occupations Code Chapter 454.

Licensing authority: Texas Board of Occupational Therapy Examiners · Application information

Licensure by endorsement
Application And Photo
Submit the application form, the non-refundable application fee and a current color U.S.-passport-standard photograph (40 TAC §364.1(a)(1)-(2)).
Education
Completion of the academic and supervised field work requirements of an ACOTE-accredited occupational therapy assistant educational program, or substantially equivalent requirements if foreign-trained (40 TAC §364.1(a)(4); Tex. Occ. Code §§454.203-454.205).
Eligibility
Passed the NBCOT certification examination and either currently licensed as an OT or OTA in another U.S. state or territory with substantially equivalent requirements, or, if not currently licensed, applying from the U.S. military or a non-licensing state or territory and able to substantiate at least two years of occupational therapy employment immediately preceding application (40 TAC §§364.1(c), 364.4(a)).
Fingerprints
Submit a complete and legible set of fingerprints for a DPS/FBI criminal history record check (40 TAC §364.1(a)(5); Tex. Occ. Code §454.217).
Jurisprudence Exam
Pass the Board jurisprudence examination on the Act and Rules (Tex. Occ. Code §454.216(a)(3); 40 TAC §364.1(a)(3)).
License Verification
Submit an original license verification for any occupational therapy license the Board cannot verify, or a verification of employment form when applying from the U.S. military or a non-licensing jurisdiction (40 TAC §364.4(a)(3)).
Military Applicants
Military service members, veterans and spouses holding a current license in good standing in another state may request alternative licensing and expedited services under 40 TAC §364.1(d)(3).
Nbcot Score
NBCOT sends the certification examination score report directly to the Board; applicants examined before 1986 may instead have NBCOT send a Verification of Certification form (40 TAC §364.4(a)(2)).
Prior Texas Licensees
Previous Texas licensees are not eligible for licensure by endorsement (40 TAC §364.4(a)).
Initial license by examination
Application And Photo
Submit the application form, the non-refundable application fee and a current color U.S.-passport-standard photograph (40 TAC §364.1(a)(1)-(2)).
Education
Completion of the academic and supervised field work requirements of an ACOTE-accredited occupational therapy assistant educational program, or substantially equivalent requirements if foreign-trained (40 TAC §364.1(a)(4); Tex. Occ. Code §§454.203-454.205).
Eligibility
Apply by examination if the applicant has not passed the NBCOT certification examination, or has passed it but is not currently licensed in another U.S. state or territory and cannot substantiate at least two years of occupational therapy employment immediately preceding application when applying from the U.S. military or a non-licensing state or territory (40 TAC §364.1(b)).
Exam Score Age
The application must be received no later than two years after the date of the passing NBCOT examination; otherwise the applicant must request Board approval and pass the NBCOT examination again for licensure purposes only (40 TAC §364.2(b)).
Fingerprints
Submit a complete and legible set of fingerprints for a DPS/FBI criminal history record check (40 TAC §364.1(a)(5); Tex. Occ. Code §454.217).
Jurisprudence Exam
Pass the Board jurisprudence examination on the Act and Rules with at least 70% of questions answered correctly (40 TAC §§362.1(7), 364.1(a)(3)).
License History
Submit an original license verification for any occupational therapy license history the Board cannot verify, including disciplinary action (40 TAC §364.2(d)).
Nbcot Exam
Pass the NBCOT Certified Occupational Therapy Assistant (COTA) Certification Examination with the score set by NBCOT; the score report must be sent directly to the Board by NBCOT (40 TAC §364.2(a)(2)).
Prior Texas Licensees
Previous Texas licensees are not eligible for initial license by examination (40 TAC §364.2(e)).
Placing or renewing a license on inactive status
jurisprudence examination
Eligibility
Licensee in good standing not actively practicing; inactive status is initiated only at renewal and may last no more than three consecutive renewal cycles or six consecutive years (40 TAC §371.1(a)).
Items
Application documenting the required continuing education, the inactive status fee and any late fees, and a passing jurisprudence examination score (40 TAC §371.1(c)).
Return from inactive to active status
jurisprudence examination
Expired Inactive
If the inactive license has been expired one year or more, the restoration procedures of 40 TAC §370.3 apply instead (40 TAC §371.1(e)).
Items
Application form, active status renewal fee and any late fees, passing jurisprudence examination score, proof of required continuing education if required, and fingerprints unless previously submitted (40 TAC §371.1(d)).
License renewal (on time or less than one year expired)
jurisprudence examination
Continuing Education
Complete 24 contact hours of continuing education every two years, including an HHSC-approved human trafficking training course (40 TAC §367.1(b)).
Fees
Renewal fee and any late fee set by the Executive Council (40 TAC §370.1(a)(1)(B)).
Fingerprints
Fingerprints unless previously submitted under Chapters 364, 370 or 371 (40 TAC §370.1(a)(1)(E)).
Jurisprudence Exam
A passing score on the jurisprudence examination (40 TAC §370.1(a)(1)(C)).
Timing
Renew every two years by the end of the birth month; a license expired less than one year may be renewed with the late fee (40 TAC §§370.1(a), 370.2(b)).
Restoration of a license expired one year or more (current license elsewhere or two years of employment)
jurisprudence examination
Deadline
Restoration requirements must be met within one year of the Board receiving the application (40 TAC §370.3(g)).
Eligibility
Texas license expired one year or more; currently licensed and unrestricted in another U.S. state or territory, or applying from the U.S. military or a non-licensing jurisdiction with at least two years of occupational therapy employment immediately preceding application (40 TAC §370.3(a)(1)).
Items
Restoration application, passport-standard photograph, human trafficking training documentation, license or employment verification, jurisprudence examination, restoration fee and fingerprints (40 TAC §370.3(a)(2)).
Restoration of a license expired at least one but less than two years (no current license or employment)
jurisprudence examination
Continuing Education
Submit 36 hours of continuing education including human trafficking training (40 TAC §370.3(b)(2)(C)).
Deadline
Restoration requirements must be met within one year of the Board receiving the application (40 TAC §370.3(g)).
Eligibility
Texas license expired at least one year but less than two years; not currently licensed elsewhere and unable to substantiate two years of occupational therapy employment (40 TAC §370.3(b)(1)).
Items
Restoration application, passport-standard photograph, license verification, jurisprudence examination, restoration fee and fingerprints (40 TAC §370.3(b)(2)).
Restoration of a license expired two years or more (no current license or employment)
Deadline
Restoration requirements must be met within one year of the Board receiving the application (40 TAC §370.3(g)).
Eligibility
Texas license expired two years or more; not currently licensed elsewhere and unable to substantiate two years of occupational therapy employment (40 TAC §370.3(c)(1)).
Items
Restoration application, passport-standard photograph, human trafficking training documentation, license verification, jurisprudence examination, restoration fee and fingerprints (40 TAC §370.3(c)(2)).
Nbcot Alternatives
Within two years before applying, satisfy one of: complete a re-entry course through an accredited college or university; obtain an advanced or post-professional occupational therapy degree; or, after requesting Board approval, take and pass the NBCOT examination for licensure purposes only with the score reported directly by NBCOT. An applicant who completes either of the first two need not sit the NBCOT examination (40 TAC §370.3(c)(2)(H)).
Placing or renewing a license on retired status (voluntary charity care)
jurisprudence examination
Eligibility
Practice limited to voluntary charity care without compensation; license current on active or inactive status or expired less than one year; retired status is initiated only at renewal (40 TAC §371.2(a)-(b)).
Items
Application form, passing jurisprudence examination score, 6 hours of continuing education including human trafficking training, the retired status fee and any late fees, and fingerprints unless previously submitted (40 TAC §371.2(d)).

provisional license

Provisional license for an occupational therapy assistant licensed in good standing in another state with substantially equivalent licensing requirements who has passed a national or other board-recognized examination. Valid until the board approves or denies the application for licensure.

Licensing authority: Texas Board of Occupational Therapy Examiners · Application information

Provisional license for an endorsement applicant facing a documentation delay
Eligibility
Applicant for licensure by endorsement with an unwarranted delay in submitting required documentation outside the applicant's control; not available with disciplinary action in the license history or pending (40 TAC §364.4(b)).
Other Requirements
All other requirements for licensure by endorsement must be met, and the Provisional License fee paid; the provisional license lasts 180 days (40 TAC §364.4(b)).

Occupational Therapy Assistant Temporary License

Temporary Texas occupational therapy assistant license for eligible applicants for licensure by examination taking the NBCOT exam for the first time.

Licensing authority: Texas Board of Occupational Therapy Examiners · Application information

Temporary license while taking the NBCOT examination for the first time
Application
Temporary license application and non-refundable temporary license fee (40 TAC §364.3(c)(6)).
Eligibility
Applicant for licensure by examination taking the NBCOT certification examination for the first time; not available to applicants previously licensed as an OT practitioner in any U.S. state or territory or with two years of occupational therapy employment from the U.S. military or a non-licensing jurisdiction, subject to the OT/OTA cross-level exception (40 TAC §364.3(a)-(b)).
Nbcot Registration
NBCOT sends the Confirmation of Exam Registration and Eligibility to Examine form directly to the Board, and the applicant submits a receipt showing an NBCOT score report was ordered for the Board (40 TAC §364.3(c)(3)-(4)).
Supervision
Submit a completed verification of supervision form; the temporary licensee practices under supervision by a regular licensee on the premises (40 TAC §§364.3(c)(5), 373.2; Tex. Occ. Code §454.211(b)).
Voidance
The temporary license is void if the applicant fails the examination, does not test within the NBCOT eligibility window or fails to have the score reported; it is valid no longer than 180 days and is not issued twice (40 TAC §364.3(d)-(f)).

OTR exam

Format
Three- and four-option single-response multiple-choice items and six-option multi-select scenario sets
Exam questions
180 items
Examination outline
  • Domain 1 — Evaluation and Assessment: Acquire information regarding factors that influence occupational performance on an ongoing basis throughout the occupational therapy process. (23%)
    • Task 1: Identify the influence of development and lived experience; body functions and body structures; values, beliefs, and spirituality; and identity on occupational performance.
    • Task 1 knowledge 1: Impact of typical development and aging on occupational performance, health, and wellness across the life span.
    • Task 1 knowledge 2: Expected patterns, progressions, and prognoses associated with conditions that limit occupational performance. Examples include signs and symptoms of disease; stages of disease; secondary complications.
    • Task 1 knowledge 3: Impact of body functions and body structures on occupational performance. Examples include cognitive impairments; congenital anomalies.
    • Task 1 knowledge 4: Influence of lived experiences and identity on occupational performance. Examples include history of trauma and adverse childhood events; socioeconomic status; gender, race, culture, religion.
    • Task 2: Assess a client’s functional skills, roles, prioritized needs and wants, and performance context to evaluate their occupational performance.
    • Task 2 knowledge 1: Resources and considerations for acquiring information about the client’s current condition and occupational performance. Examples include referrals; client records; developmental history; Individualized Education Program (IEP) plans; theoretical approach and frame of reference.
    • Task 2 knowledge 2: Administration, purpose, indications, advantages, and limitations of standardized and nonstandardized screening and assessment tools. Examples include criterion-referenced tests; norm-referenced tests; client and caregiver interviews; observation.
    • Task 2 knowledge 3: Internal and external factors influencing a client’s engagement in occupation. Examples include roles, habits, routines, and rituals; environmental context; family and social supports; medication side effects and interactions; mental health.
    • Task 3: Perform an activity analysis to determine the influence of task demands, current conditions, performance skills, and context on occupation.
    • Task 3 knowledge 1: Task requirements, steps to task completion, and task demands across contexts or settings.
    • Task 3 knowledge 2: Personal and environmental factors that facilitate or inhibit task completion or occupational engagement. Examples include compensation patterns; role of performance context; influence of current conditions.
  • Domain 2 — Analysis, Interpretation, and Planning: Formulate conclusions regarding client needs and priorities to develop and monitor an intervention plan throughout the occupational therapy process. (23%)
    • Task 1: Synthesize assessment results to determine eligibility for services and establish a client-centered intervention plan.
    • Task 1 knowledge 1: Interpretation and analysis of quantitative assessments. Examples include statistical terminology; scoring; limitations of scores; client reactions to testing.
    • Task 1 knowledge 2: Interpretation of qualitative findings. Examples include occupational profile; outcomes of needs assessment; results from interviews or observations.
    • Task 1 knowledge 3: Integration and application of quantitative assessment results and qualitative findings to guide critical decision-making and prioritize needs.
    • Task 2: Collaborate with the client, the client’s relevant others, occupational therapy colleagues, and other professionals using a client-centered approach and therapeutic use of self to manage occupational therapy services.
    • Task 2 knowledge 1: Roles and responsibilities among interprofessional teams when coordinating client care and providing services. Examples include referral to and consultation with other services; interprofessional communication methods; scope of practice.
    • Task 2 knowledge 2: Processes for managing interprofessional intervention plans. Examples include Individualized Education Program (IEP) plans; discharge plans; transition plans; palliative and hospice care plans.
    • Task 2 knowledge 3: Client-centered approaches and considerations for coordinating occupational therapy services. Examples include therapeutic use of self; advocacy; frequency/duration of intervention; level of service delivery.
    • Task 2 knowledge 4: Factors used to prioritize intervention goals and activities in collaboration with the client and family, teacher, caregiver, and relevant others. Examples include client-reported outcomes; level of support required; context of service delivery; progress toward goals.
    • Task 2 knowledge 5: Strategies for addressing and enhancing health literacy with the client and relevant others. Examples include caregiver training; teaching-learning models; methods for making health information accessible; informed decision-making; navigating challenges to professional expertise.
    • Task 3: Monitor and modify the intervention plan, approach, context, and goals on an ongoing basis using clinical reasoning.
    • Task 3 knowledge 1: Factors for determining and managing context and activities to meet individual and group intervention goals and objectives. Examples include client needs and priorities; response to intervention.
    • Task 3 knowledge 2: Strategies for monitoring the effectiveness of individual and group interventions. Examples include client-reported outcomes; reevaluation results; progress toward goals.
    • Task 3 knowledge 3: Clinical decision-making for assessing and adapting the intervention plan and prioritizing goals based on client response to intervention. Examples include physiological changes; behavioral reactions; emotion regulation; developmental needs.
    • Task 3 knowledge 4: Precautions or contraindications associated with a client’s condition or stage of recovery. Examples include postsurgical precautions; vital signs; laboratory values; suicidal ideation.
  • Domain 3 — Select and Manage Interventions: Select and implement interventions for managing a client-centered plan throughout the occupational therapy process. (38%)
    • Task 1: Incorporate preparatory techniques, activities, and modalities as an adjunct to interventions to promote healing and enhance engagement in occupation-based activities.
    • Task 1 knowledge 1: Considerations for selecting, preparing, and adapting the intervention technique to support optimal engagement and promote goal achievement. Examples include client condition; client safety.
    • Task 1 knowledge 2: Considerations for selecting, preparing, and adapting the intervention environment to support optimal engagement and promote goal achievement. Examples include ensuring privacy during telehealth sessions; equipment safety; line management.
    • Task 1 knowledge 3: Indications, contraindications, and precautions associated with wound management and maintaining skin integrity. Examples include stage of wound healing; prevention and management of pressure ulcers.
    • Task 1 knowledge 4: Indications, contraindications, precautions, and clinical application of superficial thermal agents. Examples include dry whirlpool; hot packs; cryotherapy.
    • Task 1 knowledge 5: Indications, contraindications, precautions, and clinical application of deep thermal, mechanical, and electrotherapeutic physical agent modalities. Examples include transcutaneous and neuromuscular electrical stimulation; biofeedback.
    • Task 2: Implement occupation-based strategies to support participation in activities of daily living (ADL), instrumental activities of daily living (IADL), health management, rest and sleep, education, work, play, leisure, and social participation across the life span.
    • Task 2 knowledge 1: Interventions for supporting leisure and play.
    • Task 2 knowledge 2: Methods for grading an activity, task, or technique based on level of development, client status, response to intervention, and client needs.
    • Task 2 knowledge 3: Considerations for facilitating individual and group participation in shared activities. Examples include group processes; group dynamics; group type and function.
    • Task 2 knowledge 4: Interventions to support cognitive, visual-motor, visual, and perceptual processing and sensory arousal. Examples include sensory modulation; proprioceptive input; vestibular strategies; low vision strategies.
    • Task 2 knowledge 5: Compensatory and remedial strategies for managing cognitive and perceptual deficits or developmental disabilities. Examples include graded cueing; chaining; metacognition; memory aids.
    • Task 2 knowledge 6: Adaptive and preventive strategies for supporting optimal engagement in occupation. Examples include use of technology/apps; joint protection; task simplification; energy conservation.
    • Task 2 knowledge 7: Intervention strategies and techniques used to facilitate oral motor skills for drinking, eating, and swallowing. Examples include hand-to-mouth patterns; mastication; adaptive utensils; positioning at mealtime.
    • Task 2 knowledge 8: Prevocational, vocational, and transitional services, options, and resources for supporting strengths, interests, employment, and lifestyle goals across the life span.
    • Task 2 knowledge 9: Strategies, techniques, and client-centered education to facilitate functional transfers.
    • Task 2 knowledge 10: Strategies for promoting wellness and mental health. Examples include relaxation; sleep hygiene; addiction management.
    • Task 3: Select and implement interventions for improving sensory, motor, neurological, and physiological status, considering client condition and current stage of recovery, to support occupational performance.
    • Task 3 knowledge 1: Methods for grading therapeutic exercise and conditioning programs consistent with indications and precautions.
    • Task 3 knowledge 2: Techniques for sensory and motor reeducation, pain management, desensitization, edema reduction, and scar management. Examples include manual edema mobilization; nerve gliding; neuromuscular reeducation; constraint-induced movement.
    • Task 3 knowledge 3: Techniques for promoting improved postural stability, dynamic balance, body mechanics, and breathing patterns during functional tasks.
    • Task 4: Select, fabricate, and modify orthotic devices, and provide training in the use of orthotic and prosthetic devices to support functional outcomes.
    • Task 4 knowledge 1: Types and functions of immobilization, mobilization, and restriction orthoses for managing specific conditions and congenital anomalies across the life span.
    • Task 4 knowledge 2: Types and functions of prosthetic devices for upper and lower extremity amputations.
    • Task 4 knowledge 3: Implications of anatomical, physiological, biomechanical, cognitive, and socioeconomic factors and healing principles for orthotic selection, design, fabrication, and modification.
    • Task 4 knowledge 4: Client-centered education and training methods for the safe and effective use of orthotic and prosthetic devices.
    • Task 5: Select assistive technology options, adaptive devices, mobility aids, and other durable medical equipment to enable participation in occupation.
    • Task 5 knowledge 1: Factors related to measuring, selecting, monitoring the fit of, and recommending modifications to seating systems, positioning devices, and mobility aids. Examples include equipment components; biomechanical considerations; usability and maintenance.
    • Task 5 knowledge 2: Types, characteristics, and features of high- and low-tech assistive technology and adaptive devices. Examples include interface options and processor parameters; equipment components.
    • Task 5 knowledge 3: Mobility options, vehicle adaptations, and alternative devices for supporting participation in community mobility. Examples include adapted driving controls; wheelchair tie downs; alternative transportation options; dynamic mobile standers; navigation apps.
    • Task 5 knowledge 4: Client factors influencing successful use and maintenance of assistive technology options, adaptive devices, mobility aids, and other durable medical equipment. Examples include developmental, physical, functional, cognitive, and mental health status; prioritized needs.
    • Task 5 knowledge 5: Client-centered education and training methods for successful use and maintenance of assistive technology options, adaptive devices, mobility aids, and other durable medical equipment.
    • Task 6: Recommend environmental modifications, while considering accessibility guidelines, standards, and legislation, to support participation in occupation consistent with client needs and status, task demands, and context.
    • Task 6 knowledge 1: Principles of ergonomics and universal design for identifying, recommending, and implementing features and reasonable accommodations in the workplace, home, and virtual and public spaces.
    • Task 6 knowledge 2: Processes and procedures for identifying, recommending, and implementing modifications in the workplace, home, and virtual and public spaces.
  • Domain 4 — Competency and Practice Management: Manage professional activities of self and relevant others as guided by evidence, regulatory compliance, and standards of practice to promote quality care. (16%)
    • Task 1: Employ evidence-based strategies and approaches to provide safe, effective, and efficient services relevant to individuals, groups, and populations.
    • Task 1 knowledge 1: Methods for locating, reviewing, interpreting, and critically appraising scholarly research to guide practice-relevant decision-making. Examples include defining a clinical question; determining the clinical bottom line.
    • Task 1 knowledge 2: Methods for applying continuous quality improvement processes and procedures to occupational therapy service delivery. Examples include program evaluation; outcome measures.
    • Task 1 knowledge 3: Evidence-based programming for advancing population health outcomes. Examples include aging in place; fall prevention; health and wellness; community support groups.
    • Task 2: Incorporate risk management techniques at the individual and practice-setting levels to protect clients, self, staff, and others from injury or harm.
    • Task 2 knowledge 1: Infection control procedures and universal precautions for reducing transmission of contaminants. Examples include PPE; isolation precautions; cleaning equipment.
    • Task 2 knowledge 2: Responses to adverse reactions, minor injuries, and emergency situations. Examples include minor burns and cuts; seizures; diabetic reactions.
    • Task 2 knowledge 3: Preventive measures for minimizing risk and promoting safety. Examples include proper body mechanics; safety data sheet (SDS); standard operating procedures; equipment maintenance; emergency preparedness; personal safety in the client’s environment.
    • Task 2 knowledge 4: Strategies and resources to prevent professional burnout. Examples include assessment of personal needs; self-advocacy regarding workload; stress management.
    • Task 3: Provide occupational therapy services in accordance with laws, regulations, state occupational therapy practice acts, and accreditation guidelines to protect consumers and meet applicable reimbursement requirements related to the service delivery setting.
    • Task 3 knowledge 1: Application of federal regulations, state practice acts, facility policies, and accreditation guidelines related to service delivery across occupational therapy practice settings. Examples include health care legislation; accreditation organizations; licensing and credentialing; supervisory role under state practice acts.
    • Task 3 knowledge 2: Influence of reimbursement policies and guidelines on occupational therapy service delivery.
    • Task 3 knowledge 3: Accountability processes and procedures for justifying, tracking, and monitoring outcomes. Examples include relevant practice terminology; documentation guidelines.
    • Task 4: Engage in professional development and competency assessment activities relevant to the job role, practice setting, scope of practice, and professional certification standards.
    • Task 4 knowledge 1: Methods for identifying, documenting, and monitoring service competency and professional development needs. Examples include competency self-assessment; mentoring.
    • Task 4 knowledge 2: Application of ethical decision-making and professional behaviors guided by the NBCOT Practice Standards and Code of Conduct.
Examination sources

jurisprudence examination

Provider
Texas Board of Occupational Therapy Examiners
Format
Open-book online examination with multiple choice and/or true-false questions
Exam questions
20
Passing score
At least 70%
Exam fee
No fee
Examination outline
  • Occupational Therapy Practice Act (Occupations Code Chapter 454)
  • Chapter 362 Definitions
  • Chapter 363 Consumer/Licensee Information
  • Chapter 364 Requirements for Licensure
  • Chapter 367 Continuing Education
  • Chapter 369 Display of Licenses
  • Chapter 370 License Renewal
  • Chapter 371 Inactive and Retired Status
  • Chapter 372 Provision of Services
  • Chapter 373 Supervision
  • Chapter 374 Disciplinary Actions/Detrimental Practice/Complaint Process/Code of Ethics/Licensure of Persons with Criminal Convictions
  • Chapter 375 Fees
Examination sources

COTA Certification Exam

Format
Three- and four-option single-response multiple-choice items and six-option multi-select items
Exam questions
190 items
Examination outline
  • Domain 1 — Collaborate and Gather Information: Under the supervision of the OTR, acquire information on an ongoing basis regarding factors that influence occupational performance. (27%)
    • Task 1: Recognize the influence of development and lived experience; body functions and body structures; values, beliefs, and spirituality; and identity on occupational performance.
    • Task 1 knowledge 1: Impact of typical development and aging on occupational performance, health, and wellness across the life span.
    • Task 1 knowledge 2: Expected patterns, progressions, and prognoses associated with conditions that limit occupational performance. Examples include signs and symptoms of disease; stages of disease; secondary complications.
    • Task 1 knowledge 3: Impact of body functions and body structures on occupational performance. Examples include cognitive impairments; congenital anomalies.
    • Task 1 knowledge 4: Influence of lived experiences and identity on occupational performance. Examples include history of trauma and adverse childhood events; socioeconomic status; gender, race, culture, religion.
    • Task 2: Acquire information about a client’s functional skills, roles, prioritized needs and wants, and performance context to inform the development of and updates to an occupational profile.
    • Task 2 knowledge 1: Resources for acquiring information about the client’s current condition and occupational performance. Examples include referrals; client records; developmental history; Individualized Education Program (IEP) plans.
    • Task 2 knowledge 2: Purpose, advantages, limitations, and service competency needs related to the administration of standardized and nonstandardized assessments and screening methods. Examples include criterion-referenced tests; norm-referenced tests; client and caregiver interviews; observation.
    • Task 2 knowledge 3: Internal and external factors influencing a client’s engagement in occupation. Examples include roles, habits, routines, and rituals; environmental context; family and social supports; medication side effects and interactions; mental health.
    • Task 3: Perform an activity analysis to determine the influence of task demands, current conditions, performance skills, and context on occupation.
    • Task 3 knowledge 1: Task requirements, steps to task completion, and task demands across contexts or settings.
    • Task 3 knowledge 2: Personal and environmental factors that facilitate or inhibit task completion or occupational engagement. Examples include compensation patterns; role of performance context; influence of current conditions.
    • Task 4: Collaborate with the client, the client’s relevant others, occupational therapy colleagues, and other professionals using a client-centered approach and therapeutic use of self to provide quality occupational therapy services.
    • Task 4 knowledge 1: Roles and responsibilities among interprofessional teams when coordinating client care and providing services. Examples include referral to and consultation with other services; interprofessional communication methods; scope of practice.
    • Task 4 knowledge 2: Processes for supporting interprofessional intervention plans. Examples include Individualized Education Program (IEP) plans; discharge plans; transition plans; palliative and hospice care plans.
    • Task 4 knowledge 3: Client-centered approaches and considerations for coordinating occupational therapy services. Examples include therapeutic use of self; advocacy; frequency/duration of intervention; level of service delivery.
    • Task 4 knowledge 4: Factors used to prioritize intervention goals and activities in collaboration with the client and family, teacher, caregiver, and relevant others. Examples include client-reported outcomes; level of support required; context of service delivery; progress toward goals.
    • Task 4 knowledge 5: Strategies for addressing and enhancing health literacy with the client and relevant others. Examples include caregiver training; teaching-learning models; methods for making health information accessible; informed decision-making; navigating challenges to professional expertise.
    • Task 5: Monitor the intervention plan, approach, context, and goals on an ongoing basis, in collaboration with the OTR, using clinical reasoning.
    • Task 5 knowledge 1: Factors for determining and managing context and activities to meet individual and group intervention goals and objectives. Examples include client needs and priorities; response to intervention.
    • Task 5 knowledge 2: Strategies for monitoring the effectiveness of individual and group intervention. Examples include client-reported outcomes; reevaluation results; progress toward goals.
    • Task 5 knowledge 3: Clinical decision-making for prioritizing goals and implementing modifications to the intervention plan based on client responses, under the supervision of the OTR. Examples include physiological changes; behavioral reactions; emotion regulation; developmental needs.
    • Task 5 knowledge 4: Precautions or contraindications associated with a client condition or stage of recovery. Examples include postsurgical precautions; vital signs; laboratory values; suicidal ideation.
  • Domain 2 — Select and Implement Interventions: Implement interventions, under the supervision of the OTR, in accordance with the intervention plan and level of service competence to support client participation in areas of occupation throughout the occupational therapy process. (55%)
    • Task 1: Incorporate preparatory techniques, activities, and modalities as an adjunct to interventions to promote healing and enhance engagement in occupation-based activities.
    • Task 1 knowledge 1: Considerations for selecting, preparing, and adapting the intervention technique to support optimal engagement and promote goal achievement. Examples include client condition; client safety; theoretical approach and frame of reference.
    • Task 1 knowledge 2: Considerations for selecting, preparing, and adapting the intervention environment to support optimal engagement and promote goal achievement. Examples include ensuring privacy during telehealth sessions; equipment safety; line management.
    • Task 1 knowledge 3: Indications, contraindications, and precautions associated with wounds and maintaining skin integrity. Examples include stage of wound healing; prevention and management of pressure ulcers.
    • Task 1 knowledge 4: Indications, contraindications, precautions, and clinical application of superficial thermal agents. Examples include dry whirlpool; hot packs; cryotherapy.
    • Task 1 knowledge 5: Indications, contraindications, precautions, and clinical application of deep thermal, mechanical, and electrotherapeutic physical agent modalities. Examples include transcutaneous and neuromuscular electrical stimulation; biofeedback.
    • Task 2: Implement occupation-based strategies to support participation in activities of daily living (ADL), instrumental activities of daily living (IADL), health management, rest and sleep, education, work, play, leisure, and social participation across the life span.
    • Task 2 knowledge 1: Interventions for supporting leisure and play.
    • Task 2 knowledge 2: Methods for grading an activity, task, or technique based on level of development, client status, response to intervention, and client needs.
    • Task 2 knowledge 3: Considerations for facilitating individual and group participation in shared activities. Examples include group processes; group dynamics; group type and function.
    • Task 2 knowledge 4: Interventions to support cognitive, visual-motor, visual, and perceptual processing and sensory arousal. Examples include sensory modulation; proprioceptive input; vestibular strategies; low vision strategies.
    • Task 2 knowledge 5: Compensatory and remedial strategies for managing cognitive and perceptual deficits or developmental disabilities. Examples include graded cueing; chaining; metacognition; memory aids.
    • Task 2 knowledge 6: Adaptive and preventive strategies for supporting optimal engagement in occupation. Examples include use of technology/apps; joint protection; task simplification; energy conservation.
    • Task 2 knowledge 7: Intervention strategies and techniques used to facilitate oral motor skills for drinking, eating, and swallowing. Examples include hand-to-mouth patterns; mastication; adaptive utensils; positioning at mealtime.
    • Task 2 knowledge 8: Prevocational, vocational, and transitional services, options, and resources for supporting strengths, interests, employment, and lifestyle goals across the life span.
    • Task 2 knowledge 9: Strategies, techniques, and client-centered education to facilitate functional transfers.
    • Task 2 knowledge 10: Strategies for promoting wellness and mental health. Examples include relaxation; sleep hygiene; addiction management.
    • Task 3: Implement interventions for improving sensory, motor, neurological, and physiological status, considering client condition and current stage of recovery, to support occupational performance.
    • Task 3 knowledge 1: Methods for grading therapeutic exercise and conditioning programs consistent with indications and precautions.
    • Task 3 knowledge 2: Techniques for sensory and motor reeducation, pain management, desensitization, edema reduction, and scar management. Examples include manual edema mobilization; nerve gliding; neuromuscular reeducation; constraint-induced movement.
    • Task 3 knowledge 3: Techniques for promoting improved postural stability, dynamic balance, body mechanics, and breathing patterns during functional tasks.
    • Task 4: Select, fabricate, and modify orthotic devices, and provide training in the use of orthotic and prosthetic devices in order to support functional outcomes.
    • Task 4 knowledge 1: Types and functions of immobilization, mobilization, and restriction orthoses for managing specific conditions and congenital anomalies across the life span.
    • Task 4 knowledge 2: Types and functions of prosthetic devices for upper and lower extremity amputations.
    • Task 4 knowledge 3: Implications of anatomical, physiological, biomechanical, cognitive, and socioeconomic factors and healing principles for orthotic selection, design, fabrication, and modification.
    • Task 4 knowledge 4: Client-centered education and training methods for the safe and effective use of orthotic and prosthetic devices.
    • Task 5: Integrate assistive technology options, adaptive devices, mobility aids, and other durable medical equipment into the intervention to enable participation in occupation.
    • Task 5 knowledge 1: Factors related to measuring, selecting, monitoring the fit of, and recommending modifications to seating systems, positioning devices, and mobility aids. Examples include equipment components; biomechanical considerations; usability and maintenance.
    • Task 5 knowledge 2: Types, characteristics, and features of high- and low-tech assistive technology and adaptive devices. Examples include interface options and processor parameters; equipment components.
    • Task 5 knowledge 3: Mobility options, vehicle adaptations, and alternative devices for supporting participation in community mobility. Examples include adapted driving controls; wheelchair tie downs; alternative transportation options; dynamic mobile standers; navigation apps.
    • Task 5 knowledge 4: Client factors influencing successful use and maintenance of assistive technology options, adaptive devices, mobility aids, and other durable medical equipment. Examples include developmental, physical, functional, cognitive, and mental health status; prioritized needs.
    • Task 5 knowledge 5: Client-centered education and training methods for successful use and maintenance of assistive technology options, adaptive devices, mobility aids, and other durable medical equipment.
    • Task 6: Implement environmental modifications, while considering accessibility guidelines, standards, and legislation, to support participation in occupation consistent with client needs and status, task demands, and context.
    • Task 6 knowledge 1: Principles of ergonomics and universal design for identifying, recommending, and implementing features and reasonable accommodations in the workplace, home, and virtual and public spaces.
    • Task 6 knowledge 2: Processes and procedures for identifying, recommending, and implementing modifications in the workplace, home, and virtual and public spaces.
  • Domain 3 — Uphold Professional Standards and Responsibilities: Uphold professional standards and responsibilities by achieving service competence and applying evidence-based interventions to promote quality in practice. (18%)
    • Task 1: Employ evidence-based strategies and approaches to provide safe, effective, and efficient services relevant to individuals, groups, and populations.
    • Task 1 knowledge 1: Methods for locating, reviewing, and interpreting scholarly research to guide practice-relevant decision-making. Examples include applying the Patient, Intervention, Comparison, Outcome (PICO) model; identifying best evidence.
    • Task 1 knowledge 2: Methods for contributing to continuous quality improvement processes and procedures related to occupational therapy service delivery. Examples include program evaluation; acquiring information to measure outcomes.
    • Task 1 knowledge 3: Types of evidence-based programming for advancing population health outcomes. Examples include aging in place; fall prevention; health and wellness; community support groups.
    • Task 2: Incorporate risk management techniques at the individual and practice-setting levels to protect clients, self, staff, and others from injury or harm.
    • Task 2 knowledge 1: Infection control procedures and universal precautions for reducing transmission of contaminants. Examples include PPE; isolation precautions; cleaning equipment.
    • Task 2 knowledge 2: Responses to adverse reactions, minor injuries, and emergency situations. Examples include minor burns and cuts; seizures; diabetic reactions.
    • Task 2 knowledge 3: Preventive measures for minimizing risk and promoting safety. Examples include proper body mechanics; safety data sheet (SDS); standard operating procedures; equipment maintenance; emergency preparedness; personal safety in the client’s environment.
    • Task 2 knowledge 4: Strategies and resources to prevent professional burnout. Examples include assessment of personal needs; self-advocacy regarding workload; stress management.
    • Task 3: Provide occupational therapy services in accordance with laws, regulations, state occupational therapy practice acts, and accreditation guidelines to protect consumers and meet applicable reimbursement requirements related to the service delivery setting.
    • Task 3 knowledge 1: Application of federal regulations, state practice acts, facility policies, and accreditation guidelines related to service delivery across occupational therapy practice settings. Examples include health care legislation; accreditation organizations; licensing and credentialing.
    • Task 3 knowledge 2: Influence of reimbursement policies and guidelines on occupational therapy service delivery.
    • Task 3 knowledge 3: Accountability processes and procedures for justifying, tracking, and monitoring outcomes. Examples include relevant practice terminology; documentation guidelines.
    • Task 4: Engage in professional development and competency assessment activities relevant to the job role, practice setting, scope of practice, and professional certification standards.
    • Task 4 knowledge 1: Methods for identifying, documenting, and monitoring service competency and professional development needs. Examples include competency self-assessment; mentoring.
    • Task 4 knowledge 2: Application of ethical decision-making and professional behaviors guided by the NBCOT Practice Standards and Code of Conduct.
Examination sources