Wyoming Occupational Therapy — Requirements & Free Practice
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Occupational Therapist License
Wyoming license to practice as an occupational therapist under the Occupational Therapy Practice Act (W.S. 33-40-101 et seq.), issued by the Wyoming Board of Occupational Therapy. The Board also issues limited and temporary forms of this license, which are recorded as routes.
Licensing authority: Wyoming Board of Occupational Therapy · Application information
Licensure by endorsement
- Current License Elsewhere
- W.S. 33-40-111(b) and Rule Ch. 2 Sec. 6(a): current licensure as an occupational therapist in another state, the District of Columbia or a U.S. territory (the rule says 'another jurisdiction') whose licensure standards require passage of the national certification examination administered by NBCOT (Occupational Therapist Registered (OTR) Certification Examination) or a successor examination recognized by the Board.
- Discipline History
- W.S. 33-40-111(b): the applicant has not been disciplined in the other jurisdiction for unprofessional conduct or a similar offense; the Board may still license an applicant disciplined for minor, rectified or remote unprofessional conduct.
- Examination Waiver
- W.S. 33-40-111(b): the Board waives, to the extent necessary, examination, education and continuing education requirements for such an applicant; the NBCOT examination is satisfied by the passage the other jurisdiction required, not by a new sitting.
- Lawful Presence
- Rule Ch. 2 Sec. 6(b)(iii): verification of lawful presence in the United States.
- License Verification
- Rule Ch. 2 Sec. 6(b)(iv): verification of licensure sent directly to the Board from each jurisdiction where the applicant currently holds a license.
Licensure by examination
- Character
- W.S. 33-40-106(a)(i): the applicant has a good reputation for honesty, trustworthiness and competence in all matters relevant to practicing the profession of occupational therapy.
- Education
- W.S. 33-40-106(a)(ii): successful completion of the academic requirements in occupational therapy in an approved program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or a successor organization.
- Examination Evidence
- Rule Ch. 2 Sec. 2(a)(ii): official verification of passing scores of the national certification examination administered by NBCOT (Occupational Therapist Registered (OTR) Certification Examination) sent directly by NBCOT; the rule also accepts a 'current national examination recognized by the board', which no official source identifies.
- Fieldwork
- W.S. 33-40-106(a)(iii): successful completion of the supervised fieldwork experience required by the educational institution.
- Foreign Trained
- W.S. 33-40-111(a): applicants trained outside the United States and its possessions must satisfy the examination requirements of W.S. 33-40-107 and the standards of W.S. 33-40-106.
- Lawful Presence
- Rule Ch. 2 Sec. 2(a)(iv): verification of lawful presence in the United States.
- License Verification
- Rule Ch. 2 Sec. 2(a)(iii): verification of all licenses held, active or inactive, in any healthcare profession.
- Limited License Conversion
- A limited license holder who has passed the NBCOT examination converts to full licensure with the Board's 'Full Licensure by Completing Limited License' application, which requires official passing scores of the OTR or COTA examination and the Limited License Supervision Log for each supervisory session.
Limited license (awaiting the national certification examination or its results)
- Board Page Other Use
- The Board's Applications page also describes the Limited License Application as for those who 'have not practiced occupational therapy for more than five years'; W.S. 33-40-108(d) and Rule Ch. 2 Sec. 5 provide the limited license only for applicants awaiting the examination or its scores.
- Education And Fieldwork
- Rule Ch. 2 Sec. 5(a): the applicant has completed the academic and fieldwork requirements for licensure and has not yet taken or received the results of the entry-level certification examination.
- Examination Timing
- Rule Ch. 2 Sec. 5(d)(iii): official verification from NBCOT that the applicant is approved to sit for the Occupational Therapist Registered (OTR) Certification Examination and has scheduled a date; the license is issued before the examination is passed.
- Foreign Educated
- Limited License application instructions: foreign-educated applicants also submit a Credential Evaluation letter from NBCOT.
- Supervision
- Limited License application instructions: a signed letter from the supervising Wyoming licensed occupational therapist stating that they will provide general supervision for the duration of the limited license.
- Validity
- Rule Ch. 2 Sec. 5(b)-(c): valid six months; expires when a license is issued or when the holder is notified of failing the examination; not renewable, but may be extended one month at a time up to three months for good cause.
Re entry
- Continuing Education
- Rule Ch. 2 Sec. 7(b)-(c): twelve hours of continuing education for every year or portion of a year out of practice, up to thirty-six hours, documented to the standards of Chapter 8.
- Prior Practice
- Rule Ch. 2 Sec. 7(a) and W.S. 33-40-110(f): practiced as an OT or OTA for at least one year and does not qualify for renewal (Rule Ch. 8 Sec. 2(d): more than one year after license expiration).
- Supervision
- Rule Ch. 2 Sec. 7(d): the Application Review Committee may recommend that the applicant work under supervision as a condition of approval; the Board's Full Licensure by Completing Limited License instructions state that re-entering applicants submit the documentation of their supervisory sessions with the application and fees.
Official no-examination sources
Effective from 2023-05-10.
- Wyoming Statutes Title 33, Chapter 40 - Occupational Therapy Practice
W.S. 33-40-110(f)
- Wyoming Board of Occupational Therapy Rules, Chapter 2: Licensure Requirements
Chapter 2, Section 7(a)
- Wyoming Board of Occupational Therapy Rules, Chapter 2: Licensure Requirements
Chapter 2, Section 7(b)
- Wyoming Board of Occupational Therapy Rules, Chapter 2: Licensure Requirements
Chapter 2, Section 7(c)
- Wyoming Board of Occupational Therapy Rules, Chapter 8: Renewal
Chapter 8, Section 2(d)
- Wyoming Board of Occupational Therapy - Applications
Applications for Licensure list, Re-entry Application entry
- Wyoming Board of Occupational Therapy - Licensure by Re-entry Application
Additional Information, item 1
Reinstatement after revocation
- New Licensee Requirements
- Rule Ch. 8 Sec. 2(g): as a condition of reinstatement the licensee shall meet license requirements for new licensees, which under Rule Ch. 2 Sec. 2(a)(ii) include official verification of passing scores of the NBCOT national certification examination, and pay a reinstatement fee.
- Rule2Section8
- Rule Ch. 2 Sec. 8 lists what the applicant submits without naming the examination: '(a) Evidence that just cause for reinstatement exists; (b) The application and a non-refundable fee for reinstatement to the Board; and (c) Evidence of meeting the requirements for annual renewal of the license.'
- Waiting Period
- W.S. 33-40-113(b) and Rule Ch. 2 Sec. 8: application no less than one year after the date of revocation; the Board may accept or reject it and may hold a hearing.
Annual renewal
- Continuing Education
- Rule Ch. 8 Sec. 3(a)-(b): twenty-four hours of continuing education every two years, reported in even-numbered years; ten percent of licensees are audited each even year.
- Timing
- Rule Ch. 8 Sec. 2(b)-(d): licenses expire July 31 each year; renewal applications are due by June 15 (late fee afterwards) and may be submitted up to one year after expiration.
Official no-examination sources
Effective from 2023-05-10.
- Wyoming Statutes Title 33, Chapter 40 - Occupational Therapy Practice
W.S. 33-40-110(a)
- Wyoming Board of Occupational Therapy Rules, Chapter 8: Renewal
Chapter 8, Section 2(a)
- Wyoming Board of Occupational Therapy Rules, Chapter 8: Renewal
Chapter 8, Section 3(a)
- Wyoming Board of Occupational Therapy - Frequently Asked Questions
License Renewal Questions, 'When will my Wyoming license expire?'
Temporary license (while a license application is processed)
- Application Form
- The Board takes the temporary license request with the Application for Licensure by Endorsement (temporary license fee added to the license fee).
- Current License Elsewhere
- Rule Ch. 2 Sec. 4(a)-(b): the applicant is currently licensed to practice occupational therapy in another jurisdiction and submits a complete application, the required fees and official verification of that license.
- Validity
- Rule Ch. 2 Sec. 4(a)(ii): expires ninety days after issuance or when a regular license is issued; practice may not begin before issuance.
Official no-examination sources
Effective from 2023-05-10.
- Wyoming Statutes Title 33, Chapter 40 - Occupational Therapy Practice
W.S. 33-40-108(c)
- Wyoming Board of Occupational Therapy Rules, Chapter 2: Licensure Requirements
Chapter 2, Section 4(a)
- Wyoming Board of Occupational Therapy Rules, Chapter 2: Licensure Requirements
Chapter 2, Section 4(b)
- Wyoming Board of Occupational Therapy - Application for Licensure by Endorsement
Fees, Temporary License Fees
Occupational Therapy Assistant License
Wyoming license to practice as an occupational therapy assistant under the Occupational Therapy Practice Act (W.S. 33-40-101 et seq.), issued by the Wyoming Board of Occupational Therapy. The Board also issues limited and temporary forms of this license, which are recorded as routes.
Licensing authority: Wyoming Board of Occupational Therapy · Application information
Licensure by endorsement
- Current License Elsewhere
- W.S. 33-40-111(b) and Rule Ch. 2 Sec. 6(a): current licensure as an occupational therapy assistant in another state, the District of Columbia or a U.S. territory (the rule says 'another jurisdiction') whose licensure standards require passage of the national certification examination administered by NBCOT (Certified Occupational Therapy Assistant (COTA) Certification Examination) or a successor examination recognized by the Board.
- Discipline History
- W.S. 33-40-111(b): the applicant has not been disciplined in the other jurisdiction for unprofessional conduct or a similar offense; the Board may still license an applicant disciplined for minor, rectified or remote unprofessional conduct.
- Examination Waiver
- W.S. 33-40-111(b): the Board waives, to the extent necessary, examination, education and continuing education requirements for such an applicant; the NBCOT examination is satisfied by the passage the other jurisdiction required, not by a new sitting.
- Lawful Presence
- Rule Ch. 2 Sec. 6(b)(iii): verification of lawful presence in the United States.
- License Verification
- Rule Ch. 2 Sec. 6(b)(iv): verification of licensure sent directly to the Board from each jurisdiction where the applicant currently holds a license.
Licensure by examination
- Character
- W.S. 33-40-106(a)(i): the applicant has a good reputation for honesty, trustworthiness and competence in all matters relevant to practicing the profession of occupational therapy.
- Education
- W.S. 33-40-106(a)(ii): successful completion of the academic requirements in occupational therapy in an approved program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or a successor organization.
- Examination Evidence
- Rule Ch. 2 Sec. 2(a)(ii): official verification of passing scores of the national certification examination administered by NBCOT (Certified Occupational Therapy Assistant (COTA) Certification Examination) sent directly by NBCOT; the rule also accepts a 'current national examination recognized by the board', which no official source identifies.
- Fieldwork
- W.S. 33-40-106(a)(iii): successful completion of the supervised fieldwork experience required by the educational institution.
- Foreign Trained
- W.S. 33-40-111(a): applicants trained outside the United States and its possessions must satisfy the examination requirements of W.S. 33-40-107 and the standards of W.S. 33-40-106.
- Lawful Presence
- Rule Ch. 2 Sec. 2(a)(iv): verification of lawful presence in the United States.
- License Verification
- Rule Ch. 2 Sec. 2(a)(iii): verification of all licenses held, active or inactive, in any healthcare profession.
- Limited License Conversion
- A limited license holder who has passed the NBCOT examination converts to full licensure with the Board's 'Full Licensure by Completing Limited License' application, which requires official passing scores of the OTR or COTA examination and the Limited License Supervision Log for each supervisory session.
Limited license (awaiting the national certification examination or its results)
- Board Page Other Use
- The Board's Applications page also describes the Limited License Application as for those who 'have not practiced occupational therapy for more than five years'; W.S. 33-40-108(d) and Rule Ch. 2 Sec. 5 provide the limited license only for applicants awaiting the examination or its scores.
- Education And Fieldwork
- Rule Ch. 2 Sec. 5(a): the applicant has completed the academic and fieldwork requirements for licensure and has not yet taken or received the results of the entry-level certification examination.
- Examination Timing
- Rule Ch. 2 Sec. 5(d)(iii): official verification from NBCOT that the applicant is approved to sit for the Certified Occupational Therapy Assistant (COTA) Certification Examination and has scheduled a date; the license is issued before the examination is passed.
- Foreign Educated
- Limited License application instructions: foreign-educated applicants also submit a Credential Evaluation letter from NBCOT.
- Supervision
- Limited License application instructions: a signed letter from the supervising Wyoming licensed occupational therapist stating that they will provide general supervision for the duration of the limited license.
- Validity
- Rule Ch. 2 Sec. 5(b)-(c): valid six months; expires when a license is issued or when the holder is notified of failing the examination; not renewable, but may be extended one month at a time up to three months for good cause.
Re entry
- Continuing Education
- Rule Ch. 2 Sec. 7(b)-(c): twelve hours of continuing education for every year or portion of a year out of practice, up to thirty-six hours, documented to the standards of Chapter 8.
- Prior Practice
- Rule Ch. 2 Sec. 7(a) and W.S. 33-40-110(f): practiced as an OT or OTA for at least one year and does not qualify for renewal (Rule Ch. 8 Sec. 2(d): more than one year after license expiration).
- Supervision
- Rule Ch. 2 Sec. 7(d): the Application Review Committee may recommend that the applicant work under supervision as a condition of approval; the Board's Full Licensure by Completing Limited License instructions state that re-entering applicants submit the documentation of their supervisory sessions with the application and fees.
Official no-examination sources
Effective from 2023-05-10.
- Wyoming Statutes Title 33, Chapter 40 - Occupational Therapy Practice
W.S. 33-40-110(f)
- Wyoming Board of Occupational Therapy Rules, Chapter 2: Licensure Requirements
Chapter 2, Section 7(a)
- Wyoming Board of Occupational Therapy Rules, Chapter 2: Licensure Requirements
Chapter 2, Section 7(b)
- Wyoming Board of Occupational Therapy Rules, Chapter 2: Licensure Requirements
Chapter 2, Section 7(c)
- Wyoming Board of Occupational Therapy Rules, Chapter 8: Renewal
Chapter 8, Section 2(d)
- Wyoming Board of Occupational Therapy - Applications
Applications for Licensure list, Re-entry Application entry
- Wyoming Board of Occupational Therapy - Licensure by Re-entry Application
Additional Information, item 1
Reinstatement after revocation
- New Licensee Requirements
- Rule Ch. 8 Sec. 2(g): as a condition of reinstatement the licensee shall meet license requirements for new licensees, which under Rule Ch. 2 Sec. 2(a)(ii) include official verification of passing scores of the NBCOT national certification examination, and pay a reinstatement fee.
- Rule2Section8
- Rule Ch. 2 Sec. 8 lists what the applicant submits without naming the examination: '(a) Evidence that just cause for reinstatement exists; (b) The application and a non-refundable fee for reinstatement to the Board; and (c) Evidence of meeting the requirements for annual renewal of the license.'
- Waiting Period
- W.S. 33-40-113(b) and Rule Ch. 2 Sec. 8: application no less than one year after the date of revocation; the Board may accept or reject it and may hold a hearing.
Annual renewal
- Continuing Education
- Rule Ch. 8 Sec. 3(a)-(b): twenty-four hours of continuing education every two years, reported in even-numbered years; ten percent of licensees are audited each even year.
- Timing
- Rule Ch. 8 Sec. 2(b)-(d): licenses expire July 31 each year; renewal applications are due by June 15 (late fee afterwards) and may be submitted up to one year after expiration.
Official no-examination sources
Effective from 2023-05-10.
- Wyoming Statutes Title 33, Chapter 40 - Occupational Therapy Practice
W.S. 33-40-110(a)
- Wyoming Board of Occupational Therapy Rules, Chapter 8: Renewal
Chapter 8, Section 2(a)
- Wyoming Board of Occupational Therapy Rules, Chapter 8: Renewal
Chapter 8, Section 3(a)
- Wyoming Board of Occupational Therapy - Frequently Asked Questions
License Renewal Questions, 'When will my Wyoming license expire?'
Temporary license (while a license application is processed)
- Application Form
- The Board takes the temporary license request with the Application for Licensure by Endorsement (temporary license fee added to the license fee).
- Current License Elsewhere
- Rule Ch. 2 Sec. 4(a)-(b): the applicant is currently licensed to practice occupational therapy in another jurisdiction and submits a complete application, the required fees and official verification of that license.
- Validity
- Rule Ch. 2 Sec. 4(a)(ii): expires ninety days after issuance or when a regular license is issued; practice may not begin before issuance.
Official no-examination sources
Effective from 2023-05-10.
- Wyoming Statutes Title 33, Chapter 40 - Occupational Therapy Practice
W.S. 33-40-108(c)
- Wyoming Board of Occupational Therapy Rules, Chapter 2: Licensure Requirements
Chapter 2, Section 4(a)
- Wyoming Board of Occupational Therapy Rules, Chapter 2: Licensure Requirements
Chapter 2, Section 4(b)
- Wyoming Board of Occupational Therapy - Application for Licensure by Endorsement
Fees, Temporary License Fees
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
- NBCOT 2022 OTR Examination Content Outline
pp. 3-14, complete domain/task/knowledge outline; quoted anchor at p. 3
- NBCOT 2024 Exam Frequently Asked Questions
Exam Content, Is the exam content changing for 2024?, first sentence
- NBCOT Certification Examination Handbook for OTR and COTA Candidates
p. 23, Format of Test Items on the Exams, OTR bullet
- NBCOT Foundations of the Certification Examinations
Scoring, How are the exams scored?, first paragraph
- NBCOT Certification Examination Handbook for OTR and COTA Candidates
p. 31, How Will I Get My Exam Result?, first paragraph
- NBCOT Certification Examination Handbook for OTR and COTA Candidates
p. 10, Eligibility Requirements, OTR bullet
- NBCOT Certification Examination Handbook for OTR and COTA Candidates
p. 11, Submitting the Application, first sentence
- NBCOT Certification Examination Handbook for OTR and COTA Candidates
p. 19, Scheduling the Certification Exam
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
- NBCOT 2022 COTA Examination Content Outline
pp. 3-14, complete domain/task/knowledge outline; quoted anchor at p. 3
- NBCOT 2024 Exam Frequently Asked Questions
Exam Content, Is the exam content changing for 2024?, first sentence
- NBCOT Certification Examination Handbook for OTR and COTA Candidates
p. 23, Format of Test Items on the Exams, COTA bullet
- NBCOT Foundations of the Certification Examinations
Scoring, How are the exams scored?, first paragraph
- NBCOT Certification Examination Handbook for OTR and COTA Candidates
p. 31, How Will I Get My Exam Result?, first paragraph
- NBCOT Certification Examination Handbook for OTR and COTA Candidates
p. 10, Eligibility Requirements, COTA bullet
- NBCOT Certification Examination Handbook for OTR and COTA Candidates
p. 11, Submitting the Application, first sentence
- NBCOT Certification Examination Handbook for OTR and COTA Candidates
p. 19, Scheduling the Certification Exam