How a Certified Occupational Therapy Assistant Can Help

You've invested time in finding the right occupational therapist. During the OT evaluation, you advocated for a plan of care best suited to meet your goals. Now, as you begin treatments, you find yourself being seen by a certified occupational therapy assistant (COTA).

This begs the question, "what exactly is a COTA?"

COTAs play a vital role in many occupational therapy settings. In fact, they may be the occupational professionals who you spend the bulk of your time with. As a client, it can be helpful to understand your COTAs training, their scope of practice, and the perks of seeing a COTA so you can advocate for the best care possible.

Like occupational therapists, COTAs assist people in achieving health and well-being through engagement in occupations, aka daily tasks. COTAs partner with occupational therapists in gathering information about your health, goals, environment, support system, etc. and also by implementing treatments to help you meet your goals.

Your occupational therapist is ultimately responsible for the delivery of OT services. For example, an OT must direct the evaluation, but the COTA may be delegated certain assessments in the evaluation process. Your OT must create an intervention plan, but your COTA may collaborate in the process and provide valuable input.

Here are some specific examples of tasks a COTA may perform:

• Screen patients for whether they would benefit from OT
• Administer assessments
• Provide treatment related to​:
  • Daily living skills
  • Sensorimotor skills
  • Gross and fine coordination
  • Strength and endurance
  • Range of motion
  • Tactile awareness
  • Cognitive skills
  • Psychosocial skills
• Educate the patient and family about the treatment plan
• Participate in the documentation process

To practice, COTAs need an associate degree from an accredited occupational therapy assistant program. From there, they must pass the national certification exam, which all 50 states including Guam, Puerto Rico and the District of Columbia require.

Occupational therapy assistants must then be licensed in the state where they practice. The scope of practice set forth by the license varies somewhat from state to state, especially in the area of supervision.

All COTAs must be supervised by an occupational therapist. As mentioned above, your occupational therapist is ultimately responsible for your treatment.

Most states have regulations about the minimum standard for supervision. For example, the supervision regulation from Nebraska states that a COTA, who has more than one year of satisfactory work experience, must have four hours of onsite supervision per month.

Your state, facility, or payer may have more strict rules for supervision. For example, an outpatient Medicare client must be seen by an occupational therapist (vs. a COTA) every 10th visit or every 30 days, whichever comes first.

Occupational therapists often have more administrative tasks on their plate, while a COTA often spends the majority of the day seeing patients. COTAs therefore, quickly gain hands-on experience. The amount of time they spend with patients can also give them unique insight into how the plan of care is progressing.

A COTA's license and national registration often require continuing education, which means for every year in practice your COTA will likely have acquired additional training and knowledge.

There are also many specialty certifications available to a COTA. Specialty certifications often indicate that your COTA has received continuing education in a particular area and passed a certification exam. There is a chance that your COTA will have more training in a particular area than his supervising therapist.