How to Become a Pediatric Occupational Therapist: 5 Tips to Get Started

If you have an interest in becoming a pediatric occupational therapist, investigating if your interest can blossom into a passion is the first step. Occupational therapists who work with children must have a love for the job, as emotional connection is a foundation for serving children. If you are considering starting out in pediatric occupational therapy, or you are transitioning over to working with children, there are a few key things to consider.

Tip #1: Self Reflection: Am I Playful?

Self-reflection is a critical skill for professional success in most careers and evaluating whether you are drawn to the pediatric world certainly requires this. Working with children is a specialty because along with all the explicit, developmental knowledge and therapeutic expertise involved, you must have the desire to connect and relate to these little friends.

Pediatric OT is a science and an art. Are you a “kid” person who can let loose and play? Are you able to be unapologetically silly, in hopes of inspiring and motivating these struggling but beautiful, wonderful beings? It is a skill that is hard to teach but can absolutely be learned with the desire.

Tip #2: Get Experience with Kids

If you are not already a parent or have not had a history of nannying, caring for siblings/relative’s children, summer camp counseling, etc., increasing your experience being around children in structured and unstructured situations is essential. Understanding how development looks and feels organically out in the world is a critical step beyond reading about ages and stages in books. It also allows you to find your inner playfulness so that piece is natural for you once you begin working with children with differences.

If you do have a background of being around children, and you know of specific populations that you would like to serve in the pediatric community, try to diversify your experience by getting involved with children in those populations. For example, consider volunteering at a children’s therapy clinic, camps for children with Down syndrome or Autism or at a therapeutic riding facility.

Tip #3: Investigate the Career Opportunities

Do some research regarding pediatric occupational therapy positions in your area via social media and internet job board searches. If you are not sure which pediatric settings you are drawn to, identify a few that you want to learn more about.

Reaching out to therapy clinics and/or organizations about observing, shadowing, or volunteering at these settings is the best way to get a feel for what the day to day would be like. In addition, through being physically present, you will make contacts with potential mentors who could be valuable resources.

Where Do Pediatric Occupational Therapists Work?

One of the best parts of pediatric OT is the range of settings available to you. Each has a different pace, caseload structure, and population. Knowing the differences will help you target your search.

1. Early intervention (birth to three): You’ll work in homes, coaching caregivers as much as treating children directly. Highly relationship-based and family-centered.
2. School-based practice: The largest pediatric employer. You’ll work within the IEP process, collaborate with teachers, and focus on educational access and participation. Expect a school calendar and often a large caseload, sometimes at multiple schools.
3. Outpatient pediatric clinics: Sensory gyms, feeding programs, handwriting groups. Typically the most hands-on “play-based” setting and often where new pediatric OTs start.
4. Inpatient and acute pediatrics: Children’s hospitals, rehab units, and NICUs. More medically complex, more acute, and generally requires additional training or mentorship, especially NICU, which has its own competency expectations.
5. Home health: One-on-one care in the family’s home environment, with a lot of autonomy and often lot of driving.

If you’re not sure which fits, that’s exactly what shadowing is for. Try to observe in at least two different settings before you commit.

Tip #4: Find a Mentor

Having an ambassador to join the pediatric occupational therapy world can help smooth the transition. There are quite a few different ways to seek out a mentor in the pediatric OT community. If you knew right away from getting your degree that you wanted to work in pediatrics and you sought out the pediatric fieldwork experiences, you may have a mentor in mind. This may be someone who you built rapport with, who you respect as a professional, and who you could easily see yourself emulating their therapeutic style. Finding a personal connection is ideal, but not always possible.

Knowing other occupational therapists who work in pediatrics is another route to explore. Requesting to observe sessions with someone you know is a comfortable way to determine if a mentoring relationship is possible. If you know of family or friends whose children have worked with OTs, request an introduction to open communication for possible observations or other opportunities to learn.

If you do not have any direct or indirect personal connections with pediatric OTs, reach out to facilities who offer pediatric OT in your area and ask to volunteer or observe. Express your interest in joining this practice area and show your commitment by initiating a relationship and showing up. The more you reach out, the more opportunities to be exposed to a variety of potential mentors.

I have found throughout the course of my OT career that OTs are as a group some of the most generous hearts. Mentoring is a cornerstone for propelling our profession forward, so do not be afraid to reach out and ask!

Tip #5: Determine Areas of Further Self Education

Once you have a better idea of which pediatric setting is of most interest to you, gather information regarding any specialized certifications/trainings that may make you either feel more prepared or more marketable to future employers.

An example would be getting certifications in Sensory Integration, Neurodevelopmental Treatment, DIR/Floortime or Feeding methods. If you are not able to or sure of committing to a certification, take introductory courses in the above or in IEP goal writing, depending on the settings you are interested in applying.

You can also get started exploring the plethora of evidence-based online pediatric courses on Medbridge, our recommended online CEU provider, using this link with our promo code MYOTSPOT to save $106 off your annual subscription.

Some facilities or companies may provide trainings as well, which would be something to be familiar with before or during the application process. In addition, collecting references to support your practice, such as developmental resources, evidenced-based practice research articles, or textbooks written by specific pioneers in the field is recommended.

Frequently Asked Questions About Becoming a Pediatric Occupational Therapist

How long does it take to become a pediatric occupational therapist?

The timeline is the same as becoming any occupational therapist: a bachelor’s degree followed by a master’s (typically 2–3 years) or doctorate (typically 3 years) from an ACOTE-accredited program, then passing the NBCOT exam and obtaining state licensure. From the start of undergrad, plan on roughly six to seven years total. There’s no separate degree track for pediatrics–you specialize through fieldwork placements, your first jobs, and continuing education.

Do you need a special certification to work as a pediatric OT?

No. Once you’re a licensed OT, you’re legally able to treat pediatric clients. That said, certifications like Sensory Integration, NDT (Neurodevelopmental Treatment), DIR/Floortime, and feeding-specific trainings can make you more marketable and more confident, especially in outpatient clinic settings where families often ask about them directly. Most new peds OTs start without certifications and add them over their first few years of practice.

What’s the best fieldwork placement if I want to work in pediatrics?

Any pediatric Level II placement will help, but try to get exposure to more than one setting if you can. A school-based placement and an outpatient clinic placement will show you two very different sides of the field. If you’re set on early intervention or NICU, seek those out specifically, since both are harder to break into without prior exposure.

Can I go straight into pediatrics as a new grad?

Yes, and many OTs do! Outpatient pediatric clinics and school-based positions frequently hire new graduates and often provide mentorship. More specialized areas (NICU in particular) will generally expect experience first. The most important thing as a new grad is finding a position with true mentorship rather than one where you’re the only OT in the building.

How much do pediatric occupational therapists make?

Pay varies significantly by setting and geography. Generally, school-based positions pay somewhat less than outpatient or contract work but offer a school calendar and benefits, while contract and home health roles often pay more but with less stability.

What if I’m already working in another OT setting, can I switch to pediatrics?

Absolutely! Your existing clinical reasoning transfers; what you’ll need to build is developmental knowledge and comfort with play-based intervention. Shadowing, introductory CEU courses, and PRN or part-time pediatric work alongside your current job are all good bridges. Many clinics are open to hiring experienced OTs transitioning in, especially if you’re upfront about wanting mentorship.

What skills matter most in pediatric OT?

Beyond clinical knowledge: playfulness, patience, flexibility in the moment, and the ability to build trust with caregivers. A significant portion of pediatric OT is actually working with parents: coaching, educating, and sometimes navigating difficult conversations. Strong communication with adults matters just as much as your rapport with children.

Most Importantly…

In pediatric occupational therapy, it is the children who are our greatest guides and teachers. No amount of school or courses can teach us what they will. We must be willing to take their lead and attune to their needs in the moment as well as longer term. We must be willing to play and have fun, while using our clinical reasoning to help create their path to growth.

To be a truly impactful pediatric OT, we must be able to dissect the child’s foundational challenges while having an appreciation for their gifts and strengths as the tools to help them succeed and progress. And although as OTs we are experts in our field, we should always remember no one is more of an expert on a child than his or her parent and/or primary caregiver.

Pediatric occupational therapy is such a rewarding professional path, as you can positively impact the lives of children and families.

If you think this could be your professional passion, we hope these five tips will help you initiate your journey into becoming a pediatric occupational therapist!

If you’re a pediatric OT and have any other tips you’d like to share for any prospective peds OTs, please let us know in the comments!

This post was last updated on September 14, 2026.