Exploring Pediatric Occupational Therapy Settings

If you have decided pediatric occupational therapy is where your heart lies, determining where you would like to start this journey is the next step. In this article, we will dissect all of the different pediatric occupational therapy settings as well as considerations within the varied practice areas of pediatric OT.

We will also help you to identify the right questions to ask and the right opportunities to seek out to determine your future as a pediatric occupational therapist! 

Hospital Pediatric OT Settings

Acute/Inpatient: Just as if you are working with adults in the acute care hospital setting, the pace is fast and the patient turnover quick. If your nervous system craves novelty and quick thinking and action, this could be the setting for you! In addition, working in the inpatient/hospital setting, you will have access to learning from multi-disciplinary teams, however you may be the only OT working for your shift.  

Outpatient clinic: Outpatient pediatric occupational therapy settings allow for longer term relationships with clients and families. Likely, you will have access to a team of occupational therapists to learn from via observation and more formal supervision. 

Community Outreach

Depending on your specific community, there are a variety of community outreach programs that have occupational therapists on staff. In the pediatric world, the Head Start program is an example. In these programs you are typically supporting a child in the home or in his or her community settings, such as preschool. 

The pace may be slower than an acute pediatric hospital setting, but it may require a different type of flexibility to adjust to a variety of environmental demands.  If in a classroom setting or home environment, the ability to flow in and out of “intervention time” with the routine of the classroom or family life will be important. 

Early Intervention OT

Working on an early intervention team allows you to collaborate and learn from other specialists in the field of pediatrics as well as to support children and families in their natural settings. This setting also allows you to work with children with a variety of developmental needs.  

If you are driving from house to house, organization and time management skills will be a bit different and/or more demanding in some ways than when you are working in only one location.  

Although you will be working with a team, being an early intervention therapist requires a lot of independent problem solving, self-initiated education and reflection. 

If you are new to the pediatric field or if you are assigned a case, for example, in which you feel you could use mentoring or support, it will be imperative that you are able to ask for that support. 

Home Health Pediatric OT

Home health opportunities for pediatric occupational therapists can be an exciting way to reach families on a more personal level in their homes. There are a variety of populations of children with special needs that you may be supporting/serving and therefore your skillset will need to be tailored accordingly. 

Depending on if you are in private practice or working for an agency, documentation and responsibilities will vary.

As with early intervention, the home health setting allows for more independence in terms of scheduling and controlling the pace of your day, however, you will also likely be required to be more self motivated to seek out education and mentoring in order to continue to grow as a therapist.

Home health may be best suited for therapists who have been working for several years in other OT settings (in a clinic or inpatient rehab, for example) with a specific pediatric population before working in home health.  

Private Outpatient Pediatric Clinics

Therapists working in outpatient sensory clinics become accustomed to the varied pace of 50 minute therapy hour schedule with quick parent consults, clean up and prep for incoming clients between each hour. 

The day will feel full, and the ability to adjust pace to being “in the moment” with clients for the session and then increasing your pace for the in between times is a must. 

Depending on the staff size, having colleagues available in shared treatment spaces as well as for case collaboration is a part of the outpatient therapy clinic culture which allows it to be a rich learning environment for therapists of all experience levels. 

School-Based OT

Being a part of an educational support team for children in the schools requires a therapist to focus on more academic related occupations of children. Through identifying each student’s foundational challenges, school-based OTs are integral in determining what is impacting a child’s participation and success as well as how to best support them in the school environment.

Learning from the other members of the educational team is a unique opportunity for growth, while educating others on the occupational therapy lens is the role you would provide. 

Communication, flexibility, and documentation are required for working in the schools, as you will be working/collaborating with so many different teachers and support people as well as families to best support each student.  

Want to learn more about working as a school-based OT? Check out our article, A Day in the Life of a School-Based Occupational Therapist.

Questions to Ask Potential Employers 

In addition to questions regarding salary, benefits, and pay structure that are routinely discussed in interviews, you may also want to ask these questions when determining if a specific pediatric setting is right for you:

• What is the average pace of a workday/average number of clients per day and time with each? 
• What are the documentation demands for daily client care, evaluations, progress summaries, IEPs and/or additional documentation for families or insurance? 
• Will there be one mentoring therapist to go to with questions or a variety of colleagues to reach out to? What is the process for getting support (email/weekly meeting, etc.)?
• Are there continuing education opportunities available on a regular basis during the work hours or offered on site, such as in-services or trainings?
• Are there funds offered on a yearly basis for continuing education outside of the site/facility? 

Questions to Ask Yourself

• At which pace do I work best? 
• Recommendation: Observe settings you are interested in ahead of applying. Reflect on fieldwork experiences and identify the paces within which you felt the most successful.
• What type of learner am I?
• How much mentoring would make me feel supported in a new job/first job as an OT? Do I learn best via observation, discussion, hands-on or a mixture of all?
• What pediatric population is my area of passion? Where can I be challenged and grow?
• Do I want to learn about a lot of varied diagnoses/ wide range of patient needs or specialize? Which setting will match my interests in terms of client population and foster growth of OT skills in that area? 

Challenge Yourself and Grow!

Whichever pediatric occupational therapy setting you end up in, the growth opportunities are endless.  Self-reflection and doing your research ahead of time by observing and asking potential employers the right questions will help you narrow your job search.

However, try to always keep an open mind as there are so many ways to serve children.  Follow your passion but also be available to follow a pediatric OT path you may have not thought of before!