A Day in the Life of a School-Based Occupational Therapist

We’re so thrilled to feature this article written by school-based occupational therapist Devon Breithart, OTR/L. In the article, Devon shares what a day in the life is like for her working as an occupational therapist in the school system. To learn more about Devon and what it’s like working as a school-based OT, be sure to also check out her website here.

When I first started OT school, I had a lot of questions. But the most persistent one that stuck with me was “What does being an occupational therapist actually look like?”

I knew I wanted to help people, but except for a few days shadowing in a Skilled Nursing Facility (SNF) before starting school, I really had no idea what the day-to-day was like. What did a treatment session look like? An evaluation? How did you know what activities to pick, and how did you know if they were working?

That’s why I wanted to share a little bit about my work as a school-based occupational therapist.

Whether you’re a seasoned OT looking to change settings, a new grad, or maybe even an undergraduate student trying to learn more about occupational therapy, I hope this information helps you picture a day in the life as an OT in the school system!


8:00 – 8:30 AM:

I arrive at my first school and sign in. I don’t have any office space here, but it’s always easy to find a spot to fire up my computer in the staff lounge. I check my email and respond to a few IEP meeting invitations, a question one of my teachers has, a screening request. I review my calendar and make sure there isn’t anything last-minute I need to do for any of my treatment sessions or meetings this afternoon. I double-check my bag for the things I need for my first group.

8:30 – 8:45 AM:

At this point I’m at my first classroom. It’s what’s called a moderate-severe Special Day Class (SDC) which means it’s a self-contained classroom for students with disabilities like autism, intellectual disability, orthopedic impairments, etc. This particular one is K-2, so I work with them on a lot of fine and visual motor skills. Except for two students in the class who show up later in the school day and need more individual support, I work with all of the students in a group.

I usually try to plan something that will last around 30 minutes with rest breaks given for the students who need them. I always try to plan something that I can easily modify or accommodate on the fly, especially since I’m working with kids with varying ability levels.

Today I brought a simple craft – an animal dot-to-dot that I plan to have the students trace, cut out, and paste on a piece of construction paper. I also brought a fun activity for the kids to do for the second part of the group – a tub full of water beads.

To start the craft, I go around to each student and present them with two options of color of paper and animals, having them verbally indicate, use a sign, or their augmentative and alternative communication (AAC) device to make a choice (which supports speech and language goals as well!).

Since I’m seeing all of the students, I’m lucky to have the support of the paraprofessionals and the teacher as well, which I like since it helps them carry over strategies when I’m not there. For the rest of the group, I spend my time adjusting grasps as needed, trialing what adaptive scissors may work well with certain students, and training the paraprofessionals on the most effective way to cue the students.

Once everyone has finished their craft, we all play with the water beads. The kids enjoy it, and since I’ve also brought tweezers, eye droppers, and scoop scissors, it has the added benefit of continuing to address fine motor skills. During this time, I quickly jot down some notes on my computer about each of the students’ performance – later I will go back and refine this into a short daily note.


9:15 AM:

My group has finished and one of my other students has arrived to class. I see this student on a more consultative basis, so I spend time talking with her teacher and asking how previous strategies have worked and what they need for the future. The student has recently received an iPad, so I work with the teacher on finding the ideal spot to place the stand for optimal visual and motor engagement.

I give the team some strategies for protecting their backs when they transfer the student out of her wheelchair, and make myself a note on my to-do list to order some universal-cuff bands for her.

9:45 AM:

I spend the rest of the morning pushing into gen ed classrooms for the other students on my caseload at this school. I always try to push in if possible, because I believe it’s integral to carryover of strategies both for the student and the teacher.

Most of my students have decreased fine and visual motor skills that affect their handwriting, so we work directly on that. I generally use a combination of strategies I’ve learned from Size Matters Handwriting Program, Handwriting without Tears, and just little things I’ve picked up through experience.

I always try to check in with the teacher before I leave, but if they’re busy, I’ll send an email instead.


Around 11:30 AM:

I’ll sit down and eat some lunch. I try to actually take a break, but if I’m feeling busy, I’m guilty of using this time to finish up some notes or check my email again. I try to be as responsive to email as possible because I feel like my most important role in the school system is to be a resource to my teachers. I also try to eat lunch in the staff lounge, that way if anyone might have a question for me I can be available to them.

12:00 PM:

I have another school I have to get to today, so I go ahead and make the drive over. I’m lucky that my schools are all pretty close together, so it takes less than 10 minutes. When I get to this school, I make sure to grab the testing kit that I had grabbed from the main office yesterday.

I sign in and ask the secretary if I could use some space to test a student; she sets me up in a small room off the main office that has everything I need – table, chairs, and good lighting. I get out the assessment protocol and paperwork so that my student doesn’t have to wait once he gets here.

12:30 PM:

I go retrieve my student from his classroom and chat quickly with his teacher. This is a happy day of testing, because this student has met his goals and likely no longer requires occupational therapy to access his educational program.

From reviewing his writing samples and discussing with his teacher, I feel comfortable exiting him, but my district requires a full evaluation in order to do so. A standardized test isn’t technically required, but it will help it be a stronger evaluation, and, I may catch something that the student is still struggling with.

I give him portions of the BOT-2 assessment, which is a test of motor skills. We focus on the fine and visual motor sections which involve a lot of pencil and paper tasks as well as cutting and in-hand manipulation. He does well with everything except a folding task, which I chalk up to lack of exposure.

I won’t know his actual score until I reference the manual later, but I can tell from experience he’s scoring in the average range for his age. He’s a fun kid and jokes around with me a lot during the test, and I know I will miss working with him.


1:15 PM:

We return to class, and I check in one more time with his teacher. This student had been mainly struggling with handwriting, but I check for any other fine motor concerns – opening containers at lunch, zipping up a jacket, and so on – as well as other deficits that may limit his participation as a student like attention or ability to follow directions. I’m happy to hear he’s doing well all around and doing a great job on his football team too.

I unfortunately had to cancel another student’s session in this class to have time for testing, so I check in about him too and review his writing from that afternoon. He definitely still needs some help, so I give the teacher some quick strategies and schedule a make-up session for next week.

1:45 PM:

I leave to travel to an IEP meeting at another school. I bring a printout of goal progress to add to the IEP, but otherwise work off of my computer in an effort to save paper. This IEP meeting is just an annual review, and it’s pretty cut and dry. All of the professionals on the case – gen ed teacher, special ed teacher, speech-language pathologist, and me – take turns presenting how the student has been doing.

I make sure to tell the family what I love about their student – they often don’t hear enough about their strengths.

The team proposes new goals and recommends the services the student needs to meet these goals. The student is progressing well and family is in agreement, so it’s a relatively quick meeting.

By 3:30 PM:

I’m back in my office at the district’s special education headquarters. I do some quick treatment planning for a group I’m running tomorrow, and put some finishing touches on my daily notes. I don’t touch the test results from earlier, but I do make sure I have the due date on my calendar so I can find time to work on it.

I have a strict no-taking-work-home policy, especially since I’m a travel therapist and am paid hourly. By about 4:00, I’m on my way out the door. I make sure to grab any materials I need for tomorrow and call it a day.

Some days are harder than this (and some are easier!) but this is a pretty accurate picture of what a typical day looks like for me. Sometimes I won’t have an IEP meeting, and sometimes I’ll have three that I have to juggle my time between. I think one of the key things in this job (and most OT jobs, to be honest) is the ability to be flexible.

There are definitely times when everything hits at once and it becomes stressful, but it’s all worth it for the best days when I can make a struggling student feel successful, a teacher more empowered, or a parent proud.

I will always be grateful for this experience, and I hope hearing about it has helped de-shroud some of the mystery.



We hoped you enjoyed this look into a day in the life of a school-based occupational therapist! If you’re a school-based occupational therapist yourself, we’d love to hear how your day is similar or different! Please share your experiences and thoughts in the comments. 

This post was last updated on June 15, 2023.

Be Sure to Check Out Our Day in the Life Series!

A Day in the Life of an Early Intervention Occupational Therapist

A Day in the Life of an Acute Care Occupational Therapist

A Day in the Life of an OT Professor

A Day in the Life of a SNF Occupational Therapist

A Day In The Life of an Inpatient Rehab Occupational Therapist

A Day in the Life of an OT Student

A Day in the Life of an Outpatient Neuro Occupational Therapist

A Day in the Life of an Outpatient Hand Therapist

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  • Beth April 24, 2019   Reply →

    I enjoyed reading the article on school-based OT. I would like to learn more about a specific specialty that is not often known….work hardening or industrial rehab

    • Sarah Stromsdorfer, OTR/L April 24, 2019   Reply →

      Thank you for your suggestion! I will definitely add that to the list and feature a work hardening OT for our Day in the Life series.

  • Katherine April 27, 2019   Reply →


    Is this setting one you would suggest gaining more experience prior to entering into if you’re a new grad?


    • Sarah Stromsdorfer, OTR/L April 29, 2019   Reply →

      Hi Katherine, many new grads do enter into the school system but have said it can be hard finding a school position with another OT to mentor you initially. If you’ve done a FW rotation in the schools or know that the job will have some mentorship, I think it would be fine!

      If you haven’t had any experience and wouldn’t have anyone to mentor you, waiting to get experience first might be a better option. I’d love to hear what those who have worked in the schools think about this as well.

      • Maddie February 17, 2020   Reply →

        I have done contract assignments in schools as a new grad. I didn’t have a fieldwork rotation in schools, but I didn’t think it was hard working as a new school-based OT. In the districts that I have worked for, I received about a week or two of shadowing to get familiar with the students, documentation system, and how school-based OT works before taking on my caseload. While I didn’t have a mentor, I do get to see other OTs or COTAs just about every day in the main office and can ask them questions or get treatment ideas, which was helpful. I also turned to the School-based OT/PT Facebook group, continuing ed courses, and school-based OT blogs/podcasts as resources.

        • Sarah Stromsdorfer, OTR/L February 17, 2020   Reply →

          Thank you for sharing your experience as a new grad working in schools! I think that will be really encouraging to hear for those nervous about getting started in school-based OT without having FW experience.

        • Liz December 14, 2021   Reply →

          Hi Maddie,
          I’ve done travel contracts in acute care. I’m interested in doing school based next year. Can I ask you some questions?

  • Kay O'Donoghue July 5, 2020   Reply →

    Thank you for this article! I am seeking a job in the schools, having had a few years working in peds in a clinic and private preschool where we did pull-out. I am definitely thinking that I’ll need a mentor, despite having 12 total years as an OT!

  • Justin July 15, 2020   Reply →

    Are school based OT’s always employees of the school district? Or do they occasionally work for one particular school? Or are they contracted?

  • Cheryl B Simmons July 28, 2020   Reply →

    Can my daughter get a job in the school as an OT with just a four year degree in sociology?

    • Sarah Stromsdorfer, OTR/L July 28, 2020   Reply →

      Hi Cheryl. No, in order for your daughter to practice as an Occupational Therapist, she will have to get either a Master’s in Occupational Therapy or a Doctorate in Occupational Therapy. Once she obtains either of those degrees and passes the board exam for OT (the NBCOT), then she would able to get a job in the school system.

    • M. Hernandez October 12, 2020   Reply →

      Sorry, but no. OT is its own profession with its own required state and national licensing.

    • Shonda May 14, 2021   Reply →

      No ma’am your daughter must get a graduate degree in occupational therapy then take a board exam with NBCOT and then be licensed in her state. She could however, attend an entry level program with a sociology degree. There may be prerequisite to enter.

  • Katryna Alvarez August 15, 2020   Reply →

    Thank you for sharing your experience. I was just wondering how often you see the same student in a week? Do you see them 5x/wk? 3x/wk? What is the average amount of time you see a student in a day? Thank you.

  • Abby September 29, 2020   Reply →

    I am in my freshman year of college as an OT major and this article has me so excited to get there!! The schoolwork will be difficult but this job is my dream and I absolutely cannot wait to accomplish it!!!

    • Sarah Stromsdorfer, OTR/L September 29, 2020   Reply →

      That’s so great to hear that the article is inspiring for you, thank you for sharing and best of luck throughout your program!

  • Tory October 21, 2020   Reply →

    Thanks for your view into your day. I’m a OTA student and I just finished my first 8 week level 2 field work in the schools. We were 8 am- 2 pm no break for lunch worked strait through. I went to the peds clinic on Mondays from 8-5 pm and 5 schools the rest of the week. I saw kids in small groups as well individually. I averaged 10-11 kids daily seen 1x weekly for 30-45 min depending on need. Amazing experience

    • Sarah Stromsdorfer, OTR/L October 21, 2020   Reply →

      Thanks so much for sharing your experiences!

  • Haley November 28, 2021   Reply →

    Hello school based OTs!

    What would you say is your most efficient strategy to take notes during sessions? I find that it is usually distracting me from paying full attention to the client but I feel that I need to get at least some notes in that way I don’t have to spend hours at the end of the day documenting.

  • Andrea January 15, 2022   Reply →

    I understand the prerequisites required. Have you ever known an older adult changing professions and becoming an OT? I have a Masters in International relations and was a FT Pilates instructor for 15 years. I am looking for something stable and pays better helping others. Just don’t want to be the only older student in the program.

    • Sarah Stromsdorfer, OTR/L January 20, 2022   Reply →

      Hi Andrea, it is never too late to become an OT! I had several second-career students in my cohort that were in their 30s and 40s, and really as long as you’re passionate about it, you can do it at any age. I just recommend shadowing at a variety of OT settings so you can see which one(s) would be a good fit for you.

  • Aleya Bourek April 19, 2022   Reply →


    With school-based OT do you get summers off as a teacher in the school district would?


    • Sarah Stromsdorfer, OTR/L April 24, 2022   Reply →

      Hi Aleya, it seems to depend on the district as some OTs will work with their clients over the summer and some will not. I just found a survey of school-based OTs here and it seems like a little over 50% do work at their school and 25% pick up other OT work.

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