Types of Occupational Therapy: Specialties That Set the Profession Apart

Too often, a person’s occupation or title only scratches the surface of the interests and passions that drive their day-to-day. When someone says they’re an attorney or an engineer or a teacher, you might get a vague idea of what they do, but those titles barely hint at the wide array of paths their careers might take.

Attorneys, for example, could spend their days defending clients in court, negotiating complex deals, or advocating for social justice. Engineers might specialize in designing cutting-edge technology, building infrastructure, or pioneering green energy solutions. Teachers may specialize in early childhood education or children with special needs, or they might be a researcher at a university teaching advanced linguistics.

Occupational therapists (OTs) might seem like it avoids this lack of clarity—after all, what else could they possibly do besides provide therapy to help people with their occupation? It’s right in the name! While the career may seem familiar to some, it doesn’t come close to capturing the wide range of specialties and settings in which an occupational therapist may work.

From helping children develop motor skills to guiding stroke survivors through rehabilitation, the field of occupational therapy is as diverse as the needs of the people it serves. Just like with lawyers, engineers, and teachers, the career path of an occupational therapist can branch out in several directions, making each therapist’s journey uniquely driven by their passions and expertise.

What is Occupational Therapy?

Occupational therapy is all about helping people live their lives to the fullest, regardless of the challenges they face. It focuses on helping people develop (or redevelop) the skills to perform everyday activities, or “occupations,” that are meaningful and essential to them, from dressing to cooking to working to socializing.

Whether someone is recovering from an injury, managing a chronic condition, or dealing with a developmental disorder, OT provides tailored interventions to improve their ability to fully participate in the journey of daily life. Occupational therapists do this by taking a holistic approach to working with patients. OTs look at the whole person — considering physical, emotional, and mental health — to design personalized strategies that address their specific needs and goals.

This could involve adapting tasks or environments, teaching new skills, or using assistive devices to overcome obstacles. The aim is to enhance independence and well-being in a way that’s practical and sustainable for each person.

OTs work with people of all ages, from young children learning to navigate sensory challenges to older adults striving to maintain independence in their later years. The versatility of occupational therapy means it can be applied in a wide range of settings, including schools, hospitals, rehabilitation centers, and even in a client’s home.

No matter the setting, the focus is always on helping people do what they need and want to do. By addressing the specific activities that matter most to each person, OTs help people achieve a greater sense of fulfillment and autonomy, making a significant difference in their lives.

Why Earn Specialty Certifications in Occupational Therapy?

As they aim to do with those they treat, earning specialty certifications allow individual occupational therapists to achieve a greater sense of fulfillment and autonomy within their careers.

Specializing not only enhances an OT’s expertise but also opens up new opportunities for career advancement, making them more competitive in the job market. With a specialty, an OT can become a go-to expert in their chosen area, gaining recognition and respect from colleagues, employers, and patients.

Whether driven to work with a certain type of person (i.e. kids, older adults, women, or athletes), help patients overcome specific conditions (i.e. dementia, cancer, autism, or stroke), or work within a specialized environment (i.e. school systems, workplaces, or senior communities), occupational therapy specialties make it possible for OTs to set career paths that provide them the greatest sense of purpose and professional joy. Specializing can lead to more focused and impactful work, allowing OTs to see the direct results of their work within specific populations, which can be incredibly rewarding.

Moreover, specialty certifications often provide occupational therapists with access to communities of like-minded professionals, offering valuable networking opportunities and the chance to collaborate on research, advocacy, and advanced practice initiatives. This sense of community and shared purpose can further enhance job satisfaction and contribute to a lifelong passion for their chosen specialty.

By diving deep into a particular area, OTs can continuously challenge themselves, stay engaged with the latest developments in their field, and ultimately, make a more significant difference in the lives of those they serve.

Navigating Advanced and Specialty Certifications in OT

The landscape of advanced and specialty certifications offers several options for an occupational therapist looking to set off their ideal career path. The OT field is diverse, and advanced and specialty certifications provide a pathway to focus on areas that truly align with your passions and professional goals.

Organizations like the American Occupational Therapy Association (AOTA) and other professional bodies have developed a range of certifications that set high standards for education, training, and clinical experience. These certifications don’t just provide credentials; they represent an OT’s dedication to their craft and commitment to providing specialized, high-quality care.

The process of earning these certifications typically involves a combination of advanced coursework, clinical experience, and successful completion of certification exams. These credentials validate an OT’s proficiency in a specialized area, opening doors to new career opportunities and enabling them to make a more focused impact on their clients’ lives.

Whether geriatric care, pediatric therapy, neuro, or prenatal specialties, these advanced certifications allow OTs to pursue a career that resonates more deeply with their professional aspirations.

Advanced Certification Programs in Occupational Therapy

The AOTA offers a number of advanced and specialty certifications that help occupational therapists deepen their expertise and enhance the practice of their craft. Among these, the association currently provides three advanced, board-certified specialties: gerontology (BCG), pediatrics (BCP), and physical rehabilitation (BCPR). Acquiring these certifications ensure OTs are recognized for their knowledge, skills, and training at a national level. Here’s more about each of these specialties.

Geriatric Occupational Therapy

Occupational therapists who are board-certified in gerontology (BCG) are specially trained to focus on the unique needs of a rapidly growing population: older adults. According to the Pew Research Center, around 10,000 Americans turn 65 every day, a trend that will continue through 2030.

As people age, they often face challenges related to mobility, cognition, and the ability to perform everyday tasks. A geriatric OT works closely with elderly people to maintain or improve their independence, whether through adapting their living environments, teaching strategies to manage chronic conditions, or helping them regain skills after an illness or injury. Specializing in geriatrics allows OTs to make a significant impact on the quality of life of older adults, helping them live more comfortably and confidently as they age.

Pediatric Occupational Therapy

The U.S. population isn’t only aging – around 10,000 babies are born each day, as well. Those who through the course of children require the services of OTs are likely to see a clinician who is board-certified in pediatrics (BCP).

Pediatric occupational therapists are dedicated to working with children, from infants to adolescents. This specialty focuses on helping young clients develop the skills they need to grow, learn, and interact with their environment. Pediatric OTs may work with children who have developmental delays, sensory processing disorders, autism, or physical disabilities. The goal is to assist these children in achieving milestones, improving motor skills, enhancing social interactions, and performing daily activities independently.

OTs who specialize in pediatrics to play an important role in a child’s development, supporting them and their families in navigating the challenges that arise during the formative years.

Physical Rehabilitation Occupational Therapy

When an OT is board-certified in physical rehabilitation, their work centers on helping individuals recover from injuries, surgeries, or illnesses that impact their physical abilities.

This specialty involves working with clients who may have experienced a stroke, traumatic brain injury, spinal cord injury, or musculoskeletal conditions. A physical rehabilitation occupational therapist focuses on restoring function, improving mobility, and adapting tasks or environments to accommodate the client’s needs.

But wait — isn’t that what physical therapists (PTs) do? While both professions focus on helping individuals recover from injuries, manage chronic conditions, and improve physical function, the differences lie in the OTs approach and goals when treating patients.

While an occupational therapist addresses physical rehab, it’s focus is broader than that of a PT. Their aim is to help people regain the ability to perform daily tasks and activities such as dressing, cooking, working, and more. This might include teaching ways patients can compensate for lost function, make use of adaptive equipment, and adapt their homes as necessary.

Specializing in physical rehabilitation enables OTs to guide clients through their recovery journey, helping them regain their independence and return to the activities they value most.

Which Other Areas Can Occupational Therapists Specialize?

While the AOTA’s board-certified specialties provide a robust foundation for occupational therapists looking to deepen their expertise, the journey toward professional development doesn’t end there. Many OTs choose to pursue additional specialty certifications that either complement their board-certified focus or explore entirely new areas of practice.

These specialty certifications, offered by various professional organizations, associations, and institutes, allow therapists to tailor their careers even more precisely to their interests and the needs of their focus clientele.

Occupational therapists may opt to earn multiple certifications for a variety of reasons. For some, holding multiple credentials within related areas — maybe combining pediatric certification with a specialty in sensory integration — enhances their ability to address complex client needs in a more holistic manner.

For others, obtaining certifications across diverse specialties can open up new career opportunities, broaden their scope of practice, and offer greater flexibility in their professional lives. This versatility is particularly valuable in a field where the needs of clients can vary widely across different settings and populations.

Below are various types of occupational therapy specialties and certifications that are oft-pursued by professionals in the field.

Assistive Technology Professional

Occupational therapists with the Assistive Technology Professional (ATP) certification specialize in assessing and providing assistive technology solutions to clients with disabilities. This can include a variety of impairments from mobility issues to communication disorders. These clients may struggle with daily tasks due to conditions like cerebral palsy, spinal cord injuries, or ALS.

ATP-certified OTs are trained to evaluate the needs of individuals and recommend, implement, and adjust assistive devices such as wheelchairs, communication aids, and environmental control systems. These services significantly enhance their patients’ independence and quality of life.

Certified Lymphedema Therapist

Certified Lymphedema Therapists (CLT) specialize in treating clients with lymphedema, a condition characterized by chronic swelling typically in the arms or legs. The onset of lymphedema often follows cancer treatment or surgery.

This certification trains OTs to perform comprehensive assessments and deliver treatments such as manual lymphatic drainage, compression therapy, and exercise. These interventions help manage swelling, reduce discomfort, and improve clients’ mobility and quality of life.

Certified Hand Therapist

Certified Hand Therapists (CHT) are OTs who specialize in the treatment of hand, wrist, and upper extremity conditions like fractures, tendon injuries, and repetitive strain injuries (i.e. carpal tunnel syndrome). The CHT certification involves rigorous training in advanced hand therapy techniques, enabling therapists to deliver targeted interventions that improve strength, dexterity, and function, helping clients return to their daily activities and work.

Aquatic Therapeutic Exercise Certification

Occupational therapists with an Aquatic Therapeutic Exercise Certification (ATRIC) are trained to use water-based or aquatic therapy to help clients with conditions like arthritis, chronic pain, or neurological disorders. These clients benefit from the buoyancy, resistance, and warmth of water, which can facilitate movement, reduce pain, and improve strength. ATRIC-certified OTs design and implement therapeutic exercise programs in aquatic settings, providing an effective and low-impact rehabilitation option.

Seating and Mobility Specialist

Seating and Mobility Specialists (ATP/SMS) focus on clients who require specialized seating and mobility solutions, like those with spinal cord injuries, muscular dystrophy, or multiple sclerosis. These OTs are trained to be experts in assessing clients’ postural and mobility needs, selecting and fitting wheelchairs and seating systems, and ensuring proper alignment and support. Their goal is to help clients achieve optimal comfort, mobility, and independence.

Trauma-Informed Pelvic Health Certification

People dealing with pelvic floor dysfunction, often stemming from trauma, childbirth, or chronic conditions, may find value in seeing an OT that is certified in Trauma-Informed Pelvic Health (TIPHP). Such patients may be experiencing pain, incontinence, or sexual dysfunction.

TIPHP-certified OTs are trained to approach treatment with sensitivity to past trauma, using techniques that promote healing, pain management, and improved pelvic health in a safe and supportive manner.

Certified Perinatal Health Specialist

Certified Perinatal Health Specialists (PHS) work with pregnant and postpartum women to address physical and emotional challenges like pelvic pain, postnatal depression, and recovery from childbirth. These patients benefit from interventions that support physical recovery, mental health, and the transition to motherhood. PHS-certified OTs are trained to provide comprehensive care that enhances maternal health and well-being during the perinatal period.

Certified Autism Specialist

The Certified Autism Specialist (CAS) designation is given to OTs who are trained to work with clients on the autism spectrum, from young children to adults. These clients may experience difficulties with communication, sensory processing, and social interactions. The CAS certification provides OTs with specialized knowledge in autism-specific interventions, such as sensory integration, behavioral strategies, and communication techniques. This allows them to offer tailored support that enhances their clients’ ability to navigate everyday life.

Neuro-Developmental Treatment Certification

The Neuro-Developmental Treatment Certification (C/NDT) program trains OTs to work with people who have neurological conditions such as cerebral palsy, stroke, or traumatic brain injury. These patients often struggle with motor function, balance, and coordination. C/NDT-certified OTs are trained in specialized techniques that facilitate improved movement patterns, functional motor skills, and overall physical performance, helping patients achieve greater independence in daily activities.

Certified Stroke Rehabilitation Specialist

Stroke survivors often face challenges such as hemiplegia, speech difficulties, and cognitive impairments. Certified Stroke Rehabilitation Specialists (CSRS) work with those recovering from strokes, with a focus on restoring lost functions, improving mobility, and adapting daily tasks to accommodate new limitations. The CSRS certification provides OTs with advanced skills in neurorehabilitation techniques, teaching them to create targeted interventions that help clients regain as much independence as possible and improve their overall quality of life.

Certified Brain Injury Specialist

Certified Brain Injury Specialists (CBIS) focus on the rehabilitation of clients who have suffered traumatic brain injuries (TBI). These patients may face cognitive, emotional, and physical challenges such as memory loss, mood swings, and motor impairments. The CBIS certification teaches OTs to develop and implement advanced strategies for cognitive rehabilitation, behavioral management, and community reintegration. This ensures they provide comprehensive care that supports patients’ recovery and adaptation to life after injury.

Certified Neuro Specialist

Certified Neuro Specialists (CNS) are OTs who focus on advanced rehabilitation for people with neurological conditions like stroke, traumatic brain injury, or multiple sclerosis. These neurological patients often need intensive therapy to regain motor function, cognitive skills, and daily living abilities. CNS certification provides occupational therapists with specialized training in neurorehabilitation techniques, allowing them to maximize recovery and improve patients’ quality of life.

Saebo Certified Therapist

Saebo Certified Therapists are OTs trained to use Saebo-brand orthoses and rehabilitation tools, which are designed for clients recovering from neurological injuries like stroke or traumatic brain injury. These clients often struggle with upper limb function and movement. Saebo certification equips occupational therapy practitioners with the skills to apply these devices effectively, helping neuro patients regain hand and arm function through task-specific training and neuromuscular re-education.

Skills2Care® Certification

Skills2Care® Certification is designed for occupational therapists working with caregivers of people with dementia — individuals who often face challenges related to memory loss, behavioral issues, and daily care needs. Skills2Care®-certified OTs are trained to coach caregivers on strategies to manage care tasks, reduce stress, and enhance the quality of life of both the caregiver and the person with dementia. The goal is to make home life safer and more manageable.

Certified Psychiatric Rehabilitation Practitioner

Certified Psychiatric Rehabilitation Practitioners (CPRP) specialize in helping clients with mental health issues such as schizophrenia, bipolar disorder, or severe depression. These clients often struggle with managing symptoms, social interactions, and daily functioning. A CPRP-certified occupational therapist uses evidence-based practices to support recovery, enhance independent living skills, and promote meaningful participation in community life. This offers patients a more well-rounded approach to mental health care.

Certified Diabetes Care and Education Specialist

Sometimes known simply as a certified diabetes educator, occupational therapists trained to be Certified Diabetes Care and Education Specialists (CDCES) support patients managing diabetes. They do this by helping them focus on lifestyle changes, medication adherence, and prevention of complications. Many of these patients may be struggling with blood sugar control, dietary adjustments, and the physical impacts of diabetes, such as neuropathy. CDCES-certified OTs are trained to provide comprehensive diabetes education and self-management strategies, empowering people to take control of their health and reduce the risk of serious complications.

Certified Low-Vision Therapist

Certified Low-Vision Therapists (CLVT) work with people who have visual impairments that affect their ability to perform daily tasks. This may include those with macular degeneration, glaucoma, or diabetic retinopathy. CLVT-certified OTs are trained to assess visual function, recommend adaptive techniques and devices, and modify environments to enhance safety and independence. This enables patients to maintain their quality of life despite vision loss.

Certified Industrial Rehabilitation Specialist

Certified Industrial Rehabilitation Specialists (CIRS) focus on helping people return to work after an injury. They also help workers manage work-related conditions, such as repetitive strain injuries. Often, these people need to regain the strength, endurance, and functional capacity required for their jobs. CIRS-certified occupational therapists are trained in workplace ergonomics, job task analysis, and functional capacity evaluations. This enables them to create effective return-to-work programs that ensure safe and successful job reintegration.

Certified Ergonomics Assessment Specialist

Certified Ergonomics Assessment Specialists (CEAS®) are occupational therapists trained to assess and optimize workplace ergonomics, thus preventing injuries like musculoskeletal disorders. Their clients, often employees in various industries, benefit from work environment adjustments that reduce physical strain.

Certified Industrial Ergonomic Evaluator

Like CEAS-certified OTs, Certified Industrial Ergonomic Evaluators (CIEE) specialize in assessing and optimizing work environments to prevent injuries related to poor ergonomics, such as musculoskeletal disorders. Under this certification, OTs are trained to analyze workspaces, recommend ergonomic adjustments, and educate workers on proper body mechanics, ultimately reducing injury rates and improve workplace productivity.

Certified Driver Rehabilitation Specialist

People who have impairments that impact their ability to drive safely, such as those recovering from a stroke, traumatic injury, or with conditions like Parkinson’s disease, may work with a Certified Driver Rehabilitation Specialists (CDRS). CDRS-certified OTs are trained to assess driving skills, recommend adaptive driving equipment, and provide rehabilitation plans or driving lessons.

Certified Living in Place Professional

Certified Living in Place Professionals (CLIPP) specialize in home modifications that help clients age in place or live safely at home despite disabilities. These occupational therapy patients, often older adults or individuals with mobility impairments, require environments that accommodate their physical needs. CLIPP-certified OTs are trained to assess homes for safety, recommend modifications, and implement changes that improve accessibility and reduce fall risk, helping clients remain independent in their homes.

Certified Aging in Place Specialist

Certified Aging in Place Specialists (CAPS) also focus on helping older adults remain in their homes safely as they age. Patients in need of this type of assistance may be facing mobility challenges, cognitive decline, or chronic health issues that make daily activities difficult. CAPS-certified OTs are trained to assess homes as well as recommend and implement changes that enhance accessibility, safety, and comfort, enabling older adults to live independently for as long as possible.

Physical Agent Modalities Certification

Physical Agent Modalities (PAM) Certification training provides occupational therapists with the knowledge to use modalities such as heat, cold, ultrasound, and electrical stimulation in their therapy practice. These tools are used to reduce pain, increase circulation, and improve tissue healing, particularly in clients recovering from musculoskeletal injuries or surgeries. PAM-certified OTs are trained to safely and effectively integrate these modalities into their treatment plans to enhance outcomes.

Certified Hippotherapy Clinical Specialist

One of the more unique and memorable certifications, Certified Hippotherapy Clinical Specialists (HPSC) utilize the movement of horses as a therapeutic tool for patients with physical, sensory, and cognitive challenges. This may include people with cerebral palsy, autism, or traumatic brain injury. Such individuals benefit from the rhythmic motion of horseback riding, which can improve balance, posture, coordination, and emotional well-being. HPSC-certified OTs are trained to incorporate hippotherapy into their practice, providing a unique and effective intervention.

What are Certified Occupational Therapy Assistants?

Certified Occupational Therapys Assistants (COTAs) are professionals who have completed an accredited occupational therapy assistant program and passed the national certification exam administered by the National Board for Certification in Occupational Therapy (NBCOT).  COTAs work under the supervision of licensed occupational therapists (OTs) to provide therapeutic interventions that help clients perform daily activities and improve their quality of life. Their role involves implementing treatment plans developed by OTs, assisting clients with exercises, and educating clients and families about strategies for managing their conditions.

The COTA certification is an entry-level qualification necessary to work as an occupational therapist assistant, whereas the other certifications listed above are specialized credentials that OTs and (in some cases) OTAs may pursue to gain advanced skills in specific areas of practice.

For example, some specialty certifications, like the advanced certification programs or specialties like Certified Hand Therapist (CHT), are exclusively available to licensed OTs due to the advanced level of practice required.

However, other certifications, such as the Certified Stroke Rehabilitation Specialist (CSRS) or the Assistive Technology Professional (ATP), may be available to both OTs and COTAs. The eligibility requirements for each certification vary, with some allowing COTAs to obtain the credential if they meet certain criteria, such as a specific amount of experience in the field.

Obtain Certification in the Occupational Therapy Field

The field of occupational therapy is rich with opportunities for specialization, offering an array of certifications that can enhance your practice, deepen your expertise, and ultimately help you make a greater impact in the lives of your clients.

If you’re interested in learning more about these certifications or are considering pursuing one, your first step should be to explore the specific requirements and opportunities offered by various organizations like the American Occupational Therapy Association and other credentialing bodies. Many of these certifications require a combination of qualifications, including a foundational knowledge base, relevant experience in the field, and specific prerequisites like being a licensed occupational therapist.

The process of earning a certification typically follows a standard procedure that includes:

• Meeting the eligibility requirements, which may include a certain number of hours or years of experience in the specialty area.
• Undergoing specialized training hours, which could be completed through in-person workshops, online courses, or a combination of both.
• A rigorous exam that tests your knowledge and skills in the specialty. Successfully passing this exam earns you the certification, officially recognizing your advanced expertise.
• Payment for training, certification, and/or renewal.

To get started, visit the websites of relevant certification organizations, reach out to peers who have pursued similar paths, and begin mapping out your journey toward becoming a more specialized and impactful occupational therapy professional.