Becoming (& Thriving as) a Pediatric OT

If you are curious what pediatric occupational therapy entails and/or how to become a pediatric occupational therapist, this interview will give you a glimpse into the life of a pediatric OT.

If you are interested in starting out as a pediatric occupational therapist, switching practice areas to pediatrics, or simply thriving in your current pediatric OT career, this interview with Katie Caspero, OTR/L will give you some guidance!

I know that the process of getting into pediatric therapy can raise lots of questions, so if you have any unanswered questions after reading the article, be sure to ask them in the comments below.

Sarah Lyon, OTR/L

I hope you enjoy reading this blog post.

If you want to try a free OT CEU from us, click here.


OT Potential: Where did you go to OT school? (And, what should prospective students who are interested in pediatrics be looking for in a program?)

I went to OT School at Duquesne University in Pittsburgh, PA. I liked Duquesne because they had a lot of strong healthcare programs, and many of them were accelerated (e.g. five years to get your master’s or six years for a doctorate). The pediatric professor was really great, and she had been working there for a while and was really connected to the community. This allowed us a lot of hands-on pediatric experiences before our fieldwork.

I also liked that the school, in general, offered a lot of opportunities for us to engage in community service. This allowed me to gain leadership (and other) skills, as well as other valuable experiences beyond the classroom. I apply such skills in my work as an OT, and I found the community service experience also provided me with a better understanding of people who are marginalized in our city, including people with disabilities. 

Did you seek out pediatric fieldwork assignments to help you prepare for this specialty?

Originally, I wanted to be a pediatric mental health OT, so I sought out a pediatric mental health-specific facility outside of the Pittsburgh area. It was a residential treatment facility and school for adolescents with mental health diagnoses. Looking back, I would encourage those in OT school to seek out pediatric placements in other cities, in order to increase their chances of getting pediatric fieldwork placements at credible sites. 

Is there anything else you did above and beyond your OT degree to help you find a pediatric job?

I volunteered for a few different organizations that worked with kids. The most valuable was working for a respite care organization, where I would spend time with a child with disabilities while the family ran errands or spent time with their other children. This gave me a good insight into the family dynamics that occur when a child has special needs.  

During my first year of practice, I attended as many conferences as I could afford. My personal favorite, The SOS Approach to Feeding Training by the STAR Institute, provided tons of skills and information that I incorporate into my daily practice. 

When it was time to apply to jobs, I looked at the mission and values of each company. I sent resumes to companies whose values aligned with my own, even if they did not have any job postings at that time. Having a deep understanding of a company’s mission was really helpful during the interview process, as I could use that information to explain why I was drawn to that specific organization.

What questions would you be sure to ask when applying for a job in an OP pediatrics setting? 

I think a great question to get an understanding of the daily job activities is to ask, “What does a typical day look like?” This is not unlike what we would ask our clients! 

Another question I would ask is about the expected working hours. Usually, an outpatient center is open later into the evening compared to a typical 8-5 job. An early intervention therapist might have to create his or her own schedule. This is something that you should know ahead of time, which will allow you to determine whether that role is a good fit for you. Lastly, asking how the organization will support your professional development (e.g. continuing education) throughout the year will allow you to know whether it’s an organization that prioritizes staff development. 

How do you find that pediatric OT salaries compare to other OT salaries? Has this factored into your career decision making?

Depending on the area of the country you are in, this answer may or may not apply to you. However, I find a pediatric OT salary to be lower compared with other practice areas (e.g. inpatient rehabilitation or skilled nursing facilities). An OT working as a contractor, independent consultant for schools, or early intervention provider might earn higher hourly rate—but that rate probably does not include benefits—so I have personally found the overall compensation for pediatric OTs is usually on the lower side. 

What is your favorite part about your work?

I love working with the whole family unit and seeing kids who have worked so hard on their goals finally meet them.

I love to share in their joy and smiles when they say, “Ms. Katie, I can tie my shoes!” 

I also love how different every single hour of my day is. I could be spending the morning working on feeding with a kid with autism, then work with a child with cerebral palsy in the pool, and end the day working on dressing techniques with a child with a genetic disorder. It’s a great challenge and keeps things interesting!

What is your least favorite part about your work? 

My least favorite part about the job is the lack of time to complete necessary things like calls to schools. It can also be frustrating when a child does not receive the behavioral support that he or she needs.

The higher demand for productivity, similar to adult rehabilitation, can be a challenge, too. Working with stressed-out kids and families can definitely take its toll, and it can be difficult finding the work-life balance needed to prevent burnout.

What has been the most surprising part about your work?

I didn’t expect to be working on feeding therapy with kids as much as I do, but I love it! Also, there are many different rare diagnoses that I am learning about, due to working in a city campus of an outpatient center. 

How have you kept up on research and industry trends in pediatrics?

This is a hard one, as pediatric research is not as accessible as adult rehabilitation research. 

I’ve continued to complete research with professors from school, and I make sure to maintain those networks and relationships. Also, having students both at the Level II fieldwork level and OTD level can allow for easier access and synthesis of research. I make a point to attend every meeting that has a presentation, which allows for easy learning over lunch!

Any books or movies that have inspired your practice?

Love Anthony by Lisa Genova is one of the best books I have read. It’s a mother sharing her story about her son who had autism. The Reason I Jump by Naoki Higashida is also so helpful in understanding the experience of autism from the perspective of a 13-year-old boy. 

What advice would you give to someone who has been working with adults as an OT, and is looking to switch to pediatrics?

I have inspired multiple friends to “make the switch,” so I spoke with my friend who recently switched from inpatient rehabilitation to pediatrics. I asked her what advice she would give and here was her answer:

“Start applying for jobs, even if they are not full-time. You might not get your dream peds job at first, but that’s how you start. If you don’t land your first interview, you at least learn what you need to know for the next one! One thing I said in my interview, when I transitioned from adults to pediatrics, was that I was ready to bring a fresh perspective to the peds clinic. I knew transfer techniques really well and I felt very comfortable working with patients with neurological disorders on sitting balance and adaptive ADL techniques. I found talking with peers, looking at pediatric facebook groups, having a mentor, referring back to textbooks, and completing continuing education were all very helpful for support and treatment advice.”
Mary Rose Simmons, MS, OTR/L

What changes do you hope to see in pediatric occupational therapy over the next 10 years? 

I hope to see more support for working with kids past early intervention age in the natural setting (e.g. at home and in community spaces). 

I think it’s important to work with children in their natural contexts in order to really translate the work we do in OT into patients’ daily lives. Also, I hope that the caregivers’ and siblings’ needs are addressed during therapy in order to holistically support the child as well as possible.

23 replies on “Becoming (& Thriving as) a Pediatric OT”

Hi I was wondering what your day to day schedule is like in this field. Also what’s the difference in working in schools vs hosiptals vs private practices

Also I’m a junior and was wondering about your schooling. What type of program I would be in and classes I would take.

Hi Sarah!

I am currently in OT school and have an upcoming project where we have to write a pseudo proposal for a single subject research study in an area of our interest related to OT… and I am very passionate about pediatrics. I was curious if in your practice/experience you have been seeing something that you believe could benefit from more research?

Thank you!

Hi! waves
I’m currently a Year 12 student that is really interested in pursuing paediatric OT for my career, however, the standard to get into the course is extremely high. Do you have any advice that could help me in this situation?
P.S. Your blog is fantastically written! Love it 🙂

Lucky me I discovered your website by accident on Google. I’ve saved as a favorite for later!

You shared great experience of your career path from beginning to present. Really, it’s too much encouraged.

Hello. I am an occupational therapist who works in the schools k-8. I have 3 years of experience in this area. I didn’t have experience before getting into this role and have learned so much. I am comfortable in this role but am looking to move and I see early on or early interventionist positions available. I am nervous that as the only OT of these teams that I may not have the skills and be able to be successful in this role. Could you offer advice? Thanks.

Hello, I am currently getting my undergraduate degree in psychology and going to begin applying to OT school next Summer. Are there any tips you could give me about the application process and what to expect?

Hey Jenna! I am actually working on a guide to applying to OT school! I’m hoping it will be out this fall. You can either check back or sign up for my mailing list via the chat box to get notified when it is published!

I am a recent grad searching for a my first OT job, and am truthfully lacking some much needed confidence while sending out applications. I have looked over you content on this subject numerous times and I think I am struggling with feeling qualified/competent opposed to being intimidated by the job search process. With that being said, I am contacting you in hopes for some advice or guidance. My ultimate goal is to become a pediatric OT, but I am finding it difficulty making my resume/cover letter stand out for pediatric positions. I think a major road block for me has been I feel my pediatric experience was limited due to a "luck of the draw" system utilized by my program to assign fieldwork placements, in which mine were in an acute care setting and a outpatient clinic (where I treated pediatric patients approx. 1-2x/week). Do you have any advice to bridge the gap between treatment settings when applying for population specific positions? I greatly appreciate any input if you have any to share!

Hi Lauryn,
I too had some difficulty due to the "luck of the draw" process for getting assigned fieldwork sites. I had to seek out that adolescent mental health facility because I saw that there were not enough pediatric placements.
I would encourage you to look back to other experiences that are not OT related, were you a babysitter early on/camp counselor? Or even jobs or clubs where you would have to have the skills for time management, problem-solving or working as a team. I once had a mentor who told me that it’s the clinical stuff that’s easy to help someone learn its hard work, willingness to learn, being open to feedback, and wanting what’s best for the client that is hard to teach.
Overall, the OT process is the same across settings so you can highlight that you know how to move someone from evaluation to treatment planning and discharge. You can share examples of those skills to help build your case in your cover letter.
If there is a personal story or motivation for why pediatrics stood out to you, don’t be afraid to share that in the cover letter because that speaks volumes.
Hope that helps!
-Katie Caspero

Hey Lauryn!

We all struggle with those feelings, so it’s understandable…but you have so much to offer!

If at all possible, highlight the opportunities you did have to treat peds in your outpatient assignment. 1-2x/week is way more than I had at ANY job, so that will help you stand out!

Also, I recommend shadowing at a peds clinic on nights or weekends. That way you can list it on your resume as recent experience, and the fact that you’re willing to volunteer your time to get the experience you’re missing will show how serious you are about getting into peds.

Another thing is if you tailor your resume to a specific job posting and try to echo/mimic the wording used in the job post, your resume will stand out.

I had randomly assigned clinicals (I’m a PT) that weren’t anything special, and I was able to tweak my resume in a way to make what I did look really magical (lol) and that helped me land jobs. I hope this is helpful!

Hi there! New Graduate here who just got offered a position with a company that contracts into schools. My struggle is the "fee for service" model. I am nervous that there will be weeks when a lot of my kiddos can’t make sessions for varying reasons, or I am sick, etc. This would lead to me not getting paid. Having a large sum of student debt after OT school has me worried, but my dream is to work in a school setting. Any advice on how to handle this opportunity?

Hey A! Did you end up taking this job? Sorry I am slow to respond, I had to talk this through with a pediatric OT friend. If you skim through this article, you will see that the school setting is on the lower end of OT salaries: https://otpotential.com/blog/occupational-therapy-salary-guide. That being said, as I was talking this through with my friend, we talked about how you are bond by the IEP to provide a certain number of minutes each week, so your billing should hypothetically be somewhat consistent, short of your own sickness. People handle the numbers of this situation differently, for example by starting in a higher paying practice are then transitioning to their passion area, or just biting the bullet and going for their dream. Best of luck to you and let me know if you have any other questions!

I am approaching my 2nd year as a school-based therapist. My first year was a real struggle. I felt lost most of the year with very little guidance from the contract company I’m employed with. The therapist recommended I consult with questions via email is responsive, but personally I need more guidance. How would you suggest I can I or should go about finding a mentor?

Hi Melissa,
It can be really challenging when you feel like you don’t have a person or mentor to turn to especially with clinical questions when you are early in your career. A resource I have seen other early intervention and school therapists access is AOTA’s CommunOT and Pediatric Occupational Therapist or School-Based OT Facebook Discussion groups and post about a particular case scenario or to get resources about a particular diagnosis. I personally would go back to my OT class’s Facebook page or reach out to a former classmate to ask a particular question as well. I personally enjoy Tuesday Talks from Lauren G. (https://www.instagram.com/lgthefitot/) who also went to school with me! She has a great instragram account that you can post questions and has a lot of School OT related resources. Let me know if you have any other thoughts or concerns!- Katie Caspero

I’m a new grad and my first job is school based OT. I have never attended an IEP meeting before and I have to do one in a week. It is an initial IEP meeting for a transfer student. What advice do you have for me as far as approaching this meeting? What are some typical things that the OT discuss or said during this meeting? I tried to ask my mentor at the school but her response was "I’m not here to teach you how to do your job, you should know that by now" . I’m in a pickle and feeling anxiety!

Hi April,
I have been a pediatric OT for over 7 years now, with 5 years of experience in school based specifically. Sorry I am seeing this late so you may already be done with your IEP but please feel free to reach out with any questions anytime!

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