As program director for the certified occupational therapy assistant program at Sacramento (Calif.) City College, Ada Boon Hoerl, COTA/L, MA, could have taken more than 100 new students for her popular regional program. But she had slots for only 33.

"We turned 69 away this past year," she said. "We had people flying in or taking the train or driving two to three hours just for our informational meetings."

Terra Ruppert, OTR, PhD, the occupational therapy program director at Lone Star College in Tomball, Texas, is experiencing the same growth in applicants: 100 potential students for 20 slots.

Both are on the front line of an explosion in OTA education in the United States. Currently supporting 177 accredited programs in 47 states, OTA education is in the process of adding another 56 schools with certified programs, said Ellen McLaughlin, OTR/L, EdD, the incoming chairwoman of the Accreditation Council for Occupational Therapy Education.

"One of the reasons we’re seeing growth is because of the economy," McLaughlin said. "People see OTA education as an affordable option for a career. If you look at the average salary and the financial investment in school, you get a great return."

Numbers from the Bureau of Labor Statistics bears this out. With most OTA programs in low-cost community colleges, students can pay under $5,000 for a two-year program and earn an average salary of $25 an hour, or $52,150 a year.

"Our last graduating class got between $30 and $40 an hour fresh out of college," Hoerl said. "And they all got jobs."

Ruppert said: "Our graduates told us it wasn’t about whether they will get a job, but which one they will take."

Fueling the OTA Market



A number of factors are contributing to the huge increase in OTA demand, which is expected to grow 43% and add an additional 12,300 jobs by 2020, according to the BLS. Among them are the increasing aging population, the expansion of autism diagnoses, and a higher demand for occupational therapy among veterans who suffered injuries in the recent wars in Iraq and Afghanistan, Hoerl said.

Other emerging areas for OTA employment include vision rehabilitation, driver rehab and medical equipment companies, McLaughlin said. "OTAs are educated as generalists," she said. "That means they can start at the entry level in a wide variety of settings, from schools and hospitals to long-term care and home care."

The new master’s degree requirement for occupational therapists also is helping to fuel the shorter OTA program, Hoerl said. "Many interested in the profession want to go to a shorter program and get to work," she said.

The average age of an OTA in school is 43, Hoerl said. Most OTA students are on their second or even third careers, Ruppert said. Generally, four classes are required to enter an OTA school: anatomy, biology, psychology and physiology.

"OTA is often a midlife career change," Hoerl said. Most students do not go on to earn an OT, but instead go straight into the workforce, she said.

Despite the older population at the school, Sacramento City’s OTA program also is included in a healthcare summer academy offered to high school students, Hoerl said.

Innovative Curriculum



Many OTA schools are reaching out to local patient groups and finding other ways to enhance their curricula ahead of changes required by ACOTE for certification by July 2013 (see sidebar).

"One thing we hear employers asking for is training in the Allen Cognitive Levels," Hoerl said. "It’s an assessment typically used in psychiatric settings, but more and more employers in skilled nursing and sub-acute care are asking us to have our students trained in ACL."

OTA students at Sacramento City train in trauma informational care to better understand patients’ trauma backgrounds and how that influences their daily lives, Hoerl said. A working knowledge of Medicare and Medicaid is embedded in classroom coursework, as are ways to identify evidence-based practices, she said.

In addition, OTA schools are reaching out to the community while educating their students. "We are doing a lot of community-based, hands-on work with clients," Ruppert said. The Lone Star College recently built an entire two-story house, complete with kitchen, stairs, bathroom and front door, to enable students to work with population groups as if they were in their homes, she said.

"The design is unique," Ruppert said. "It’s not the same old four walls classroom." The house design teaches that occupational therapy is not just a medical model, but a more holistic profession, she said.

"The house creates an attachment with patients that students need," Ruppert said. "It helps them see things in the way patients are in their daily living."

Another program at the college brings disabled children from the community to the school for events such as Halloween parties, where a "snoezelen" — a multisensory experience with lights, bubbles and soft textures — is brought out for the children to experience.

Sacramento City recently started a pilot program partnering with disabled students on campus that have sensory issues. "We have a sensory modulation program for students to test the benefits of helping them self-regulate better and become more academically successful," Hoerl said. "It was very successful and we now have an official course that can serve the whole campus."

OTA students also work with autistic students on campus as fieldwork credit.

Both schools put on a CarFit program, which helps to assess older drivers and their safety in relation to their vehicles. Upon graduation, the OTAs at the school are CarFit certified technicians.

Budget/Faculty Barriers to Growth



Despite the demand, many OTA schools cannot grow because of budget limits and faculty shortages, school officials say. The next step may be to expand to remote classes through the Internet and traveling labs. "We are exploring new models," Hoerl said. •

Teresa McUsic is a freelance writer.



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