The History of Occupational Therapy... Where Did We Come From?...

How Did We Get Here?

The history of Occupational Therapy is an interesting "story". Many people
believe that Occupational Therapy is a new profession. As you will see, this is
not so. It's development is woven into the fabric of human existence; as,
"occupation" has been central to our survival since the beginning of time.
Many different ideas have been presented throughout history concerning;
who should work, what type of work should be performed, what is considered
to be "work", who should play, and when the "playing" should begin and end.
Health and occupation have evolved to become intertwined, after all, when
health suffers, so too does the ability to perform an "occupation" and take
part in daily activities.
In the 1700's, during the "Age of Enlightenment", Occupational Therapy
began to emerge. It was during this period that revolutionary ideas were
evolving regarding the "infirmed" and mentally ill. At that time in history, the
mentally ill were treated like prisoners; locked up and considered to be a
danger to society.
It wasn't until two gentlemen; Phillipe Pinel (a French physician, philosopher,
and scholar) and William Tuke (an English Quaker) started to challenge
society's beliefs about the mentally ill, that a new understanding, philosophy
and treatment would emerge.
In 1793, Phillipe Pinel began what was then called "Moral Treatment and
Occupation", as an approach to treating people with mental illness. He firmly
believed that moral treatment meant treating one's emotions. This Moral
Treatment Movement then began to define occupation as "man's goaldirected use of time, energy, interests, and attention". Treatment for the
mentally ill thus became based on purposeful daily activities. Pinel began
advocating for, and using, literature, music, physical exercise, and work as a
way to "heal" emotional stress, thereby improving one's ability to perform
activities of daily living ("ADL's as we now call them).
Around the same time, William Tuke was also trying to challenge society's
beliefs about how the mentally ill should be treated. He too was disgusted by
the way patients were treated and the horrendous conditions they had to
endure in the insane asylums.

Tuke therefore developed many principles that would advocate "moral

treatment" for the mentally ill. His basic premise which underlined these
principles was to treat these people with "consideration and kindness" (I
know, what a bizarre concept huh? Boy, have we come a long way... thank
goodness!). Tuke felt occupations, religion (which helped bring in the concept
of family), and purposeful activities should be prescribed in order to
maximize function and minimize the symptoms of the patient's mental
illness.
Tuke then became a unique and positive influence when he founded a retreat
center in England based on some of the same ideas. He encouraged patients
to learn and grow by engaging them in a variety of employment or
"amusements" (what we now call leisure activities) that were best adapted to
their level of functioning and interests.
Well, 1840-1860 were the "golden years" for the application of Moral
Treatment and Occupation in American hospitals. It was during this time that
the benefits of arts and crafts began to be noticed. Arts and crafts thus
became a highly used activity to promote both relaxation and feelings of
being productive, at the same time. A whole new approach was just about to
emerge!
Unfortunately, during the 19th century, in the U.S., moral treatment almost
became extinct in the chaos and aftermath of the Civil War. It became less of
a priority and there seemed to be no one to carry on the ideas and insightful
philosophies from Tuke and Pinel.
Luckily, a nurse by the name of Susan Tracy came along just in time (in the
early 1900's)! She successfully brought back the use of "occupation" with the
mentally ill. She began to specialize in this field and even initiated educating
student nurses on the therapeutic use of activities as part of treatment. Tracy
coined the term "Occupational Nurse" for those she successfully trained in
this specialty.
In 1914, two people began a series of correspondences concerning the
founding of an organization for individuals interested in "Occupation Work"
(as Occupational Therapy was originally known until this time). George E.
Barton, an architect, contacted Dr. William R. Dunton, Jr. because he was
interested in learning about the response of the human body to the
therapeutics of occupation.

On March 15, 1917, the National Society for the Promotion of Occupational
Therapy (NSPOT) was founded. Charter members included; Eleanor Clarke
Slagle (a partially trained social worker), George Edward Barton (a disabled
architect), Adolph Meyer (a psychiatrist), Susan Johnson, Thomas Kidner,
Isabel G. Newton (Barton's secretary who later became his wife), and Susan
Tracy.
This organization flourished through the 1920's and 1930's until the Great
Depression. It was during this time that Occupational Therapy became more
closely related to and aligned with organized medicine, thus creating a more
"scientific approach" to this field of study. It is also this organization that
would later be known as the American Occupational Therapy Association of
today.
Following the Great Depression, however, it was difficult to find therapists
due to low budgets an poor staffing of clinics. But, then came World War I,
which necessitated the use of every available therapist possible! It was this
time that Occupational Therapists were called on to develop programs and
treat injured soldiers, of which there were too many!
From the 1940's through the 1960's, the "Rehabilitation Movement" was in
full force. With the thousands of injured soldiers (physically and mentally)
returning home from the war, there was a surge in the demand for
Occupational Therapists (or, OT's as we now call ourselves). At this point,
OT's were not only treating the mentally ill who were already
institutionalized, but began treating physical disabilities due to the injuries
sustained in battle. Besides the mentally ill, the injured war veterans, OT's
also became called upon to treat an ever increasing number of survivors of
"modern medicine's miracles". Now OT's hit physical disabilities at high
speed with the aforementioned, PLUS survivors of spinal cord injuries,
amputations, traumatic brain injuries, and cerebral palsy.
In 1947 The journal, Occupational Therapy and Rehabilitation and the first
major textbook, Willard & Spackman's Principles of Occupational Therapy,
were finally published. Occupational Therapists finally achieved military
status. This recognition provided other opportunities to gain financial support
from the federal government for the education of OT personnel, and it
provided leadership training skills for members of the American Occupational
Therapy Association.

In 1956 The Certified Occupational Therapy Assistant (COTA) position was

created to alleviate the demand for OT's who were required to attend 4-6
years of schooling. The COTA required only minimal training and was utilized
as an assisting body and aide.
The field of Occupational Therapy kept growing. During the 1960's, as
medicine became "specialized", so did OT. Occupational Therapists were also
called upon and qualified to treat in the fields of pediatrics and
developmental disabilities. And, with de-institutionalization came an even
greater need to help mentally ill, physically infirmed, and developmentally
challenged individuals become independent and productive members of
society. It was Occupational Therapists that could easily fill this role, and the
surge for competently educated therapists was on.
In 1965, under the amendments to the Social Security Acts, Medicare now
covered inpatient occupational therapy services.
In 1975, The Education of the Handicapped Act was passed and Occupational
Therapy was included in the schools as a "Related Service".
During the 1980's and 1990's, Occupational Therapy began to focus more on
a person's quality of life, thus becoming more involved in education,
prevention, screenings, and health maintenance. Goals of occupational
therapy could now focus on prevention, quality, and maintaining
independence.
Today, occupation is the main focus of the profession. It is certainly an everevolving and dynamically moving profession. You will find Occupational
Therapists working in a variety of settings with several different age groups
and disabilities. Anyone with a physical, emotional, or developmental deficit
can be referred by his/her physician, school, or parent for any one of the
following reasons: prematurity, birth defect, spina bifida, attention deficit
disorder, developmental disabilities, cerebral palsy, sensory dysfunction,
autism, hyperactivity, down syndrome, amputation, stroke, arthritis, burns,
head injury, dementia, diabetes, or cardiac conditions.
Occupational Therapy is a product of, and dependent on, a social
environment that values the individual and believes that each person has the
capacity to act on his/her own behalf to achieve a better state of health
through occupation. Many challenges still need to be met... the future is
now!

"What Is Occupational Therapy Anyways?"

For those of you who are new to all of this, you might be wondering...
what IS Occupational Therapy? And, why do I keep telling you to seek an
Occupational Therapist out?
Many people have heard about occupational therapy, "OT" as we like to call
it, but often don'tfully understand.
Our profession is somewhat complex, but I will do my best to define
occupational therapy and help you understand it.
What Is Occupational Therapy?... Technically, it is defined by the
American Occupational Therapy Association executive board (1976)
as: "The therapeutic use of work, self-care, and play activities to increase
development and prevent disability. It may include adaptation of task or
environment to achieve maximum independence and to enhance the quality
of life." Wow, that is a mouthful! Let me try to break it down for you.
First, let's focus on the word "occupation", since it is THE basis for our
professional "title". The dictionary definition of occupation is, "that which
chiefly engages one's time, trade, profession, or business."
One's occupation can therefore be defined as the way in which we
occupy our time. Thus, our time is divided into three categories of
activities in which we take part daily:
Self-Care: sleeping, eating, grooming, dressing, and toileting
Work: effort that is exerted to do or make something, or perform a task
Leisure: free, unoccupied time in which one chooses to do something
they enjoy (i.e., hobby, tv, socializing, sports, "chill out", read, write, listen to
music, travel, etc.) If you read these very carefully, you will see that any task
or use of our time during the day fits into one of these three categories.
This is critical to understand as our basis for the meaning of the term
"occupation". It IS how we spend our time; whether paid or unpaid,
restful or fun, obligation or choice and that which fulfills us, gives
us purpose, and allows us to interact with, be productive, and
function in the world around us to the best of our ability.

Here is where the "therapy" comes in. If, at any point in our lives
(whether present at birth or onset at a later time), illness, injury or disability
prevents us from effectively or independently functioning in one or more
"occupational" areas, then it is the job of Occupational Therapy to provide
intervention which will help you regain function, maintain level of
functioning, or make accommodations for any deficits you may be
experiencing.
It is our job, as an Occupational Therapist to figure out which areas
are suffering and how we can assist that person in performing these
activities in a more functional, successful and independent way.
Some disabilities and areas of dysfunction are blatantly obvious, but
others are not. The obvious is when we help patients regain function after
recent onset of illnesses or injuries or developmental delays such as with
autism, cerebral palsy, down syndrome and the like.
The less obvious are the more silent disabilities such as mental health, early
development concerns/issues, the inability to occupy one's time in any of the
work, rest or play areas, and difficulties associated with sensory processing
disorders.
One of the most frequent questions every Occupational Therapist gets asked
when we announce our profession is, "What is Occupational Therapy?... Oh,
is that like Physical Therapy?" Truthfully, there are aspects of Occupational
Therapy that overlap with Physical Therapy, as our clients often have
multiple issues which are best treated through a team approach.
Although we may do activities for strengthening and increasing movement,
we approach therapy differently than PT.
Generally, Physical Therapists do exercises purely for exercise's sake to
increase strength, range of motion, and particular body and muscle
movements for the eventual outcome of increased function and mobility.
The Goal Of OT
Occupational Therapy has the same goal in mind (increasing function and
independence) in regards to physical disabilities and limitations, and we may
use repetitive exercises, but most often we use them in the context of a
"functional activity". This refers to performing meaningful activities
while simultaneously working on increasing function and mobility.

For example, suppose we have a patient with limitations in upper extremity

strength and range of motion. A Physical Therapist may have a patient doing
an arm exercise bike or repetitively lifting weights over their head (using
heavier weights as the patient tolerates). Don't misunderstand me, this HAS
it's place and definite purpose in rehab!
Occupational Therapy then takes the therapy one step further (not a better
way, just in conjunction with or in addition to). For example, given the same
physical condition, suppose we find out (which is part of our job) that you
enjoy playing basketball. We then may have you increasing your strength,
range of motion and help you regain function by engaging you in practicing
"shootin' hoops". We also would "grade" (gradually increasing demands) the
activity by starting with a light ball and low basket. As you improved the
basket would get higher and the ball heavier (I may even try to block a few
shots!). Thus, these "exercises" will allow you to regain function and allow
you to participate in the game with your maximum potential. This is only one
simple example of so many possibilities!
Physical disabilities are only one aspect of Occupational Therapy and is
usually the ONLY SIGNIFICANT aspect that will overlap with Physical Therapy.
However, in Occupational Therapy we also work on other functional deficits,
as I stated earlier; from mental health, as it interferes with daily
functioning, to developmental delays or disabilities, as they interfere.
For example, we may help someone with a mental illness learn (or re-learn)
to use their leisure time productively, handle their symptoms, get them back
to work, or help them learn life skills such as healthy choices, assertiveness
or relaxation skills, managing their money or their stress (just to name a
few!)
Our functions are many and are often "defined" by the setting we
are in.What we do in an early intervention setting, a school, rehab, clinic, in
someone's home or in a hospital will "define" our role. This is the reason it is
sometimes difficult to answer; "what is occupational therapy?"
Thus, it IS varied (which is part of the reason our job is misunderstood by
others),but it is all based on one guiding principle no matter which
setting; that is, maintaining or increasing skills and/or adapting
environments to meet the unique needs of an individual so they may
become as independent, functional, emotionally and physically pain
free, and developmentally on target as they are capable of.

Therefore, it is clear that Occupational Therapy has a definite role in

helping/treating children with sensory processing disorders.
As you may have seen already, or may see afterwards on the multiple pages
within this site, there are many functional, developmental and "behavioral"
issues that accompany children with this disorder. Once we correctly identify
these deficits, we then have a unique role in their treatment!

Important People in Occupational Therapy

Eleanor Clark Slagle
Eleanor Clark Slagle is known as the "mother of Occupational Therapy." With
a degree in social work, she went to Johns Hopkins University in Baltimore,
MD in 1912 and and began directing the department of occupational therapy.
She opened the first professional school for occupational therapy. She
served as the secretary of AOTA for 15 years, and used habit training to help
mentally ill patients engage in structured occupations.
Dr. William Rush Dunton Jr.
Dr. William Rush Dunton Jr. is know as the "father of OT." He was a
psychiatrist and educator who published the first account of the
Occupational Therapy profession. He attended Harvard and UPenn medical
school. He witnessed the healing potential of Occupational Therapy,
published a manual for nurses on how OT should be utilized in 1915, and
used quilt making in his practices. His articles are cited in Occupational
Therapy textbooks and he traced Occupational Therapy back to philosophical
movement. He started NSPOT.
Dorothy Dix
Dorothy Dix was the first woman to graduate from medical school. She
founded thirty two mental hospitals and was a strong reformer who acted in
changing the horrible conditions found in mental hospitals. These mental
hospitals were reformed into state owned, operated, and regulated facilities
for mentally ill patients.
Phillippe Pinel
Phillipe Pinel was a French physician who was co-responsible for the
development of the theory of moral treatment. He opened the Friends
Asylum in 1796 with William Tuke, which was designed for the humane

treatment of mentally ill people. There were craft shops, places for
recreational activity, and gardens.
William Tuke
William Tuke was an English Quaker who was co-responsible for the
development of the theory of moral treatment. He opened the Friends
Asylum in 1796 with Phillippe Pinel, which was designed for the humane
treatment of mentally ill people. There were craft shops, places for
recreational activity, and gardens.
Susan Tracy
Susan Tracy was a nurse who was involved in the work therapy movement,
which valued Occupational Therapy techniques and taught them to nursing
students regularly. She noticed that occupation helped to relieve nervous
tension and made things more tolerable.
Adolf Meyer
Adolf Meyer was the head of the first Occupational Therapy department,
which was in Baltimore, MD. He thought that mental illness was a problem of
adoption, habitat deterioration, and lack of balance of work and play. He
thought that engagement in occupations were pleasurable, educational, and
creative.
Dr. Herbert Hall
Dr. Herbert Hall was a physician who did research a population
of neurologically impaired people. He studied the theraputic effects of using
arts and crafts with this group of people. He was the president of the
National Society for the Promotion of Occupational Therapy for twenty years.

Susan Johnson
Susan Johnson was a member of the National Society for the Promotion of
Occupational Therapy and was an educational Occupational Therapist. She
lectured at Columbia Teachers College and was a strong advocate for using
crafts in Occupational Therapy to redirect thoughts, strengthen bodies, and
regain self confidence.
Thomas Kinder
Thomas Kinder was a member of the first National Society for the Promotion

of Occupatioinal Therapy and was an architect. He was a past president of

AOTA and allowed soldiers to re-cooperate to work and learn a new trade.

Important Movements in Occupational Therapy

Moral Treatment
In the 1990's, a humanitarian approach to treat individuals with mental
illnesses was created. It focused on productive, creative, and recreational
occupations. This was helpful for mentally ill patients to recover by engaging
in typical activities such as daily routines and tasks. Mental illness was a
problem of adoption, habitat deterioration, and lack of balance.
Work Therapy
Work therapy was created in 1904 by President Roosevelt. As the economy
was getting better, monopolies were forming and mass production was
helping prices go down. This was helping education to be taken more
seriously. There were a lot of immigrants working in factories and laws about
child labor were starting to be created. Segregation was getting worse.
Work therapy gave people the ability to perform a task successfully and it
helped their self esteem. Life can be enhanced by work that produces an
end product.
World War I
During World War I, there were approximately 1200 nurses, artists, teachers,
and craftswomen who cared for injured soldiers. They provided arts and
crafts for the wounded men and that helped in the initial stages of recovery.
It also helped to raise their spirits. There was a high demand for treatment
and training of sick and wounded soldiers. The war helped society become
aware of the benefits of Occupational Therapy.
National Society for the Promotion of Occupational Therapy
The National Society for the Promotion of Occupational Therapy was started
on March 17, 1917 when five people came together in Clifton Springs, NY.
This society was created from the moral treatment of people, scientific
medicine, and arts and crafts. It also included social reform. The first official
definition of OT was: "OT may be defined as an activity, mental or physical,
definitely prescribed for the distinct purpose of contributing to and hastening
recovery from disease or injury." (Dr. H. A. Patterson)
American Occupational Therapy Association
AOTA was founded on March 17, 1917 as the National Society for the

Promotion of Occupational Therapy. It was renamed AOTA in 1923. It is a

nonprofit organization that is dedicated to expanding and refining the
knowledge base of Occupational Therapy. It provides support to research
and education through grants and scholarships.
Great Depression
The Great Depression took place in the United States from 1929 through
1939. The stock market crashed, there was an unstable economy, and an
uneven distribution of wealth. After people lost their jobs, they started to
become anxious and depressed. Thousands of people
were malnourished because there just was not enough food. The Red Cross
called upon Occupational Therapists to help World War I veterans adjust to
civilian life. Veterans who had been independent felt dependent and sought
the help of Occupational Therapists.
World War II
World War II took place from 1939 until 1945. The United States entered the
war in 1941. During the war, women started working more and OT services
continued to grow. Military hospitals needed more Occupational Therapists
than anywhere else in the country. In 1945 there were twenty one OT
programs and 3224 Occupational Therapists. During WWII there was a
higher survival rate, and over five million people needed care. There was
more physical rehab services and less mental health services.
Rehabilitation Movement
During the Rehabilitation Movement, there were many injured veterans,
which created a higher demand for trained personnel to focus on job related
occupations and treat soldiers.
Vocational Rehabilitation Act of 1943
The Vocational Rehabilitation Act of 1943 was created to amend the
vocational education acts of 1930 and 1936. This act allowed OT's to be paid
to provide medical services. WWII and the rehabilitation movement helped
the growth of the profession and helped increase public awareness of the
benefits of Occupational Therapy.
Role of the COTA is established
A COTA is a certified occupational therapy assistant. COTAs were introduced
to help with the high demands for an occupational therapist.

Rehabilitation Act of 1973

The Rehabilitation Act of 1973 was the first legislation
that prohibited discrimination against people with disabilities. People with
mental or physical disabilities have the right to live independently, make
choices, pursue careers, enjoy self determination, and be involved in
American society with equal opportunity, according to the National
Confederation of the Blind. Occupational Therapy is part of the Community
Rehabilitation program. This program is designed to facilitate the
advancement of vocational rehab services to disabled peoples.
Education for all Handicapped Children Act of 1975
The Education for all Handicapped Children Act of 1975 has four parts. All
children with disabilities can receive free public education. This education
will be specialized for each unique need of every child. The rights of the
children and parents will be protected. Children's education is effective
through constant record keeping and analysis. This allows many educated
children to be educated in neighborhood schools in regular classrooms with
non-disabled peers. This act has caused an increase in graduation, college
enrollment, and employment rates among disabled children.
Individual with Disabilities Education Act 1975
The Individual with Disabilities Education Act was enacted in 1975. It was
amended in 1986 to include preschoolers. It was renamed in 1990. When
this act was created, people were becoming more educated about disabilities
and more accepting of people with disabilities. Schools were becoming
more accommodating for students with disabilities. Occupational Therapists
were brought into schools and practiced with people ages zero through
twenty one. Additional services including assistive technology devices were
being provided and increased focus and funds were being provided to
programs for children with emotional disturbances.
Americans with Disabilities Act 1990
The Americans with Disabilities Act was created on July 29, 1990. It created
equal opportunities for employment, local and state services, transportation,
telecommunications and public accommodations for people with disabilities.

WFOT
History

The World Federation of Occupational Therapists (WFOT) began with formal

discussions at a meeting of occupational therapists held in England in June
1951, at which there were 28 representatives from various countries. There
was a continued discussion in September of the same year at the Congress
of the International Society of the Rehabilitation of the Disabled held in
Stockholm, Sweden.
1952
A Preparatory Commission was held in Liverpool, England in 1952, attended
by representatives from seven countries with occupational therapy
associations or organizations and written approval for the organization of
such an association from three other countries. These ten associations from
the USA, United Kingdom (England and Scotland), Canada, South Africa,
Sweden, New Zealand, Australia, Israel, India and Denmark, inaugurated the
WFOT. At this meeting, Ms Helen Willard of the USA served as temporary
chairperson until the officers were elected. The first elected officers were
President, Ms Margaret B Fulton of Scotland; First Vice-President, Ms Gillian
Crawford of Canada; Second Vice-President, Ms Ingrid Pahlsson of Denmark;
Secretary-Treasurer, Ms Clare S Spackman of USA; Assistant SecretaryTreasurer Mrs Glyn Owens of England.
The Constitution was developed at the 1952 meeting and contained the
following initial objectives:

to act as the official international organization for the promotion of

occupational therapy;
to promote international cooperation among occupational therapy
associations, therapists and other allied professional groups;
to advance the practice and standards of occupational therapy;
to help maintain the ethics and to advance the interests of the
profession;
to facilitate the international exchange and placements of therapists
and students;
to facilitate the exchange of information;
to promote the education and training of therapists; and
to hold international congresses.

1959
In 1959 WFOT was admitted into official relations with the World Health
Organisation (WHO).

1963
In 1963 WFOT was recognised as a Non-Governmental Organisation (NGO)
by the United Nations (UN).

History of AOTA Accreditation

The National Society for the Promotion of Occupational Therapy was founded
in 1917 and incorporated under the laws of the District of Columbia.
The object of the Association as set forth in its Constitution shall be to study
and advance curative occupations for invalids and convalescents; to gather
news of progress in occupational therapy and to use such knowledge to the
common good; to encourage original research, to promote cooperation
among occupational therapy societies, and with other agencies of
rehabilitation.
About 3 years after its incorporation, the Association was urged by several
leading physicians and authorities on hospital administration to establish a
national register or directory of occupational therapists for the protection of
hospitals and institutions from unqualified persons posing as occupational
therapists.
After careful consideration and on the advice of other national organizations
in the field of medicine, the Association decided that the first step toward the
establishment of a national register or directory was the establishment of
minimum standards of training for occupational therapists.
In 1921, the name of the Association was changed to the American
Occupational Therapy Association (AOTA). In 1923, accreditation of
educational programs became a stated function of the American
Occupational Therapy Association, and basic educational standards were
developed.
AOTA approached the Council on Medical Education of the American Medical
Association (AMA) in 1933 to request cooperation in the development and
improvement of educational programs for occupational therapists.
The ESSENTIALS OF AN ACCEPTABLE SCHOOL OF OCCUPATIONAL THERAPY
were adopted by the AMA House of Delegates in 1935. This action
represented the first cooperative accreditation activity by the AMA.
In 1958, AOTA assumed responsibility for approval of educational programs
for the occupational therapy assistant. The standards on which accreditation

was based were modeled after the Essentials established for baccalaureate
programs.
In 1964, the AOTA/AMA collaborative relationship in accreditation was
officially recognized by the National Commission on Accrediting (NCA). The
NCA was a private agency serving as a coordinating agency for accrediting
activities in higher education. Although it had no legal authority, it had great
influence on educational accreditation through the listing of accrediting
agencies it recommended to its members. The NCA continued its activities in
merger with the Federation of Regional Accrediting Commissions of Higher
Education since January 1975. The new organization was the Council on
Postsecondary Accreditation (COPA).
In 1990, AOTA petitioned the Committee on Allied Health Education and
Accreditation (CAHEA) to include the accreditation of the occupational
therapy assistant programs in the CAHEA system. After approval of the
change by the AMA Council on Medical Education, CAHEA petitioned both
COPA and the USDE for recognition as the accrediting body for occupational
therapy assistant education.
In 1991, occupational therapy assistant programs with approval status from
the AOTA Accreditation Committee became accredited by CAHEA/AMA in
collaboration with the AOTA Accreditation Committee.
On January 1, 1994, the AOTA Accreditation Committee changed its name to
the AOTA Accreditation Council for Occupational Therapy Education (ACOTE)
and became operational as an accrediting agency independent of
CAHEA/AMA.
During 1994, ACOTE became listed by the USDE as a nationally recognized
accrediting agency for professional programs in the field of occupational
therapy. ACOTE was also granted initial recognition by the Commission on
Recognition of Postsecondary Accreditation (CORPA). CORPA was the
nongovernmental recognition agency for accrediting bodies that was formed
when COPA dissolved in 1994.
On March 1, 1994, 197 previously accredited/approved and developing
occupational therapy and occupational therapy assistant educational
programs were transferred into the ACOTE accreditation system.
In a ballot election concluded October 31, 1994, the AOTA membership
approved the proposed AOTA Bylaws Amendment that reflected the creation
of AOTAs new accrediting body and establishment of ACOTE as a standing

committee of the AOTA Executive Board. At that time, responsibility for

review and revision of the educational standards (Essentials) was transferred
from the AOTA Commission on Education (COE) Educational Standards
Review Committee (ESRC) to ACOTE. The authority for final approval of the
educational standards, which previously required acceptance by both the
AOTA Representative Assembly and CAHEA/AMA, was also transferred to
ACOTE. This action allowed ACOTE to meet the recognition criteria of both
USDE and CORPA.
The Council on Higher Education Accreditation (CHEA) is presently the
nongovernmental agency for accrediting bodies that replaced CORPA. In
February 1997, CHEA voted to accept CORPAs recognition status of ACOTE.
In August 1997, ACOTE voted to open its accreditation process to
occupational therapy programs located outside the United States. In
December 1998, ACOTE accredited its first non-U.S. program: Queen
Margaret University College in Edinburgh, Scotland.
At its April 1998 meeting, ACOTE adopted the following position statement
regarding the draft accreditation standards: Given the demands, complexity,
and diversity of contemporary occupational therapy practice, ACOTEs
position is that the forthcoming educational standards are most likely to be
achieved in post-baccalaureate degree programs.
In December 1998, ACOTE adopted the Standards for an Accredited
Educational Program for the Occupational Therapist and Standards for an
Accredited Educational Program for the Occupational Therapy Assistant.
These Standards, which went into effect on July 1, 2000, replaced the 1991
EssentialsUpdated.
At AOTAs April 1999 Annual Conference & Expo, the Representative
Assembly passed Resolution J, Movement to Required Postbaccalaureate
Level of Education. This resolution called for the eventual installation of a
postbaccalaureate requirement for entry-level occupational therapy
education. After an exhaustive evaluation of the short- and long-term impact
of the decision to move to postbaccalaureate-degree entry, ACOTE voted at
its August 1999 meeting that professional entry-level occupational therapy
programs must be offered at the postbaccalaureate level by January 1, 2007
to receive or maintain ACOTE accreditation status.
In August of 2004, ACOTE voted to transition from accreditation of
occupational therapy educational programs to accreditation of occupational

therapy program degree levels, effective January 1, 2005. Any institution

adding a new degree level or changing the current occupational therapy
degree level was required to apply for and receive formal accreditation
status for that degree level prior to the admission of students into the
program.
In August 2006, ACOTE formally adopted new Accreditation Standards for
Masters-Degree-Level Educational Programs for the Occupational
Therapist and newAccreditation Standards for Educational Programs for the
Occupational Therapy Assistant. In December 2006, ACOTE formally
adopted Accreditation Standards for a Doctoral-Degree-Level Educational
Program for the Occupational Therapist. An effective date of January 1, 2008,
was established for all sets of 2006 ACOTE Standards.
At its April 2008 meeting, AOTAs Representative Assembly (RA) established
that the official position of AOTA is one that supports the associate degree as
the requirement for entry to the field as an occupational therapy assistant.
The RA further recommended that ACOTE implement a 5-year timeline for
the existing 3 certificate-level programs to transition to the associate degree
level. This transition period may be extended for good cause.
In response to the RAs action, ACOTE adopted a policy at its April 2008
meeting that effective July 1, 2013, all occupational therapy assistant
educational programs must be offered at the associate degree level in order
to retain ACOTE accreditation. In addition, ACOTE voted that effective May
10, 2008, ACOTE will only accept applications for new occupational therapy
assistant (OTA) programs that are offered at the associate degree level.