Occupational Therapist Scope of Practice

OTs provide care that increases independence in daily living. 

Occupational therapy (OT) enables individuals to perform daily activities when a health condition, injury, or disability limits their participation (American Occupational Therapy Association (AOTA) 2021). Occupational therapists (OTs) evaluate a person’s daily activities and environment, then design interventions to support independence in those activities (Bureau of Labor Statistics (BLS) 2025, AOTA 2021, Boop et al. 2020, Figure 1). They work with people across age groups including individuals recovering from injuries and those with long-term developmental or neurological conditions (AOTA 2021, Boop et al. 2020). OTs coordinate care with physicians and other clinicians.  

To practice, OTs must complete master’s or doctoral-level training and pass a national certification exam (AOTA 2021, National Board for Certification in Occupational Therapy (NBCOT) n.d.). OTs complete ongoing professional development to maintain their credentials. Some pursue optional specialty credentials in pediatrics, geriatrics, physical rehabilitation environmental accessibility, or assistive technology (Rehabilitation Engineering and Assistive Technology Society of North America 2025).  

OTs build skills, adapt environments, and use assistive technologies to address patient barriers. 

OTs identify barriers in motor, cognitive, sensory, and social areas of daily living (Cleveland Clinic 2024, Boop et al. 2020). They then determine what environmental or task changes are needed for a person to independently perform everyday activities (Cleveland Clinic 2024, AOTA 2021). They align treatments to reduce barriers to a patient’s goals for independence in dressing, grooming, meal preparation, driving, and job tasks (AOTA 2021, Cleveland Clinic 2024, Boop et al. 2020, Figure 1). Interventions include skill building, task simplification, assistive technology training, and home, school, or workplace modifications.  

Unlike physical therapists (PTs), OTs do not diagnose movement disorders or prescribe programs to build or restore gross motor skills like standing or walking (Seivert 2024, VA News 2017). Physical therapists (PTs) assess and treat movement disfunction to restore mobility, strength, balance, and pain through exercises (Seivert 2024, VA News 2017). In stroke recovery, PTs improve walking and balance, while OTs restore dressing, bathing, cooking, driving, and return-to-work routines (Cleveland Clinic 2024, Seivert 2024). For a child with cerebral palsy, PTs address posture, gait, and strength while OTs adapt tasks and environments to support self-care and school routines (Barfield n.d., Chicago Kid’s Therapy n.d.). 

Figure 1. Occupational Therapy Interventions for Children and Adults. Occupational therapists (OTs) use standard evaluations to identify a patient's functional status and implement interventions tailored to that patient. For children, the focus is on developmental growth and school participation. For adults, the emphasis is on restoring independence and safety after an injury or illness. Both populations benefit from specialized equipment and environmental modifications designed to facilitate daily self-sufficiency. 

MO statutes define OT practice and ensure they meet professional standards. 

In MO, OTs pursue activities or interventions that promote a patient’s health, prevent injury, and provide for the highest level of independence possible (RSMo 324.050).  OTs are permitted to provide services including assessment and interventions to develop or restore daily living skills. The Missouri Board of Occupational Therapy (MBOT) regulates the profession by enforcing state-specific standards for licensure, ethics, and professional conduct (RSMo 324.065, Board of Occupational Therapy n.d.). While NBCOT sets national standards, MBOT verifies that OTs meet MO’s requirements, which include completing 24 continuing competency credits every two years (Board of Occupational Therapy n.d., NBCOT n.d.). MBOT investigates complaints and takes disciplinary action to ensure public safety (Board of Occupational Therapy n.d.). MO participates in the Occupational Therapy Licensure Compact, which grants permission for MO OTs to practice in the 31 compact-participating states (RSMo 324.087).  

References 

American Occupational Therapy Association (AOTA) (2021) Occupational Therapy Scope of Practice. American Journal of Occupational Therapy, 75(Suppl. 3): 7513410030. https://doi.org/10.5014/ajot.2021.75S3005 

Barfield M (n.d.) Pediatric PT vs Pediatric OT: What’s the Difference, and Does My Child Need Both? https://www.abilotkidstherapy.com/blog/xu682tjgqqm4yv0fr3wxpht5jv4grd  

Board of Occupational Therapy (n.d.) Rules and Statutes. Missouri Department of Commerce and Insurance. https://pr.mo.gov/octherapy-rules-statutes.asp  

Boop C, Cahill SM, Davis C, Dorsey J, Gibb V, et al. (2020) Occupational Therapy Practice Framework: Domain and Process, Fourth Edition. American Journal of Occupational Therapy, 74(Suppl. 2): 741210010. https://dx.doi.org/10.5014/ajot.2020.74S2001  

Bureau of Labor Statistics (BLS) (2025) What Occupational Therapists Do. U.S. Federal Statistics System. https://www.bls.gov/ooh/healthcare/occupational-therapists.htm#tab-2 

Chicago Kids Therapy (n.d.) Similarities and Differences Between Pediatric Physical Therapy and Occupational Therapy. https://chicagokidstherapy.com/resources/articles/similarities-and-differences-between-pediatric-physical-therapy-and-occupational-therapy/ 

Cleveland Clinic (2024) Occupational Therapist. https://my.clevelandclinic.org/health/articles/24617-occupational-therapist  

Dickerson A, Davis ES (2020) Checklist of Community Mobility Skills: Connecting Clients to Transportation Options.  OT Practice Issues. https://www.aota.org/publications/ot-practice/ot-practice-issues/2020/transportation-checklist  

National Board for Certification in Occupational Therapy (NBCOT) (n.d.) Certification. https://www.nbcot.org/certification  

Rehabilitation Engineering and Assistive Technology Society of North America (RESNA) (2025). Assistive Technology Professional Candidate Handbook. https://www.resna.org/Portals/0/Candidate%20Handbook/ATP%20Handbook%20-%20August%202025_Final.pdf?ver=43NlDQ9CivqOA1P0x536Fw%3d%3d  

Revisor of Missouri § 324.050 (2008). https://revisor.mo.gov/main/OneSection.aspx?section=324.050&bid=17267&hl=  

Revisor of Missouri § 324.065 (2009). https://revisor.mo.gov/main/OneSection.aspx?section=324.065&bid=17271&hl=  

Revisor of Missouri 324.087 (2021). https://revisor.mo.gov/main/OneSection.aspx?section=324.087&bid=49648&hl=  

Sievert D (2024) What’s the Difference Between Occupational Therapy and Physical Therapy? UCLA Health. https://medschool.ucla.edu/news-article/occupational-therapy-vs-physical-therapy  

VA News (2017) Similarities and Differences Between Physical Therapists and Occupational Therapists. https://news.va.gov/37168/similarities-and-differences-between-physical-therapists-occupational-therapists/