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 AOTA’s 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 CORPA’s 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, ACOTE’s 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 Essentials–Updated.

At AOTA’s 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 Master’s-Degree-Level Educational Programs for the Occupational Therapist and new Accreditation 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, AOTA’s 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 RA’s 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.

At its August 2015 meeting, ACOTE voted on the entry-level degree for the occupational therapist and the occupational therapy assistant as follows:

  • Occupational Therapist: ACOTE determined that the entry-level-degree requirement for the occupational therapist will remain at both the master’s and the doctoral degree. The Council’s decision was based on a comprehensive review of available literature, specific reports, and extensive commentary from stakeholders. The overarching justifications for the Council’s decision were: (1) limited outcomes differentiate master’s and doctorally prepared graduates; (2) the academic infrastructure of many institutions is not sufficient to meet the occupational therapy doctorate standards, especially with respect to faculty resources and institutional support; (3) the readiness and capability of institutions to deliver quality fieldwork and experiential components of the program is constrained; and (4) retaining two entry levels allows for flexibility of the profession to assess and address the changing health care needs of individuals and populations.
  • Occupational Therapy Assistant: ACOTE determined that the entry-level-degree for the occupational therapy assistant will be offered at both the associate and bachelor’s degree. The Council’s decision was based on a number of findings, which were informed in significant part by information and commentary from stakeholders, including: (1) the ability to better prepare individuals for further academic advancement and leadership positions; (2) the expansion of opportunities within the current scope of practice; and (3) two entry levels permits additional flexibility to assess and address the changing health care needs of individuals and populations. The option for programs to seek accreditation for the entry-level-degree for the OTA at the baccalaureate level will become active after baccalaureate entry-level Standards are written and adopted by ACOTE.