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Top 5 Considerations for Your First Early Intervention OT Job

August 1st, 2017 in  Allied Health
by Bridget McNamara

You’ve just graduated and passed the NBCOT (YAY!), and now it’s time to find your first early intervention OT job!

You want to work in pediatrics, but where to start? Positions in different settings can provide different benefits and challenges. This article outlines some important considerations for the early intervention (EI) setting to keep in mind during your search for the perfect first position!

Early intervention services are for children under three who have developmental delays, established risk, or are determined to be at risk. One of the most exciting parts of working with this population is the potential for progress!

A child at this stage of development is often able to make significant gains in a short amount of time, helping you as the therapist validate your hard work. That, and the ability to treat the entire family in their natural environment, makes this pediatric setting particularly appealing.

So here are some things to think about when considering an early intervention OT job.


The EI setting also has some unique aspects that can be challenging for a new grad, such as the level of independence needed to be successful.

Early intervention services often take place in the home or a daycare (the child’s natural environment). That means that the OT is required to travel to the child’s environment, leaving the potential collaborative support of a clinic setting and venturing out on your own. If you are the type that loves to jump in head first and figure things out, this setting could be a great fit! It is also a way for you to build confidence as a new practitioner, developing your skills independently without looking to others for help.

Keep in mind though, this means there is no co-worker there if things don’t go according to plan. While solving your own problems is one of the best ways to grow as a practitioner, it can be overwhelming. Even for someone who takes pride in being independent, it’s a great idea to have a mentor to support you in your new role.

Having someone to call after a tough session. Someone to ask about a family you are struggling with. Or someone to help you identify your mistakes and ways you can improve is a vital part of being a successful occupational therapist.


Many early intervention positions offer a higher hourly rate, such as $60-$80 in an area that typically pays around $40/hour. While this may look enticing, there are a few things to keep in mind. First of all, many early intervention OT jobs pay per visit as opposed to per hour. You would get $80/hour if you were seeing two kids within that hour back to back, but that does not include travel time between sessions, or time spent documenting those visits. Any time spent outside of billable hours, a.k.a. time spent actually treating clients, is not paid for at the high hourly rate.

Some companies will reimburse mileage, and this is something to make sure you ask about during your job search. Again, this requires you to keep track of your mileage and submit the proper paperwork so you are able to get paid, and can help you manage your finances if you carefully plan your schedule.

Positions often have new therapists start with a smaller caseload and building the number of clients as they go. This means you will need to have a flexible budget. It is an investment in yourself, and there are many children who are in need of services, but it does require a leap of faith and an ability to live on a smaller paycheck at the beginning.

Organization and flexibility

This is where organization and flexibility are key. Organizing your schedule early and communicating that to your parents (parents of your clients, not your ACTUAL parents) allows for you to have first dibs on those highly sought after spots (before lunch, not during nap time, etc.). This proactive step is the best way for you to organize your schedule and increase your billable hours so you aren’t stuck driving all over the place, getting paid next to nothing!

Children often get sick, go on vacation, or have various other life events that come up and cause disruption in your carefully planned schedule. This is also where it pays to be close with your families, relying on communication from the parents and families to save you an unpaid trip.

One of the greatest things about being in charge of your own schedule is the flexibility it can afford. Especially if you have two incomes, have young kids, or are able to work on a part time basis, this flexibility allows for work life balance. It also allows you to control the number of children on your caseload, giving you the option to see more kids and make more money! There are tips of the trade to make scheduling your day less hectic and more productive in the event of cancellations.

Stay tuned for that article coming in the near future!

Access to resources

Another important factor to consider when seeking your first early intervention OT job is the investment required from you. Sometimes, you are in charge of buying your own therapeutic tools and toys. This is doable through garage sales, secondhand children’s stores, and the hand-me-downs from friends and family members whose children have outgrown their toys.

You can also utilize some toys that families already have to supplement your own. Teaching the family how to utilize the resources they already have to promote development. While it does require an initial investment on your part, you should be able to make your money back quickly! This is also something to bring up during the interview process, especially if you don’t feel ready or able to purchase your own supplies.

Parent/family relationships

With this population, the legislation specifically states that the family is your client too. One of the best parts about early intervention services is the chance to work so closely with the family.  Communication with family is a vital part of pediatric practice in any setting and can be challenging. Building trust with the family leads to increased likelihood for carry over of treatment, increased chance for progress, and increased job satisfaction!

And while you are not in it for the recognition, building a positive relationship can lead to better compliance with home treatment plans. A better understanding of the family’s situation can lead to services better suited for that family. It can also lead to a special bond between therapist and family.

Families often work with the same therapist for years, and the family really comes to appreciate the work that you do as the OT. This meaningful connection with family can be much more difficult in other settings where parent interaction is not as readily available.

At the same time, working so closely with parents can also be incredibly challenging. Because services are state funded, the OT services are free of charge for the families. As with many free services, there can be those who take these services for granted. There are also those who will not think you are as amazing as we know you are, and will not appreciate what you are trying to accomplish. You also may run into parents who would prefer a more experienced therapist and will they will make it clear.

There are ways to work with challenging parents, but in the end, working with parents is an awesome part of this setting, and pediatrics in general.

There are many things to consider when choosing your first early intervention OT job. If you consider yourself independent, organized, and flexible, early intervention OT job could be the perfect fit! It is very important to explore your options and find the position that is right for you.