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North Dakota Occupational Therapy — Requirements & Free Practice

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Occupational Therapist License (OT/L)

License to practice occupational therapy in North Dakota under N.D.C.C. chapter 43-40.

Licensing authority: North Dakota State Board of Occupational Therapy Practice · Application information

Initial licensure by examination
Applicant Status
Has passed the NBCOT OTR examination and has never been licensed in another state (Board application, Initial Licensure).
Character
No grounds for denial under N.D.C.C. 43-40-16 (N.D. Admin. Code 55.5-02-01-01.1(1)(c)); notarized application with two references.
Education
Degree from an occupational therapy program accredited by ACOTE, or a foreign occupational therapy program NBCOT deems comparable (N.D. Admin. Code 55.5-02-01-01.1(1)(a)); supervised fieldwork required by the accredited program (N.D.C.C. 43-40-08(4)).
Exam Time Limit
The NBCOT passing score must come from an examination taken within eighteen months of the application (N.D. Admin. Code 55.5-02-01-01(1)(b)); the Board's form states that an applicant who took the exam more than 18 months ago and is not licensed in another state must retake it.
Jurisprudence Timing
The application must be submitted before the online jurisprudence exam can be taken; the license is not issued until the jurisprudence exam is completed (Board Requirements for Licensure page).
Passing Standard
Passing score established by NBCOT in effect at the time of administration (N.D. Admin. Code 55.5-02-01-05).
Reinstatement of an expired license within three years (late renewal)
Jurisprudence Exam for License Renewal (assessment without a question bank)
After Three Years
More than three years after expiration the initial application process is required (initial licensure or reciprocity routes).
Expired License
License expired after June thirtieth of the renewal year not more than three years earlier (N.D.C.C. 43-40-15(1); N.D. Admin. Code 55.5-02-01-02).
Items
Renewal application, renewal license fee, continued competency documentation and late charges (N.D. Admin. Code 55.5-02-01-02(1)(c)).
Jurisprudence
The Board's Reinstatement of License page requires completion of the Jurisprudence Exam for License Renewal and states it does not require a passing score.
Military spouse initial licensure
Competency And Experience
Demonstrates competency through methods or standards determined by the board, including experience as an occupational therapist or assistant for at least two of the four years preceding application (N.D. Admin. Code 55.5-02-01-01.2(1)(b)).
Examination Sources
N.D. Admin. Code 55.5-02-01-01.2 lists the military spouse requirements without naming an examination, while 55.5-02-01-01.1 requires every applicant to have passed the NBCOT OTR examination and completed the jurisprudence examination, and 55.5-02-01-01(6) lets the board require the jurisprudence examination; the Board's application asks a military spouse without licensure in another state for current NBCOT certification.
Fees
Military spouses are not assessed license fees (N.D. Admin. Code 55.5-02-01-01.2(2)).
Military Spouse Status
Meets the definition of military spouse in N.D.C.C. 43-51-01 (N.D. Admin. Code 55.5-02-01-01.2(1)).
Provisional License
If the applicant substantially meets the requirements the board may issue a provisional license valid up to two years; it is granted automatically if the board does not act within thirty days (N.D. Admin. Code 55.5-02-01-01.2(2)).
Licensure by reciprocity (currently licensed in another state)
Character
No grounds for denial under N.D.C.C. 43-40-16 (N.D. Admin. Code 55.5-02-01-01.1(1)(c)); notarized application with two references.
Education
Degree from an occupational therapy program accredited by ACOTE, or a foreign occupational therapy program NBCOT deems comparable (N.D. Admin. Code 55.5-02-01-01.1(1)(a)); supervised fieldwork required by the accredited program (N.D.C.C. 43-40-08(4)).
Exam Time Limit
The Board's form applies the 18-month limit on the NBCOT score only to applicants who are not licensed in another state ("If you took the exam more than 18 months ago and are NOT licensed in another state, you will need to retake the exam.").
Other State Law And Rules
A copy of the law and rules of at least one state of current licensure that establishes the requirements for obtaining and maintaining a license there (Board application form).
Other State License
Currently licensed in another state or jurisdiction; verification of licensure must be sent from every state in which the applicant holds or has held licensure (Board Requirements for Licensure page).
Statutory Waiver
N.D.C.C. 43-40-12: "The board may waive the examination, education, or experience requirements and grant a license to any applicant who presents proof of current licensure or registration as an occupational therapist or occupational therapy assistant in another state which requires standards for licensure or registration considered by the board to be equivalent". The Board's rule 55.5-02-01-01.1 nevertheless requires every applicant to have passed the NBCOT OTR examination.
Biennial license renewal
Jurisprudence Exam for License Renewal (assessment without a question bank)
Continued Competency
Twenty contact hours within the twenty-four months before the renewal application (N.D. Admin. Code 55.5-02-01-04).
Current License
Holds a current North Dakota license; licenses are renewable biennially in even-numbered years (N.D. Admin. Code 55.5-02-01-02).
Deadline
Renewal application, continued competency documentation and fees postmarked or delivered by June first of the renewal year to avoid the late charge.
Jurisprudence Discretion
The rule states the board may require a completed jurisprudence examination at renewal; the Board's 2026/2028 renewal application lists a completed Jurisprudence Exam among the required items.

Occupational Therapist Limited Permit

Limited permit to practice occupational therapy under supervision of a North Dakota licensed occupational therapist until examination results are available to the Board and it decides whether to issue a license; the permit is not a license.

Licensing authority: North Dakota State Board of Occupational Therapy Practice · Application information

Limited permit for a recent graduate awaiting the NBCOT examination
Education
Has completed the education and experience requirements (N.D.C.C. 43-40-13(1)); the Board issues limited permits only to those who graduated within the past four months.
Exam Timing
The NBCOT OTR examination is taken after the permit is issued: the holder must take the next available examination, meaning within four months of completing the education and experience requirements (N.D.C.C. 43-40-13(2); N.D. Admin. Code 55.5-02-01-06); the permit is valid until results are available and the board decides on the license.
Jurisprudence Timing
The limited permit is not issued until the jurisprudence exam is completed (Board Requirements for Licensure page).
Supervision
Practice only under supervision of a North Dakota licensed occupational therapist, directly supervised at least twenty percent of weekly hours (N.D. Admin. Code 55.5-02-03-01.3).
One time renewal (extension) of a limited permit
OTR exam
Eligibility
The holder failed the NBCOT OTR examination or, with good cause as determined by the board, failed to take the next examination (N.D.C.C. 43-40-13(3)).
Request
Written or email request to the Board office reviewed by the Board chair; the permit can be extended only once for another four months (Board Requirements for Licensure page).

Occupational Therapy Assistant License (OTA/L)

License for an occupational therapy assistant, authorizing use of that title and the abbreviation OTA/L.

Licensing authority: North Dakota State Board of Occupational Therapy Practice · Application information

Initial licensure by examination
Applicant Status
Has passed the NBCOT COTA examination and has never been licensed in another state (Board application, Initial Licensure).
Character
No grounds for denial under N.D.C.C. 43-40-16 (N.D. Admin. Code 55.5-02-01-01.1(2)(c)); notarized application with two references.
Education
Degree from an occupational therapy program accredited by ACOTE, or a foreign occupational therapy program NBCOT deems comparable (N.D. Admin. Code 55.5-02-01-01.1(2)(a)); supervised fieldwork required by the accredited program (N.D.C.C. 43-40-08(4)).
Exam Time Limit
The NBCOT passing score must come from an examination taken within eighteen months of the application (N.D. Admin. Code 55.5-02-01-01(1)(b)); the Board's form states that an applicant who took the exam more than 18 months ago and is not licensed in another state must retake it.
Jurisprudence Timing
The application must be submitted before the online jurisprudence exam can be taken; the license is not issued until the jurisprudence exam is completed (Board Requirements for Licensure page).
Passing Standard
Passing score established by NBCOT in effect at the time of administration (N.D. Admin. Code 55.5-02-01-05).
Reinstatement of an expired license within three years (late renewal)
Jurisprudence Exam for License Renewal (assessment without a question bank)
After Three Years
More than three years after expiration the initial application process is required (initial licensure or reciprocity routes).
Expired License
License expired after June thirtieth of the renewal year not more than three years earlier (N.D.C.C. 43-40-15(1); N.D. Admin. Code 55.5-02-01-02).
Items
Renewal application, renewal license fee, continued competency documentation and late charges (N.D. Admin. Code 55.5-02-01-02(2)(c)).
Jurisprudence
The Board's Reinstatement of License page requires completion of the Jurisprudence Exam for License Renewal and states it does not require a passing score.
Military spouse initial licensure
Competency And Experience
Demonstrates competency through methods or standards determined by the board, including experience as an occupational therapist or assistant for at least two of the four years preceding application (N.D. Admin. Code 55.5-02-01-01.2(1)(b)).
Examination Sources
N.D. Admin. Code 55.5-02-01-01.2 lists the military spouse requirements without naming an examination, while 55.5-02-01-01.1 requires every applicant to have passed the NBCOT COTA examination and completed the jurisprudence examination, and 55.5-02-01-01(6) lets the board require the jurisprudence examination; the Board's application asks a military spouse without licensure in another state for current NBCOT certification.
Fees
Military spouses are not assessed license fees (N.D. Admin. Code 55.5-02-01-01.2(2)).
Military Spouse Status
Meets the definition of military spouse in N.D.C.C. 43-51-01 (N.D. Admin. Code 55.5-02-01-01.2(1)).
Provisional License
If the applicant substantially meets the requirements the board may issue a provisional license valid up to two years; it is granted automatically if the board does not act within thirty days (N.D. Admin. Code 55.5-02-01-01.2(2)).
Licensure by reciprocity (currently licensed in another state)
Character
No grounds for denial under N.D.C.C. 43-40-16 (N.D. Admin. Code 55.5-02-01-01.1(2)(c)); notarized application with two references.
Education
Degree from an occupational therapy program accredited by ACOTE, or a foreign occupational therapy program NBCOT deems comparable (N.D. Admin. Code 55.5-02-01-01.1(2)(a)); supervised fieldwork required by the accredited program (N.D.C.C. 43-40-08(4)).
Exam Time Limit
The Board's form applies the 18-month limit on the NBCOT score only to applicants who are not licensed in another state ("If you took the exam more than 18 months ago and are NOT licensed in another state, you will need to retake the exam.").
Other State Law And Rules
A copy of the law and rules of at least one state of current licensure that establishes the requirements for obtaining and maintaining a license there (Board application form).
Other State License
Currently licensed in another state or jurisdiction; verification of licensure must be sent from every state in which the applicant holds or has held licensure (Board Requirements for Licensure page).
Statutory Waiver
N.D.C.C. 43-40-12: "The board may waive the examination, education, or experience requirements and grant a license to any applicant who presents proof of current licensure or registration as an occupational therapist or occupational therapy assistant in another state which requires standards for licensure or registration considered by the board to be equivalent". The Board's rule 55.5-02-01-01.1 nevertheless requires every applicant to have passed the NBCOT COTA examination.
Biennial license renewal
Jurisprudence Exam for License Renewal (assessment without a question bank)
Continued Competency
Twenty contact hours within the twenty-four months before the renewal application (N.D. Admin. Code 55.5-02-01-04).
Current License
Holds a current North Dakota license; licenses are renewable biennially in even-numbered years (N.D. Admin. Code 55.5-02-01-02).
Deadline
Renewal application, continued competency documentation and fees postmarked or delivered by June first of the renewal year to avoid the late charge.
Jurisprudence Discretion
The rule states the board may require a completed jurisprudence examination at renewal; the Board's 2026/2028 renewal application lists a completed Jurisprudence Exam among the required items.
Supervision
An OTA supervised during the renewal period submits substantiation of supervision (N.D. Admin. Code 55.5-02-01-02(2)(a)(1)).

Occupational Therapy Assistant Limited Permit

Limited permit for a recent occupational therapy assistant graduate to practice under supervision of a North Dakota licensed occupational therapist until examination results are available to the Board and it decides whether to issue a license; the jurisprudence exam must be completed before issuance, and the permit is not a license.

Licensing authority: North Dakota State Board of Occupational Therapy Practice · Application information

Limited permit for a recent graduate awaiting the NBCOT examination
Education
Has completed the education and experience requirements (N.D.C.C. 43-40-13(1)); the Board issues limited permits only to those who graduated within the past four months.
Exam Timing
The NBCOT COTA examination is taken after the permit is issued: the holder must take the next available examination, meaning within four months of completing the education and experience requirements (N.D.C.C. 43-40-13(2); N.D. Admin. Code 55.5-02-01-06); the permit is valid until results are available and the board decides on the license.
Jurisprudence Timing
The limited permit is not issued until the jurisprudence exam is completed (Board Requirements for Licensure page).
Supervision
Practice only under supervision of a North Dakota licensed occupational therapist, directly supervised at least twenty percent of weekly hours (N.D. Admin. Code 55.5-02-03-01.3).
One time renewal (extension) of a limited permit
COTA Certification Exam
Eligibility
The holder failed the NBCOT COTA examination or, with good cause as determined by the board, failed to take the next examination (N.D.C.C. 43-40-13(3)).
Request
Written or email request to the Board office reviewed by the Board chair; the permit can be extended only once for another four months (Board Requirements for Licensure page).

OTR exam

Format
Three- and four-option single-response multiple-choice items and six-option multi-select scenario sets
Exam questions
180 items
Examination outline
  • Domain 1 — Evaluation and Assessment: Acquire information regarding factors that influence occupational performance on an ongoing basis throughout the occupational therapy process. (23%)
    • Task 1: Identify the influence of development and lived experience; body functions and body structures; values, beliefs, and spirituality; and identity on occupational performance.
    • Task 1 knowledge 1: Impact of typical development and aging on occupational performance, health, and wellness across the life span.
    • Task 1 knowledge 2: Expected patterns, progressions, and prognoses associated with conditions that limit occupational performance. Examples include signs and symptoms of disease; stages of disease; secondary complications.
    • Task 1 knowledge 3: Impact of body functions and body structures on occupational performance. Examples include cognitive impairments; congenital anomalies.
    • Task 1 knowledge 4: Influence of lived experiences and identity on occupational performance. Examples include history of trauma and adverse childhood events; socioeconomic status; gender, race, culture, religion.
    • Task 2: Assess a client’s functional skills, roles, prioritized needs and wants, and performance context to evaluate their occupational performance.
    • Task 2 knowledge 1: Resources and considerations for acquiring information about the client’s current condition and occupational performance. Examples include referrals; client records; developmental history; Individualized Education Program (IEP) plans; theoretical approach and frame of reference.
    • Task 2 knowledge 2: Administration, purpose, indications, advantages, and limitations of standardized and nonstandardized screening and assessment tools. Examples include criterion-referenced tests; norm-referenced tests; client and caregiver interviews; observation.
    • Task 2 knowledge 3: Internal and external factors influencing a client’s engagement in occupation. Examples include roles, habits, routines, and rituals; environmental context; family and social supports; medication side effects and interactions; mental health.
    • Task 3: Perform an activity analysis to determine the influence of task demands, current conditions, performance skills, and context on occupation.
    • Task 3 knowledge 1: Task requirements, steps to task completion, and task demands across contexts or settings.
    • Task 3 knowledge 2: Personal and environmental factors that facilitate or inhibit task completion or occupational engagement. Examples include compensation patterns; role of performance context; influence of current conditions.
  • Domain 2 — Analysis, Interpretation, and Planning: Formulate conclusions regarding client needs and priorities to develop and monitor an intervention plan throughout the occupational therapy process. (23%)
    • Task 1: Synthesize assessment results to determine eligibility for services and establish a client-centered intervention plan.
    • Task 1 knowledge 1: Interpretation and analysis of quantitative assessments. Examples include statistical terminology; scoring; limitations of scores; client reactions to testing.
    • Task 1 knowledge 2: Interpretation of qualitative findings. Examples include occupational profile; outcomes of needs assessment; results from interviews or observations.
    • Task 1 knowledge 3: Integration and application of quantitative assessment results and qualitative findings to guide critical decision-making and prioritize needs.
    • Task 2: Collaborate with the client, the client’s relevant others, occupational therapy colleagues, and other professionals using a client-centered approach and therapeutic use of self to manage occupational therapy services.
    • Task 2 knowledge 1: Roles and responsibilities among interprofessional teams when coordinating client care and providing services. Examples include referral to and consultation with other services; interprofessional communication methods; scope of practice.
    • Task 2 knowledge 2: Processes for managing interprofessional intervention plans. Examples include Individualized Education Program (IEP) plans; discharge plans; transition plans; palliative and hospice care plans.
    • Task 2 knowledge 3: Client-centered approaches and considerations for coordinating occupational therapy services. Examples include therapeutic use of self; advocacy; frequency/duration of intervention; level of service delivery.
    • Task 2 knowledge 4: Factors used to prioritize intervention goals and activities in collaboration with the client and family, teacher, caregiver, and relevant others. Examples include client-reported outcomes; level of support required; context of service delivery; progress toward goals.
    • Task 2 knowledge 5: Strategies for addressing and enhancing health literacy with the client and relevant others. Examples include caregiver training; teaching-learning models; methods for making health information accessible; informed decision-making; navigating challenges to professional expertise.
    • Task 3: Monitor and modify the intervention plan, approach, context, and goals on an ongoing basis using clinical reasoning.
    • Task 3 knowledge 1: Factors for determining and managing context and activities to meet individual and group intervention goals and objectives. Examples include client needs and priorities; response to intervention.
    • Task 3 knowledge 2: Strategies for monitoring the effectiveness of individual and group interventions. Examples include client-reported outcomes; reevaluation results; progress toward goals.
    • Task 3 knowledge 3: Clinical decision-making for assessing and adapting the intervention plan and prioritizing goals based on client response to intervention. Examples include physiological changes; behavioral reactions; emotion regulation; developmental needs.
    • Task 3 knowledge 4: Precautions or contraindications associated with a client’s condition or stage of recovery. Examples include postsurgical precautions; vital signs; laboratory values; suicidal ideation.
  • Domain 3 — Select and Manage Interventions: Select and implement interventions for managing a client-centered plan throughout the occupational therapy process. (38%)
    • Task 1: Incorporate preparatory techniques, activities, and modalities as an adjunct to interventions to promote healing and enhance engagement in occupation-based activities.
    • Task 1 knowledge 1: Considerations for selecting, preparing, and adapting the intervention technique to support optimal engagement and promote goal achievement. Examples include client condition; client safety.
    • Task 1 knowledge 2: Considerations for selecting, preparing, and adapting the intervention environment to support optimal engagement and promote goal achievement. Examples include ensuring privacy during telehealth sessions; equipment safety; line management.
    • Task 1 knowledge 3: Indications, contraindications, and precautions associated with wound management and maintaining skin integrity. Examples include stage of wound healing; prevention and management of pressure ulcers.
    • Task 1 knowledge 4: Indications, contraindications, precautions, and clinical application of superficial thermal agents. Examples include dry whirlpool; hot packs; cryotherapy.
    • Task 1 knowledge 5: Indications, contraindications, precautions, and clinical application of deep thermal, mechanical, and electrotherapeutic physical agent modalities. Examples include transcutaneous and neuromuscular electrical stimulation; biofeedback.
    • Task 2: Implement occupation-based strategies to support participation in activities of daily living (ADL), instrumental activities of daily living (IADL), health management, rest and sleep, education, work, play, leisure, and social participation across the life span.
    • Task 2 knowledge 1: Interventions for supporting leisure and play.
    • Task 2 knowledge 2: Methods for grading an activity, task, or technique based on level of development, client status, response to intervention, and client needs.
    • Task 2 knowledge 3: Considerations for facilitating individual and group participation in shared activities. Examples include group processes; group dynamics; group type and function.
    • Task 2 knowledge 4: Interventions to support cognitive, visual-motor, visual, and perceptual processing and sensory arousal. Examples include sensory modulation; proprioceptive input; vestibular strategies; low vision strategies.
    • Task 2 knowledge 5: Compensatory and remedial strategies for managing cognitive and perceptual deficits or developmental disabilities. Examples include graded cueing; chaining; metacognition; memory aids.
    • Task 2 knowledge 6: Adaptive and preventive strategies for supporting optimal engagement in occupation. Examples include use of technology/apps; joint protection; task simplification; energy conservation.
    • Task 2 knowledge 7: Intervention strategies and techniques used to facilitate oral motor skills for drinking, eating, and swallowing. Examples include hand-to-mouth patterns; mastication; adaptive utensils; positioning at mealtime.
    • Task 2 knowledge 8: Prevocational, vocational, and transitional services, options, and resources for supporting strengths, interests, employment, and lifestyle goals across the life span.
    • Task 2 knowledge 9: Strategies, techniques, and client-centered education to facilitate functional transfers.
    • Task 2 knowledge 10: Strategies for promoting wellness and mental health. Examples include relaxation; sleep hygiene; addiction management.
    • Task 3: Select and implement interventions for improving sensory, motor, neurological, and physiological status, considering client condition and current stage of recovery, to support occupational performance.
    • Task 3 knowledge 1: Methods for grading therapeutic exercise and conditioning programs consistent with indications and precautions.
    • Task 3 knowledge 2: Techniques for sensory and motor reeducation, pain management, desensitization, edema reduction, and scar management. Examples include manual edema mobilization; nerve gliding; neuromuscular reeducation; constraint-induced movement.
    • Task 3 knowledge 3: Techniques for promoting improved postural stability, dynamic balance, body mechanics, and breathing patterns during functional tasks.
    • Task 4: Select, fabricate, and modify orthotic devices, and provide training in the use of orthotic and prosthetic devices to support functional outcomes.
    • Task 4 knowledge 1: Types and functions of immobilization, mobilization, and restriction orthoses for managing specific conditions and congenital anomalies across the life span.
    • Task 4 knowledge 2: Types and functions of prosthetic devices for upper and lower extremity amputations.
    • Task 4 knowledge 3: Implications of anatomical, physiological, biomechanical, cognitive, and socioeconomic factors and healing principles for orthotic selection, design, fabrication, and modification.
    • Task 4 knowledge 4: Client-centered education and training methods for the safe and effective use of orthotic and prosthetic devices.
    • Task 5: Select assistive technology options, adaptive devices, mobility aids, and other durable medical equipment to enable participation in occupation.
    • Task 5 knowledge 1: Factors related to measuring, selecting, monitoring the fit of, and recommending modifications to seating systems, positioning devices, and mobility aids. Examples include equipment components; biomechanical considerations; usability and maintenance.
    • Task 5 knowledge 2: Types, characteristics, and features of high- and low-tech assistive technology and adaptive devices. Examples include interface options and processor parameters; equipment components.
    • Task 5 knowledge 3: Mobility options, vehicle adaptations, and alternative devices for supporting participation in community mobility. Examples include adapted driving controls; wheelchair tie downs; alternative transportation options; dynamic mobile standers; navigation apps.
    • Task 5 knowledge 4: Client factors influencing successful use and maintenance of assistive technology options, adaptive devices, mobility aids, and other durable medical equipment. Examples include developmental, physical, functional, cognitive, and mental health status; prioritized needs.
    • Task 5 knowledge 5: Client-centered education and training methods for successful use and maintenance of assistive technology options, adaptive devices, mobility aids, and other durable medical equipment.
    • Task 6: Recommend environmental modifications, while considering accessibility guidelines, standards, and legislation, to support participation in occupation consistent with client needs and status, task demands, and context.
    • Task 6 knowledge 1: Principles of ergonomics and universal design for identifying, recommending, and implementing features and reasonable accommodations in the workplace, home, and virtual and public spaces.
    • Task 6 knowledge 2: Processes and procedures for identifying, recommending, and implementing modifications in the workplace, home, and virtual and public spaces.
  • Domain 4 — Competency and Practice Management: Manage professional activities of self and relevant others as guided by evidence, regulatory compliance, and standards of practice to promote quality care. (16%)
    • Task 1: Employ evidence-based strategies and approaches to provide safe, effective, and efficient services relevant to individuals, groups, and populations.
    • Task 1 knowledge 1: Methods for locating, reviewing, interpreting, and critically appraising scholarly research to guide practice-relevant decision-making. Examples include defining a clinical question; determining the clinical bottom line.
    • Task 1 knowledge 2: Methods for applying continuous quality improvement processes and procedures to occupational therapy service delivery. Examples include program evaluation; outcome measures.
    • Task 1 knowledge 3: Evidence-based programming for advancing population health outcomes. Examples include aging in place; fall prevention; health and wellness; community support groups.
    • Task 2: Incorporate risk management techniques at the individual and practice-setting levels to protect clients, self, staff, and others from injury or harm.
    • Task 2 knowledge 1: Infection control procedures and universal precautions for reducing transmission of contaminants. Examples include PPE; isolation precautions; cleaning equipment.
    • Task 2 knowledge 2: Responses to adverse reactions, minor injuries, and emergency situations. Examples include minor burns and cuts; seizures; diabetic reactions.
    • Task 2 knowledge 3: Preventive measures for minimizing risk and promoting safety. Examples include proper body mechanics; safety data sheet (SDS); standard operating procedures; equipment maintenance; emergency preparedness; personal safety in the client’s environment.
    • Task 2 knowledge 4: Strategies and resources to prevent professional burnout. Examples include assessment of personal needs; self-advocacy regarding workload; stress management.
    • Task 3: Provide occupational therapy services in accordance with laws, regulations, state occupational therapy practice acts, and accreditation guidelines to protect consumers and meet applicable reimbursement requirements related to the service delivery setting.
    • Task 3 knowledge 1: Application of federal regulations, state practice acts, facility policies, and accreditation guidelines related to service delivery across occupational therapy practice settings. Examples include health care legislation; accreditation organizations; licensing and credentialing; supervisory role under state practice acts.
    • Task 3 knowledge 2: Influence of reimbursement policies and guidelines on occupational therapy service delivery.
    • Task 3 knowledge 3: Accountability processes and procedures for justifying, tracking, and monitoring outcomes. Examples include relevant practice terminology; documentation guidelines.
    • Task 4: Engage in professional development and competency assessment activities relevant to the job role, practice setting, scope of practice, and professional certification standards.
    • Task 4 knowledge 1: Methods for identifying, documenting, and monitoring service competency and professional development needs. Examples include competency self-assessment; mentoring.
    • Task 4 knowledge 2: Application of ethical decision-making and professional behaviors guided by the NBCOT Practice Standards and Code of Conduct.
Examination sources

NDBOTP Jurisprudence Exam

Provider
North Dakota State Board of Occupational Therapy Practice
Format
Online open-book exam; a paper version is available
Exam questions
20
Examination outline
  • N.D.C.C. chapter 43-40 — Occupational Therapists
  • N.D.C.C. chapter 43-40.1 — Occupational Therapy Licensure Compact
  • N.D. Admin. Code chapter 55.5-02-01 — Initial Licensure and Renewals
  • N.D. Admin. Code chapter 55.5-02-02 — Code of Ethics
  • N.D. Admin. Code chapter 55.5-02-03 — Supervision
  • N.D. Admin. Code chapter 55.5-02-05 — Information Changes
  • N.D. Admin. Code chapter 55.5-03-01 — Scope of Practice
Examination sources

Jurisprudence Exam for License Renewal

This assessment does not have a question bank.

Provider
North Dakota State Board of Occupational Therapy Practice
Format
Paper exam submitted with the renewal or reinstatement application; no passing score
Examination sources

COTA Certification Exam

Format
Three- and four-option single-response multiple-choice items and six-option multi-select items
Exam questions
190 items
Examination outline
  • Domain 1 — Collaborate and Gather Information: Under the supervision of the OTR, acquire information on an ongoing basis regarding factors that influence occupational performance. (27%)
    • Task 1: Recognize the influence of development and lived experience; body functions and body structures; values, beliefs, and spirituality; and identity on occupational performance.
    • Task 1 knowledge 1: Impact of typical development and aging on occupational performance, health, and wellness across the life span.
    • Task 1 knowledge 2: Expected patterns, progressions, and prognoses associated with conditions that limit occupational performance. Examples include signs and symptoms of disease; stages of disease; secondary complications.
    • Task 1 knowledge 3: Impact of body functions and body structures on occupational performance. Examples include cognitive impairments; congenital anomalies.
    • Task 1 knowledge 4: Influence of lived experiences and identity on occupational performance. Examples include history of trauma and adverse childhood events; socioeconomic status; gender, race, culture, religion.
    • Task 2: Acquire information about a client’s functional skills, roles, prioritized needs and wants, and performance context to inform the development of and updates to an occupational profile.
    • Task 2 knowledge 1: Resources for acquiring information about the client’s current condition and occupational performance. Examples include referrals; client records; developmental history; Individualized Education Program (IEP) plans.
    • Task 2 knowledge 2: Purpose, advantages, limitations, and service competency needs related to the administration of standardized and nonstandardized assessments and screening methods. Examples include criterion-referenced tests; norm-referenced tests; client and caregiver interviews; observation.
    • Task 2 knowledge 3: Internal and external factors influencing a client’s engagement in occupation. Examples include roles, habits, routines, and rituals; environmental context; family and social supports; medication side effects and interactions; mental health.
    • Task 3: Perform an activity analysis to determine the influence of task demands, current conditions, performance skills, and context on occupation.
    • Task 3 knowledge 1: Task requirements, steps to task completion, and task demands across contexts or settings.
    • Task 3 knowledge 2: Personal and environmental factors that facilitate or inhibit task completion or occupational engagement. Examples include compensation patterns; role of performance context; influence of current conditions.
    • Task 4: Collaborate with the client, the client’s relevant others, occupational therapy colleagues, and other professionals using a client-centered approach and therapeutic use of self to provide quality occupational therapy services.
    • Task 4 knowledge 1: Roles and responsibilities among interprofessional teams when coordinating client care and providing services. Examples include referral to and consultation with other services; interprofessional communication methods; scope of practice.
    • Task 4 knowledge 2: Processes for supporting interprofessional intervention plans. Examples include Individualized Education Program (IEP) plans; discharge plans; transition plans; palliative and hospice care plans.
    • Task 4 knowledge 3: Client-centered approaches and considerations for coordinating occupational therapy services. Examples include therapeutic use of self; advocacy; frequency/duration of intervention; level of service delivery.
    • Task 4 knowledge 4: Factors used to prioritize intervention goals and activities in collaboration with the client and family, teacher, caregiver, and relevant others. Examples include client-reported outcomes; level of support required; context of service delivery; progress toward goals.
    • Task 4 knowledge 5: Strategies for addressing and enhancing health literacy with the client and relevant others. Examples include caregiver training; teaching-learning models; methods for making health information accessible; informed decision-making; navigating challenges to professional expertise.
    • Task 5: Monitor the intervention plan, approach, context, and goals on an ongoing basis, in collaboration with the OTR, using clinical reasoning.
    • Task 5 knowledge 1: Factors for determining and managing context and activities to meet individual and group intervention goals and objectives. Examples include client needs and priorities; response to intervention.
    • Task 5 knowledge 2: Strategies for monitoring the effectiveness of individual and group intervention. Examples include client-reported outcomes; reevaluation results; progress toward goals.
    • Task 5 knowledge 3: Clinical decision-making for prioritizing goals and implementing modifications to the intervention plan based on client responses, under the supervision of the OTR. Examples include physiological changes; behavioral reactions; emotion regulation; developmental needs.
    • Task 5 knowledge 4: Precautions or contraindications associated with a client condition or stage of recovery. Examples include postsurgical precautions; vital signs; laboratory values; suicidal ideation.
  • Domain 2 — Select and Implement Interventions: Implement interventions, under the supervision of the OTR, in accordance with the intervention plan and level of service competence to support client participation in areas of occupation throughout the occupational therapy process. (55%)
    • Task 1: Incorporate preparatory techniques, activities, and modalities as an adjunct to interventions to promote healing and enhance engagement in occupation-based activities.
    • Task 1 knowledge 1: Considerations for selecting, preparing, and adapting the intervention technique to support optimal engagement and promote goal achievement. Examples include client condition; client safety; theoretical approach and frame of reference.
    • Task 1 knowledge 2: Considerations for selecting, preparing, and adapting the intervention environment to support optimal engagement and promote goal achievement. Examples include ensuring privacy during telehealth sessions; equipment safety; line management.
    • Task 1 knowledge 3: Indications, contraindications, and precautions associated with wounds and maintaining skin integrity. Examples include stage of wound healing; prevention and management of pressure ulcers.
    • Task 1 knowledge 4: Indications, contraindications, precautions, and clinical application of superficial thermal agents. Examples include dry whirlpool; hot packs; cryotherapy.
    • Task 1 knowledge 5: Indications, contraindications, precautions, and clinical application of deep thermal, mechanical, and electrotherapeutic physical agent modalities. Examples include transcutaneous and neuromuscular electrical stimulation; biofeedback.
    • Task 2: Implement occupation-based strategies to support participation in activities of daily living (ADL), instrumental activities of daily living (IADL), health management, rest and sleep, education, work, play, leisure, and social participation across the life span.
    • Task 2 knowledge 1: Interventions for supporting leisure and play.
    • Task 2 knowledge 2: Methods for grading an activity, task, or technique based on level of development, client status, response to intervention, and client needs.
    • Task 2 knowledge 3: Considerations for facilitating individual and group participation in shared activities. Examples include group processes; group dynamics; group type and function.
    • Task 2 knowledge 4: Interventions to support cognitive, visual-motor, visual, and perceptual processing and sensory arousal. Examples include sensory modulation; proprioceptive input; vestibular strategies; low vision strategies.
    • Task 2 knowledge 5: Compensatory and remedial strategies for managing cognitive and perceptual deficits or developmental disabilities. Examples include graded cueing; chaining; metacognition; memory aids.
    • Task 2 knowledge 6: Adaptive and preventive strategies for supporting optimal engagement in occupation. Examples include use of technology/apps; joint protection; task simplification; energy conservation.
    • Task 2 knowledge 7: Intervention strategies and techniques used to facilitate oral motor skills for drinking, eating, and swallowing. Examples include hand-to-mouth patterns; mastication; adaptive utensils; positioning at mealtime.
    • Task 2 knowledge 8: Prevocational, vocational, and transitional services, options, and resources for supporting strengths, interests, employment, and lifestyle goals across the life span.
    • Task 2 knowledge 9: Strategies, techniques, and client-centered education to facilitate functional transfers.
    • Task 2 knowledge 10: Strategies for promoting wellness and mental health. Examples include relaxation; sleep hygiene; addiction management.
    • Task 3: Implement interventions for improving sensory, motor, neurological, and physiological status, considering client condition and current stage of recovery, to support occupational performance.
    • Task 3 knowledge 1: Methods for grading therapeutic exercise and conditioning programs consistent with indications and precautions.
    • Task 3 knowledge 2: Techniques for sensory and motor reeducation, pain management, desensitization, edema reduction, and scar management. Examples include manual edema mobilization; nerve gliding; neuromuscular reeducation; constraint-induced movement.
    • Task 3 knowledge 3: Techniques for promoting improved postural stability, dynamic balance, body mechanics, and breathing patterns during functional tasks.
    • Task 4: Select, fabricate, and modify orthotic devices, and provide training in the use of orthotic and prosthetic devices in order to support functional outcomes.
    • Task 4 knowledge 1: Types and functions of immobilization, mobilization, and restriction orthoses for managing specific conditions and congenital anomalies across the life span.
    • Task 4 knowledge 2: Types and functions of prosthetic devices for upper and lower extremity amputations.
    • Task 4 knowledge 3: Implications of anatomical, physiological, biomechanical, cognitive, and socioeconomic factors and healing principles for orthotic selection, design, fabrication, and modification.
    • Task 4 knowledge 4: Client-centered education and training methods for the safe and effective use of orthotic and prosthetic devices.
    • Task 5: Integrate assistive technology options, adaptive devices, mobility aids, and other durable medical equipment into the intervention to enable participation in occupation.
    • Task 5 knowledge 1: Factors related to measuring, selecting, monitoring the fit of, and recommending modifications to seating systems, positioning devices, and mobility aids. Examples include equipment components; biomechanical considerations; usability and maintenance.
    • Task 5 knowledge 2: Types, characteristics, and features of high- and low-tech assistive technology and adaptive devices. Examples include interface options and processor parameters; equipment components.
    • Task 5 knowledge 3: Mobility options, vehicle adaptations, and alternative devices for supporting participation in community mobility. Examples include adapted driving controls; wheelchair tie downs; alternative transportation options; dynamic mobile standers; navigation apps.
    • Task 5 knowledge 4: Client factors influencing successful use and maintenance of assistive technology options, adaptive devices, mobility aids, and other durable medical equipment. Examples include developmental, physical, functional, cognitive, and mental health status; prioritized needs.
    • Task 5 knowledge 5: Client-centered education and training methods for successful use and maintenance of assistive technology options, adaptive devices, mobility aids, and other durable medical equipment.
    • Task 6: Implement environmental modifications, while considering accessibility guidelines, standards, and legislation, to support participation in occupation consistent with client needs and status, task demands, and context.
    • Task 6 knowledge 1: Principles of ergonomics and universal design for identifying, recommending, and implementing features and reasonable accommodations in the workplace, home, and virtual and public spaces.
    • Task 6 knowledge 2: Processes and procedures for identifying, recommending, and implementing modifications in the workplace, home, and virtual and public spaces.
  • Domain 3 — Uphold Professional Standards and Responsibilities: Uphold professional standards and responsibilities by achieving service competence and applying evidence-based interventions to promote quality in practice. (18%)
    • Task 1: Employ evidence-based strategies and approaches to provide safe, effective, and efficient services relevant to individuals, groups, and populations.
    • Task 1 knowledge 1: Methods for locating, reviewing, and interpreting scholarly research to guide practice-relevant decision-making. Examples include applying the Patient, Intervention, Comparison, Outcome (PICO) model; identifying best evidence.
    • Task 1 knowledge 2: Methods for contributing to continuous quality improvement processes and procedures related to occupational therapy service delivery. Examples include program evaluation; acquiring information to measure outcomes.
    • Task 1 knowledge 3: Types of evidence-based programming for advancing population health outcomes. Examples include aging in place; fall prevention; health and wellness; community support groups.
    • Task 2: Incorporate risk management techniques at the individual and practice-setting levels to protect clients, self, staff, and others from injury or harm.
    • Task 2 knowledge 1: Infection control procedures and universal precautions for reducing transmission of contaminants. Examples include PPE; isolation precautions; cleaning equipment.
    • Task 2 knowledge 2: Responses to adverse reactions, minor injuries, and emergency situations. Examples include minor burns and cuts; seizures; diabetic reactions.
    • Task 2 knowledge 3: Preventive measures for minimizing risk and promoting safety. Examples include proper body mechanics; safety data sheet (SDS); standard operating procedures; equipment maintenance; emergency preparedness; personal safety in the client’s environment.
    • Task 2 knowledge 4: Strategies and resources to prevent professional burnout. Examples include assessment of personal needs; self-advocacy regarding workload; stress management.
    • Task 3: Provide occupational therapy services in accordance with laws, regulations, state occupational therapy practice acts, and accreditation guidelines to protect consumers and meet applicable reimbursement requirements related to the service delivery setting.
    • Task 3 knowledge 1: Application of federal regulations, state practice acts, facility policies, and accreditation guidelines related to service delivery across occupational therapy practice settings. Examples include health care legislation; accreditation organizations; licensing and credentialing.
    • Task 3 knowledge 2: Influence of reimbursement policies and guidelines on occupational therapy service delivery.
    • Task 3 knowledge 3: Accountability processes and procedures for justifying, tracking, and monitoring outcomes. Examples include relevant practice terminology; documentation guidelines.
    • Task 4: Engage in professional development and competency assessment activities relevant to the job role, practice setting, scope of practice, and professional certification standards.
    • Task 4 knowledge 1: Methods for identifying, documenting, and monitoring service competency and professional development needs. Examples include competency self-assessment; mentoring.
    • Task 4 knowledge 2: Application of ethical decision-making and professional behaviors guided by the NBCOT Practice Standards and Code of Conduct.
Examination sources