Occupational Therapy vs. School Psychology – Career Comparison

If you are looking into a career working with children, then both of these careers may appeal to you. Which should you pursue? They share some similarities, but differ in theory and on the job responsibilities. Both occupational therapists and school psychologists may work with children in the school system, their teachers, and school programs to promote play, education, and child development for their milestones. Both professions would collaborate with the child, their teachers, parents, and team in meetings such as annual IEP, or the child’s individualized educational plan meetings.


Occupational therapy (OT) requires a Master’s degree after an undergraduate degree and typically 2.5 years.

School psychologists need a minimum Master’s degree in Psychology, Educational Psychology or School Psychology.

So both require about the similar cost, time of education, and clinical hours as experience after.

Both require licensure in the state they work in and keeping up with their continuing education requirements.

OT may be considered more “science-based” than psychology, but both educations involve learning many theories as a foundational basis for treatment. OT school involves more a general education and includes learning about mental health, pediatrics, and adults. A school psychology degree may be more “focused” and specialized in what you want to do, but it also means you are limited in your options should you choose to transition to say, working with adults. An education more general in psychology may be an option, but again, it’s less specialized to school psychology.

Both occupational therapists and school psychologists play important roles in helping a child succeed in school.


Salary is very similar for both. According to BLS.gov, occupational therapists earned $40.84 median pay per hour in 2019 and school psychologists $42.04. A general psychologist earned medium $38.64/hr. This of course will depend on the state you work in, your experience, etc.  Both are in high demand and expected to have growth in healthcare, but OT is higher due to overall demand from the older population reaching retirement age and requiring therapy (3% growth for psychology and 16% for occupational therapy).

Therapist working with a child with cerebral palsy.


The school psychologist administers tests. These may include IQ tests and other psychological surveys as part of the evaluation portion of IEP planning. A school psychologist may work with a child if they have mental health challenges. They may make observations during the meeting about your child’s psychological state or concerns. School psychologists may also provide counseling to students. Here are some things they may learn in their degree and do on the job:

  • Data collection and analysis
  • Assessment
  • Progress monitoring
  • School-wide practices to promote learning
  • Resilience and risk factors
  • Consultation and collaboration
  • Academic/learning interventions
  • Mental health interventions
  • Behavioral interventions
  • Instructional support
  • Prevention and intervention services
  • Special education services
  • Crisis preparedness, response, and recovery
  • Family-school-community collaboration
  • Diversity in development and learning
  • Research and program evaluation
  • Professional ethics, school law, and systems

School psychologists help students, families, teachers, and members of the community understand and resolve both short-term and long-term issues that students may face. They are a highly skilled and ready resource in the effort to ensure that all children and youth thrive in school, at home, and in life.


The occupational therapist may also administer their battery of tests, perform observations, interview children/parents/teachers, and come up with annual goals for the student’s IEP.

However, occupational therapists in this setting have more “hands-on” and 1:1 with the child directly when they learn, play, and interact with their environment. The school OT may also implement learning goals for school such as handwriting, learning, learning to use scissors (fine-motor skills), or learn ways to manage their sensitivities to the environment due to conditions such as autism. School OT’s implement interventions for play such as with their peers, on the playground, or in the classroom. They also highly skilled therapists that provide resources and interventions for children to do well in school as well as their life outside of school. According to the AOTA, American Occupational Therapy Association, school OTs help children and students with:

  • Conducting activity and environmental analysis and making recommendations to improve the fit for greater access, progress, and participation
  • Reducing barriers that limit student participation within the school environment
  • Providing assistive technology to support student success
  • Supporting the needs of students with significant challenges, such as by helping to determine methods for alternate educational assessment and learning
  • Helping to identify long-term goals for appropriate post-school outcomes
  • Helping to plan relevant instructional activities for ongoing implementation in the classroom
  • Preparing students for successfully transitioning into appropriate post–high school employment, independent living, and/or further education

Team Approach

In the school setting, occupational therapists and psychologists may be on the same team for the child, such as in an IEP meeting.

Which Career?

The best thing you can do, if possible – is to shadow both professions on the job. Shadow a school psychologist and an occupational therapist in the school setting and notice what they have in common or not. Pay attention to the paperwork and “administrative” things that each profession has to do in the day-to-day. What else does each do outside of working with the student? What is their interaction with teachers, family, etc.

While reading about each profession online can offer a lot of insight, the best way to make a decision is to gain experience in real-life. I can’t really say one is better than the other, even as an occupational therapist. Each has their pros and cons and you – the future therapist, have different interests, backgrounds, and preferences for an ideal job.

In a pandemic situation, it may be hard to shadow in person. Try shadowing virtually such as through Zoom. Do a google search for where you live for the children’s schools near you. You may be able to get in touch with a therapist that way. Another way is looking on public licensure databases for therapists near you and seeing if you can find any contact information – but this may require a lot of work and cold calling.

One idea may be looking on social media, e.g. school OT or school psychologist tag in the search bar. Many profiles will say their title, e.g. School Occupational Therapist. Many professionals have social media accounts that share their daily work with pictures and even videos (with permission from the student of course). This not only can offer a lot of insight into each profession, but you may be able to direct message them and reach out and tell them you are interested in shadowing, even if it is virtual. You can also try reaching out to schools and degree programs for OT and school psychology to see what their website suggests for shadowing in a pandemic situation.

Give these a try and go from there. If you decide to go with OT, come back to this website as there are many resources for pre-OT students considering or who are studying in school to become occupational therapists. I made a course on Udemy for Pre-OT if you are considering OT and as it has a broader focus – it goes over the other aspects of OT besides school OT as well that you may be interested in, including mental health in settings such as hospitals.

You can’t go wrong with either career.

Best of luck!