Date of Award


Document Type

Scholarly Project

Degree Name

Master of Occupational Therapy (MOT)


Occupational Therapy

First Advisor

Janet Jedlicka


Disabled Persons; Employment; Internet Access; Licensure; Mental Disorders; Occupational Therapy


Purpose This study was conducted to gain insight on the 50 United States and Washington D.C. occupational therapy (OT) licensure application process. This study sought to examine the accessibility of the OT licensure websites as well as the compliance each OT state licensure application has with the Americans with Disabilities Act (ADA). The researchers predicted that, while the profession of OT seeks inclusion for all individuals, there is discrimination prominent in the OT state licensure process for individuals living with disabilities.

Methodology A two-fold process was used to collect information regarding accessibility and accommodation within licensing processes for OT licensure applications. First, 51 United States/territories were examined using the Website Content Accessibility Guidelines (WCAG) 2.1. These guidelines, published in 2018, focus on allowing greater accessibility for individuals with disabilities through use of Level AAA, items of highest rigor, and the three of the four corresponding principles: Perceivable, Operable, and Understandable (Bradbard & Peters, 2010). Using these guidelines as a checklist, each principle was assessed for each corresponding website and data was recorded. After examined using these guidelines, each website URL was placed into the WAVE© accessibility tool from to in order to triangulate the data and increase the rigor of this study (WebAIM, 2018).

Secondly, 41 of the 51 United States/territories OT applications were examined for compliance with the ADA with use of two articles, one published by Schroeder et al. (2009) and the other published by Jones et al. (2018). Ten of the 51 applications were removed from use in this study as those applications were not directly available via download on the state website and the state regulatory board either did not respond to requests for the application in an alternative format or the application was not available in an alternative format.

The Schroeder et al. (2009) article defined four categories of questions in regard to licensure applications and the ADA: permissible, likely permissible, likely impermissible, and impermissible. Using this information, along with information from Jones et al. (2018), the categories for this research project were created, and 41 of the 51 OT United States/territories licensure applications were reviewed and data was recorded.

Results Use of WCAG 2.1 guidelines indicates that many states appear to meet Level AAA standards of accessibility. The lowest score obtained was 6 out of 11 checkpoints, held by just two states. Seven states scored 100% with the guidelines. It was found that the majority of states met Principle 1 and 3 guidelines: Perceivable and Understandable. Many states were observed to have difficulties meeting Principle 2: Operable; this was often evidenced by websites that were inaccessible for use with a variety of devices such as a mouse and keyboard, touchscreen, desktop, mobile device, or tablet. Under the third Principle: Understandable, many states failed to provide context-sensitive help, or technological assistance within the webpage. Through use of the WAVE© checker, results were only categorized in terms of Level A or AA. The most common issues resulted in difficulties with use of screen readers and alternative mechanisms.

Nineteen states, or approximately 46% of the applications reviewed, asked questions that are impermissible or likely impermissible, indicating noncompliance or potential noncompliance with the ADA. Additionally, 17 applications contained questions that were permissible, 10 of those applications (24%) asked solely permissible questions in regard with the ADA. An additional 12 applications (29%) were unable to be placed into the categorizes created by the two guides used in this study, indicating that roughly 54% of the applications are compliant with the ADA. Therefore, results show that 22 of 41 applications reviewed (54%) were compliant with the ADA and 19 of 41 applications reviewed (46%) were either likely noncompliant or noncompliant with the ADA in regard to the questions asked on the application.

Conclusion The results of this study indicate that the majority of OT licensure websites are minimally accessible to individuals with disabilities. However, the national guidelines for website accessibility remain at WCAG 2.0 Level AA, and few states currently do not communicate these standards or offer increased assistance for those who may need it. Therefore, increased compliance with this standard, WCAG 2.1 Level AAA would allow greater accessibility to websites for those living with disabilities.

The applications for licensure, however, have a vast discriminatory basis to individuals living with disabilities and are not compliant with the ADA. Nineteen of the 41 states reviewed asked questions that were impermissible or likely impermissible with the ADA. Removing all questions that are not permissible with the ADA would provide equal opportunity to all applicants as well as eliminate discrimination in the OT licensure application. Additionally, in eliminating discriminatory questions within the application, occupational therapist practitioners may be more open in articulating their needs and seeking services if needed, as fear to lose licensure will no longer exist. In turn, this would also communicate the value of inclusion that the profession of occupational therapy holds to all applicants applying for OT licensure.