One downside of working in a school setting is being the only OT on site, which can make it challenging to collaborate with others in your discipline or receive regular clinical feedback from fellow OTs. While professional development is well-supported with continuing education funds and dedicated days off, there’s limited room for upward career growth—as the sole OT, opportunities for leadership or supervisory roles are minimal. The school’s structure is rooted in ABA practices, so you may need to adapt your OT approach to align with behavior-based data collection and documentation systems. Additionally, because it’s a nonprofit organization the pay while competitive for pediatric settings may be lower than what you could earn in a medical, home health or private practice setting.