Building and sustaining a pediatric therapy workforce has become increasingly challenging. Organizations are balancing growing referral volumes, increasing medical complexity, health plan expectations, and pressure to reduce turnover while maintaining high-quality care.
For many organizations, the greatest challenges are not simply finding therapists. The larger questions often become:
How do we help therapists build needed skills quickly after they are hired?
How do we support them in ways that encourage them to stay?
Organizations increasingly need therapists who can confidently support children with feeding challenges, AAC needs, sensory and regulation differences, chronic or progressive conditions, and complex medical histories. Yet expecting every new hire to arrive with expertise in all specialty areas is unrealistic.
The goal is not necessarily to hire therapists who already know everything. The goal is to hire the right people and create systems that help them grow into what your organization and families need. Read on to learn more in this article by Jennifer Lawson, OTR, MS, Director of Educational Instruction & Design for Knowledge Is Now.
Hiring Beyond the Resume
Resumes can tell us where someone has worked and what credentials they hold. They rarely tell us whether a therapist can confidently navigate difficult caregiver conversations, document medical necessity effectively, adapt when a child is not responding as expected, or apply strong clinical reasoning when situations become complex.
Technical skills matter, but successful pediatric therapists often need additional qualities:
- Curiosity and willingness to learn
- Strong clinical reasoning skills
- Ability to build relationships with children and caregivers
- Flexibility and adaptability
- Comfort receiving feedback
- Commitment to professional growth
- Ability to manage complexity and uncertainty
Instead of asking: “Can this therapist do the job today?”
Consider asking: “Can this therapist grow into who our organization needs them to become?”
Why the Interview Matters More Than We Think
Interviews are often underutilized opportunities. Too frequently they become conversations focused on availability, productivity expectations, and previous experience.
Strong interviews reveal how therapists think.
Consider incorporating questions such as:
- Tell me about a child whose progress was slower than expected. What did you do?
- Describe a difficult conversation with a caregiver. How did you handle it?
- How do you determine whether a goal is meaningful and medically necessary?
- What areas of pediatric practice do you feel strongest in, and where do you want to grow?
- Describe a time you received difficult feedback.
- How do you adapt when a child is dysregulated or not engaging?
Questions like these often reveal communication skills, self-awareness, emotional intelligence, clinical reasoning, and growth mindset.
When hiring, you are not simply selecting therapists. You are selecting future teammates, mentors, leaders, and contributors to your organization’s culture.
The Real Work Begins After Hiring
Even highly talented therapists can struggle without support.
Many organizations unintentionally assume: “They’ve graduated, passed boards, and have experience. They should be ready.”
The reality is that pediatric therapy often requires significant transition-to-practice support.
New therapists commonly report challenges related to:
- Documentation efficiency
- Medical necessity and health plan expectations
- Goal writing
- Dosage decisions
- Complex diagnoses
- Feeding or AAC cases
- Family communication
- Clinical reasoning
- Time management
- Confidence
Without support, uncertainty often becomes stress, burnout, and eventually turnover. But these challenges do not necessarily indicate a poor hire.
Increasingly, organizations are recognizing that skill development can be accelerated through intentional onboarding, mentorship, and focused clinical pathways.
For example, several organizations have shared a similar challenge with us. They hired strong therapists but needed them to develop feeding expertise quickly to meet growing referral demands. The issue was not that they hired the wrong therapists. The issue was creating systems that helped those therapists gain knowledge, confidence, and support rapidly enough to meet patient and organizational needs.
The same principle applies across specialty areas including feeding, AAC, caregiver coaching, regulation, and medically complex populations.
Five Tips for Supporting New Team Members
1. Establish expectations early
Clarify expectations related to documentation, communication, productivity, clinical reasoning, and professional growth. Ambiguity creates anxiety.
2. Create structured check-ins
Don’t wait until annual reviews. Initially schedule weekly meetings and build opportunities for questions, case discussions, and progress reviews so support remains proactive rather than reactive.
3. Normalize not knowing everything
New therapists frequently feel pressure to appear confident. Psychological safety supports stronger learning and stronger teams.
Create environments where team members hear: “You don’t have to know everything. You just have to keep learning.”
4. Invest in specialty development
As referrals become increasingly complex, organizations need therapists with specialized knowledge.
Organizations that create structured pathways for specialty development help therapists build skills faster and feel more supported in their work.
Therapists gain confidence and growth opportunities. Organizations strengthen clinical capacity and improve their ability to meet community needs.
5. Develop mentorship intentionally
Mentorship should not mean: “Go ask someone if you need help.”
Strong mentorship includes defined goals, scheduled meetings, case-based learning, feedback processes, and individualized development plans.
Mentorship creates consistency, accelerates readiness, and supports retention.
Investing in Growth Improves More Than Retention
Organizations that intentionally support therapist development are not simply reducing turnover.
They are creating stronger recruitment pipelines, accelerating therapist readiness, improving clinical consistency, reducing onboarding burden, and helping therapists feel equipped to meet the needs of increasingly complex pediatric populations.
Hiring the right therapist matters. Helping them grow matters even more.
Successful pediatric organizations are not built simply by finding talent. They are built by developing it.
Interested in additional resources?
