Patients who need occupational therapy fall into a wide range of capabilities. Some progress quickly through therapy plans. Others struggle and need modified plans. All of them need hands-on observation and guidance. The Certified Occupational Therapy Assistant (COTA) is the link between the Registered OT and the patient. The COTA is the one who greets each patient with a smile, listens and observes to determine their progress, and maintains records for the OT to review.