For the past ten years, concerns have been voiced about the preservice preparation of occupational therapy (OT) practitioners to work in schools and early childhood programs. States and local districts have long complained of shortages of occupational therapists (OTs) in these settings. In addition, the "Twenty-Second Annual Report to Congress on the Implementation of the IDEA" (U.S. Department of Education [USDOE], 2000) highlighted the need for additional full-time therapy positions. In this article, the authors discuss the unique role of OT in the schools and describes factors that affect the supply and demand for OTs. They also discuss the preparation and education of occupational therapists as well as their certification or license to work in the schools. (Contains 3 tables.)