Over the years the need for occupational therapists practicing in the school setting has increased. The purpose of this study is to compare the knowledge concerning school based practice of occupational therapy students who have completed their didactic courses with that of practicing occupational therapists. The question remains whether the additions the academic communities have made to their curriculum have been enough to allow the occupational therapy students to demonstrate an increase in knowledge of occupational therapy in the schools. The 40 question "KNOTS Scale for Pediatric Occupational Therapists" was completed by 43 occupational therapy students and school-based therapists. The questions were divided into three categories: (a) school-based, (b) general pediatric, and (c) legislative. Results of the data analysis indicated that there was a statistically significant difference between occupational therapy students who have completed their didactic course work and school-based occupational therapists in all three categories. The KNOTS Scale has many potential practical applications.