Twenty percent of occupational therapists are employed in schools nationwide. Despite years of service since the Brown vs. U.S. Board of Education Law was enacted in 1954, school-based occupational therapists are restricted from advancing into formal Professional Educator License leadership roles. Due to state legislation and credentialing issues, they are ineligible to pursue leadership positions such as special education director and assistant director in 45 of 50 states. Most State Boards of Education recognize other service providers for leadership, including speech-language pathologists, social workers, school nurses, and psychologists, but they omit occupational therapists. Consequently, their careers are restricted, and students and school staff are not receiving the full benefit of their expertise and leadership potential. This qualitative case study explored the Illinois School Board of Education Professional Educator License policy, its impacts on school-based occupational therapists, and ways to enhance their careers in Illinois public-schools. Archival data related to the Illinois School Board of Education, the Illinois Occupational Therapy Association, and the American Occupational Therapy Association policies were gathered. Interviews and focus groups were conducted with occupational therapists working in Illinois public-schools. Data analysis clarified barriers to their leadership development, including a lack of professional development training, inadequate advocacy, and limited national and state support. The study also revealed other challenges they face, such as ambiguous role definitions, a minimized sense of belonging, and arbitrarily limited access to state licensure. These limitations and challenges directly contradict many of the primary principles of transformational leadership theory, which served as the theoretical framework for the study. The findings indicate that Illinois School Board of Education policymakers need to be more fully aware of school-based occupational therapists' leadership potential and make changes that will enlist them as part of school leadership teams. These changes would empower the American Occupational Therapy Association's 2025 Centennial Vision in strengthening occupational therapists' ability to lead in schools. Future research in other states is recommended, as well as large-scale quantitative and mixed methods studies designed to further advance the cause of school-based occupational therapists advancing into leadership positions. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://bibliotheek.ehb.be:2222/en-US/products/dissertations/individuals.shtml.]