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Marion R. Spear founded the occupational therapy program at Western Michigan University in 1922 and served as its first faculty member. At that time, two students were enrolled in the program, which required three months of coursework and was located at the Kalamazoo State Hospital. Under Spear's leadership, the program eventually grew into an academic unit, providing a 27-month program requiring 32 hours of college credit before admission.

In 1939, the program received full accreditation from the Council on Medical Education of the American Medical Association in collaboration with the American Occupational Therapy Association. It was one of the first five programs to gain such recognition.

The program moved to the campus of Western Michigan College in 1944, and students earned a Bachelor of Science in Occupational Therapy. Thirty students were enrolled at that time. By 1949, the enrollment had increased to 150 full-time students. In 1953, the department developed one of the first occupational therapy graduate programs in the country.