Florida Department of Education
Bureau of Instructional Support and Community Services
Considerations for Educationally Relevant Therapy
for
Occupational Therapy and Physical Therapy
(CERT-Revised 7/04)
The
Considerations for Educationally Relevant Therapy (CERT)
has been developed to
assist occupational therapists (OTs) and physical therapists (PTs) working in the educational
environment in determining the need for educationally relevant therapy in the schools. The
CERT
is
not
an evaluation or assessment instrument. It is a summary of educational
considerations based on a review of student records, evaluations, observations, parent/teacher
information, and other data.
According to 34 CFR 300.24, the role of a related service, such as occupational or physical
therapy, is to enable the student to benefit from special education in order to receive a free
and appropriate public education (FAPE). The OT and/or PT along with the individual
educational plan (IEP) team, determines the need for educationally relevant therapy.
The emphasis of school-based services provided by OTs and PTs has shifted over the years
from a medical approach to an educational approach. The functional skills a student needs to
perform in the educational setting are dependent on a variety of factors, including the
student's diagnosis; present level of function; educational program; and overall
developmental, cognitive, and academic abilities. Medical therapy concerns such as
improving range of motion, strengthening, improving swallowing, or preventing contractures
may affect a student's ability to accomplish the educational goals,
but are not the specific
goals
.
Likewise, sensory processing deficits, attention deficits, or physical impairments are
not reasons, in themselves, to provide therapy services. The impairment must be linked to
the student's inability to achieve educational goals and objectives on the IEP.
Therapy in the educational environment should be viewed as a continuum of services that
encompasses a variety of service delivery models and intervention strategies. Research has
shown that interventions embedded in class routines using functional life skills increase the
achievement of IEP goals and motivation needed for participation in the general education
curriculum. The knowledge and expertise of an OT and/or PT can be utilized to determine
and design intervention strategies that can be integrated into a student's daily routine and
implemented by school-based personnel. The student's needs may vary from year to year and
are dependent on multiple factors, including the student's present level of performance, overall
development, and educational program.
Directions for Completing the CERT
The CERT includes a
Summary Sheet
, a
Student Profile,
and a
Therapy Profile
.
Information from the
Student Profile
and
Therapy Profile
is recorded on the
Summary
Sheet
in the appropriate sections. The following is a description of each part of the CERT.
The
Student Profile
describes student performance in five areas of school-related functions:
Personal Care, Mobility, Gross Motor, Fine Motor/Visual Motor, and Sensory Processing.
Within each area, there is a continuum based on student ability. The
Student Profile
is
completed after a review of student records, evaluations, observations, parent/teacher
information, and other data. The therapist should thoroughly read each paragraph before
choosing the column that best describes the student's abilities and current level of support. A
therapist interprets the descriptors within the context of the student’s educational environment.
The points from each of the five areas are recorded in the
Student Profile
section of the
Summary Sheet
. Specific evaluation tools should be noted in the
Sources of Information and
Additional Comments
section. The date the Student Profile is completed should be recorded.
The
Therapy Profile
describes factors in five areas that commonly influence the effectiveness
of therapy services. These areas include number of years the student has received
educationally relevant therapy, the student’s potential response to educationally relevant
therapy, the student’s learning environment, therapy services to be provided to the student, and
support services to be provided to school staff and/or parents. The therapist should thoroughly
read each column and, after collaborating with the IEP team, choose the column that best
describes the student's learning environment, current level of support, and potential response to
educationally relevant therapy. The points from each of the five areas are recorded in the
Therapy Profile
section of the
Summary Sheet
. The
Sources of Information and Additional
Comments
section should include parent/teacher input and other information shared at the IEP
team meeting.
The
Summary Sheet
includes information from the
Student Profile
, the student’s priority
educational needs, IEP goals and objectives, information from the
Therapy Profile
,
and
Recommendation for Therapy.
All information, except the
Student Profile
, should be
completed at the IEP meeting by the school-based therapist. Based on the student’s priority
educational needs and goals/objectives, the IEP team should then determine if the expertise
and intervention of an OT and/or PT is needed.
A recommended frequency of therapy can be derived by completing the grid at the bottom of
the
Summary Sheet
. Place an X on the horizontal axis of the
Student Profile
that corresponds
with the total points. Place an X on the vertical axis of the
Therapy Profile
that corresponds with
the total points. The point where the axes intersect indicates a recommended frequency of
therapy. The following descriptors are guidelines for the therapist to use in interpretation of
the scoring grid.
Services are not indicated
when the student is self-reliant and functional in the educational
environment or the student's needs are addressed by classroom curriculum or other existing
services (which may include total assistance by school staff).
2
?
Periodic Services
may include documented environmental or equipment modifications and
training and/or consultation with parents and/or school staff. Examples of frequency of
therapy are one time per month, twice per grading period, or once per semester.
Regular Services
may include specific therapeutic strategies, environmental or equipment
modifications, and training and/or collaboration with parents and/or school staff. Examples of
frequency of therapy are two times per month, once per week, or 30-45 minutes per week.
Intensive Services
may include intensive therapeutic strategies, multiple environmental or
equipment modifications, and training of parents and/or school staff. Examples of frequency
of therapy are one to two times per week or 45-60 minutes per week.
The IEP team proceeds with a
Recommendation for Therapy Services
on the
Summary Sheet
.
Comments should be noted if the professional judgment of the therapist differs from the IEP
team’s recommendation.
If both an OT and PT have evaluated the student, each school-based therapist, based on his or
her area of expertise, should complete all sections of the CERT on separate forms.
3
?