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Directions for Completing the CERT(Abridgedfrom CERT Script FL DOE)

The CERT outlines a srudent's need for educationally relevant therapy as determined by the school-basedtherapist in collaboration with the IEP team. Best pracrice would be to use the CERT with evaluations andre-evaluations at a minimum. Academic goal.s and objectives should be written for each srudent integratingOT/PT goals under independent functioning. These goals are reviewedby the IEP team annually. Annualreview of goals will determine the necessiry for changes in service rype, duration, intensiry, etc. Such reviewswill guide the necessiry for continuing, altering, or discontinuing the related sewice. The CERT may be avaluabie tool in leading this &scussion or assisting in consensus of the team.

The CERT form involves a rwo-step process. The first part of the process-complerion of the SrudentProfile-occursbeforethe IEP meeting, at the conclusion of the initial evaluarion, and during any re-evaluation.The second part of the process-completion of the Therapy Frofile and lower portion of the Summary Sheet-occurs at the IEP meeting. Remember, the IEP team members, together, determine whether the expertise andintewention of an occupational or physical therapist is needed. If the student has been evaluated by an

occuparional therapist cnd a physical therapist, then each therapist should complete a separateCERT form,filling in all sections based on their specific &scipline and expertise.

The CERT is completed using multiple sources of information, inclu&ng the results of srudent evaluarionssuchas theEvaluationofFunctionalskillsintheEducanonalEnvironmentAssessmentdevelopedbytheDeparrmentofEducation or other assessments, observations of the student in various educational settings, interviews withteachers and parents, and other relevant student records.

The CERT consists of a Summary Sheet, Scudent trrofile Sheets, and a Therapy Profile Sheet. The SummarySheet contains one section that is completed before the IEP meeting, with the remainder completed at the IEPmeeting. The Student Profile section of the CERT summarizes the student's performance in five areas of school-related functions: personal care, mobiliry, gross motor, fine and visual motor, and sensory processing. These fiveareas are more fully described on pages rwo and three of the CERT.

The Summary Sheet also contains information from the student's prioriry educational needs, information fromthe Therapy Profile, and recommendations for therapy. Let's take a closer look at each of the five areasaddressed in the Student Profile section.

Personal Carerefers to the management of personal needs and equipment within the educacional environment.Examples of personal care include:o Obtaining food from the cafeteria or lunch boxo Use of utensils for feedingo Dressing andundressing. Toileting, ando Washinghands

Mobilityrefers to safe and adequate movement with or without equipmenr or devices.Exampies of this include:o Boar&ng, riding, or exiting a school busa Ascending or descending stairsa Maneuvering throughout the school campus or other places in the community in a safe and efficient

manner. This movement may involve:-Even and uneven surfaces with or without assistance devices-Carrying school materials such as a backpack or lunch rray'Opening and closing doors-Transferring to and from the 0oor-Use of chairs or toilet seats, and -Accessing age-appropriate playground equipment

Gross Motor Skillsarc developmental motor skills, positioning equipment, an#or static and dynamic balanceneeded to participate in the educational environment.Examples of gross motor skills include:. Changing or maintaining appropriate positioninga Static and dlmamic sitting balanceo Static and dynamic standing balanceo Participacion in physical educaEion activities, anda Bilateral integracion and coordination

Fine motor Skillsinclude visual perception, visual motor, and fine motor skills needed to manipulate andmanage materials within the educational environment.Examples of fine or visual motor skills include:o Grasping and the use of tools such as writing instruments, utensils, and scissorso Manipulation of objectso Management of fasteners such as buttons, snaps, and zipperso Coordinated bilateral hand use, ando Visual-motor integration or eye-hand coordination

Sensory Processingrefers to body awareness and sense of movement, sensory perception, exploration, andinteraction with others during play and work activities within the student's educarional environment. Sensoryprocessing deficits may be observed in siluations where the srudent is asked to:o Explore various stimuli by touching or smellingo Waikinlinea Playwith other s[Lldents

The Student Profile is completed by school-based therapists prior ro the IEP meering using informacionobtained from student tecords, evaluarions, observations, parent-teacher input, and other data along withthe therapist's professional knowledge. For each of the five areas of the Student Profile, rhe CERT documenrcontains a description of four levels of srudent abiliry along a continuum.

The therapist must read each descriptor carefully before choosing the level which best describes the presenrlevel of perforrnance and support. The therapist then interprets these descriptors within rhe conrexr of thesrudent's educational environment. The description does not have to match the srudent completelyinorder ro beselected. Rather, the score should reflect the best description of the overall functional abiliry of rhe srudenr inthat category. A doubie asterisk (**) indicates that the srudent's needs are being addressed through theclassroom curriculum or other existing services-including assistance by school staff-and no additionalservices are necessary.

Scores from each of the five areas are recorded in the Srudent Profile section of the Summary Sheet and chenadded to show rhe total score. In the Source of Inlormation and Additional Commenrs column, specific tools

used for evaluation should be identified and written down. The therapist completing the Srudent Profile shouldsign and date this section, leaving no sections blank.

Only the Student Profile section of the Summary Sheet may be completed prior to the IEP meering. During theIEP meeting, the occupacional and/or physical therapist will complece the Therapy Profile seccion of theSummary Sheet basedupon the input of the IEP team. It is important for the entire IEP team to provide inputfor the completion of the CERT. The occupational and/or physical therapist should complete the form duringthe IEP team process. Remind the team that their input is important. Discussing what other resources andneeds are available may affect the needed frequency of the service.

At the IEP meering, the team discusses the student's prioriry educarional needs,goals and objectives. Basedupon the s$denCs goals and objectives, as determined by che team, they can then determine if the srudent'sgoals and objectives require the support of an occupational or physical rherapist. At this time, the therapistrecords the student's prioriry edueational goals and objectives that require the support of an occupationalandlor physical therapist on the CERT Summary Sheet.

The next secEion of the CERT form, the Therapy Profile, describes factors in five areas that commonly influencethe effectiveness of therapy services.Having reviewed the srudent's record, the therapist should go to the meeting knowing the number of years ofeducationally relevant sewice the srudent has received. Then the therapist should thoroughly read eachcolumn and choose the coiumn that best describes the following information:

o The number of years the student has received educationally rela,anttherupyo The student's potential response to educationally relevant therapy (To determine potencial response,

consider the srudent's current performance level and determine if therapy services are needed to supportthe IEP goals and objectives.)

o The srudent's abiliry to access their learning environment, including the need for community-basedinslntction with or without modificarions or accommodations required, and any recommended assistivetechnology

In determining the therapy services, the IEP team should consider the amounr of support needed tomeet the student's educational goals, recognizing that no one service delivery model is better than theother. Rather, therapy services are a conrinuum. The IEP team must keep in mind that therapy workstoward a funccional outcome that meets the srudent's goals.

Support services to be provided to school staff and/or parents, inciuding the amounr of training needed byteachers or parents to follow through on the student's educational program andwhether or nor trainedschool personnel can assist with adaptive equipment and techniques throughout rhe school day

The scores from each of the five areas in the Therapy Profile are then recorded on the Summary Sheet in theTherapy Proftle section. The scores are added together and the total recorded in rhe appropriate box.

In the Sources of Information and Additional Comments section, the therapist should include parent orteacher input and other information shared at the IEP meeting. The therapist complering the Therapy Profileshould sign and date this section, ensuring that no sections are left blank.

The IEP team-including the occupational and/or physical therapist-can now proceed with aRecommendation

forTherapy Services. The grid at the bottom of the CERT form is designed to assist in determining if therapyservices are indicated and, if they are, the frequency at which therapy should occur.

)

Using the score derived from the Srudent Profiie SecEion, place an X over the range that contains thesrudent's score on the top row of the grid. Using the score derived from the Therapy Profile secrion,place an X over the range that contains the srudent's score on the first coiumn of the grid. Draw a linedown from the srudent profile score and across from the therapy profile score. The point where thelines intersect indicates a recommended frequency of therapy. The therapist who atrends the IEPmeetingmust sign this section

For purposes of this video, we are providing the following examples as guidelines for the therapist to use ininterpreting the scoring grid:. Services are not indicated when the student is self-reliant and funcrional in the educational environmenr

or the student's needs are addressed by the classroom curriculum or other exisring services, which mayinclude any assistance provided by school staff.

r Periodic Services include environmental or equipment modifications and rraining and,/or consultationwith parents and/or school staff. Examples of therapy frequency at this level include once a month, Ewice agra&ngperiod, or once a semes[er.

. Regular Services include specific therapeutic strategies, environmental or equipment modifications, andrraining or collaboration with parents and school staff. Examples of therapy frequency include fwice amonth, once a week, or less than 45 minutes per week.

r Intensive Services include intensive therapeuric srrategies, muhiple environmental or equipmentmodifications, implemented throughout the day with classroom particrpation, and rraining of parenrsand/or school staff. Examples of therapy frequency include one or Ewo rimes a week or less than 60 minutesper week. Notes, such as a difference in the professional judgment of the therapist and the IEP team'srecommendation, should be noted on the comment secrion of the form.

According to the Individuals with Disabilities Educacion Act, the role of a related service, such asoccupacional or physical therapy, is to enable the student co benefit from special educarion in order ro receivea free appropriate public education. Occupational and physical therapists, along with other IEP teammembers, determine the need for educarionally relevant therapy.

.JL\KConsiderations for Educationally Relevant Therapy

OccupnnoNAL AND Pnvsrcnt Txempv Sunnuany Sneer

School District:

RelatedService(s): flOccupationalTherapy flenysicalTherapy

Florida Department of EducationBureau of Exceptional Education and Student Services

Student:

ESE Program(s):

Sources of lnformation and Additional Comments

Total Points: Completed by: Date:

To be completed at IEP meeting

According to 34 CFR 300.24, related services such as occr:pational and physical therapy are provided to assist the studentwith a disability to benefit from special education. The student's priority educational needs and goals and objectives identifiedon the IEP that require the support of an occupational therapist or physical therapist are:

gEe[\a.EoF

Points Sources of lnformation and Additional Comments

Number of Years Student Has ReceivedEducationally Relevant Therapy

Potential Response to Educationally Relevant Therapy

Student's Learning Environment

Therapy Services to Be Provided to Student

Support Services to Be Provided to School Staff/Parents

Total Points: Gompleted by: Date:

Student Protile

ooa.\a-goF

The IEP team recommendation is:

- ffi Occupational therapy is not indicated

_ ffi Physical therapy is not indicated.

Recommendation for Therapy Services

Place an X on the horizontal axis to reflect the score on theStudent Profile. Place an X on the vertical axis to reflect thescore on the Therapy Profile. The point where the axes inter-sect indicates a recommended frequency of therapy.

Therapist's Signature Print Therapisfs Name

_ Occupational therapy is indicated.

_ Physicaltherapy is indicated.

The recommended frequency of therapy is:

- Wperiodic.

- ffi regutar.

- I intensive

Comments:

(CERT-Revised 8/04)ESE 8575

0L r6Student Profile

Personal car+ management of personal needs and equipment within the educauonal environment

Sh.adent demonstrateadeqtnte dressing/undressirg,hygien€, self-feediry skills, ororal motor skills witr/rvithorXpresent equipment or devlces.

Sfudent demonstrateeadequate personal care skiilsusing equipmenUdarices.

Student requires supervision/proTpts fc dressing/urdreasing,h)€iene, sdf-feeding, or oralmotaskills.

Student require supervision/prompts to use personal careequipmenUdwices.

Student reguires physicalassistanceor specificSrategles for eessirg/urdressing, hygiene, sdf -feedng, or oral motor skills.

Student requires multipleequipment /devices and needsphyscal assistane.

Student requires Intensfuetrainirg by heragst tofacilitate ernergirg'dr€sslr41undressing, hlglene,sdf-feeding, or oral motorskills.

Sludent require mr/tpleequipmenUdevices anilneeds jntensive hainlng bytherapist in use of derrices.

Mobility- safe and adequate {no.v.9lnTt (e-g-' transfers, transitions between positions or locations, the ability tonavigate architecturar ba'iers) within the iuricationat environment vvetqsrro ur rv(

Student demonslratesadequate mobilig with pr*entequipment or denices.

Student dernonstratesa@uate mobility withortequipment or dwie.

Student dernonstraGsadequate hansferandtransition skills.

*

Student uses equipment ordevices for mobilit/ wift superui-sior/prompts.

Studant requlres supenrlsion/prompts for safe and dequatemobility.

Student requires superrrlsion/prompts to complete transitons/transfers.

Student reguires grysicalassistance or specific skatsgies to use equipment fcmobility.

Student requires physicalassistiance or specificstrategies for safe andadeqrate mobility.

Strrdent requires physlcalassistanceor specificstrategies to completetransitionsltransfers.

Student requires intenslvetralnirg by ttreapist lnspecific strategies for netrrequipment.

Student requlre intershotraining by therapist todemonstrate anergringimobiliVskills.

SMent requires lntenslwhainirq by herapisn bdenronstrate ernergnStransition/transfer sldlli.

Gt".."? M.oto1;.dw.dopmental motorskills, pcitioning equipment, and/or staticldynamic balance needed toparticipate within the educational environmdnt ' 'e -1--r'--'ii' 5'r

Sfudent sr as$Jme, maintaln,or cfiarqe positlons needed forparffdpation.

Stt.ldent dernonstratesadeguate gross motor skillsnded forpartidpafion

SMent dernmstratesadequate use of equipmenUpositioning dadces for grossmotorskills.

$tudenl require supenridon/prornpts to assume maintain, orchange pc$tbns.

Strdent requires supervislonlpronpb to perform gross motorskills.

Sfudant requires supenrislory'prompts to use equipmenUpasitbning deryi,ces for grossmotorskilfs.

Student requiree phlrsicalassistance ard/or speciflcslrategies to assume, mainhh,or change positions.

Student requires physlcalassistarrce or speciftc sbategies to perform gross motorskills.

Studvrt requirw physicalassistance andor specificstrategies to use equipmenU@timing device forgrwsmotqskills.

Sftdent has anergirg skillsand requires lntensiwhaldng byherag$ bassumef maintaio, orcharqe positions.

Student requireC lntanlhrefainirq tdperturmsossmotorskills. , r,

Sturdent requires multipletdals of positiontqg eqirtpment to accass theeducatimal envirorunenl

bk\k Therapy Profile

Number of Years student Has Received Educationally Relevant Therapy

More than 8 years of therapy 5 to I years oftherapy 3 to 5 years of thaapy Les than 3 years of therapy

Potential Response to Educationally Relevant Therapy

Student is ereected tofunction in the educationalswironment withort therapyseryie.

Student is elgec*ed to maintaincunent levd of performancewith pen:odic therapy serrrie inthe educational environment.

Student is eryeded to makeprogress torads educationalgoals with therapy senrices.

Student is el<pected to makesignificant progress tolrlardseducati,onal goals with therapyservices.

Student is able to access theleaming erwironment with/wifrtout use of conpensatoryskills or modifications.

Periodic revieur or modificationof the student's leamingenvironment, indudingoornmunity-based instrdionsites, is neccsary.

Regular rwievv or modificationof the student's learningenvironmqrt, indudingoommunr'ty-based insdrudionsits, is necessary.

bdensive revievv or modifietion of the studsrt's leamingenvironment, indudirgcornmunig-based instnrc-tionsites, is necessary.

Therapy Services to Be provided to Student

Strdent does not rquireinterventon by the theiapistorne sugg€sted modificationsare in plae.

Studsrt does not requireintenrention by the therapistto access and benelit fromspecial education.

StJdent requires paiodicsupport from the therapist tobenefit from special education.

Sttdsrt requires regularsupport from the therapist tobenefit ftrom spedal edr.rcation.

Student requires extensivesupport ftom the therapist tobenelit frorn specjal educationas strrdent's educational needsare ftequantly cfranging.

support services to Be Provided to school staffand/or parents

Statr/parents do not requirettrerapist involvement to€stablish a program andsdeci adaptive equipment,technique, or routines.

Staff/parenb require periodictherapist invdvesnent and/ortraining to etablish a programand sdect adaptive equipmant,techniques, or routines.

Staff/parents require regulartherapist inrolvernent and/orhaining to estauish a progftmard sded adaptive equignent,techniques, or routires.

Staff/parenb require intensfuetherapist involvenrent and/ortraining to estrablistr a programand select adaplive equipment,techniques, or routines.

Student Profile

Fine MotorMsual Motor-visual perception, visual motor, and fine motor skills needed to manipulate and managematerials within the educational environment

Stulent denronstratesadequate visual perceptualard/or Msual motor skills.

Sttdent can manipulateobjectsftools/ada$ive dwices.

**

Student requires supenrision/prompb to perfonn Msualperceptual and/or visual motorskills.

Student requires supervision/prompts to manipulateobrech/tools/adaptive dwices.

Student requires physicalassistance and/or specifi cstrategie to perform visualpercepfual and/or visual motorskills.

Student requires physicdassistance ard/or specif icstratqies to manipulateobjecdsltoolVadaptive dwices.

Student requires intensivetraining by thaapist to performvisual perceptual andorvisual motorskills.

Student requires intensivekaining by therapist todernonstrate enrergingmanipulation ofobiedMools/adaptive dedces.

*!|s:.w Processing- body awareness and sgnse of movement, sensory perception, exploration, and interactionwith others during play and work adivities within the eoucationai Lnvironment

Student toleratee movement,toucfr, todures, sights, sounds,and srndls occuning in theeducati,snal erwironment.Sfudent seeks appropriatesensory input.

Sludent adequately usessuggested technigues for sdf-regulation.

Stdent is able to makecfioices, organize, motor plan,and initiate tasks.

Student reguires super-vision/prompts to tolerate toudr,textures, sights, sounds, andsmells or to seek appropriatesensory input.

Student requires supervision/prompts to utilize suggestedtechniques for adequate sdf-regulation.

Student requires supenrision/prompts to make cfioices,organize, motor plan, andinitiate tasks.

Student require phpicalassistance and/or specifi cstrategies to deratemor/ernfft, toucfi , texture,siglrts, somds, and smdls orto seek appropriate sensoryinput.

Student requires phystcalassistrarrce ard or speciftcstrategies to utilize sqggestedtecfiniques for adeqtnte sdf-regulatior.

Student requips physicalassistance and/or specif icslrategies to make choices,organize, motor plan, andinitiate tasks-

Student requires intgrsiveintenrentions by therapist totolqate movernent, touch,teXures, sights, sourds, andsmdls cto seek appropriatesensory input.

Student requires intensivetraining by therapist to usesuggeted tecfiniques for sdf-regulation.

Student requires intensivetraining by theraftst to makechoiges, organia, motor plan,and initiate tasks.

* student's needs are addressed through dassroom qniculum or other existing senrices, rvhi,cfr may indude total assistance bysdmlstafi-