Specialty Certification in Environmental Modification

Specialty Certification in Environmental Modification (SCEM) is for occupational therapists and occupational therapy assistants who modify, adapt, or change contexts – especially the environments of home, school, work, or community. Practitioners determine environmental needs and provide intervention strategies, devices, space adaptations and/or assistive technology that reflect the person-environment fit and address occupational performance that maximizes participation, safety, accessibility, and independence. 

While all occupational therapy practitioners deliver environmental modification services at some level, a specialist in environmental modification brings a focused level of expertise to his or her practice that goes beyond what a generalist might be able to do. This involves implementation of, or overseeing environmental modification recommendations and evaluating their effectiveness, and modifying them as needed. As described in the AOTA position paper on Complex Environmental Modifications (AOTA, 2015), it may include:

  • Being involved in synthesizing (occupational therapists only) assessment results in order to prioritize and make well-reasoned recommendations regarding home, school, work, school, and/or community environments.
  • Delivering interventions that require specialized knowledge of assistive technology (AT), environmental modifications, and community resources to ensure that the solutions will meet the client’s immediate and future needs.
  • Recommending modifications that expand beyond routine consumer-grade and marketed adaptations such as grab bars, ramps, and AT.
  • Recommending modifications for clients with changes in function due to injury or disability or those with progressive or chronic conditions.

Specialization in SCEM might also include:

  • Consultation on residential and commercial projects requiring additional knowledge and experience such as remodeling and construction of new homes, work environments, and community spaces including plan review.
  • Consultation and collaboration on projects that include a general contractor, designer, or architect or modifications requiring building permits.
  • Advocating for the needs of those requiring modifications to home and community environments through interfacing with governmental agencies, payment sources, and community planners.

American Occupational Therapy Association. (2015). Complex environmental modifications. American Journal of Occupational Therapy, 69(Suppl.).


Download the overview. Parts 1 and 2 will make up the application. Please follow the instructions in Part 1 for submitting your completed application.

SCEM - Occupational Therapist (OT)

SCEM-A – Occupational Therapy Assistant (OTA)


Download the overview. Parts 1 and 2 will make up the application. Please follow the instructions in Part 1 for submitting your completed application.

Occupational Therapist (OT)