Early Intervention 101
WHAT SHOULD YOU TAKE
FROM THIS PRESENTATION?
Learning Objectives
By the end of this training, you will be able to:
1) Identify at least 2 effects of prenatal drug/alcohol exposure
2) Explain the responsibilities of an Education Rights Holder
3) Know how to refer a child to the regional center for early intervention services
4) Understand the transition from regional center to school district services around age 3
•
All children develop and learn in different ways.
•
Being eligible for early intervention services does not mean that the child is “dumb” or cannot learn.
•
Just means they need specialized services to assist with their learning and development.
Alliance for Children’s Rights Education Manual Page 2, Handout #1
THE TRUTH ABOUT CHILDREN WHO NEED
EARLY INTERVENTION SERVICES
IMPORTANT FACTS ABOUT CHILDREN IN FOSTER CARE
• Incidence of disability in general population is 15%, in foster care it is 50%.
• Only 40% of foster youth graduate from high school.
• Only 3% of foster youth earn a college degree.
• Early Intervention can change the direction of a child’s life!
THEORY OF EARLY INTERVENTION
What Are We Trying to Accomplish?
PURPOSE OF EARLY INTERVENTION
• Theory:
• Serving kids earlier reduces delays, prepares children for school either without the need for special education or less special education services
EFFECTS OF PRENATAL DRUG
EXPOSURE
OVERVIEW OF SUBSTANCES THAT ADVERSELY AFFECT INFANTS
• Nicotine: causes a host of problems including low birth weight ‐ a significant risk factor for developmental delay. It can also affect cognition and is associated with behavioral problems
• Cocaine, Marijuana, and Other Illicit drugs:
• Cocaine and Marijuana: impaired attention, language, learning skills, and behavioral problems.
• Methamphetamine: low birth weight, decreased arousal, and poor quality of movement in infants
• Heroin: low birth weight
• Alcohol: most widely used substance during pregnancy
Information from the National Institute on Drug Abuse www.drugabuse.gov
FETAL ALCOHOL SPECTRUM DISORDER “FASD”
• FASD is a catchall term to describe various effects of prenatal alcohol exposure.
• Babies and children with fetal alcohol syndrome may have:
• Low birth weight
• Problems eating and sleeping
• Impaired hearing and vision
• Difficulty following directions and learning how to do simple things
• Trouble paying attention and learning in school
• Difficulty getting along with others and controlling their behavior
• Need for medical care all their lives
See Handout #2 “FASD: My Story”
Information obtained from the National Institute on Alcohol Abuse and Alcoholism http://www.niaaa.nih.gov/& CDC.gov
HOW TO IDENTIFY
DEVELOPMENTAL DELAYS:
DEVELOPMENTAL SCREENINGS
WHAT IS A DEVELOPMENTAL SCREENING?
• It is a broad term used to describe something that is done to tell if the child is learning basic skills typical for that child’s age
• It can be any tool used to spot delays in a child’s development:
• A short test
• A series of questions
• A checklist
• A formal screening administered by a professional such as a pediatrician
DEVELOPMENTAL SCREENINGS
• Great resource for high quality milestones:
http://www.cdc.gov/ncbddd/actearly/milestones/index.html
See Handout #3
EDUCATION RIGHTS
WHO HAS THE LEGAL RIGHT TO MAKE
DECISIONS FOR EARLY INTERVENTION SERVICES?
• The Education Rights Holder (ERH) has the legal right to make education‐related decisions for a child, including: requesting records, early intervention evaluations and assessments, and consenting to early intervention services and placements in the Individualized Family Service Plan (IFSP).
Alliance for Children’s Rights Education Manual Page 4
WHAT YOU SHOULD KNOW ABOUT ERH
•
Who can hold Ed rights?
•
Why might Ed rights change?
•
How are Ed rights changed?
Alliance for Children’s Rights Education Manual Page 4
REFERRING CHILDREN FOR EARLY
INTERVENTION SERVICES
WHO PROVIDES EARLY INTERVENTION SERVICES IN CALIFORNIA?
• Local regional centers contract with the state to provide
services to children ages 0‐3 under a program called Early Start.
Local education agencies serve children with low incidence disabilities.
• Regardless of whether you think your child has a
developmental delay or a low incidence disability, the initial referral should be sent to your local regional center.
• Step 1: Find the child’s local regional center:
http://www.dds.ca.gov/RC/RCZIPLookup.cfm
• Step 2: Send the regional center a referral letter requesting a developmental evaluation and comprehensive assessments.
See Handout 4 for a sample referral letter
• Step 3: Contact the child’s social worker and request that the social worker also submit a referral on Form 5004.
EVALUATIONS & ASSESSMENTS
THE EVALUATION AND ASSESSMENT
•
After a referral is made a regional center representative will contact the ERH to discuss their concerns.
•
Next step: Evaluation and Assessment
• The Evaluation: Looks at all areas of development to determine Early Start eligibility.
• The assessment: A more detailed examination of a particular area of development (i.e., communication, gross motor) used to determine the amount of service the child will receive.
Alliance for Children’s Rights Education Manual page 9
TIMELINES
DATES AND TIMELINES TO MONITOR
• Initial Referral – this is the date that either you or the social worker first contacted the regional center to make the referral
• 45‐day timeline – the regional center has 45 days from the date of the referral to evaluate and assess the child in all necessary areas and develop the IFSP.
• Calculate and keep track of when the IFSP is due!
• Day 35 – if you have not heard from the regional center by day 35 to schedule the IFSP meeting, call the regional immediately to schedule the meeting
• If the IFSP is held late, the child may be entitled to compensatory or “make up”
services dating back to the date when the IFSP should have been held.
Alliance for Children’s Rights Education Manual Page 4
THE INDIVIDUALIZED FAMILY
SERVICE PLAN “IFSP”
3 ways to be eligible for the Early Start program:
1) Developmental Delay – a 33% delay in any one area
• Cognitive Development
• Adaptive Development
• Social‐Emotional Development
• Communication Development
• Physical & Motor Development, Including Vision and Hearing
2) Established Risk Condition
3) High Risk
DETERMINING ELIGIBILITY
Alliance for Children’s Rights Education Manual Page 10
WHAT IS THE IFSP AND WHO SHOULD BE PART OF THE TEAM?
• The IFSP is the plan to improve the child’s development
• Required members of the IFSP team are:
• Education Rights Holder
• Regional Center Service Coordinator
• Early Intervention service providers/evaluators/assessors
• Optional members
• CASA
• Social worker
• Other family members (if appropriate)
• Others who know about the child’s needs
Alliance for Children’s Rights Education Manual page 11
WHAT IS INCLUDED IN THE IFSP?
• An IFSP includes:
• Present Level of Development: child’s strengths and weaknesses/needs in each developmental area
• Developmental Outcomes: goals for the next 6 months in each area of identified need
• Outcomes must include how and when progress will be measured
• Ex: Sally will learn 10 new words in the next 6 months.
• Specific Early Intervention Services
Alliance for Children’s Rights Education Manual page 11
WHAT ARE EARLY INTERVENTION SERVICES?
• Services are designed to meet the child’s needs in 5 developmental domains.
• The most common services are:
• Infant Stimulation or a Center‐Based Program
• Speech and Language Therapy
• Physical Therapy
• Occupational Therapy (feeding, fine motor, adaptive, sensory processing)
• The type and amount of service should be clearly written into the IFSP document.
Alliance for Children’s Rights Education Manual page 11
IFSP CONT.
• Duty to Use Generic Resources
• Insurance/Medi‐Cal must be used to access services before regional center funding is used
• This requirement does not apply to evaluations/assessments
• Many services may be covered by insurance/Medi‐Cal but this is a slow process, so start as early as possible
• In order to prevent delay, request that the regional center provide “gap funding” for all services required in the child’s IFSP
• How to access services through Insurance/Medi‐Cal
• Describe delays to child’s pediatrician and request prescription for specific service
• If insurance denies service take that denial to the child’s service coordinator and the regional center will have to provide the service.
Alliance for Children’s Rights Education Manual page 12
IFSP CONT.
• Signing the IFSP
• Before signing, review all outcomes, services and notes to ensure they clearly outline what the child will receive
• Do not sign a blank document
• Services cannot begin until IFSP is signed
• If there are parts of the IFSP that the ERH agrees with, but others she does not, the ERH can sign for implementation of only the portions agreed to, as long as that is clearly written on signature page
• Don’t leave the meeting without a copy of the service page, including ERH signature
• Request a copy of the IFSP document be sent to you within 5 business days
WHAT HAPPENS TO A CHILD’S
EARLY INTERVENTION SERVICES
WHEN HE MOVES?
Regional Center Transfers
• When a child moves, such as when a child changes placements, the child’s Early Start case will need to be transferred to a
different regional center if the child is living in a new service area.
• AB 1089, which came into effect this year, requires the new regional center resume services for foster children within 30 days of receiving notice of the move.
• The child’s social worker must notify the former regional center immediately of the move.
• If services do not resume within 30 days, regional centers are now required to notify the court and explain the delay.
TRANSITIONING & PRE‐SCHOOL
BENEFITS OF PRESCHOOL
All children benefit from enrolling in a high‐quality early care and education program to develop skills that
contribute to school success, regardless of whether or not they have a developmental delay. Preschool also helps
children prepare for kindergarten both academically and
socially. See Handout #5
Comparison of early intervention services for children ages 0‐3 and children 3‐5
Part B: special education 3-22 years old
• Helps kids w/ disabilities benefit from education
• School districts
• Assessment and IEP
See Manual page 29
Part C: early intervention 0-3 years old
• Remediates delays early
• Regional centers
• Assessment and IFSP
TRANSITION FROM REGIONAL CENTER TO SCHOOL DISTRICT SERVICES
• Why do Early Start services through the regional centers stop at age 3?
• Early Start ends on child’s third birthday
• If child is diagnosed with a developmental disability, he may continue to receive regional center services under the Lanterman Act after age 3 and may also receive special education through their school district.
• If the child does not have a developmental disability but still has developmental delays he may be eligible for special education through his local school district.
• How do we figure out what program the child will be eligible for?
Alliance for Children’s Rights Education Manual Page 14
CHRISTOPHER’S STORY
• Christopher is 18 months old. He is making some sounds but he is not babbling and has not said any words. Christopher is able to pull himself up to standing but is not yet walking.
Christopher’s caregiver reports that he is very “jumpy” and gets easily startled by sounds. Caregiver also mentioned that
Christopher was waving bye‐bye but has stopped and doesn’t give her hugs or kisses. Christopher is able to feed himself
crackers and fruit and can hold a sippy cup.
• What can you do to help Christopher?
How can the Alliance for Children’s Rights help?
• If you feel that the child would benefit from representation by an attorney you can request that the child’s attorney send a “0‐3 Referral for Regional Center Advocacy” to our office.
See Handout #6
• The caregiver or ERH can also contact our intake line at 213.368.6010.
For more information contact us at 213.368.6010 www.kids‐alliance.org