Early Intervention and Preschool Assessment

1. Early Intervention and Preschool Assessment Dr. George A. Giuliani Hofstra University

2. Overview of Lecture • This lecture focuses on the importance of assessment and education in the birth to 5-year-old population. After listening to this lecture, you should understand the following: • Overview and purpose of early intervention • Part C of the Individuals with Disabilities Education Improvement Act • Eligibility criteria for early intervention services • Evaluation of infants and toddlers for early intervention services • Individualized Family Service Plan (IFSP) • Purpose of the initial IFSP process • Notice required to families for an IFSP meeting

3. Overview of Chapter • Timeline corresponding with an IFSP • Contents of an IFSP • Early intervention services available to infants and toddlers • IFSP Reviews • Transition from early intervention to preschool settings • Overview of preschool assessment • The challenge of preschool assessment • Working with families

4. Early Intervention • In 1986, Congress created a nationwide incentive for states to implement coordinated systems of early intervention services for infants and toddlers with disabilities and their families by enacting P.L. 99-457. This is currently known as Part C of IDEIA. • Part C of the Individuals with Disabilities Education Improvement Act provides financial assistance to states for the purpose of providing services to infants and toddlers (age birth through two) with disabilities. The purpose of these services is to enhance the development of infants and toddlers with disabilities and to minimize their potential for developmental delay.

5. Early Intervention • Under Part C of IDEIA, states must provide services to any child “under 3 years of age who needs early intervention services” because the child: • “(i) is experiencing developmental delays, as measured by appropriate diagnostic instruments and procedures in one or more of the areas of cognitive development, physical development, communication development, social or emotional development, and adaptive development; or • (ii) has a diagnosed physical or mental condition which has a high probability of resulting in developmental delay” [34 C.F. R. 303.16; 20 U.S.C. 1432(5)(A)].

6. Eligibility Criteria for Early Intervention Services • Referral to early intervention services can be based on objective criteria, screening tests, or clinical suspicion. Under IDEIA (Part C), individual states retain the right to determine eligibility criteria for early intervention services, and some require referral within a certain time period. • The following two eligibility criteria are typical of most states: • 1. Birth to 3 years of age; and • 2. Developmental delay or deficit in one or more of these areas: • cognitive development (e.g., limited interest in environment, play, and learning); • physical and motor development, including vision and hearing (e.g., hypertonia, dystonia, asymmetry); • communication development (e.g., limited sound use, limited response to speech); • emotional-social development (e.g., impaired attachment, self-injurious behavior); and • adaptive development (e.g., feeding difficulties)

7. Evaluation of Infants and Toddlers for Early Intervention Services • IDEIA requires that a child receive a timely, comprehensive, multidisciplinary evaluation and assessment. The purposes of the evaluation and assessment are to find out: • the nature of the child’s strengths, delays, or difficulties, and • whether or not the child is eligible for early intervention services. • how the child functions in five areas of development: cognitive development, physical development, communication, social-emotional development, and adaptive development.

8. Evaluation of Infants and Toddlers for Early Intervention Services • When a child's needs are assessed and the child is found eligible for services, a service coordinator will be assigned to the family. • This person should have a background in early childhood development and methods for helping young children who may have developmental delays. The service coordinator should know the policies for early intervention programs and services in the parents’ state. • This person can help parents locate other services in their community, such as recreation, child care, or family support groups. • The service coordinator will work with the family as long as the baby is receiving early intervention services and, after the child is 2 years old, the service coordinator will help the family move on to programs for children ages 3 through 5.

9. Individualized Family Service Plan (IFSP) • An Individualized Family Service Plan (IFSP) documents and guides the early intervention process for children with disabilities and their families. • This written plan is developed with the family. The information gathered during the evaluation process is used to identify all of the services the child needs and services the family needs to enhance the development of their child. • The IFSP identifies and describes the services that are going to be provided and who will provide the services. • The IFSP also identifies the service coordinator who will assist families throughout the child’s eligibility.

10. Purposes of an Individualized Family Service Plan (IFSP) • An IFSP has many purposes including, but not limited, to the following: • To summarize all information known regarding the child's strengths and needs and the family's strengths, concerns, priorities, preferences, and current resources; • To review the family’s identified routines, daily activities, and natural environments; • To develop and refine outcomes the family has chosen (includes outcomes for both the child and the family); • To develop strategies for meeting the identified outcomes;

11. Purposes of an Individualized Family Service Plan (IFSP) • To determine appropriate services and supports that link to meeting the identified outcomes; • To develop a written document that will guide the family, the family service coordinator, and the other service providers; • To determine the responsibilities of each team member; • To determine how communication between the parent and other team members will be maintained; and • To determine where (natural environments), when, and how services and supports will be delivered to the child and family

12. Notice and the Individualized Family Service Plan (IFSP) • Under IDEIA, meeting arrangements must be made with, and written notice of the meeting provided to, the family and other participants early enough before the IFSP meeting date to ensure that they will be able to attend. • Parents must be informed of their rights prior to the meeting, including the right to bring a family member or other individual who knows the child and family and can contribute to preparing the IFSP. • If parents (or child advocate) are unable to attend the scheduled IFSP meeting, the team will not meet. The reason for the cancellation of the meeting must be documented in the child's records. The IFSP meeting must be rescheduled as soon as possible and at a time mutually agreed upon by the parents and other team members

13. Contents of the Individualized Family Service Plan (IFSP) • According to IDEIA, the contents of the IFSP MUST include: • a statement of the child's present levels of physical development (including vision, hearing, and health status), cognitive development, communication development, social or emotional development, and adaptive development...based on professionally acceptable objective criteria [34 C.F.R. 303.344(a)] • a statement of the family's resources, priorities, and concerns related to enhancing the development of the child (with the concurrence of family) [34 C.F.R. 303. 344(b)] • a statement of the major outcomes expected to be achieved for the child and family [34 C.F.R. 303.344(c)] • a statement of the criteria, procedures, and timelines used to determine the degree to which progress toward achieving the outcomes is being made [34 C.F.R. 303.344(c)(1)]

14. Contents of an Individualized Family Service Plan (IFSP) • a statement of the specific early intervention services necessary to meet the unique needs of the child and the family to achieve the outcomes identified including the location of the services [34 C.F.R. 303.344(d)(1)]. • the frequency, intensity, and method of delivering each early intervention service [34 C.F.R. 303.344(d)(1)(i)]. • a statement of the specific early intervention services to be provided in the natural environments and a justification of the extent, if any, to which the services will not be provided in a natural environment [34 C.F.R. 303.344(d)(1)(ii)]. • the payment arrangements, if any [34 C.F.R. 303.344(d)(1)(iv)]. • a statement of whether modifications or revisions of the outcomes or services are necessary [34 C.F.R. 303.344(c)(2)]. • the projected dates for initiation of the services...as soon as possible after the IFSP meetings [34 C.F.R. 303.344(f)(1)].

15. Contents of an Individualized Family Service Plan (IFSP) • the anticipated duration of those services [34 C.F.R. 303.344(f)(2)]. • parental consent for the early intervention services. If the parents do not provide consent with respect to a particular early intervention service or withdraw consent after first providing it, that service may not be provided [34 C.F.R. 303.342(e)]. • the steps to be taken to support the transition of the child to Preschool services under Part B of IDEIA, or other services that may be available, if appropriate [34 C.F.R. 303.344(h)(1)]. • the name of the service coordinator from the profession most immediately relevant to the child's or family's needs (or who is otherwise qualified to carry out all applicable responsibilities), who will be responsible for the implementation of the IFSP and coordination with other agencies and persons [34 C.F.R. 303.344(g)(1)].

16. Attendance at an IFSP Meeting • Each initial IFSP meeting must include the following participants: • the parent or parents of the child; • other family members, as requested by the parent(s) if feasible to do so; • an advocate or person outside of the family, if the parent requests that the person participate; • a service coordinator a person or persons directly involved in conducting the evaluations and assessments; and, • as appropriate, specific providers to the child and/or family [34 C.F.R. 303.343].

17. Early Intervention Services Available to Infants and Toddlers • Early Intervention Services include: • Assistive technology Audiology • Family training, counseling, and home visits Health services • Medical services (only for diagnostic or evaluation purposes). • Nursing Nutrition. • Occupational therapy Physical therapy • Psychological services Service coordination • Social work services Special instruction • Speech and language pathology Transportation and related costs • Vision services

18. IFSP Reviews • Periodic IFSP reviews for a child and his or her family must be conducted every six months or more frequently if conditions warrant, or if the family requests a review. • Such reviews may be carried out at a face-to-face meeting or by another means that is acceptable to the parents and other participants. • The intent of this review is to ensure that the constantly changing developmental needs of the child and priorities of the family are acknowledged and documented.

19. Transition from Early Intervention to Preschool Settings • When the child with a disability nears the age of three, he or she must be considered for services beyond early intervention services. These services include, but are not limited to, special education preschool programs (under Part B of the IDEIA), Head Start programs, and public and private preschool programs. • Special education preschool programs are available to children with disabilities who are 3 to 5 years old. If the child is eligible for preschool special education services, he or she must have an Individualized Education Program (IEP) in place by age three. All services provided under the IEP must be free to the parents. If a child is not eligible for special education preschool, Head Start, or public or private preschool programs should be considered.

20. Preschool Assessment • Early childhood education consists of activities and/or experiences that are intended to effect developmental changes in preschool children prior to their entry into elementary school. • Early childhood education programs include any type of educational program that serves children in the preschool years and is designed to improve later school performance. • The goal of assessment in early childhood is the same as it is for an individual of any age—that is, to derive information to facilitate decision making with respect to that individual. Such decisions revolve around the potential existence, implications, and treatment needs of problems for the child and family.

21. The Challenge of Preschool Assessment • Environmental and cultural influences must be considered when testing young children. Special educators can expect much more variability in test performance due to environmental influences on infants and preschool children than on older school-age children. • Cultural influences also must be considered, as they may affect parenting style and the child’s responsiveness to the examiner and the testing process. For instance, a young Native American child may make less eye contact, act more shy, and be less verbal with the examiner than a Caucasian child, but these differences may represent cultural influences rather than developmental delay. • Reviewing the cross-cultural literature regarding the developmental performance of infants who are African American, Asian American, Hispanic, and other cultural groups would be helpful to the prospective examiner.

22. The Challenge of Preschool Assessment • To effectively meet the challenges posed, the assessment process in early childhood should try to achieve eight fundamental goals: • Determine the eligibility for services and the appropriateness of alternative environments • Identify developmentally appropriate and functional intervention goals • Identify the unique styles, strengths, and coping strategies of each child • Identify parents’ goals for their children and their needs for themselves • Build and reinforce parents’ sense of competence and worth • Develop a shared and integrated perspective on child and family needs and resources • Create a shared commitment to intervention goals • Evaluate the effectiveness of services for children and families

23. Conclusion • The early years of a child’s life are extremely important. During the infant and toddler years, children grow quickly and have much to learn. However, some children and families face special challenges and need extra help. • Early help does make a difference. Young children present many challenges to the special educator, who is charged with evaluating their intellectual, language, motor, and adaptive functioning. Normal developmental transitions of infancy and early childhood influence motivation, interest, and cooperation with the testing process. • The special educator experienced in testing school-age children may expect a young child to exhibit appropriate “testing behavior”—sitting quietly at a desk, attending to a task at hand, and being motivated to complete the tasks presented. Such characteristic testing behavior is not often present in this age group or, if present, is limited to a few brief moments. • The special educator examining young children must be aware of the developmental influences affecting the young child and must be flexible enough to adapt the testing procedures accordingly.