NECTAC Webinar Series on Early Identification and Part C Eligibility

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NECTAC Webinar Series on Early Identification
and Part C Eligibility

• Session 4 Streamlining Eligibity Determination
  for Part C Early Intervention
• May 10, 2010

Carl J. Dunst, Ph.D
Orelena Hawks Puckett Institute Asheville, NC
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Purposes

• Clarify the meaning of the categories of infants
  and toddlers who are eligible for Part C early
  intervention
• Describe the procedures for developing
  guidelines for simplifying eligibility
  determination for participation in Part C early
  intervention

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Placing the Streaming Process in Perspective(A
short history of eligibility determination)
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United States of America Committee on Education
and LaborCongressional Report 99-860Education
of the Handicapped Act Amendments of 1986

• Definition of the term Handicapped Infants and
  Toddlers
• 1. Experiencing developmental delays, as
  measured by
• appropriate diagnostic instruments and
  proceduresor
• 2. have a diagnosed physical or mental
  condition which has a high probability of
  resulting in a developmental delay (emphasis
  added) (e.g., a child with Down Syndrome is de
  facto eligible)

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Congressional Report 99-860

• Meaning of Term Diagnosed Physical and Mental
  Condition
• A condition which has a high probability of
  resulting in a
• developmental delay and includes infants and
  toddlers who will
• need early intervention services even though many
  will not
• exhibit developmental delays at the time of
  diagnosis
• (emphasis added)
• The term diagnosed physical and mental
  condition may also
• include at a States discretioninfants and
  toddlers who are at
• risk of having substantial developmental delays
  if early
• intervention services are not provided (emphasis
  added)

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Individuals with Disabilities Education
Improvement Act of 2004Public Law 108-446

• An infant or toddler with a disability means an
  individual who
• (A)(i) is experiencing developmental delays as
  measured by appropriate diagnostic instruments
  and procedures,
• (A)(ii) has a physical or mental condition that
  has a high probability of resulting in
  developmental delays, and
• (B)(i) at risk infants and toddlers who may
  experience a substantial developmental delay if
  early intervention were not provided

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Tracking, Referral and Assessment Center for
Excellence (TRACE)

• I want to take the information about eligibility
  and describe
• the development of an eligibility determination
  process that
• attempts to streamline eligibility decisions.

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Decision Making Algorithms
An algorithm is a step-by-step decision-making
process that results in an accurate decision in
as few steps as possible The more straightforward
the decision making process, the higher the
probability that accurate decisions will be made
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An Eligibility Determination Algorithm
The eligibility criteria for Part C early
intervention were used to develop a
decision-making process that could facilitate and
streamline infants and toddlers enrollment in
early intervention.
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(No Transcript)
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Decision Rules
1. If a child has an identified condition or
diagnosis that has a high probability of
resulting in a developmental delay and the
condition or diagnosis is included in the States
eligibility definition, then the child is
eligible for early intervention. 2. If a child
has one or more biological at-risk conditions and
any of these conditions are included in the
States eligibility criteria, then the child is
eligible for Part C early intervention. 3. If a
child has one or more environmental risk
conditions and the number of conditions a child
is experiencing meets the States eligibility
criteria, then the child is eligible for early
intervention. 4. If the child has no identified
condition or diagnosis and no biological or
environmental risk factors but has a
developmental delay and the degree of the delay
meets a States eligibility criteria, then the
child is eligible for early intervention. 5. If
the child does not meet any of the above
conditions but informed clinical opinion
indicates that the child has an obvious need,
then the child may be considered eligible for
early intervention.
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Eligibility Determination Decision Algorithm
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Relationship Between Federal and State
Eligibility Criteria
Federal Criteria
State Criteria
Step 1
Is the condition included in the States
Eligibility Definition?
Does the child have an identified condition?
Yes
Yes
Child is Eligible for Early Intervention
No
No
to Step 2
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Relationship Between Federal and State
Eligibility Criteria
Federal Criteria
State Criteria
Step 2
Is the biological risk condition included in the
States Eligibility Definition?
Does the child have a biological risk condition?
Yes
Yes
Child is Eligible for Early Intervention
No
No
to Step 3
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Relationship Between Federal and State
Eligibility Criteria
Federal Criteria
State Criteria
Step 3
Are the environmental risk factors included in
the States Eligibility Definition?
Does the child experiencing environmental risk
factors?
Yes
Yes
Child is Eligible for Early Intervention
No
No
to Step 4
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Relationship Between Federal and State
Eligibility Criteria
Federal Criteria
State Criteria
Step 4
Does the child have an established developmental
delay?
Does the degree of delay meet the States
Eligibility Definition?
Yes
Yes
Child is Eligible for Early Intervention
No
No
to Step 5
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Relationship Between Federal and State
Eligibility Criteria
Federal Criteria
State Criteria
Step 5
Is there a developmental concern that warrants
intervention?
Yes
Yes
Is early intervention warranted based on clinical
opinion?
Child is Eligible for Early Intervention
Child is not eligible for early intervention
No
No
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Field-Test of the Algorithm

• As part of research at TRACE, we used the
  eligibility
• determination algorithm on a sample of 180
  infants and toddlers
• to determine the usability of the decision making
  process.ª
• Results showed that the decision-making process
  correctly
• identified eligible children at a 95 accuracy
  rate.
• ª Mott, D.W., Dunst, C.J. (2006). Use of
  presumptive eligibility for enrolling children in
  Part C early intervention. Journal of Early
  Intervention, 29, 22-31.

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What is Needed to Use the Algorithm?

• An operational definition of developmental delay,
  explicit procedures for administering and scoring
  a developmental scale or instrument, and clearly
  defined steps for determining if a childs
  developmental standing meets a States definition
  of delay.
• A list of identified conditions that without
  exception make a child eligible for early
  intervention.
• If included in a States eligibility definition,
  a list of risk factors and the particular number
  or constellation of factors that make a child
  eligible for early intervention.
• Clearly stated guidelines and procedures for
  making a child eligible for early intervention
  using informed clinical opinion.

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State of the States

• Most States and Jurisdictions (N 47) do not
  serve at-risk infants and toddlers
• The level of developmental delay necessary to be
  eligible for early intervention has become
  increasingly more stringent
• The identified conditions that make a child
  eligible for early intervention are in some cases
  not as explicit as necessary and in other cases
  are not known by providers at the street-level
• Procedures for using informed clinical opinion
  are more often than not vague and difficult to
  understand

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Conclusion

• One of the conclusions of the Presidents
  Commission on
• Special Education (2001) was that IDEA
  establishes complex
• requirements that are difficult to effectively
  implement at the
• state and local level. Nowhere in IDEA is this
  more complex than
• the eligibility determination process. Add to
  this the
• cumbersome and complex procedures states have in
  the past
• and continue to develop, and the complexity is
  compounded.
• Eligibility determination need not be a
  cumbersome process, and
• methods like and eligibility determination
  algorithm could
• streamline infant and toddler enrollment in early
  intervention and
• ensure the timely provision of early intervention
  supports.

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NECTAC Webinar Series on Early Identification
and Part C Eligibility

• Session 4 Streamlining Eligibility
  Determinations for Part C Early Intervention
• May 10, 2010

Thank you for listening. Presentations from this
series and their related resources are made
available on the NECTAC Web Site
at http//www.nectac.org/calls/2010/earlypartc/
earlypartc.asp