Module III: IFSP outcomes in natural environments
Unit 3 Lesson 2: Early Intervention Services (EIS)
Early Intervention Services (EIS) is the last lesson in Module III. There are a number of regulations to read and understand. Please take the time to carefully read through the regulations. As a provider you will be responsible for following these laws and practicing in accordance with them.
Early Intervention Services (EIS) (34 CFR 303.12)
c) General. As used in this part, early intervention services means services that --
1) are designed to meet the developmental needs of each child eligible under this part and the needs of the family related to enhancing the child’s development;
2) are selected in collaboration with the parents;
3) are provided:
i) under public supervision,
ii) by qualified personnel, as defined in Sec. 303.21, including the types of personnel listed in paragraph (e) of this section,
iii) in conformity with an individualized family service plan, and
iv) at no cost, unless subject to Sec. 303.520 (b) (3), Federal or State law provides a system of payments by families, including a schedule of sliding fees; and,
4) meets the standards of the State, including the requirements of this part.
d) Natural environments: To the maximum extent appropriate to the needs of the child, early intervention services must be provided in natural environments, including the home and community settings in which children without disabilities participate.
e) General role of service providers. To the extent appropriate, service providers in each area of early intervention services included in paragraph (d) of this section are responsible for --
1) consulting with parents, , other service providers, and representatives of appropriate community agencies to ensure the effective provision of services in that area;
2) training parents and others regarding the provision of those services; and,
3) participating in the multidisciplinary team’s assessment of a child and child’s family and in the development of integrated goals and outcomes for the individualized family service plan
f) EIS includes:
1) Assistive technology device means any item, piece of equipment, or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve the functional capabilities of children with disabilities. Assistive technology service means a service that directly assists a child with a disability in the selection, acquisition, or use of an assistive technology device. Assistive technology services include:
i) the evaluation of the needs of a child with a disability, including a functional evaluation of the child in the child’s customary environment;
ii) purchasing, leasing, or otherwise providing for the acquisition of assistive technology devices by children with disabilities;
iii) selecting, designing, fitting, customizing, adapting, applying, maintaining, repairing, or replacing assistive technology devices;
iv) coordinating and using other therapies, interventions, or services with assistive technology devices, such as those associated with existing education and rehabilitation plans and programs;
v) training or technical assistance for a child with disabilities or if appropriate, that child’s family; and,
vi) training or technical assistance for professionals (including individuals providing early intervention services) or other individuals who provide services to, or are otherwise substantially involved in the major life functions of individuals with disabilities.
2) Audiology includes:
i) identification of children with auditory impairments, using at risk criteria and appropriate audiologic screening techniques;
ii) determination of the range, nature, and degree of hearing loss and communication functions, by use of audiological evaluation procedures;
iii) referral for medical and other services necessary for the habilitation or rehabilitation of children with auditory impairment;
iv) provision of auditory training, aural rehabilitation, speech reading and listening device orientation and training, and other services;
v) provision of services for prevention of hearing loss; and
vi) determination of the child’s need for individual amplification, including selecting, fitting, and dispensing appropriate listening and vibrotactile devices, and evaluating the effectiveness of those devices.
3) Family training, counseling, and home visits means services provided, as appropriate, by social workers, psychologists, and other qualified personnel to assist the family of a child eligible under this part in understanding the special needs of the child and enhancing the child’s development.
4) Health Services (See Section 303.13)
5) Medical Services only for diagnostic or evaluation purposes means services provided by a licensed physician to determine a child’s developmental status and need for early intervention services.
6) Nursing Services include:
i) the assessment of health status for the purpose of providing nursing care, including the identification of patterns of human response to actual or potential health problems;
ii) provision of nursing care to prevent health problems, restore or improve functioning, and promote optimal health and development; and,
iii) administration of medications, treatments and regimens prescribed by a licensed physician.
7) Nutrition Services includes conducting individual assessments in:
i) nutritional history and dietary intake;
ii) anthropometric, biochemical, and clinical variables;
iii) feeding skills and feeding problems; and,
iv) food habits and food preferences;
v) developing and monitoring appropriate plans to address the nutritional needs of children eligible based on assessment findings; and,
vi) making referrals to appropriate community resources to carry out nutrition goals.
8) Occupational Therapy includes services to address the functional needs of a child related to adaptive development, adaptive behavior and play, and sensory, motor, and postural development. These services are designed to improve the child’s functional ability to perform tasks in home, school, and community settings and include:
i) identification, assessment and intervention;
ii) adaptation of environment, and selection and design and fabrication of assistive and orthotic devices to facilitate development and promote the acquisition of functional skills; and,
iii) prevention or minimization of the impact of initial or future impairment, delay in development or loss of functional ability.
9) Physical Therapy includes services to address the promotion of sensorimotor function through enhancement of musculoskeletal status, neurobehavioral organization, perceptual and motor development, cardiopulmonary status, and effective environmental adaptation. These services include:
i) screening, evaluation, and assessment of infants and toddlers to identify movement dysfunction; and,
ii) obtaining, interpreting, and integrating, information appropriate to program planning to prevent, alleviate, or compensate for movement dysfunction and related functional problems, and
iii) providing individual and group services or treatment to prevent, alleviate, or compensate for movement dysfunction and related functional problems.
10) Psychological Services include:
i) administering psychological and developmental tests, and other assessment procedures;
ii) interpreting assessment results;
iii) obtaining, integrating and interpreting information about child behavior, and child and family conditions related to learning, mental health, and development; and,
iv) planning and managing a program of psychological services, including psychological counseling for children and parents, family counseling, consultation on child development, parent training and education programs.
11) Service coordination services means assistance and services provided by a service coordinator to an eligible child and the child’s family that are in addition to the following functions and activities as defined in 34 CFR 303.23.
12) Social Work Services include:
making home visits to evaluate a child’s living conditions and patterns of parent-child interaction;
i) preparing a social or emotional developmental assessment of the child within the family context;
ii) providing individual and family-group counseling with parents and other family members, and appropriate social skill-building activities with the child and parents;
iii) working with those problems in a child’s and family’s living situation (home, community, and any center where early intervention services are provided) that affect the child’s maximum utilization of early intervention services; and,
iv) identifying, mobilizing, and coordinating community resources and services to enable the child and family to receive maximum benefit from early intervention services.
13) Special Instruction includes:
i) the design of learning environments and activities that promote the child’s acquisition of skills in a variety of developmental areas, including cognitive processes and social interaction;
ii) curriculum planning, including the planned interaction of personnel, materials, and time and space, that leads to achieving the outcomes in the child’s individualized family service plan;
iii) providing families with information, skills, and support related to enhancing the skill development of the child; and,
iv) working with the child to enhance the child’s development.
14) Speech/Language Pathology includes:
i) identification of children with communicative or oropharyngeal disorders and delays in development of communication skills, including the diagnosis and appraisal of specific disorders and delays in those skills;
ii) referral for medical or other professional services necessary for the habilitation or rehabilitation of children with communicative or oropharyngeal disorders and delays in development of communication skills; and,
iii) provision of services for the habilitation, rehabilitation or prevention of communicative or oropharyngeal disorders and delays in development of communication skills.
15) Transportation and Related Costs includes the cost of travel (e.g., mileage, or travel by taxi, common carrier, or other means) and related costs (e.g., tolls and parking expenses) that are necessary to enable a child eligible for the program and the child’s family to receive early intervention services.
16) Vision Services means:
i) evaluation and assessment of visual functioning, including the diagnosis and appraisal of specific visual disorders, delays, and abilities;
ii) referral for medical or other professional services necessary for the habilitation or rehabilitation of visual functioning disorders, or both; and,
iii) communication skills training, orientation and mobility training for all environments, visual training, independent living skills training, and additional training necessary to activate visual motor abilities.
g) Qualified personnel.
Early intervention services must be provided by qualified personnel, including:
1) Audiologists;
2) Family therapists;
3) Nurses;
4) Nutritionists;
5) Occupational therapists;
6) Orientation and mobility specialists;
7) Pediatricians and other physicians;
8) Physical therapists
9) Psychologists;
10) Social workers;
11) Special educators; and,
12) Speech and language pathologists.
(Authority: 20 U.S.C. 1401[1] and [2] 1432[4] )
Note: The lists of services in paragraph (d) and qualified personnel in paragraph (e) of this section are not exhaustive. Early intervention services may include such services as the provision of respite and other family support services. Qualified personnel may include such personnel as vision specialists, paraprofessionals, and parent-to-parent support personnel.
(58 FR 40959, July 30, 1993, as amended at 63 FR 18294, Apr. 14, 1998; 64 FR 12535, Mar. 12, 1999)
Following is an outline of the regulations regarding the documentation of services in the IFSP. Take a few minutes to read this resource.
Health Services (34 CFR 303.13)
a) As used in this part, health services means services necessary to enable a child to benefit from the other early intervention services under this part during the time that the child is receiving the other early intervention services.
b) The term includes:
1) such services as clean intermittent catheterization, tracheotomy care, tube feeding, the changing of dressings or colostomy collection bags, and other health services, and
2) consultation by physicians with other service providers concerning the special health care needs of eligible children that will need to be addressed in the course of providing other early intervention services.
c) The term does not include
1) services that are:
i) surgical in nature (such as cleft palate surgery, surgery for club foot, or the shunting of hydrocephalus); or
ii) purely medical in nature (such as hospitalization for management of congenital heart ailments, or the prescribing of medicine or drugs for any purpose);
2) devices necessary to control or treat a medical condition; or,
3) medical-health services (such as immunizations and regular “well-baby” care) that are routinely recommended for all children.
(Authority: 20 U.S.C. 1432[4])
NOTE: The Definition in this section distinguishes between the health services that are required under Part C of the IDEA and the medical-health services that are not required. The IFSP requirements under Part C provide that, to the extent appropriate, these other medical-health services are to be included in the IFSP, along with the funding sources to be used in paying for the services or the steps that will be taken to secure the services through public or private sources. Identifying these services in the IFSP does not impose an obligation to provide the services if they are otherwise not required to be provided under Part C of IDEA. (See Sec. 303.344(e) and note 3 following that section.)
Key points from the regulations for Early Intervention Services:
1. Frequency
2. Intensity
3. Method (e.g., consulting, training, participating)
4. Natural environments (include any justification for not providing services in the natural environment)
5. Location
6. Payment source
7. Other services
8. Dates of initiation and duration
9. Name of service coordinator
Review questions:
1. What are the four main components of early intervention services?
2. Natural environments includes what settings beside the home?
3. What is the definition of an assistive technology device?
4. In the definition of EIS is there a provision for services to prevent hearing loss?
5. Occupational therapy provides for improving a child's functional ability to perform tasks in what three places?
6. True or False - Psychological services include provisions for parents and families.
7. True or False - Speech/Language services include habilitation or rehabilitation of children with delays in the development of communication skills.
8. There are the 12 identified "qualified personnel" allowed to provide EIS services. Who are they?
Reflection questions:
1. Early intervention services are designed to meet the developmental needs of the child and his or her family related to enhancing the child’s development. How is this different than the medical model that stresses observable normed developmental guidelines?
2. The general role of service providers includes consulting with families, training parents and others about services, and participating in the team’s assessment of the child and the family and the development of integrated outcomes for the IFSP. The natural environmental model provides services in surroundings familiar to the family. Why should parent’s be included in the delivery of services?
3. Services must be provided in the natural environment; meaning, settings that are natural or normal for the child’s age peers who have no disabilities. How can this be affected by the community a family lives in?
4. The IFSP must include the frequency, intensity, and method of delivering services identified by the IFSP team; the date of initiation and the duration of the service; the location(s) of the service; and the method of service delivery. Reflect on how the IFSP differs from the standard.
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If you have a question about this module please check the Q & A pages. If you still have a question after reviewing the Q & A pages please send an email to: webreplyspefs@dese.mo.gov or call 573.751.0187