WHAT IS EARLY INTERVENTION?

Early intervention is the term used to describe the services and supports that are available to babies and young children with developmental delays and disabilities and their families. It can have a significant impact on a child’s ability to learn new skills and overcome challenges and can increase success in school and life.

Early intervention focuses on helping eligible babies and toddlers learn the basic and brand-new skills that typically develop during the first three years of life, such as:

• physical (reaching, rolling, crawling, and walking);
• cognitive (thinking, learning, solving problems);
• communication (talking, listening, understanding);
• social/emotional (playing, feeling secure and happy); and
• self-help (eating, dressing).

Authorized by law | Early intervention is available in every state and territory of the United States. The Individuals with Disabilities Education Act (IDEA) requires it–Part C of IDEA, to be precise. That’s why you’ll sometimes hear early intervention referred to as Part C.

Who is eligible for early intervention services?

Early intervention is intended for infants and toddlers who have a developmental delay or disability.  Eligibility is determined by evaluating the child (with parents’ consent) to see if the little one does, in fact, have a delay in development or a disability. Eligible children can receive early intervention services from birth through the third birthday (and sometimes beyond).

For some children, from birth | Sometimes it is known from the moment a child is born that early intervention services will be essential in helping the child grow and develop. Often this is so for children who are diagnosed at birth with a specific condition or who experience significant prematurity, very low birth weight, illness, or surgery soon after being born. Even before heading home from the hospital, this child’s parents may be given a referral to their local EarlySteps office.

For others, because of delays in development | Some children have a relatively routine entry into the world, but may develop more slowly than others, experience setbacks, or develop in ways that seem very different from other children. For these children, a visit with a developmental pediatrician and a thorough evaluation may lead to an early intervention referral.

What is EarlySteps?

EarlySteps, Louisiana’s Early Intervention Program, provides services to families with infants and toddlers ages birth to three years (36 months) who have a developmental delay or a medical condition likely to result in a developmental delay. Children with delays in cognitive, motor, vision, hearing, communication, social-emotional or adaptive development may be eligible for services. EarlySteps services are designed to improve the family’s capacity to enhance their child’s development. These services are provided in the child’s natural environment, such as the child’s home, child care, or any other community setting typical for children ages birth to 3 years (36 months).

When and how do I access EarlySteps?

If you, your child’s doctor, or other care provider is concerned about your child’s development, ask to be connected with EarlySteps, Louisiana’s early intervention program, to find out if your child can get services to help. Children can be referred to EarlySteps by their parents or a professional by contacting the System Point of Entry (SPOE) in their region. Parents don’t have to wait for a professional to refer their child. Once the SPOE receives the referral, parents will be contacted to begin the eligibility determination process.

What to say to the early intervention contact person | If your child is under age 3, you can call the EarlySteps office in your Region of the State.  Explain that you are concerned about your child’s development. Say that you think your child may need early intervention services. Explain that you would like to have your child evaluated under Part C of IDEA. It is a good idea to write down the names and phone numbers of everyone you talk to as you move through the early intervention process.

What does EarlySteps offer?

The EarlySteps system is designed to support families regarding their child’s development through:

• Assisting families in helping their child develop and learn;
• Assisting families in understanding their rights in EarlySteps;
• Assisting families in communicating their child’s specific needs; and
• Determining a family’s concerns, priorities, and resources regarding their child’s special needs.

The following services are provided by EarlySteps:

• Service Coordination
• Speech-Language Services
• Special Instruction
• Occupational Therapy
• Physical Therapy
• Audiology Services
• Other services based on individual need

The evaluation and assessment process

Service coordinator | Once connected with EarlySteps, you’ll be assigned a service coordinator who will explain the early intervention process and help you through the next steps in that process. The service coordinator will serve as your single point of contact with the early intervention system.

Screening and/or evaluation| One of the first things that will happen is that your child will be evaluated to see if, indeed, he or she has a developmental delay or disability. The family’s service coordinator will explain what’s involved in the evaluation process and ask for your permission to proceed. You must provide your written consent before screening and/or evaluation may take place.

The evaluation group will be made up of qualified people who have different areas of training and experience. Together, they know about children’s speech and language skills, physical abilities, hearing and vision, and other important areas of development. They know how to work with children, even very young ones, to discover if a child has a problem or is developing within normal ranges. Group members may evaluate your child together or individually. As part of the evaluation, the team will observe your child, ask your child to do things, talk to you and your child, and use other methods to gather information. These procedures will help the team find out how your child functions in the five areas of development.

Exceptions for diagnosed physical or mental conditions |  It’s important to note that an evaluation of your child won’t be necessary if he or she is automatically eligible due to a diagnosed physical or mental condition that has a high probability of resulting in a developmental delay. Such conditions include but aren’t limited to chromosomal abnormalities; genetic or congenital disorders; sensory impairments; inborn errors of metabolism; disorders reflecting disturbance of the development of the nervous system; congenital infections; severe attachment disorders; and disorders secondary to exposure to toxic substances, including fetal alcohol syndrome.

Determining eligibility | The results of the evaluation will be used to determine your child’s eligibility for early intervention services. You and a team of professionals will meet and review all of the data, results, and reports. The people on the team will talk with you about whether your child meets the criteria under IDEA and state policy for having a developmental delay, a diagnosed physical or mental condition or being at risk for having a substantial delay. If so, your child is generally found to be eligible for services.

Initial assessment of the child | With parental consent, in-depth assessment must now be conducted to determine your child’s unique needs and the early intervention services appropriate to address those needs. Initial assessment will include reviewing the results of the evaluation, personal observation of your child, and identifying his or her needs in each developmental area.

Initial assessment of the family | With the approval of the family members involved, assessments of family members are also conducted to identify the resources, concerns, and priorities of the family related to enhancing the development of your child. The family-directed assessment is voluntary on the part of each family member participating in the assessment and is based on information gathered through an assessment tool and also through an interview with those family members who elect to participate.

Writing the Individualized Family Service Plan (IFSP)

Having collected a great deal of information about your child and family, it’s now possible for the team (including you as parents) to sit down and write an individualized plan of action for your child and family. This plan is called the Individualized Family Service Plan, or IFSP. It is a very important document, and you, as parents, are important members of the team that develops it.  Your service coordinator can explain what the IFSP guidelines are in Louisiana.

Guiding principles | The IFSP is a written document that, among other things, outlines the early intervention services that your child and family will receive. One guiding principle of the IFSP is that the family is a child’s greatest resource, that a young child’s needs are closely tied to the needs of his or her family. The best way to support children and meet their needs is to support and build upon the individual strengths of their family. So, the IFSP is a whole family plan with the parents as major contributors in its development. Involvement of other team members will depend on what the child needs. These other team members could come from several agencies and may include medical people, therapists, child development specialists, social workers, and others.

 What info is included in an IFSP? | Your child’s IFSP must include the following:

• Your child’s present physical, cognitive, communication, social/emotional, and adaptive development levels and needs
• Family information (with your agreement), including the resources, priorities, and concerns of you, as parents, and other family members closely involved with the child
• The major results or outcomes expected to be achieved for your child and family
• The specific services your child will be receiving
• Where in the natural environment (e.g., home, community) the services will be provided (if the services will not be provided in the natural environment, the IFSP must include a statement justifying why not)
• When and where your son or daughter will receive services
• The number of days or sessions he or she will receive each service and how long each session will last
• Who will pay for the services
• The name of the service coordinator overseeing the implementation of the IFSP
• The steps to be taken to support your child’s transition out of early intervention and into another program when the time comes.

The IFSP may also identify services your family may be interested in, such as financial information or information about raising a child with a disability.

Informed parental consent | The IFSP must be fully explained to you, the parents, and your suggestions must be considered. You must give written consent for each service to be provided. If you do not give your consent in writing, your child will not receive that service.

Reviewing and updating the IFSP | The IFSP is reviewed every six months and is updated at least once a year. This takes into account that children can learn, grow, and change quickly in just a short period of time.

Timeframes for all this

When the early intervention system receives a referral about a child with a suspected disability or developmental delay, a time clock starts running. Within 45 calendar days from the referral, the early intervention system must complete the critical steps discussed thus far:

• screening (if used in the state),
• initial evaluation of the child,
• initial assessments of the child and family, and
• writing the IFSP (if the child has been found eligible).

That’s a tall order, but important, given how quickly children grow and change. When a baby or toddler has developmental issues, they need to be addressed as soon as possible. So—45 days, that’s the timeframe from referral to completion of the IFSP for an eligible child.

Who pays for the services?

Whether or not you, as parents, will have to pay for any services for your child depends on the policies in Louisiana which can change from time to time. Check with your service coordinator. Louisiana’s system of payments must be available in writing and given to you, so there are no surprises or unexpected bills later.

What’s free to families | Under Part C of IDEA, the following services must be provided at no cost to families:

• Child Find services;
• evaluations and assessments;
• the development and review of the IFSP; and
• service coordination.

When services are not free | Depending on Louisiana’s policies, you may have to pay for certain other services. You may be charged a “sliding-scale” fee, meaning the fees are based on what you earn. Some services may be covered by your health insurance, by Medicaid, or by Indian Health Services. The Part C system may ask for your permission to access your public or private insurance in order to pay for the early intervention services your child receives. In most cases, the early intervention system may not use your health care insurance (private or public) without your express, written consent. If you do not give such consent, the system may not limit or deny you or your child services.

Every effort is made to provide services to all infants and toddlers who need help, regardless of family income. Services cannot be denied to a child just because his or her family is not able to pay for them.

How does my child transition out of EarlySteps?

When your child is between the ages of 2 years 3 months and 2 years 9 months of age, your EarlySteps Family Support Coordinator will convene an Individualized Family Support Plan (IFSP) meeting to discuss the transition process with you and other team members in order to develop a “transition plan.” This meeting is called the Transition Conference. The transition plan will identify options for your child and family after your child’s third birthday, including preschool, private preschool, child care, Head Start, Early Head Start, developmental disabilities services (Human Services Authority/District), local education agency special education services, or other community early childhood programs. The Transition Plan will include the steps and services your child and family will need to obtain information, review options, visit programs, and make decisions about the appropriate program for your child.

As always, Families Helping Families of GNO is here for you if you have any questions about getting EarlySteps services for your child or transitioning out of EarlySteps.