Definition
Infant and toddler intervention services must be available to children from birth through two years of age who meet the criteria described below.
(M. R. 3425.1350, subp. 1)
The team shall determine that a child from birth through the age of two years is eligible for infant and toddler intervention services if:
A. the child meets the criteria of one of the disability categories;
or
B. the child meets one of the criteria for developmental delay in sub item (1) and the criteria in subitem (2):
the child has a diagnosed physical or mental condition or disorder that has a high probability of resulting in developmental delay regardless of whether the child has a demonstrated need or delay*; (see below for conditions)or
The child is experiencing a developmental delay that is demonstrated by a score of 1.5 standard deviations or more below the mean, as measured by the appropriate diagnostic measures and procedures, in one or more of the following areas:
(a) cognitive development;
(b) physical development, including vision and hearing;
(c) communication development;
(d) social or emotional development; and
(e) adaptive development.
* If the the infant or toddler has a diagnosed condition or disorder that has a high probability of resulting in developmental delay, the eligibility for services has already been determined. Norm-referenced evaluation is not needed in such cases. Criterion-referenced tools, in combination with information reported by a parent and gained through observation, will allow the team to determine the developmental status of the child in each required domain. a family-directed assessment of the resources, priorities, and concerns of the family and the supports and services necessary to enhance the family's capacity to meet the developmental needs of the infant or toddler with a disability must be offered.
Timeline and Requirements
| Eligibility Determination | Due Process Requirements | Documentation |
| Part C categorical- At any age below age 3 it is permissible to complete both Part C and Part B initial evaluations to determine eligibility for both Parts C & B at the time of entrance into Part C if the child is thought to be potentially eligible under a categorical disability. The re-evaluation would be due within 36 months after the date of initial evaluation. ____________________________________ | Part C categorical- * It must be made clear that parents have the right to refuse one or both evaluations. Their refusal of an evaluation under Part B cannot influence Part C eligibility and/or IFSP services. * Each evaluation must follow the due process requirements set forth under the relevant Part (timelines, areas of evaluation, assessment of need, etc.) * If parent contests the eligibility decision, follow the procedural safeguards under the relevant Part (C or B).
The evaluation and assessment requirements for Part C must be met for all children who will be served in Part C. An IEP must be in place by the child's 3rd birthday. Parents must provide written consent for the initial provision of services under Part B. __________________________________________ | Part C categorical- * Documentation of eligibility for Part C must be included in the Evaluation Report. * Documentation of eligibility for Part B must be included in the Evaluation Report. The team should review the child's status as they approach their third birthday to ensure that the child still meets the eligibility requirements for Part B. The team should review the child's status as they approach their third birthday to ensure that the child still meets the eligibility requirements for Part B. ______________________________________ |
| Developmental Delay (DD)- If children are identified at age 2 years or older, it is permissible, with parent consent, to consider eligibility for both Part C and Part B (if the child appears to be potentially eligible for Part B) at the time of entrance into Part C. | Developmental Delay (DD)- Follow the due process, procedural safeguards and documentation requirements listed above for categorical disabilities: * Parents must be given both Part C & Part B Prior Written notice and Parental Consent forms * It must be made clear that parents have the right to refuse one or both evaluations. Their refusal of Part B cannot influence Part C eligibility and/or IFSP services. * Each evaluation must follow the due process requirements set forth under the relevant Part (timelines, areas of evaluation, assessment of need, etc.) * If parent contest the eligibility decision, follow the procedural safeguards under the relevant Par (C or B). | Developmental Delay (DD)- * Documentation of eligibility for Part C must be included in the Evaluation Report. * Documentation of eligibility for Part B must be included in the Evaluation Report. The team should review the child's status as they approach their third birthday to ensure that the child still meets the eligibility requirements for Part B. |
| If children are identified prior to age 2 years, determine eligibility for Part C only at this time. An evaluation to determine eligibility for Part B will take place before age three, if the child appears to be potentially eligible for Part B. This initial Part B evaluation must be conducted early enough to allow time for the development and implementation of an IEP by the child's 3rd birthday. | Before services can be initiated under Part B, parents must receive an appropriate Prior Written Notice and provide written Parental Consent. |
“High probability” means that current research findings indicate that with or without intervention at least half the infants with a given condition will experience a developmental delay in one or more areas of development (listed in the above criteria) at school age. Information regarding diagnosed conditions changes as medical advances and new information becomes available.
Research continues to inform us about child outcomes and reflects medical and intervention advancements. The conditions workgroup and the Governor’s Interagency Coordinating Council have developed a list of diagnosed conditions that is based upon a review of current literature and other state’s lists of diagnosed conditions.
There are a limited number of major chronic diseases and disabilities impacting adult health. However, each of them occurs with relatively high frequency. With children, the pattern is reversed. More than 200 chronic conditions and disabilities affect children and youth. With a few exceptions, most conditions affecting children are not common. Developing an exhaustive list of conditions is not practical, given the rarity of so many conditions. This list of conditions taken from the Minnesota Department of Health web site is an inclusive list, but not an exhaustive list. Please know that there will be periodic changes and updates made to the list, based upon advancements in both the medical and early intervention fields.
How to Determine if a Child Meets the Criteria if the Condition is not Listed?
In order to determine if a child has a condition or disorder that has a high probability of resulting in a delay, you will need the following information.
Obtain the name of all diagnoses, conditions or disorders from the child’s health care or mental health provider.
Be sure to get a list of all health conditions a child has, since this information will give the team a complete picture upon which to make an eligibility determination.
Since many conditions sound similar, make sure to get an accurate spelling.
Verbal confirmation of the diagnosis/condition/disorder from the appropriately licensed health care professional or clinic is required prior to determining eligibility.
Learn about the condition
Review the literature and available research in order to learn about the condition:
e-medicine, the National Library of Medicine, the National Organization of Rare Diseases (NORD), GeneReviews and the Centers for Disease Control and Prevention are all reliable web sites for information regarding specific health conditions. Other pages of the Minnesota Department of Health web site also have information about some of the more common health conditions and conditions identified through a variety of newborn screening and surveillance programs [ii]
Particularly make note of which areas of development are impacted. This will help in long-term planning.
Note commonly associated conditions
Try to develop an understanding of the variability in outcomes/impact of a specific diagnosis
Look for articles/documentation of outcomes at school-age. (Because some conditions are very rare, finding recent studies on long-term outcomes may be challenging, but usually not impossible.)
Contact the R.N. Barr Library (library@health.state.mn.us or 651-201-5090) at the Minnesota Department of Health for searching assistance if needed.
Solicit input from the health care provider:
What is this child’s prognosis?
Do you anticipate there will be an impact on development in either the short-term or long-term?
Has this child been hospitalized frequently? Are frequent hospitalizations anticipated?
Has this child had other complications?
It is important to remember that children with conditions with a high probability of resulting in a delay are eligible for services even if there is no demonstrated need or delay.
Categories of Conditions with a High Probability of Resulting in a Delay at School Age with Examples
The list of conditions provided on this web site is an inclusive list, but not an exhaustive list.
A. Conditions or syndromes that are likely to result in intellectual disabilities such as:
T
Maternal drug use (prenatal use confirmed by a physician or other health care provider)
B. Prenatal infections such a cytomegalovirus (CMV)
C. Infants born at <1500 grams (3 lbs. 5 oz.)
D. Grades III and IV intracranial hemorrhage (PVH-IVH, stroke)
E. Congenital Diaphragmatic Hernia
Physical Conditions
A. Neuro-muscular disorders such as:
Muscular dystrophies
Neonatal adrenoleukodystrophy
Spinal muscular atrophy
B. Respiratory
Bronchopulmonary dysplasia (BPD)
C. Toxic Exposures such as:
Elevated blood lead levels
D. Complex Health Conditions which are conditions impacting multiple organs or systems such as:
Charge Syndrome
DiGeorge, Opitz, Velocardialfacial and Related Syndromes (22q 11.2 deletion)
Noonan Syndrome
E. Musculoskeletal
Arthrogryposis multiplex congenital
Osteogenesis Imperfecta
Sensory
A. Hearing loss as recommended by the Minnesota Early Hearing Detection and Intervention team
B. Vision impairment: A diagnosed vision impairment that is not correctable with treatment, surgery, glasses or contact lenses
Social or Emotional Conditions
A. Axis I conditions from the Diagnostic Classifications 0-3 including:
Adjustment Disorders
Anxiety Disorders of Infancy and Childhood
Depression of Infancy and Early Childhood
Deprivation/Maltreatment Disorder
Disorders of Affect
Fedding Behavior Disorders
MIxed Disorder of Emotional Expressiveness
Post-traumatic stress disorder (PTSD)
Prolonged Bereavement/Grief disorder
Regulation Disorders of Sensory Processing
Sleep Behavior Disorder
Services and supports are documented on an Individual Family Service Plan (IFSP). These services and supports are to be provided in natural environments such as the home, day care or other typical setting. The services and supports are provided year around and as such do not require a determination for extended school year services.
Part C services are considered early intervention, it is not required that the child demonstrate a need for special education. As such it is possible the only service the child and family receives is service coordination.
Recipients of the services and supports may be the infant/toddler and/or the family. This is different from Part B services where the recipient of the special education and related services is almost always exclusively the child.
For Children Potentially Eligible for Part B
Good timely transition planning is critical. The service coordinator provided for in Minnesota Statutes, section 125A.33 must facilitate transition from infant and toddler intervention services before the child's third birthday. The transition conference must be held between 2 years 3 months and 90 days prior to the child's 3rd birthday if the child is potentially eligible for Part B. The IFSP must include steps to determine and document eligibility for special education, and steps to support the transition of the child to special education or to other appropriate community-based services that may be available.
For a child who may be eligible for special education services, the service coordinator must, with the approval of the family of the child, convene a conference between the family, the local educational agency, and community-based service providers to discuss services that the child may receive. The conference must be held not less than 90 days, and at the discretion of all the parties, not more than nine months, before the child is eligible for the preschool services.
For Children Who May Not be Eligible for Part B
In the case of a child who may not be eligible for Part B services, the case manager should make reasonable efforts to convene a meeting to discuss the appropriate services that the child might receive. Appropriate people to invite, in addition to the parents, would include district staff and providers of other appropriate services for children who are not eligible for preschool services under Part B such as Head Start, Learning Readiness or Early Childhood Family Education.
Transition Plan
A transition plan must be developed for all children potentially eligible and not eligible for Part B. The plan should include:
The steps to be taken to support the transition of the child to
Preschool services under Part B, as appropriate;
Other services that may be available, if appropriate
These steps include
Discussions with, and training of parents regarding future placements and other matters related to the child's transition;
Procedures to prepare the child for changes in service delivery, including steps to help the child adjust to, and function in, a new setting
The IFSP must include steps to determine and document eligibility for special education;
This documentation could occur either as an outcome or the activity page of the IFSP could be used.
The team shall determine that a child from the age of three years through six years is eligible for special education when:
A. the child meets the criteria of one of the categorical disabilities as defined in Minnesota Rules; or
B. the child meets one of the criteria for developmental delay in sub item (1) and the criteria in sub item (2). Local school districts have the option of implementing these criteria for developmental delay. If a district chooses to implement these criteria, it may not modify them1. The child:
a. has a diagnosed physical or mental condition or disorder that has a high probability of resulting in developmental delay; see above for conditionsor
b. has a delay in each of two or more of the areas of cognitive development; physical development, including vision and hearing; communication development; social or emotional development; and adaptive development that is verified by an evaluation using one or more technically adequate, norm-referenced instruments.. The instruments must be individually administered by appropriately trained professionals and the scores must be at least 1.5 standard deviations below the mean in each area;
2. The child's need for special education is supported by:a. at least one documented, systematic observation in the child's daily routine setting by an appropriate professional or if observation in the daily routine setting is not possible, the alternative setting must be justified.
b. a developmental history; and
c. at least one other evaluation procedure in each area of identified delay that is conducted on a different day than the medical or norm-referenced evaluation; which may include criterion-referenced instruments, language samples, or curriculum-based measures.
The evaluation used to determine whether a child is eligible for infant and toddler intervention services must be conducted within the timelines established in Code of Federal Regulations, title 34, part 303. It must be based on informed clinical opinion*, must be multidisciplinary in nature, involving two or more disciplines or professions; and must be conducted by personnel trained to utilize appropriate methods and procedures. The evaluation must include:
A. a review of the child's current records related to health status and medical history;
B. an evaluation of the child's levels of cognitive, physical, communication, social or emotional, and adaptive developmental functioning;
C. an assessment of the unique needs of the child in terms of each of the developmental areas in item B;
and
D. at least one documented, systematic observation in the child's daily routine setting by an appropriate professional or if observation in the daily setting is not possible, the alternative setting must be justified.
*The National Early Childhood Technical Assistance Center (NECTAC) clarifies that informed clinical opinion is a process that makes use of "qualitative and quantitative information to assist in forming a determination regarding difficult-to-measure aspects of current developmental status and the potential need for early intervention." Examples include:
A physical therapist must make judgments about muscle tone abnormality based on the therapist's training and experience with other children.
A psychologist may note in observing a child playing that she performs tasks in adaptive ways not permitted during the administration of a standardized cognitive assessment.
Some children do not perform well on norm-referenced evaluation tools that rely exclusively on elicited responses. many tools incorporate parent report as a means of enhancing validity. The team also has the ability to utilize informed clinical opinion as a means of determining eligibility. The use of informed clinical opinion should be considered when children cannot or do not respond in a testing situation or when a child performs a skill in a way that is qualitatively different from age expectations. Informed clinical opinion is not the same as a team override.
Children who have been served under Part C who the team clearly determines will not be eligible for Part C, simply age out of services. The documentation for this determination would be progress on goals, progress on criterion referenced tools, observations and parent and service provider report.
To the maximum extent possible, all ASEC districts are committed to providing early intervention services in natural environments. Appropriate program alternatives to meet the special education needs, goals, and objectives of the child must be determined on an individual basis. Choice of specific program alternatives must be based on the child's current levels of performance, special education needs, goals, and objectives, and written in the IFSP/IEP. The provision of early intervention services in a setting other than a natural environment must occur only when early intervention cannot be achieved satisfactorily for the infant or toddler in a natural environment.
Program alternatives are composed of type of services, setting in which services occur, and amount of time and frequency in which special education services occur. A child may receive special education services in more than one alternative based on the IFSP/IEP.
A. There are two types of special education services: services provided directly and services provided indirectly.
1. Direct special education services are provided by a teacher or a related services professional when the services are related to instruction. Direct services occur when a teacher or related services professional provides instruction directly to the child, or to the child, parent, or caregiver together in a center-based, home-based, or community-based setting.
2. Indirect special education services include ongoing progress review; cooperative planning; consultation; demonstration teaching; modification and adaptation of the environment, curriculum, materials, or equipment; and direct contact with the child to monitor, observe, and follow up. Indirect services may be provided by a teacher or related services professional to another teacher, related services professional, support staff, parents, and public and nonpublic agencies to the extent that the services are written in the child's IFSP/IEP.
B. There are three types of settings: home, district preschool classroom, and community-based programs.
1. Home includes the home of the child and parent or relative, or licensed family child care setting in which the pupil is placed by the parent.
2. District preschool classrooms are located in one of the district's schools or community center building housing elementary students or preschool-aged children who do not have disabilities.
3. Community-based programs include licensed public or private nonsectarian child care programs other than a family child care setting, licensed public or private nonsectarian early education programs, community cultural centers, Head Start programs, and hospitals. A school district must provide direct or indirect special education services by district special education staff to a child attending a community-based program
Revised 11/10/2009