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Federal Early Intervention Services

Early Intervention Services

Early intervention services means developmental services that:

    • Are provided under public supervision;
    • Are selected in collaboration with the parents;
    • Are provided at no cost, except, subject to §§303.520 and 303.521, where Federal or State law provides for a system of payments by families, including a schedule of sliding fees;
    • Are designed to meet the developmental needs of an infant or toddler with a disability and the needs of the family to assist appropriately in the infant's or toddler's development, as identified by the IFSP Team, in any one or more of the following areas, including—
      • Physical development;
      • Cognitive development;
      • Communication development;
      • Social or emotional development; or
      • Adaptive development;
    • Meet the standards of the State in which the early intervention services are provided, including the requirements of part C of the Act;
    • Include services identified below;
    • Are provided by qualified personnel;
    • To the maximum extent appropriate, are provided in natural environments; and
    • Are provided in conformity with an IFSP.

Assistive Technology Device and Service 

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 an infant or toddler with a disability. The term does not include a medical device that is surgically implanted, including a cochlear implant, or the optimization (e.g., mapping), maintenance, or replacement of that device.

Assistive technology service means any service that directly assists an infant or toddler with a disability in the selection, acquisition, or use of an assistive technology device. The term includes:

    • The evaluation of the needs of an infant or toddler with a disability, including a functional evaluation of the infant or toddler with a disability in the child's customary environment;
    • Purchasing, leasing, or otherwise providing for the acquisition of assistive technology devices by infants or toddlers with disabilities;
    • Selecting, designing, fitting, customizing, adapting, applying, maintaining, repairing, or replacing assistive technology devices;
    • Coordinating and using other therapies, interventions, or services with assistive technology devices, such as those associated with existing education and rehabilitation plans and programs;
    • Training or technical assistance for an infant or toddler with a disability or, if appropriate, that child's family; and
    • Training or technical assistance for professionals (including individuals providing education or rehabilitation services) or other individuals who provide services to, or are otherwise substantially involved in the major life functions of, infants and toddlers with disabilities.

Audiology Services

    • Identification of children with auditory impairments, using at-risk criteria and appropriate audiologic screening techniques;
    • Determination of the range, nature, and degree of hearing loss and communication functions, by use of audiological evaluation procedures;
    • Referral for medical and other services necessary for the habilitation or rehabilitation of an infant or toddler with a disability who has an auditory impairment;
    • Provision of auditory training, aural rehabilitation, speech reading and listening devices, orientation and training, and other services;
    • Provision of services for prevention of hearing loss; and
    • Determination of the child's individual amplification, including selecting, fitting, and dispensing appropriate listening and vibrotactile devices, and evaluating the effectiveness of those devices.

Family Training, Counseling, and Home Visits 

Services provided, as appropriate, by social workers, psychologists, and other qualified personnel to assist the family of an infant or toddler with a disability in understanding the special needs of the child and enhancing the child's development.

Health Services 

Health services mean services necessary to enable an otherwise eligible child to benefit from the other early intervention services under this part during the time that the child is eligible to receive early intervention services.

The term includes—

    • Such services as clean intermittent catheterization, tracheostomy care, tube feeding, the changing of dressings or colostomy collection bags, and other health services; and
    • Consultation by physicians with other service providers concerning the special health care needs of infants and toddlers with disabilities that will need to be addressed in the course of providing other early intervention services.

The term does not include—

  • Services that are—
    • Surgical in nature (such as cleft palate surgery, surgery for club foot, or the shunting of hydrocephalus);
    • Purely medical in nature (such as hospitalization for management of congenital heart ailments, or the prescribing of medicine or drugs for any purpose); or
    • Related to the implementation, optimization (e.g., mapping), maintenance, or replacement of a medical device that is surgically implanted, including a cochlear implant.
      • Nothing in this part limits the right of an infant or toddler with a disability with a surgically implanted device (e.g., cochlear implant) to receive the early intervention services that are identified in the child's IFSP as being needed to meet the child's developmental outcomes.
      • Nothing in this part prevents the EIS provider from routinely checking that either the hearing aid or the external components of a surgically implanted device (e.g., cochlear implant) of an infant or toddler with a disability are functioning properly;
  • Devices (such as heart monitors, respirators and oxygen, and gastrointestinal feeding tubes and pumps) necessary to control or treat a medical condition; and
  • Medical-health services (such as immunizations and regular “well-baby” care) that are routinely recommended for all children.

Medical Services

Services provided by a licensed physician for diagnostic or evaluation purposes to determine a child's developmental status and need for early intervention services.

Nursing Services

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;

The provision of nursing care to prevent health problems, restore or improve functioning, and promote optimal health and development; and

The administration of medications, treatments, and regimens prescribed by a licensed physician.

Nutrition Services 

Conducting individual assessments in:

    • Nutritional history and dietary intake;
    • Anthropometric, biochemical, and clinical variables;
    • Feeding skills and feeding problems; and
    • Food habits and food preferences;

Developing and monitoring appropriate plans to address the nutritional needs of children eligible under this part, based on the findings in paragraph (b)(7)(i) of this section; and

Making referrals to appropriate community resources to carry out nutrition goals.

Occupational Therapy

Occupational therapy includes services to address the functional needs of an infant or toddler with a disability 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:

    • Identification, assessment, and intervention;
    • Adaptation of the environment, and selection, design, and fabrication of assistive and orthotic devices to facilitate development and promote the acquisition of functional skills; and
    • Prevention or minimization of the impact of initial or future impairment, delay in development, or loss of functional ability.

Physical Therapy

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:

    • Screening, evaluation, and assessment of children to identify movement dysfunction;
    • Obtaining, interpreting, and integrating information appropriate to program planning to prevent, alleviate, or compensate for movement dysfunction and related functional problems; and
    • Providing individual and group services or treatment to prevent, alleviate, or compensate for, movement dysfunction and related functional problems.

Psychological Services 

    • Administering psychological and developmental tests and other assessment procedures;
    • Interpreting assessment results;
    • Obtaining, integrating, and interpreting information about child behavior and child and family conditions related to learning, mental health, and development; and
    • 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.

Service Coordination Services (case management)

Service coordination services mean services provided by a service coordinator to assist and enable an infant or toddler with a disability and the child's family to receive the services and rights, including procedural safeguards.

Each infant or toddler with a disability and the child's family must be provided with one service coordinator who is responsible for:

    • Coordinating all services required under this part across agency lines; and
    • Serving as the single point of contact for carrying out the activities described below.

Service coordination is an active, ongoing process that involves:

    • Assisting parents of infants and toddlers with disabilities in gaining access to, and coordinating the provision of, the early intervention services required under this part; and
    • Coordinating the other services identified in the IFSP under §303.344(e) that are needed by, or are being provided to, the infant or toddler with a disability and that child's family.

Service coordination services include:

    • Assisting parents of infants and toddlers with disabilities in obtaining access to needed early intervention services and other services identified in the IFSP, including making referrals to providers for needed services and scheduling appointments for infants and toddlers with disabilities and their families;
    • Coordinating the provision of early intervention services and other services (such as educational, social, and medical services that are not provided for diagnostic or evaluative purposes) that the child needs or is being provided;
    • Coordinating evaluations and assessments;
    • Facilitating and participating in the development, review, and evaluation of IFSPs;
    • Conducting referral and other activities to assist families in identifying available EIS providers;
    • Coordinating, facilitating, and monitoring the delivery of services required under this part to ensure that the services are provided in a timely manner;
    • Conducting follow-up activities to determine that appropriate part C services are being provided;
    • Informing families of their rights and procedural safeguards, as set forth in subpart E of this part and related resources;
    • Coordinating the funding sources for services required under this part; and
    • Facilitating the development of a transition plan to preschool, school, or, if appropriate, to other services.

Use of the term service coordination or service coordination services. The lead agency's or an EIS provider's use of the term service coordination or service coordination services does not preclude characterization of the services as case management or any other service that is covered by another payor of last resort (including Title XIX of the Social Security Act—Medicaid), for purposes of claims in compliance with the requirements of §§303.501 through 303.521 (Payor of last resort provisions).

Sign Language

Sign language and cued language services include teaching sign language, cued language, and auditory/oral language, providing oral transliteration services (such as amplification), and providing sign and cued language interpretation.

Social Work

    • Making home visits to evaluate a child's living conditions and patterns of parent-child interaction;
    • Preparing a social or emotional developmental assessment of the infant or toddler within the family context;
    • Providing individual and family-group counseling with parents and other family members, and appropriate social skill-building activities with the infant or toddler and parents;
    • Working with those problems in the living situation (home, community, and any center where early intervention services are provided) of an infant or toddler with a disability and the family of that child that affect the child's maximum utilization of early intervention services; and
    • Identifying, mobilizing, and coordinating community resources and services to enable the infant or toddler with a disability and the family to receive maximum benefit from early intervention services.

Special Instruction 

    • The design of learning environments and activities that promote the infant's or toddler's acquisition of skills in a variety of developmental areas, including cognitive processes and social interaction;
    • Curriculum planning, including the planned interaction of personnel, materials, and time and space, that leads to achieving the outcomes in the IFSP for the infant or toddler with a disability;
    • Providing families with information, skills, and support related to enhancing the skill development of the child; and
    • Working with the infant or toddler with a disability to enhance the child's development.

Speech-language Pathology Services

    • Identification of children with communication or language disorders and delays in development of communication skills, including the diagnosis and appraisal of specific disorders and delays in those skills;
    • Referral for medical or other professional services necessary for the habilitation or rehabilitation of children with communication or language disorders and delays in development of communication skills; and
    • Provision of services for the habilitation, rehabilitation, or prevention of communication or language disorders and delays in development of communication skills.

Transportation

Transportation and related costs include the cost of travel and other costs that are necessary to enable an infant or toddler with a disability and the child's family to receive early intervention services.

Vision Services 

    • Evaluation and assessment of visual functioning, including the diagnosis and appraisal of specific visual disorders, delays, and abilities that affect early childhood development;
    • Referral for medical or other professional services necessary for the habilitation or rehabilitation of visual functioning disorders, or both; and
    • Communication skills training, orientation and mobility training for all environments, visual training, and additional training necessary to activate visual motor abilities.

Reference

34 CFR §303.13

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