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Building the Legacy for Our Youngest Children with Disabilities:

Module 4

Screening, Evaluation, and Assessment Procedures

Produced by:National Dissemination Centerfor Children with Disabilities

This module was developedin collaboration by:

The U.S. Department of Education,Office of Special Education andRehabilitative Services (OSERS),

Office of Special EducationPrograms (OSEP) |

Rhonda Spence

OSERS’ Office of Policy and Planning |Mary Louise Dirrigl and Jessica Spataro

The U.S. Department of Education,Office of the General Counsel |

Kala Surprenant

The National Dissemination Centerfor Children with Disabilities (NICHCY) |

Lisa Küpper

A training curriculum on Part C of IDEA 2004

4-2 Trainer’s Guide: Module 4 | Screening, Evaluation, and Assessment Procedures

September 2014

National Dissemination Center for Children with Disabilities

Copyright free. You’re welcome to share this module far and wide. Please do givecredit to its producer, the National Dissemination Center for Children withDisabilities.

Suggested citation:

Küpper, L. (Ed.). (2014). Screening, evaluation, and assessment procedures(Module 4). Building the legacy for our youngest children with disabilities: A trainingcurriculum on Part C of IDEA 2004. Washington, DC: National DisseminationCenter for Children with Disabilities.

Available online at: http://www.parentcenterhub.org/repository/partc-module4/

This training curriculum is designed and produced byNICHCY, the National Dissemination Center for Childrenwith Disabilities, at the request of our funder, the Officeof Special Education Programs (OSEP) at theU.S. Department of Education.

NICHCY Lead: Lisa Küpper

OSEP Lead: Rhonda Spence

OGC Lead: Kala Surprenant

Funding for NICHCY officially ended on September 30,2014. All training materials in this Part C trainingcurriculum are now available at the website of the Centerfor Parent Information and Resources, at:

http://www.parentcenterhub.org/repository/legacy-partc/

Trainer’s Guide: Module 4 | Screening, Evaluation, and Assessment Procedures 4-3

Background and Discussion

This module is part of atraining curriculum on the Part Cregulations of the Individuals withDisabilities Education Act, asamended in 2004. The curriculumprovides a detailed discussion ofthe Part C regulations aspublished in the Federal Register onSeptember 28, 2011.1

The curriculum is entitledBuilding the Legacy for Our YoungestChildren with Disabilities. Thismodule is entitled Screening,Evaluation, and Assessment Proce-dures and is the 4th module in thecurriculum.

Please be aware that theinformation in this module is nota substitute for the requirementsreflected in the IDEA statute andPart C regulations.

Alert! This is a Two-PartModule

Module 4 is divided into twoparts for the trainer’s convenience:

4A | Screening procedures:Screening procedures are a way forStates to determine if an infant ortoddler referred to Part C is sus-pected of having a disability ordevelopmental delay and, there-fore, needs the thorough evalua-tion required by IDEA. Becausescreening is an option for States(not a requirement), not all Statesinclude screening as a preliminarystep in determining whether ornot a baby or toddler might have adisability or developmentaldelay—a result that would meanthe child should be evaluated.

How the Trainer’s Guide is Organized

This trainer’s guide is organized by slide. A thumbnail picture of eachslide is presented, along with brief instructions as to how the slideoperates. This is followed by a discussion intended to providetrainers with background information about what’s on the slide.Any or all of this information might be appropriate to share withan audience, but that decision is left up to trainers.

For this reason, we’ve splitthe slideshow forscreening proceduresinto a separate mini-presentation. If yourState has adoptedscreening procedures tosee if a child might be suspectedof having a disability, then you’llwant to use this stand-alonepresentation before you delve intowhat Part C requires in terms ofevaluation and assessment. Thediscussion of the screeningslideshow is included in thistrainer’s guide, along with thediscussion for the separateslideshow for evaluation andassessment procedures.

4B | Evaluation andassessment procedures: As we’vesaid, not all States use screeningprocedures with the babies andtoddlers referred to early interven-tion. Many launch straight in andask for parental consent to con-duct an evaluation of the child. If

parents provide theirconsent, the lead agencyproceeds to conduct the

evaluation, the results ofwhich are used to deter-

mine the child’s eligibilityfor early intervention

services. If the child is foundeligible, then the lead agency orEIS provider will then ask parentsto provide consent for an assess-ment of the child and family. Ifparents provide consent, then anassessment of the child andfamily is conducted.

If your State doesn’t usescreening as a preliminary step inthe evaluation and assessmentprocess, then you’ll want to usethe 4B presentation, whichfocuses exclusively on evaluationand assessment.

Trainer’s Note

Throughout this training module,all references in the discussion section for a slide areprovided at the end of that slide’s discussion.


Early Intervention and IDEA

Thanks to a powerful and importantfederal law called the Individuals withDisabilities Education Act, or IDEA,336,895 eligible infants and toddlersbirth through age 2 received earlyintervention services in 2011 underPart C of IDEA.2

Early intervention services areconcerned with all the basic and brand-new developmental skills that babiestypically develop during the first threeyears of life, such as:

• physical (reaching, rolling, crawling,and walking);

• cognitive (thinking, learning, solvingproblems);

• communication (talking, listening,understanding);

• social/emotional (playing, feeling secure andhappy); or

• adaptive behavior (eating, dressing).3

Early intervention services are designed to meetthe needs of eligible infants and toddlers who havea developmental delay or disability. Services may alsoaddress the needs and priorities of each child’sfamily, to help family members understand thespecial needs of the child and how to enhance his orher development.4

Screening, Evaluation, and Assessment inEarly Intervention

Subpart D of the Part C regulations provides theframework for effectively identifying, locating, andproviding early intervention services to all eligibleinfants and toddlers with disabilities. The frameworkconsists of:

• pre-referral activities, which include (a) settingup a comprehensive child find system toidentify, locate, and evaluate all infants andtoddlers with disabilities in the State who areeligible for early intervention services; and (b)operating a public awareness program to makeresidents of the State aware of the availability ofearly intervention services;

• referral activities, which includeestablishing a system by which primaryreferral sources (e.g., hospitals,physicians, parents, and others) canrefer a child under the age of three toPart C; and

• post-referral activities, which includescreening (optional), evaluation andassessment, determining a child’seligibility for EI services, and activitiesassociated with developing an individu-alized family service plan (IFSP) for eacheligible child and family.5

Clearly, this module falls into the post-referral part of the framework because of

its focus on screening, evaluation. andassessment. All post-referral activities must

be completed within 45 days unless the child is notavailable due to family circumstances or the parenthas not provided consent. The 45-day timeline,which begins on the date of referral, ensures ac-countability, consistency, and predictability forStates and parents.

Screening, evaluation, and assessment aredistinct processes with different purposes under theprovisions of Part C. This module explores anddescribes each of these processes.

Screening in Context

Screening is a term we hear a lot about these days:screening, neonatal screening, developmentalscreening, pediatric screening, autism screening,hearing screening, lead screening…. and so on. Thisreflects our increased awareness that identifyingchildren with delays or disabilities as early as pos-sible in their lives also means beginning interven-tion as early as possible, which in turn can lead tomore positive outcomes for these children.

[T]here is one widely-accepted fact: earlyand intensive intervention can have aprofound impact on the quality of life forchildren at risk and their families. The key isearly detection.6

That said, “screening” has a host of meaningsand associations. There are screening guidelines forhospitals, pediatricians, physicians, day careproviders, and more. There are screening tools, too,


including those designed specifically for very youngchildren.

In fact, one of the most recent screeninginitiatives was launched in March, 2014 by U.S.Department of Education and U.S. Department ofHealth and Human Services (HHS)—the Birth to 5:Watch Me Thrive! initiative. Watch Me Thrive! ismeant to encourage developmental and behavioralscreening for young children. The initiative includestools and resources for families and service provid-ers across disciplines, service sectors, and programs,including a compendium of screening measures.You can find out more about this initiative at theEarly Childhood Technical Assistance Center (ECTACenter), at: http://ectacenter.org/topics/earlyid/screeneval.asp

However, let’s be clear: This module looksspecifically at what screening is under Part C ofIDEA. Screening’s purpose in Part C is also clear:To determine if a child is suspected of having adisability. If so, then the required evaluation andassessment process laid out in the Part C regula-tions would be in order. If not, the lead agency orEIS provider would not be required to conduct anevaluation of the child unless the parents request it(which they can at any time).

Evaluation and Assessment in Context

Although screening is an option for States,evaluation and assessment have long been arequired part of the early intervention experience.Evaluation and assessment are not the same thing,even though the terms often appear together.Consider them in sequence:

1. Referral | A baby or toddler is referred to earlyintervention when someone suspects he orshe may have a delay or disability. Withparental consent….

2. Screening (optional) | The leadagency or EIS provider may screenthe child, if an option in the State,to see if, indeed, there’s cause tosuspect a delay or disability. If thereis, and with parental consent….

3. Evaluation | An evaluation is conducted tosee if, indeed, the child has a delay or disability andwhether the child is eligible for early interventionservices. If the child is eligible, and with parentalconsent…

4. Assessment | An assessment of the child isconducted to identify his or her present levels ofdevelopment and needs and what type of earlyintervention services are necessary to address thoseneeds. An assessment of the family is alsoconducted (with the family members’ consent) toidentify the family’s priorities, resources, andconcerns related to enhancing the child’sdevelopment.

This Module in the Part CTraining Curriculum

The training curriculum on Part C of IDEA isorganized into separate themes, with multipletraining modules under most themes. The themesare:

Theme A | Welcome to IDEA

Theme B | Public Awareness Program and ChildFind

Theme C | Evaluating Infants and Toddlersfor Disabilities

Theme D | Individualized Family Service Plan(IFSP)

Theme E | Transition from Part C to Part B ofIDEA

Theme F | Procedural Safeguards

Theme G | Use of Funds

This module falls within the umbrellatopic of Theme C, Evaluating Infantsand Toddlers with Disabilities and isthe only module in the theme.


Files You’ll Need for This Module

Trainer’s Guide Discussion. The Trainer’s Guidedescribes how the slides operate and explains thecontent of each slide, including relevant require-ments of the statute passed by Congress in De-cember 2004 and the final regulations for Part Cpublished in September 2011. The guide providesdiscussion for both slideshow 4A (on screening)and slideshow 4B (on evaluation and assessment)and is available in PDF and Word® formats.

PowerPoint® Slideshow. We are pleased toprovide two slideshows (produced inPowerPoint®) around which trainers can frametheir presentations and training on: (a) screeningprocedures, if an option in the State; and/or (b)evaluation and assessment procedures.

Important note: You do NOT need the PowerPoint®software to use these slide shows. It’s set todisplay, regardless, because the PowerPointViewer® is included. (You may be asked to agree toViewer’s licensing terms when you first open theslideshow.)

Module 4 includes the components listed below, provided in separate files. All of these files can bedownloaded free of charge from the website of the Center for Parent Information and Resources (CPIR),at: http://www.parentcenterhub.org/repository/partc-module4/

For Whom Is This Module Designed?

This module is primarily intended for trainers touse with audiences who are newcomers to the law,the early intervention process, and especially theprotections known as Part C’s procedural safeguards.This includes:

• parents and family members of an infant ortoddler who has, or is suspected to have, adevelopmental delay or a disability;

• early childhood candidates who are learningabout Part C early intervention programs for ouryoungest children with disabilities, includingthe role that procedural safeguards play inprotecting the rights and privacy of families andchildren receiving EI services;

• stakeholders in the early childhood community,including Head Start and Early Head Startpersonnel, preschool professionals, and earlychildhood educators;

Handouts for Participants. There are two hand-outs for this training module. They are:

• Handout 6, Post-Referral Procedures—Screenings, Evaluations, and Assessments

• Handout 7 | Parent Notification and ParentConsent

The handouts are available in PDF and Word®formats. The PDF versions are designed to sharewith participants. The Word versions are madeavailable for those participants who need orrequest accessible materials.

• new staff, advocates, policy makers, administra-tors, and early childhood specialists who will beworking with either the Part C system or withinfants and toddlers who have disabilities andtheir families, but who have limited knowledgeof what the law requires in terms of protectingthe rights and privacy of children and families;and

• staff of Parent Training and Information (PTI)centers and of Community Parent ResourceCenters (CPRCs), as well as other organizationsserving families of children who have disabili-ties.


1 U.S. Department of Education. (2011, September 28). Early intervention program for infants andtoddlers with disabilities: Rules and regulations. Federal Register, 76(188), 60140-60309.Washington, DC: Office of Special Education and Rehabilitative Services, Department ofEducation. Online at: http://www.gpo.gov/fdsys/pkg/FR-2011-09-28/pdf/2011-22783.pdf

2 Technical Assistance Coordination Center. (2012). Historical state-level IDEA data files: Part C childcount 2011. Retrieved November 11, 2013, from: http://uploads.tadnet.org/centers/97/assets/2414/download

3 Center for Parent Information and Resources. (2014, March). Overview of early intervention.Washington, DC: NICHCY. Online at: http://www.parentcenterhub.org/repository/ei-overview/

4 §303.13(b)(3) of the Part C regulations.

5 Subpart D—Child Find, Evaluations and Assessments, and Individualized Family Service Plans.§303.300—General.

6 First Signs. (n.d.). Our mission. Retrieved July 7, 2014 from the First Signs website:http://firstsigns.org/

References &&&&& Footnotes


Looking for IDEA 2004?

Visit the Center for Parent Information and Resources’ website, where you can downloadcopies of:

• IDEA’s statute (the law passed by Congress in 2004)

• Part C regulations (published by the U.S. Department of Education on September28, 2011)

• Part B regulations (published by the U.S. Department of Education on August 14,2006)

Find all at: http://www.parentcenterhub.org/repository/idea-copies/

Finding Specific Sections of the Regulations: 34 CFR

As you read the explanations about the Part C regulations, you will find references tospecific sections, such as §303.21. (The symbol § means “Section.”) These referencescan be used to locate the precise sections in the Part C regulations that address the issuebeing discussed. In most instances, we’ve also provided the verbatim text of the Part Cregulations so that you don’t have to go looking for them.

The Part C regulations are codified in Title 34 of the Code of Federal Regulations. This ismore commonly referred to as 34 CFR or 34 C.F.R. It’s not unusual to seereferences to specific sections of IDEA’s regulations include this—such as 34 CFR§303.21, which is where you’d find Part C’s definition of “infant or toddler with adisability.” We have omitted the 34 CFR in this training curriculum for ease of reading.

Citing the Regulations in This Training Curriculum

You’ll be seeing a lot of citations in this module—and all the other modules, too!—that look like this: 76 Fed. Reg. at 60250

This means that whatever is being quoted may be found in the Federal Registerpublished on September 28, 2011—Volume 76, Number 188, to be precise. The numberat the end of the citation (in our example, 60250) refers to the page number on whichthe quotation appears in that volume. Where can you find Volume 76 of the FederalRegister? At this address:

http://www.gpo.gov/fdsys/pkg/FR-2011-09-28/pdf/2011-22783.pdf


Slide 4A-1Title Slide

How to Operate the Slide:

Slide loads fully. Noclicks are necessaryexcept to advance to thenext slide.

Use this slide to introduce your audience to what thistraining will be about: the screening procedures that a

State may choose to adopt as a step in identifying infantsand toddlers who are suspected of having a disability.

Warming up to Screening: Slides 1-4

There are 4 warm-up slides used to sneak up onscreening. This first slide shows the title of the slideshowand a gorgeous Chinese screen, such as you’d hang on thewall. You don’t need to say anything, just click and moveon to the next slide… and then the next…

CLICK to advance to next slide.

Trainer’s Note!

If your State doesn’t use screening as part of its child findsystem, you probably won’t be delving into Slideshow 4A. Skipforward to page 30 in this trainer guide to where the slides anddiscussion begin for Slideshow 4B, Evaluation and AssessmentProcedures.

Of course, even if your State doesn’t use screening, you can stillprovide training on the process so that your participants are upto speed with what’s required! That’s up to you—and what theyneed to be well informed.

Screening Procedures


Slide 4A-2Screens (Slide 2 of 4)



There are screens....

Slide 4A-2 continues the warm-up by showingfour different graphics of screens:

• the Chinese screen just seen

• a computer monitor rimmed by post-it notes

• a screen in a door or window

• many screens in a line-up of cell phones

The tagline also appears: “There are screens…”

Again, you don’t need to say anything. CLICK

once, and move on to the next slide.


Slide 4A-3



Screens (Slide 3 of 4)

Hopefully, your audience will instantly recognize themost dreaded screen that’s shown on the slide: The

blue screen that lets us known that our computer hascrashed, hit the wall, failed, choked… and will now rebootitself, thank you very much.

No one likes the blue screen—it is dreaded and dreadful.

But CLICK again, and finally get to the point.

...and there are dreaded screens....


Slide 4A-4



Screens (Slide 4 of 4)

...and there are veryimportant screens....

http://www.firstsigns.org/

Last warm-up slide, and very much to the pointof this presentation.

The photos on the slide come from the frontpage of the First Signs website. They show twochildren and two sets of text (“Concerns about aChild” on the left, and “Screening” on the right).Juxtaposed beneath these photos and text is thetagline “and there are very important screens.”

This is meant to zero the audience in on thesubject of the slideshow—screening of babies andtoddlers.

What’s First Signs?

The audience is not likely to recognize the homepage of First Signs, but they may have heard of thisorganization, seen its developmental milestonecharts on the walls of a pediatrician’s office, orcaught its public service announcements on TV.

First Signs is a national non-profit organizationdedicated to educating pediatric professionals andparents about the early warning signs of develop-mental disorders (especially autism) and theimportance of early intervention at this crucialstage of life. It’s funded through a combination of:

• government agencies (including the Centers forDisease Control and Prevention);

• State agencies (e.g., Alabama, Minnesota,Pennsylvania);

• foundations (e.g., Doug Flutie Jr. Foundationfor Autism); and

• individual donors.7


Suggestions for Quick OpeningActivities

Any of the following suggestionswould take about 1-2 minutes. Youcan expand each to 5 minutes byhaving participants then call out whattheir “partners” told them and jottingthese down on a flipchart.

Suggestion 1 | In large group, ask participantsto share what they know about developmentalmilestones and developmental screening. What aresome of the “first signs” they might look for, thatwould make them suspect a baby or toddler has adelay or disability? Use a flipchart to jot down theiranswers.

Suggestion 2 | Ask participants to introducethemselves to the person seated next to (or behind)them and exchange two pieces of information: (a)

7 First Signs. (2014). Funding. Retrieved July 7, 2014 from the FirstSigns website: http://firstsigns.org/about/funding.htm

References

one thing they already know about thetopic (screening of babies and toddlersfor disabilities or delays), and (b) onething they hope to learn about thetopic.

Suggestion 3 | Ask participants tostand up and politely bow to two orthree people nearby, asking them why

they are here today, taking this trainingon screening procedures, and what they hope totake away from it.

Suggestion 4 | Ask participants to shake handswith one neighbor and tell that person how thistopic relates to their personal or professional life.


Slide 4A-5

Slide loadscompletely. No clicksare necessary exceptto advance to thenext slide.


Agenda

In this module you’ll learn:

• States have the option ofadopting screening as partof Child Find

• What States must do, if theyadopt screening procedures

• The importance of parentnotification and consent

• What the Part C regulations sayabout screening, verbatim

With this agenda, you can dive into thistraining on Screening Procedures.


Slide 4A-6



The Option of Screening

States may choose to includein their child find systems:

Pertinent Handout:• Handout 6, Post-Referral Procedures—

Screenings, Evaluations, and Assessments

What?Procedures for the screeningof children who have beenreferred to Part C…

Why?…to determine whether

they are suspected ofhaving a disability

As the slide makes clear, adopting screeningprocedures is an option for States. They may

choose to include screening as part of their childfind systems. And many do.

Screening in Context

Many States participate in interagency screeningactivities as part of their pre-referral procedures andcomprehensive child find system (discussed below).This type of screening is often the responsibility ofother State agencies in order to meet their require-ments to locate and identify children who may be atrisk for developmental delays, or because of healthand medical concerns. Using screening proceduresas part of post-referral activities is now an optionthat a lead agency may choose, but is not required,to include.

What’s Child Find?

Child find was discussed in Module 3, Pre-referralActivities. Here, you may wish to present a briefsummary of child find for participants, mentioningaspects such as:

• Each State early intervention system mustinclude a comprehensive child find system thatensures that all infants and toddlers withdisabilities eligible for EI services are identified,located, and evaluated.

• Part C’s child find system must be consistentwith Part B’s child find system, which focuseson identifying school-aged children who mayhave disabilities and evaluating them todetermine their eligibility for special educationand related services.


8 §303.310(a)—Post-referral timeline (45 days). Note that the 45-day timeline does not apply for anyperiod when the child or parent is unavailable due to exceptional family circumstances that aredocumented in the child’s early intervention records; or when the parent has not provided consent forthe screening, initial evaluation, or initial assessment despite repeated attempts to obtain consent.

9 76 Fed. Reg. at 60194.

10 72 Fed. Reg. 89 at 26471. This is the 2007 Notice of Proposed Rulemaking (NPRM) for the Part Cregulations. It’s available online at: https://www.federalregister.gov/articles/2007/05/18/E7-9566/early-intervention-program-for-infants-and-toddlers-with-disabilities

References

• The Part C and Part B child findsystems are strongly intertwined. Thismeans that all children withdisabilities in the State eligible underIDEA are to be identified, located,and evaluated.

Thus, child find is quite a sweepingobligation.

Child Find and the Post-Referral Process

After a child is referred to the Part C system, the“post-referral” time clock starts ticking. From thetime that the lead agency or EIS provider receivesthe child’s referral, it has 45 days in which to:

• conduct a screening of a child (if a Stateoption);

• conduct the initial evaluation of the child;

• conduct the initial assessments of the child andfamily; and

• hold the initial IFSP meeting to develop thechild’s individualized family service plan(IFSP).8

Prior written notice and parental consent | Atmultiple points in this chain of events, the leadagency or EIS provider must provide parents withprior written notice (explaining in detail what it isproposing to do) and ask for and obtain theirinformed written consent. Prior written notice andconsent are discussed on Slide 4A-8 (see page 4-20).

What’s the Purpose of Screening?

The “Why?” on the slide speaks to the purpose ofscreening. In States that adopt screening as part oftheir child find process, a lead agency or EIS

provider would screen infants and toddlersreferred to Part C to identify, at the earliestpossible age, if they are suspected to have adisability.

Note this word, “suspected.” Screening isnot sufficiently in depth to determine that

a child does have a disability or delay or toestablish a child’s eligibility for early inter-

vention. Screening will merely indicate thatthere is cause for concern—and, thus, cause to

proceed (with parental consent) to the moredetailed and comprehensive evaluation of the child.As the Department notes in its Analysis of Commentsand Changes:

[Section] 303.320 makes clear that thepurpose of screening is to determine if achild is suspected of having a disability. Ifeligibility is to be determined, new§303.321 requires that an evaluation (notscreening) be used to determine eligibility.9

Is Screening New to IDEA andthe Part C Regulations?

Yes, and no.

To clarify, no | According to the Department,section 639(a)(4) of the Act has always referenced“screening” as a possibility that States could incor-porate into their child find systems. To date, manyStates have done just that as a way to help them”efficiently identify, from the increased number ofpotential referrals, those children experiencingdevelopmental delays or potentially eligible for earlyintervention services.”10

To clarify, yes | What’s new in the 2011 Part Cregulations is the set of requirements listed at§303.320 (provided in the box on the next page and


§303.320 Screening procedures (optional).

(a) General. (1) The lead agency may adoptprocedures, consistent with the requirements ofthis section, to screen children under the age ofthree who have been referred to the Part Cprogram to determine whether they are sus-pected of having a disability under this part. Ifthe lead agency or EIS provider proposes toscreen a child, it must—

(i) Provide the parent notice under §303.421of its intent to screen the child to identifywhether the child is suspected of having adisability and include in that notice adescription of the parent’s right to request anevaluation under §303.321 at any time duringthe screening process; and

(ii) Obtain parental consent as required in§303.420(a)(1) before conducting the screeningprocedures.

(2) If the parent consents to the screeningand the screening or other available informationindicates that the child is—

(i) Suspected of having a disability, afternotice is provided under §303.421 and onceparental consent is obtained as required in§303.420, an evaluation and assessment of thechild must be conducted under §303.321; or

(ii) Not suspected of having a disability, thelead agency or EIS provider must ensure thatnotice of that determination is provided to theparent under §303.421, and that the noticedescribes the parent’s right to request anevaluation.

(3) If the parent of the child requests andconsents to an evaluation at any time duringthe screening process, evaluation of the childmust be conducted under §303.321, even if thelead agency or EIS provider has determinedunder paragraph (a)(2)(ii) of this section thatthe child is not suspected of having a disability.

(b) Definition of screening procedures. Screeningprocedures—

(1) Means activities under paragraphs (a)(1)and (a)(2) of this section that are carried outby, or under the supervision of, the lead agencyor EIS provider to identify, at the earliest pos-sible age, infants and toddlers suspected ofhaving a disability and in need of early inter-vention services; and

(2) Includes the administration of appropri-ate instruments by personnel trained to admin-ister those instruments.

(c) Condition for evaluation or early interventionservices. For every child under the age of threewho is referred to the Part C program orscreened in accordance with paragraph (a) ofthis section, the lead agency is not required to—

(1) Provide an evaluation of the child under§303.321 unless the child is suspected of havinga disability or the parent requests an evaluationunder paragraph (a)(3) of this section; or

(2) Make early intervention services availableunder this part to the child unless a determina-tion is made that the child meets the definitionof infant or toddler with a disability under§303.21.

on Handout 6). If a State does adopt screeningprocedures, it must comply with those requirements,which we will discuss across the next several slides.


Slide 4A-7

Slide loadswith thisview.

Click 1:The picture liftsaway, and the textbeneath (“Screen-ing proceduresinclude…”) isrevealed.

CLICK AGAIN to advance to next slide.

CLICK 1

Defining Screening Procedures


OpeningView

• The lead agency

• Early interventionservice providers

• Those under thesupervision of thelead agency or anEIS provider

Who may carry outscreening of children?


• The lead agency

• Early interventionservice providers

• Those under thesupervision of thelead agency or anEIS provider

Who may carry outscreening of children?

Screening proceduresinclude—

The administration ofappropriate instruments

by qualified personnel

that can assist indetermining whether a

child is suspected ofhaving a disability

See discussion on next page


Slide 4A-7: Background and Discussion1 Click

Now that we know the purpose of screening andthat many States are already using it to help

them fulfill their child find obligations, let’s seewhat IDEA now requires States to adopt in terms oftheir screening procedures.

The slide’s text distills Part C’s new requirementsquite tidily. Refer participants to Handout 6 (page2) and compare the slide with the regulations at§303.320(b), which read:

(b) Definition of screening procedures.Screening procedures—

(1) Means activities under paragraphs(a)(1) and (a)(2) of this section that arecarried out by, or under the supervision of,the lead agency or EIS provider to identify,at the earliest possible age, infants andtoddlers suspected of having a disabilityand in need of early intervention services;and

(2) Includes the administration ofappropriate instruments by personneltrained to administer those instruments.

As you can see, lead agencies, EIS providers, andthose under their supervision are those who arepermitted to carry out screening of children. There’smore to the story, naturally. Keep reading!

Who may carry out screenings, clarified | Theregulations indicate that screening includesadministering appropriate instruments and that thepersonnel who administer those instruments mustbe trained to do so. The Department clarifies thatthis will “ensure that personnel, such as paraprofes-sionals or other individuals who are trained toadminister a specific screening instrument, mayconduct screenings.”11

Is screening necessary for infants and toddlerswith established physical or mental conditions? |This question arises because of other provisions inthe regulations that permit some eligibility decisionsto be made based on a child’s medical or otherrecords. Those provisions, at §303.321(a)(3)(i),read:

(3)(i) A child’s medical and other recordsmay be used to establish eligibility (withoutconducting an evaluation of the child)under this part if those records indicate thatthe child’s level of functioning in one ormore of the developmental areas identifiedin §303.21(a)(1) constitutes adevelopmental delay or that the childotherwise meets the criteria for an infant ortoddler with a disability under §303.21. Ifthe child’s Part C eligibility is establishedunder this paragraph, the lead agency or EISprovider must conduct assessments of thechild and family in accordance withparagraph (c) of this section.

As you can see by these regulations, determiningsome children’s eligibility based on their medical orother records removes the need to conductevaluations of those children. Similarly, there is noneed to conduct screenings of the children. As theDepartment states:

For children with established diagnosedconditions, screening is not needed becauserecords establish that the child is not onlysuspected of having a disability, but in facthas a disability.12



11 76 Fed. Reg. at 60194.

12 76 Fed. Reg. at 60194-60195.

References


Slide 4A-8

Click 1:The question“What if the parentdoes not giveconsent?” appears,the picture liftsaway, and the textbeneath is revealed.

CLICK 1

Procedures Required Before IFSP Meetings


Parental Notification and Consent!

...are required before any screeningprocedures may be administered

• is fully aware of the nature of the evaluationand assessment of the child, or the servicesthat would be available

• understands that the child will not be able toreceive these unless consent is given



OpeningView


What ifparentdoes notgive consent?

...are required before any screeningprocedures may be administered

The lead agency must make reasonableefforts to ensure that the parent:

The lead agency may not override theparents’ refusal of consent


Slide 4A-8: Background and Discussion1 Click



• Handout 7 | Parent Notification andParent Consent

Parent notification and parental consent arediscussed in many of the modules in this

training curriculum, because both are very, veryimportant.

Discussing the Slide

• Don’t click when the slide first loads | Whenthe slide first loads, only the top part is visible,highlighting that parent notification andconsent are required before any screeningprocedures may be administered. This providesthe opportunity to discuss notification andconsent in any level of detail you feel is appro-priate for your audience. So don’t click untilyou’re done presenting information aboutnotification and consent, drawing from thedetails discussed below.

• Once you click | The slide will change so thatyou can discuss what happens if the parents donot give their consent for their infant ortoddler to be screened. Draw from the informa-tion provided much further below (under thesection “What if parents don’t give theirconsent?).

First, the Regulations

Before we start throwing tons of information atyou about notice, consent, native language, and thecontext of this entire discussion, let’s see the regula-tory basis for this slide, which is also how the PartC regulations for screening begin. We’ve bolded keyphrases to draw the eye to “notice” and “consent.”

§303.320 Screening procedures(optional).

(a) General. (1) The lead agency mayadopt procedures, consistent with therequirements of this section, to screen

children under the age of three who havebeen referred to the Part C program todetermine whether they are suspected ofhaving a disability under this part. If thelead agency or EIS provider proposes toscreen a child, it must—

(i) Provide the parent notice under§303.421 of its intent to screen the child toidentify whether the child is suspected ofhaving a disability and include in thatnotice a description of the parent’s right torequest an evaluation under §303.321 atany time during the screening process; and

(ii) Obtain parental consent as requiredin §303.420(a)(1) before conducting thescreening procedures. [emphasis added]

Trainer’s Note!

If your audience is already well acquaintedwith notification and consent, you won’tneed to delve deeply into the topic. If you’renot sure how much participants already knowabout this important requirement in Part C,ask them directly (show of hands) or take amoment and discuss with them their experi-ences in asking for or providing consent. Forexample, in what sort of situations have theybeen asked to provide their consent, as aparent, as a patient, or for some other reason?

Adjust the amount of detail you offerabout notification and consent, based on thesense you get of how familiar participants arewith these two parts of Part C. The informa-tion provided below gives you the details.Handout 7 gives participants the verbatimregulations.


Now, the Ton of Information

To give you a heads-up ideaof what information we’regoing to provide in theupcoming pages, allassociated with this slide,here’s a quick table ofcontents:

• Context | Parents asa child’s most vitalresource

• What’s prior written notice?

• Prior written notice specific to screening

• Can parents understand the prior writtennotice they receive?

• About native language

• Parental consent

• What if parents don’t give their consent?

• May the lead agency override a parent’s lack ofconsent?

While the slide is designed to be quick and tothe point, you may want to offer some or all of thedetails provided in the discussion below, as fits theneeds of your audience and the time you haveavailable for training.

Context | Parents as a Child’s Most VitalResource

Regardless of how parents and child come to theEI system, it’s a whole new experience to them.They are likely to be unfamiliar with the processesand procedures used in early intervention, thejargon or specialized vocabulary they may hear, andwhat awaits their child and family in this program.There’s a lot to learn and a lot to decide immedi-ately—including, in the case of screening, what thepurpose of screening is and what’s involved in theprocess.

All this takes place in the context of parents’vital role in caring for their baby or toddler. Fromits earliest roots, the early intervention system hasrecognized that parents are the most important andinfluential resource in the lives of their babies andtoddlers with disabilities. They are also the primarydecision makers for their child.13

To be able to make sound decisions about theirchild’s involvement in early intervention—andtheir own involvement—parents need to be fullyinformed about what will take place and where,what’s being proposed or rejected, and much more.To that end, early intervention systems are requiredto provide full notice to parents at specific pointsin time—certainly before screening the child andbefore any evaluation or assessment of the child—and to obtain their consent before certain activitiesmay take place.

What’s Prior Written Notice?

Prior written notice refers to the notification thatmust be provided to parents a reasonable timebefore the lead agency or an EIS provider proposes(or refuses) to “initiate or change the identification,evaluation, or placement of their infant or toddler,or the provision of early intervention services to theinfant or toddler with a disability” and his or herfamily.14 Participants can see these exact words onHandout 7.

The notice must be in sufficient detail to informparents about—

• the action that is being proposed or refused;

• the reasons for taking the action; and

• all procedural safeguards that are available toparents (e.g., mediation, filing a State com-plaint or a due process complaint, relevanttimelines).15

Examples | Several examples will serve to illus-trate when prior written notice must be provided toparents in the context of screening, evaluation, andassessment.

• The lead agency wants to screen the child tosee if there’s reason to suspect the child has adisability or developmental delay. (Proposedaction: Screening)

• The lead agency determines, after screening thechild, that the little one is not suspected ofhaving a disability or delay and that a morethorough evaluation does not need to beconducted. (Refused action: Evaluation)

• The lead agency wants to evaluate the child tosee if he or she is eligible for Part C servicesbecause of a disability or developmental delay.(Proposed action: Evaluation)


• The lead agency or EIS provider evaluates thechild, but finds that the child is not eligible forearly intervention services. It must informparents of this result. (Refused action: Eligibil-ity and the provision of early interventionservices)

• The EIS provider would like parents to partici-pate in a family assessment, where their priori-ties, resources, and concerns for their child willbe discussed and identified. (Proposed action:Family assessment)

In each of these instances, the parents wouldneed to be provided with prior written notice by thelead agency or EIS provider. These are not the onlytimes that prior written notice is required, but theyare among the first instances that parents new toearly intervention would encounter.

Prior Written Notice Specific to Screening

The lead agency or EIS provider must provideparents with prior written notice of its intention toscreen their infant or toddler, and it must explainthe reasons why—namely, that the screening’spurpose is “to identify whether the child is sus-pected of having a disability.”16 Parents mayrequest information about the screening processsuch as what screening involves (e.g., types ofactivities, instruments or processes used).

Finally, and importantly, the prior written noticefor screening must include “a description of theparent’s right to request an evaluation…at any timeduring the screening process”17—a requirement thatparticipants can see on Handout 6 (bottom of page1 and top of page 2).

Can Parents Understand the Prior WrittenNotice They Receive?

It’s critical that the prior written notice isunderstandable to the parent. Otherwise, itwouldn’t be very informative! The Part Cregulations are exceedingly clear that prior writtennotice must be:

• written in language that the general publicwould understand; and

• provided to parents in their native language (orother mode of communication), unless it isclearly not feasible to do so.18

You’ll find the applicable regulations in the boxbelow and on Handout 7.

About Native Language

“Native language” is defined at §303.25. Thedefinition pertains to parents with limited Englishproficiency; the infant or toddler in question; andto parents with blindness, deafness, or no writtenlanguage. For these latter parents, native languageis considered to be the mode ofcommunication that isnormally used by theindividual (such as signlanguage, Braille, or oralcommunication).

Providing Prior Written Notice inParents’ Native Language or Other Modeof Communication | §303.421(c)

(c) Native language. (1) The notice mustbe—

(i) Written in language understandableto the general public; and

(ii) Provided in the native language, asdefined in §303.25, of the parent or othermode of communication used by theparent, unless it is clearly not feasible to doso.

(2) If the native language or other modeof communication of the parent is not awritten language, the public agency ordesignated EIS provider must take steps toensure that—

(i) The notice is translated orally or byother means to the parent in the parent’snative language or other mode of commu-nication;

(ii) The parent understands the notice;and

(iii) There is written evidence that therequirements of this paragraph have beenmet.


When there’s no written language | As can beseen in the regulations cited in the box on theprevious page, the public agency has specificresponsibilities when providing prior written noticeto a parent whose native language is not a writtenone. Specifically, the lead agency or EIS providermust take steps to ensure:

• that the prior written notice is “translatedorally or by other means” to the parents intheir native language or other mode ofcommunication;

• that the parent understands the notice; and

• that there is written evidence that theserequirements have been met.19

The Department noted that these rights “areessential to ensure that public agencies provide allparents the requisite prior written notice in ameaningful and understandable manner.”20

Native language and the child in question |We won’t go into how native language is definedfor the babies and toddlers who enter the earlyintervention program for screening or evaluationand assessment, or those who are found eligibleand begin receiving EI services. It’s not relevanthere, where we are talking about the prior writtennotice that must be provided to parents. But it willsoon be relevant, when we talk about the actualscreening or evaluation and assessment of thechild.

Parental Consent

Consent within IDEA has a very specific meaningthat is closely tied to prior written notice. Consent,in IDEA, means informed written consent. Priorwritten notice comprehensively describes a pro-posed or refused action and is intended to informparents fully about a specific issue. Only by build-ing that foundation of understanding can informedconsent be given.

Consider the definition of consent in the Part Cregulations (provided at the bottom of page 2 onHandout 7 and in the box on this page):

While participants will most likely have anintuitive and experience-based grasp of what“consent” means, this definition includes severalpoints worth bringing to their attention:

• Consent is voluntary on the part of the parent.It’s not a one-shot-and-done action. Parentsmay withdraw (revoke) their consent at anytime.

• Requesting parents’ consent for a given ac-tion—in this case, screening of the child—mustoccur in the parents’ native language or othermode of communication, unless it is clearlynot feasible to do so.

• Parental consent must be given in writing. It’sinsufficient for parents to provide only verbalagreement.

Make it clear to your participants that the rightto give or refuse consent for pivotal activities is animportant procedural safeguard for parents. Itrecognizes their authority and responsibility inmaking decisions about their child’s involvement inearly intervention, and the family’s.

§303.7 Consent.

Consent meansthat—

(a) The parent hasbeen fully informed ofall information relevant to the activity forwhich consent is sought, in the parent’snative language, as defined in §303.25;

(b) The parent understands and agrees inwriting to the carrying out of the activityfor which the parent’s consent is sought,and the consent form describes that activityand lists the early intervention records (ifany) that will be released and to whomthey will be released; and

(c)(1) The parent understands that thegranting of consent is voluntary on the partof the parent and may be revoked at anytime.

(2) If a parent revokes consent, thatrevocation is not retroactive (i.e., it does notapply to an action that occurred before theconsent was revoked).


What if Parents Don’t Give Their Consent?

Okay, back to the slide. If you CLICK, the ques-tion will descend (“What if parent does not giveconsent?”), and the picture will lift away, revealingthe text beneath—which, essentially, answers thequestion and comes nearly verbatim from the PartC regulations, as shown in the box to the right andon page 2 of Handout 7.

In a nutshell, when parents do not consent tothe requested activity (in this case, screening oftheir child), the lead agency or EIS provider mustmake reasonable efforts to explain to the parents:

• the nature of what it wants to do (e.g., whatactivities screening will involve, and why it’sasking parents for permission to screen thechild); and

• what will not occur without their consent (e.g.,their child will not be screened).

May the Lead Agency Override a Parent’sLack of Consent?

No. It is the parent’s right to give or refuseconsent.21 The lead agency may not use IDEA’s dueprocess procedures to challenge the parent’sdecision.

What Happens if Parents Do Not ProvideTheir Consent?| §303.420(b) and (c)

(b) If a parent does not give consentunder paragraph (a)(1), (a)(2), or (a)(3) ofthis section, the lead agency must makereasonable efforts to ensure that the parent—

(1) Is fully aware of the nature of theevaluation and assessment of the child orearly intervention services that would beavailable; and

(2) Understands that the child will not beable to receive the evaluation, assessment, orearly intervention service unless consent isgiven.

(c) The lead agency may not use the dueprocess hearing procedures under this part orPart B of the Act to challenge a parent’srefusal to provide any consent that is re-quired under paragraph (a) of this section.

13 Hurth, J., & Goff, P. (2002, June). Assuring the family’s role on the early intervention team:Explaining rights and safeguards. Chapel Hill, NC: National Early Childhood TechnicalAssistance Center. Online at: http://www.nectac.org/~pdfs/pubs/assuring.pdf

14 §303.421(a)—Prior written notice and procedural safeguards notice: General.

15 §303.421(b)—Prior written notice and procedural safeguards notice: Content of notice.

16 §303.320(a)(1)(i)—Screening procedures (optional): General.

17 §303.320(a)(1)(i)—Screening procedures (optional): General.

18 §303.421(c)(1)—Prior written notice and procedural safeguards notice: Native language.

19 303.421(c)(2)—Prior written notice and procedural safeguards notice: Native language.

20 71 Fed. Reg. at 46692 (August 14, 2006).

21 §303.420—Parental consent and ability to decline services.

References


Slide 4A-9


Click 1:The “yes” answer isgiven and what thelead agency mustdo.

Click 2:The “no” answer isgiven and what thelead agency mustdo. The asteriskedtext appears below.


CLICKS 1-2

Results of the Screening

OpeningView


Results of the Screeningand Other Available Info

Results of the Screeningand Other Available Info

Yes

No

The child is suspected ofhaving a disability

The child is not suspectedof having a disability

Yes

No

The child is suspected ofhaving a disability

The child is not suspectedof having a disability

The lead agency forPart C must...

• Evaluate the child

• Provide parentswith prior writtennotice *

* If the parents request an evaluationof their child, the child must be evaluated


Slide 4A-9: Background and Discussion2 Clicks



All right, let’s say that the parents have providedtheir informed written consent to have their

infant or toddler screened. The results of thatscreening are now “in.” Is the child suspected ofhaving a disability? Or not? What happens in eachof these scenarios?

Results: Yes, a disability is suspected | If thechild is suspected of having a disability, a series ofsteps takes place:

1. The parent must be given prior written noticeof that determination.

2. The lead agency or EIS provider must ask forthe parent’s permission to conduct an evalua-tion of the child.

3. Parental consent for the evaluation must beobtained.

4. Only then may the lead agency or EIS providerevaluate the child.

Results: No, a disability is not suspected | Ifthe child is not suspected of having a disability, thelead agency must provide notice of that determina-tion to the parent, including the reasons for thedetermination. The notice must also describe theparent’s right to request an evaluation of the child.However, the lead agency is not required to providean evaluation of the child unless the parent re-quests it and provides consent.

And if the parent so requests and consents? |The regulations are clear: Even if the lead agency orEIS provider has determined that the child is notsuspected of having a disability, it must evaluate thechild fully if the parent requests an evaluation andprovides consent. The parent is thus spared having

to use IDEA’s due process procedures to appeal the“no” determination. Moreover:

The Department’s experience indicates thatparents often can identify or suspectdevelopmental delays in their children thatmay not be identified through a screening.For this reason, parents should be able torequest and receive an evaluation withoutthe potential delay and expense of a dueprocess hearing. We believe this approachfacilitates a comprehensive child findsystem tasked with identifying all infantsand toddlers with disabilities.

Additionally, because a child is onlyeligible for Part C services for a short periodof time and providing services earlier ratherthan later can enhance the development ofinfants and toddlers with disabilities, timeis of the essence with regard to identifyinga child as an infant or toddler with adisability. Thus, it is important thatparents retain the right to request anevaluation at any time during thescreening process.

What do the regulations say? | We’ve providedthe Part C regulations relevant to this slide in thebox on the next page. They appear at§303.320(a)(2). Participants will find theregulations on Handout 6 (top of page 2).


Regulations at §303.320(a)(2) and the Results of theScreening

(2) If the parent consents to the screening and thescreening or other available information indicates thatthe child is—

(i) Suspected of having a disability, after notice isprovided under §303.421 and once parental consent isobtained as required in §303.420, an evaluation andassessment of the child must be conducted under§303.321; or

(ii) Not suspected of having a disability, the leadagency or EIS provider must ensure that notice of thatdetermination is provided to the parent under §303.421,and that the notice describes the parent’s right to requestan evaluation.

(3) If the parent of the child requests and consents toan evaluation at any time during the screening process,evaluation of the child must be conducted under§303.321, even if the lead agency or EIS provider hasdetermined under paragraph (a)(2)(ii) of this sectionthat the child is not suspected of having a disability.

22 76 Fed. Reg. at 60193.

References


Slide 4A-10 Round-up Time! (Last slide in Part A)

Slide loadscompletely. No clicksare necessary exceptto end the slideshow.

CLICK to END the slideshow.

Round-up Time!

Name 5 factsabout screening

Congratulations! You’ve come to the end of this stand-alone mini-presentation on screening procedures, an

option that States can adopt as part of operating acomprehensive child find system. Use this slide as suitsyour purpose and agenda.

• You’re done | If you’re finished completely with thistraining and are not going to segue into the trainingpresentation on evaluation and assessment, use theslide as an opportunity to “wrap up” and review theinformation you’ve presented. Ask participants toname 5 facts about screening they learned or couldshare with another. Have each person jot down theirown 5 facts, then share in the large group, jottingdown items on a flipchart.

• You’re continuing on with evaluation andassessment |Moving on to look at what the Part Cregulations require in terms of evaluation andassessment? If so, use this slide as a transition slide.

Now’s also a good time to take a break, and letparticipants get up and stretch stiffening muscles.While they are having that break, you can: close the4A slideshow and open the 4B slideshow, inpreparation for the next part of your training session.

What You’ll Needfor Training Session Bon Evaluation and Assessment

• Slideshow 4B

• Handout 6Post-Referral Procedures—Screenings, Evaluations, andAssessments

• Handout 7Parent Notificationand Parent Consent


Slide 4B-1Title Slide

How to Operate the Slide:



Trainer’s Note!

Use this slide to introduce your audience towhat this training will be about.

If your training session did not start withthe optional presentation on ScreeningProcedures (Slideshow 4A), consider thesuggestions given to the right for openingactivities.

If you did provide training on screeningto this audience, then just move on tothe next slide.

Suggestions for Quick Opening Activities

Any of the following suggestions would takeabout 1-2 minutes. You can expand each to 5minutes by having participants then call out whattheir “partners” told them and jotting these downon a flipchart.

Suggestion 1 |Ask participants to introducethemselves to the person seated next to (or behind)them and exchange two pieces of information: (a)one thing they already know about the topic(evaluation and assessment in early intervention),and (b) one thing they hope to learn about thetopic.

Suggestion 2 | Ask participants to stand up andpolitely bow to two or three people nearby, askingthem why they are here today, taking this trainingon evaluation and assessment, and what they hopeto take away from it.

Suggestion 3 | Ask participants to shake handswith one neighbor and tell that person how thistopic relates to their personal or professional life.


Slide 4B-2



Agenda

In this module you’ll learn:

• The importance of parentalnotification and consent

Evaluation

• Purpose

• Required procedures

• What kind ofinformation is collected

Assessment

• Purpose

• What’s required forassessment of the childand of the family

• What kind of informationis collected

With this agenda, you can dive into thistraining on evaluation of the child and

assessment of the child and family.


Slide 4B-3

Click 1:The question“What if the parentdoes not giveconsent?” appears,the picture liftsaway, and the textbeneath is revealed.

CLICK 1




...are required before any screening, evaluation, or assessmentmay be conducted

• is fully aware of the nature of the evaluationand assessment of the child, or the servicesthat would be available

• understands that the child will not be able toreceive these unless consent is given



OpeningView


What ifparentdoes notgive consent?

The lead agency must make reasonableefforts to ensure that the parent:

The lead agency may not override theparents’ refusal of consent

...are required before any screening, evaluation, or assessmentmay be conducted


Slide 4B-3: Background and Discussion1 Click



• Handout 7 | Parent Notification andParent Consent

Parent notification and parental consent werediscussed in the separate mini-presentation

focused on screening procedures (slideshow 4A,Slide 8). The current slide is almost a duplicate ofthe other, except that this slide also refers toevaluation and assessment (not just screening).

As with screening, the lead agency’s or EISprovider’s intention to conduct an evaluation of thechild triggers the need for:

• prior written notice to parents; and

• parental consent.

Both are also required when the lead agency orEIS provider intends to conduct an assessment ofthe child and family.

Discussion of Parent Notification and Consent

Rather than repeat the information aboutparental notification and consent previouslypresented in this trainer’s guide, we are pleased torefer you to that earlier examination of these twoimportant requirements in Part C—see the extensivediscussion presented under Slide 8 in slideshow 4A(page 20 in this guide).


Slide 4B-4

Click 3:Right door slidesaway. (Assessment)

CLICKS 1-3




OpeningView

Screening | Evaluation | Assessment

Distinct processeswith different purposes


Distinct processeswith different purposes

Screeningincludes:

• activities to identifychildren who may besuspected of having adisability and thus needfurther evaluation

Evaluationis used:

• to determine that a delayor disability exists

• to determine a child’sinitial or continuingeligibility for Part C

• to identify the child’sstrengths and needs inall areas of development

Assessmentis used to determine:

• the child’s uniquestrengths and needs

• the child’s present levelof performance

• early intervention oreducational needs

• the family’s concerns,resources, & prioritiesClick 1:

Left doorslidesaway.(Screening)

Click 2:Middle door slidesdown. (Evaluation)


Slide 4B-4: Background and Discussion3 Clicks



This slide highlights the differences between thepost-referral procedures of screening,

evaluations, and assessments.23

Screening

As the slide summarizes, screening includes“activities to identify children who may besuspected of having a disability and thus needfurther evaluation.” Immediately, participants cansee that screening is not the same as evaluation.

For participants who didn’t receive training onscreening procedures (using slideshow 4A), you’llwant to give a brief summary of screeningprocedures as an option that States can use prior tothe actual evaluation and assessment process.Draw from the information presented earlier inthis trainer’s guide, including such points as:

• Screening is an option for States,not a requirement. [Does yourState include screening as partof operating its comprehen-sive child find system?Definitely share this informa-tion with participants.]

• Parent notification andparental consent are requiredbefore a child may be screened.

• The purpose of screening is todetermine if a child referred to Part C issuspected of having a disability ordevelopmental delay. It includes activities suchas the administration of appropriateinstruments by personnel trained toadminister those instruments.

• Yes | If the screening results indicate that thechild is suspected of having a disability, theState must conduct an evaluation after obtain-ing parental consent.

• No | If screening results indicate that theinfant or toddler is not suspected of having adisability, parents must be provided notice ofthat determination. That notice must alsodescribe the parent’s right to request anevaluation.

• Parents have the right to request an evaluationof their child at any time during the screeningprocess.

The Part C regulations at §303.320 set forthwhat’s required of States that adopt screeningprocedures Those regulations appear on Handout6.

Evaluation and Assessment

The summary language on the slide indicatesthat evaluation is used to:

• to determine that a child has a delay ordisability (stated as “a delay or disabilityexists”), which in turn is used to determine achild’s initial or continuing eligibility for Part Cand

• to identify the child’s strengths and needs in allareas of development.

Assessment, as summarized on the slide, clearlygoes into more depth than evaluation and includesidentifying what early intervention services areneeded, given the child’s present levels of develop-ment and performance. Assessment also focuses onthe family, if parents or other family memberchoose to participate. One of the purposes of thefamily-directed assessment is to identify thefamily’s resources, priorities, and concerns withrespect to enhancing their child’s development.


Notice and consent for evaluation | If the leadagency or EIS provider would like to evaluate thechild, prior written notice must be provided to thatchild’s parents before the evaluation. Among otherthings, the notice explains to parents why it seeksto evaluate the child and what that evaluation willinvolve. Parents must give their informed writtenconsent before the evaluation of the child may beconducted.

Notice and consent for assessment, too! | Thesame cycle of prior written notice and parentalconsent is required when the lead agency or EISprovider proposes to conduct an assessment of thechild and the assessment of the family.

Summary of evaluation and assessmentprocesses | In case you’d like to lay a bare-bonesfoundation as to what evaluation and assessmentin early intervention typically involve, here areseveral salient points:

• Evaluation and assessment are not the samething, even though the terms are often usedtogether. The Part C regulations define eachterm, as provided next.

• Evaluation means “the procedures used byqualified personnel to determine a child’sinitial and continuing eligibility.”24

• Assessment means “the ongoing procedures usedby qualified personnel to identify the child’sunique strengths and needs and the early

23 The summaries of screening, evaluation, and assessment have been adapted from the work of theEarly Childhood Technical Assistance Center (ECTA Center), one of the many national technicalassistance projects funded by the Office of Special Education Programs (OSEP). The ECTA Centeris a rich resource for States, lead agencies, EIS providers, families, and others about the currentstate of early intervention and early childhood education in the United States. Lots of info for allat the ECTA website: http://ectacenter.org

24 §303.321(a)(2)(i)— Evaluation of the child and assessment of the child and family: General.

25 §303.321(a)(2)(ii)—Evaluation of the child and assessment of the child and family: General.


References

intervention services appropriate to meet thoseneeds throughout the period of the child’seligibility.”25

• Obviously, evaluation comes first, because it isused to determine a child’s eligibility for Part Cservices. The only time that an evaluation isn’tneeded to establish eligibility is when a child’seligibility can be established by using thechild’s medical or other records.26

• If the child is found eligible for early interven-tion, then the lead agency or EIS provider mustconduct assessments of the child and family inkeeping with the requirements in the Part Cregulations. As noted above, prior writtennotice and parental consent are required beforeany assessment procedures may occur.

• If the child is not found eligible for earlyintervention, the lead agency or EIS providermust give parents written notice as to thatdetermination. The notice must let parentsknow that they have the right to challenge thenon-eligibility determination through IDEA’sdispute resolution mechanisms.No assessment of thechild or family needs tobe conducted, becausehe or she was notfound eligible forPart C.


Slide 4B-5


Evaluation (Slide 1 of 2)



Each child under the age of 3 who is referred forevaluation or EI services and who is suspected of

having a disability must receive—

• an evaluation that istimely, comprehensive,and multidisciplinary

Unless...

• eligibility is established throughmedical or other records

• parents do not give their consentfor the evaluation

Let’s dive into the specifics of evaluation underthe Part C regulations. Those regulations can be

found at §303.321 (refer participants to Handout6), and begin:

§303.321 Evaluation of the child andassessment of the child and family.

(a) General. (1) The lead agency mustensure that, subject to obtaining parentalconsent in accordance with§303.420(a)(2), each child under the ageof three who is referred for evaluation orearly intervention services under this partand suspected of having a disability,receives—

(i) A timely, comprehensive,multidisciplinary evaluation of the child inaccordance with paragraph (b) of thissection unless eligibility is establishedunder paragraph (a)(3)(i) of this section…

As you can see, the slide text tracks the regula-tions closely and also includes the language from303.321(a)(3)(i) and 303.420(a). Two points riseto the surface as “exceptions” to the lead agency’smandate to evaluate each child under the age ofthree who is referred to Part C and who is suspectedof having a disability. No evaluation of the childwould need to be conducted:

• if parents have not given their informedwritten consent to the evaluation; or

• if the child’s eligibility for Part C has beenestablished through medical or other records.





Purpose of evaluation | Theregulations clearly state that the initialevaluation of the child is conducted todetermine the child’s initial eligibilityfor early intervention services. Evaluationsare also conducted to establish a child’scontinuing eligibility.27

Parental consent |The importance of parentalconsent was discussed under Slide 4B-3, so the needfor consent before evaluation of a child shouldn’tsurprise anyone. Nor should the fact that, beforeevaluating the child, the lead agency or EIS pro-vider must provide parents with prior written noticeof its intention to evaluate and ask parents for theirwritten consent. As the slide indicates, withoutparental consent, the lead agency or EIS providermay not evaluate the child.

What’s this about medical and other records?| The slide mentions “medical and other records” asa way by which a child’s eligibility may be estab-lished. But the regulations just cited don’t explicitlysay that, do they? No, they don’t. Instead, theregulations refer it in the phrase “in paragraph(a)(3)(i) of this section…”. This cross-referencedprovision appears on Handout 6 (see page 3) andin the box below.

Establishing eligibility through medical andother records is new in the Part C regulations. Onthe next slide we’ll take a more detailed look atwhat types of diagnosed conditions

automatically make an infant ortoddler eligible for early interventionservices and, thus, eliminate the needto conduct a comprehensive and

multidisciplinary evaluation of thechild.

However, as the provision in the boxmakes clear, if eligibility is established through

medical or other records, the assessments of thechild and family must still be conducted (withparental consent).

What does “comprehensive” mean? | As theslide indicates, evaluations must be “comprehen-sive.”28 What does this mean? While not defined inthe regulations, comprehensive has the generallyunderstood meaning of “complete.” The dictionarydefines the word as meaning “of large scope;covering or involving much; inclusive.”29

As you’ll see in upcoming slides, the Part Cregulations include multiple references to evaluat-ing the child in each of the five development areas.The five developmental areas are as follows:

• cognitive development

• physical development (including vision andhearing)

• communication development

• social or emotional development

• adaptive development.30

(3)(i) A child’s medical and other records may beused to establish eligibility (without conducting anevaluation of the child) under this part if thoserecords indicate that the child’s level of functioningin one or more of the developmental areas identifiedin §303.21(a)(1) constitutes a developmental delayor that the child otherwise meets the criteria for aninfant or toddler with a disability under §303.21. Ifthe child’s Part C eligibility is established under thisparagraph, the lead agency or EIS provider mustconduct assessments of the child and family inaccordance with paragraph (c) of this section…

Establishing a Child’s Eligibility ThroughMedical and Other Records: §303.321(a)(3)(i)


Evaluating a child in each of these areas isrequired, thus making the evaluation“comprehensive” and “of large scope.”

What does “multidisciplinary” mean? |Evaluations of children must also be“multidisciplinary.” The Part C regulations expresslydefine the meaning of the word, as shown in thebox below.

In this definition, we see that, when conductingevaluation of a child and the assessments of thechild and family, the term multidisciplinary meansthat people from two or more separate disciplinesor professions are involved. In this context, thedefinition also permits one person to be qualified inmore than one discipline or profession. Thus,evaluations of children are conducted by one ormore professionals with expertise in different areas,bringing together complementary skills, knowledge,and experience in child development.

What’s considered “timely”? | Children changequickly and infants and toddlers don’t stay inearly intervention very long, so it’s criticalthat evaluations be conducted in a timelymanner and that services needed byeligible children can begin as soon aspossible.

“Timely” is not a term that theregulations define. However, the regsdo stipulate a timeline for completingpost-referral activities. The very firstprovisions on Handout 6 spell out thatpost-referral timeline:

• The timeline begins when the lead agencyreceives a child’s referral and includes screening

§ 303.24 Multidisciplinary.

Multidisciplinary means the involvementof two or more separate disciplines orprofessions and with respect to—

(a) Evaluation of the child in §§303.113and 303.321(a)(1)(i) and assessments ofthe child and family in §303.321(a)(1)(ii),may include one individual who isqualified in more than one discipline orprofession…

(if an option in the State) and the initialevaluation of the child. If the child is foundeligible for Part C, the timeline also includesthe initial assessments of the child and family,and the initial meeting to write the child’s IFSP.

• The duration of the timeline is 45 days fromwhen the lead agency or EIS provider receivesthe child’s referral to Part C.31

Thus, the evaluation and assessmentprocesses must be completed within that45-day timeframe, which also includesholding the meeting to write the child’sinitial IFSP. Exceptions apply to the 45-daytimeframe, including if the parent or child is

not available for the evaluation, assessment,and initial IFSP meeting due to exceptional

family circumstances that are documented in thechild’s early intervention records, or if the parentdoes not provide consent for any of the activities.

27 §303.321(a)(2)— Evaluation of the child and assessment of the child and family: General.


29 Dictionary.com. (n.d.). Definition of comprehensive. Retrieved July 21, 2014 from:http://dictionary.reference.com/browse/comprehensive

30 §303.21(a)(1)—Infant or toddler with a disability.

31 §303.310—Post-referral timeline (45 days).

References


Slide 4B-6


Evaluation (Slide 2 of 2)



Evaluationprocedures

must include—

• administering an evaluationinstrument

• taking the child’s history (includinginterviewing the parent)

• identifying the child’s level offunctioning in each of the 5developmental areas

• gathering information from othersources, if necessary

• reviewing medical, educational, orother records



No single proceduremay be used as thesole criterion fordetermining a child’seligibility under Part C

As has been said, the term “evaluation” in theregulations means “the procedures used by

qualified personnel to determine a child’s initialand continuing eligibility.”32 This slide looks atwhat those procedures must include.


The slide is designed to let you move swiftlythrough the required elements of evaluation proce-dures. More information is also provided below,should you care to elaborate.

Refer participants to Handout 6 (page 3, bottomof right column), where the regulations spell outthe evaluation procedures to be used. For yourconvenience, we’ve also included the regulations inthe box on the next page.

The Developmental Areas

One of the required evaluation procedures is toidentify the child’s level of functioning in each ofthe developmental areas listed in the cross-reference. In the previous slide’s discussion, weidentified what those areas are—there are five.

Take a moment and talk with participants aboutthe skills involved in each of the developmentalareas, so that they will have a solid understandingof the types of information gathered in theevaluation of a child.

Cognitive development | Cognitive develop-ment refers to children’s ability to learn and solveproblems, which typically grows dramatically


between birth andthree years old aschildren begin to makesense of the worldaround them.

Developmentalmilestones of cognitive

development include:

• paying attention to faces and recognizingfamiliar people (2 months);

• showing curiosity and trying to get to objectsthat are out of reach (6 months);

• knowing what ordinary things are for (e.g.,spoon, toothbrush, comb) and being able tofollow one-step commands (such as “sitdown”) (18 months).33

Physical development | This includes a child’sgross motor skills, fine motor skills, and sensoryand perceptual abilities.

• Fine motor skills include the child’s ability to usesmall muscles, specifically in the hands andfingers, to pick up small objects, hold a spoon,turn pages in a book, or use a crayon to draw.

• Gross motor skills refer to the child’s ability touse large muscles. Large muscle developmentwill help a baby learn to sit up withoutsupport, crawl or roll from one place toanother, and pull up to a stand by holdingonto furniture.

• Sensory and perceptual abilities include visionand hearing, as mentioned in the Part Cregulations.

Interestingly, motor skills development inchildren generally progresses from head to toe, withbabies usually gaining control of their body parts inthe following order:

• head and neck at about 2 months of age;

• arms and hands, with grasping at about 3months;

• trunk, with sitting well by about 8 months;

• legs and feet, with most children walking by 14or 15 months.34

Communication development | This refers tothe child’s ability to both understand and uselanguage to communicate with people and expresshis or her own emotions. Typical milestonebehaviors at different ages include:

• babbling (4 months);

• responding to sounds by making sounds andresponding to own name (6 months);

• copying actions that others make, such asshaking the head to indicate “no” or waving“bye-bye” (9 months), and

• using a few simple words (18 months).35

By age 3, a child may know as many as 900words.36

Procedures for Evaluation of the Child§303.321(b)

(b) Procedures for evaluation of thechild. In conducting an evaluation, nosingle procedure may be used as the solecriterion for determining a child’s eligibilityunder this part. Procedures must include—

(1) Administering an evaluationinstrument;

(2) Taking the child’s history (includinginterviewing the parent);

(3) Identifying the child’s level offunctioning in each of the developmentalareas in §303.21(a)(1);

(4) Gathering information from othersources such as family members, othercare-givers, medical providers, socialworkers, and educators, if necessary, tounderstand the full scope of the child’sunique strengths and needs; and

(5) Reviewing medical, educational, orother records.


Social or emotional development | This isanother of the developmental areas investigatedduring the child’s evaluation. Zero to Three gives anexcellent summary of the social-emotional domain,as follows:

Making friends. Showing anger in ahealthy way. Figuring out conflictspeacefully. Taking care ofsomeone who has been hurt.Waiting patiently. Followingrules. Enjoying the company ofothers. All of these qualities,and more, describe the arc ofhealthy social-emotionaldevelopment. Like any skill,young children develop theseabilities in small steps over time.37

Examples of typical milestones of social-emotional development include:

• smiling spontaneously, especially at people (4months);

• clinging to familiar adults and perhaps beingafraid of strangers (9 months);

• having temper tantrums (18 months); and

• playing mainly beside other children, butbeginning to include other children, such as inchase games (2 years).38

Adaptive development | Adaptive developmentconcerns the ability to adapt to changing circum-stances and take care of oneself. It’s a vital skill inlife, to be sure.

For babies and toddlers, adaptive developmentincludes learning the self-help skills involved indaily living—to eat independently (with fingers atfirst, then with a spoon), to getdressed, use the toilet, and see tobasic hygiene and grooming. Notsurprisingly, as children acquiremore adaptive skills, theybecome more independent.39

How Are These Areas Evaluated?

Good question, and one that participants mayvery well ask, considering we’re talking aboutevaluating babies and toddlers! The answer is that

practices and evaluation tools vary fromState to State. Under the Part C regulations,

each State defines the term “develop-mental delay” (as discussed under the

next slide) and describes theevaluation and assessmentprocedures that will be used tomeasure a child’s development ineach of the five developmental

areas. The State must also specify thelevel of developmental delay in

functioning (or other comparable criteria)that constitutes a developmental delay in one

or more of the developmental areas.40

Gathering Information from Other Sources

The bullet on the slide mentions “gathering infofrom other sources, if necessary” but this has beenshortened from what the regulations say, due tospace constraints on the slide. So it’s important tooffer the full information about this item as anevaluation procedure. The Part C regulations statethe item as follows:

(4) Gathering information from othersources such as family members, othercare-givers, medical providers, socialworkers, and educators, if necessary, tounderstand the full scope of the child’sunique strengths and needs…41

What’s not mentioned on the slide is:

• who this additional information might begathered from (e.g., individuals such as familymembers, other care-givers, medical providers,social workers, and educators)

• why and when the additional informationabout the child would be necessary (i.e., tounderstand the full scope of the child’s uniquestrengths and needs).


Reviewing Medical, Educational, and OtherRecords

We’ve already seen how eligibility for Part C maybe determined through medical or other records. Inthe current context as a procedure within theevaluation process, however, examining the medicaland other records can contribute a lot of informa-tion about the child, especially in tandem withtaking a child’s history. In many cases, the child’srecords can help flesh out the understanding of thechild’s unique strengths and needs.

No Single Procedure

The last item to discuss is also the last item toappear on the slide. After all the bullets aredisplayed, then comes the final point: No singleprocedure may be used as the sole criterion fordetermining a child’s eligibility under Part C.

When you look at the regulations themselves(cited earlier, on page 41), this statement is actuallythe lead-in to the list of required evaluationprocedures, not final at all. Its meaning is clear. Achild’s eligibility may not be determined based onthe results of only one evaluation procedure.Multiple evaluation proceures are required, so that acomprehensive picture of the child’s functioning inthe five developmental levels can be built and thatchild’s eligibility decided.

32 §303.321(a)(2)— Evaluation of the child and assessment of the child and family: General.

33 See the Centers for Disease Control and Prevention (CDC) website pages called DevelopmentalMilestones, which begin at: http://www.cdc.gov/ncbddd/actearly/milestones/index.html

34 Encyclopedia of Children’s Health. (n.d.). Development tests. Retrieved March 8, 2012 from:http://www.healthofchildren.com/D/Development-Tests.html


36 Parlakian, R., & Lerner, C. (2008). Your child’s development: 30 to 36 months. Washington, DC: Zeroto Three. http://main.zerotothree.org/site/DocServer/30-36Handout.pdf?docID=6085

37 Zero to Three. (n.d.). Development of social-emotional skills. Retrieved March 8, 2012 from:http://www.zerotothree.org/child-development/social-emotional-development/social-emotional-development.html


39 Para-eLink. (n.d.). Development of adaptive behavior. Retrieved March 8, 2012 from thePara-eLink website: http://paraelink.org/eck1/eck1_6.html

40 §303.111—State definition of developmental delay.

41 §303.321(b)(4)—Evaluation of the child and assessment of the child and family: Procedures forthe evaluation of the child.

References


Slide 4B-7

Slide loads fully. Noclicks are necessaryexcept to advance tothe next slide.

Determining a Child’s Eligibility


Many factors play a partin how a child’s eligibilityis determined in Part C

• IDEA’s definition of “infantor toddler with a disability”

• Diagnosed physical ormental conditions

• State definitions andprocedures

• Results of the evaluation

• Informed clinical opinion



Determining a Child’s Eligibility

A stated purpose of evaluation is to provide theinformation necessary to determine the child’s

eligibility for early intervention services. All right,then. The evaluation of the child has beencompleted. Time to determine the eligibility of theinfant or toddler in question.

This slide looks at several key factors involved inmaking an eligibility determination.

IDEA’s Definition of “Infant or Toddlerwith a Disability”

The definition of “infant or toddler with adisability” is certainly a pivotal factor in determin-ing a child’s eligibility. The first part (and mainpart) of the definition in the Part C regulations isgiven in the box on the next page and appears onthe last page of Handout 6.

(Note: There are two other parts to the definitionof “infant or toddler with a disability.” We haven’tincluded them in the box because they concern twoState options, not requirements. For your informa-tion, however, the other two parts are:

• at the State’s discretion, to include “at-riskinfant or toddler” in its definition42

• at the State’s discretion, to continue to provideearly intervention services to a child past his orher third birthday (called the Part C extensionoption).43


In the main part of how Part C defines “infantor toddler with a disability,” you can see that theterm refers to infants or toddlers who have either:

• a developmental delay; or

• a diagnosed physical or mental condition thathas a high probability of resulting in develop-mental delay.

About developmental delay | As you know,developmental delays can occur in one or more ofthe five developmental areas. Each State decides foritself how much of a delay in any one area isneeded for a child to qualify as an “infant ortoddler with a disability” and be found eligible forPart C services. Developmental delays are identifiedin the evaluation process.

About diagnosed physical or mentalconditions | The definition of “infant or toddlerwith a disability” also includes children under theage of three with a diagnosed physical or mentalcondition that has a high probability of resulting indevelopmental delay. Participants heard about thison an earlier slide (Slide 4B-5)—do they recall thata child’s eligibility can sometimes be determinedthrough medical or other records, thereby eliminat-ing the need for an evaluation of the child? Time tohear more about it—in particular, the examples ofsuch diagnosed conditions given in the Part Cregulations.

Diagnosed Physical or Mental Conditions

Refer participants to the last page of Handout 6,where the main part of the definition of “infant ortoddler with a disability” appears. Do they see thelist of conditions the regulations specificallymention? It’s a pretty hefty list…

…conditions such as chromosomalabnormalities; genetic or congenitaldisorders; sensory impairments; inbornerrors of metabolism; disorders reflectingdisturbance of the development of thenervous system; congenital infections;severe attachment disorders; and disorderssecondary to exposure to toxic substances,including fetal alcohol syndrome.44

These conditions are considered “conditions ofestablished risk.” Children with these conditions areeligible for services under Part C of IDEA by virtue

§303.21 Infant or toddler with adisability.

(a) Infant or toddler with a disability meansan individual under three years of age whoneeds early intervention services becausethe individual—

(1) Is experiencing a developmentaldelay, as measured by appropriatediagnostic instruments and procedures, inone or more of the following areas:

(i) Cognitive development.

(ii) Physical development, includingvision and hearing.

(iii) Communication development.

(iv) Social or emotional development.

(v) Adaptive development; or

(2) Has a diagnosed physical or mentalcondition that—

(i) Has a high probability of resulting indevelopmental delay; and

(ii) Includes conditions such aschromosomal abnormalities; genetic orcongenital disorders; sensory impairments;inborn errors of metabolism; disordersreflecting disturbance of the developmentof the nervous system; congenitalinfections; severe attachment disorders;and disorders secondary to exposure totoxic substances, including fetal alcoholsyndrome.


of their diagnosis, regardless of whethera measurable delay is present.45

State policy may also break downthe broad categories given in theregulations (e.g., chromosomalabnormalities, genetic or congenitaldisorders) and identify what specificconditions will automatically qualify ababy or toddler for Part C.

Other conditions possible | The regula-tions use the word “includes” before the list ofconditions—which means that the conditionslisted aren’t necessarily the only ones. States mayinclude additional conditions in their definition of“diagnosed physical or mental condition” andprovide EI services to eligible children with thoseconditions.

State Definitions and Procedures

Children’s evaluations for Part C—and thedetermination of their eligibility for Part C ser-vices—are very much based upon the State’s defini-tions and procedures. To illustrate:

• The term developmental delay is defined by eachState.

• Each State also specifies how each child’sdevelopment will be measured in each develop-mental area (e.g., cognitive, physical).

• Each State spells out how big the delay in anyone area of functioning has to be to meet theState’s definition of developmental delay.46

How does your State define developmentaldelay? | Obviously, it’s very important to knowyour State’s policies, especially its definition ofdevelopmental delay. Don’t know? Get in touchwith your State’s lead agency for Part C. Theinformation should be readily available.

The ECTA Center also makes available asummary table of States’ and territories’definitions of, or criteria for, eligibilityunder Part C of IDEA. Find that sum-mary at: http://ectacenter.org/~pdfs/topics/earlyid/partc_elig_table.pdf

Results of the Evaluation

Naturally, the results of the child’sevaluation play a part in determining that

child’s eligibility for early intervention. Informationabout the child’s functioning in the five develop-mental areas has been gathered through multiplemethods—what do the results indicate? Does thechild meet the State’s definition of developmentaldelay?

Informed Clinical Opinion

When conducting an evaluation of the child,qualified personnel must use informed clinicalopinion. The lead agency must ensure that informedclinical opinion may be used as an independentbasis to establish a child’s eligibility under Part C,even when other instruments do not establisheligibility. However, in no event may informedclinical opinion be used to negate the results ofevaluation instruments used to establisheligibility.47

The Part C regulations do not include adefinition of “informed clinical opinion.” However,the Department’s comments on the subject areilluminating. They are as follows:

The use of informed clinical opinion byqualified personnel is neither an objectivecriterion nor a separate assessment strategy.Rather, informed clinical opinion is theway in which qualified personnel utilizetheir cumulative knowledge and experience

Trainer’s Note!

Share your State’s policies and definition with the audience.Include both as a handout that participants can refer to now andlater, if that information would be valuable to them. If you havetime available and would like to give partipants an opportunity tomove around and interact, consider using the handout as part ofan activity or guided discussion.


in evaluating and assessing a child and ininterpreting the results of evaluation andassessment instruments….

[A]ll States must allow qualifiedpersonnel, when conducting evaluations,to use their informed clinical opinion todetermine whether the child meets theState’s definition of developmental delay.Given the Department’s monitoringexperience in States where qualifiedpersonnel are not permitted to usetheir informed clinical opinion as aseparate basis to establish eligibility,we have set forth in new §303.321(a)(3)(ii) that suchpersonnel must be able to useinformed clinical opinion as analternate basis for establishingeligibility.

Permitting informed clinical opinion toserve as a separate basis to establish achild’s eligibility under part C of the Act isimportant given that standardizedinstruments may not capture the extent ofa child’s delay. The purpose of new§303.321(a)(3)(ii) is to alleviate theconfusion and to expressly permit qualifiedpersonnel to use their informed clinicalopinion to establish a child’s eligibility forearly intervention services under part C ofthe Act, even when other instruments failto identify or confirm the level ofdevelopmental delay to establish part Celigibility.48

Additionally, the ECTA Center offers a 7-pagebrief on the use of informed clinical opinion. Thebrief uses a question-and-answer format to addressthree key issues:

• What does informed clinical opinion mean inthe context of Part C?

• How does informed clinical opinion affect thedetermination of eligibility?

• Why is it necessary to document informedclinical opinion?

Find the brief at:http://ectacenter.org/~pdfs/pubs/nnotes28.pdf

§303.322 Determination that a child isnot eligible.

If, based on the evaluation conductedunder §303.321, the lead agencydetermines that a child is not eligible underthis part, the lead agency must provide theparent with prior written notice required in§303.421, and include in the noticeinformation about the parent’s right todispute the eligibility determinationthrough dispute resolution mechanismsunder §303.430, such as requesting a dueprocess hearing or mediation or filing aState complaint.

Eligible or Not Eligible?

All of the factors discussed on this slide can playa part in determining a child’s eligibility for Part C.What happens after the eligibility determination ismade?

No, not eligible | If the determination is“no, the child is not eligible,” then the lead

agency must inform parents of thatdetermination using prior writtennotice. That notice must includeinformation on parents’ right todisagree with the “no” determina-tion using one of IDEA’s disputeresolution mechanisms (e.g.,mediation, due process). The Part Cregulations specifying this areprovided in the box below and on

the last page of Handout 6.

Yes, eligible | If a child is found to beeligible…well, move on the next slide and continuethe story of evaluation and assessment in Part C!


42 §303.21(b)—Infant or toddler with a disability.

43 §303.21(c)—Infant or toddler with a disability.

44 §303.21(a)(2)—Infant or toddler with a disability.

45 Shackelford, J. (2006, July). State and jurisdictional eligibility definitions forinfants and toddlers with disabilities under IDEA. NECTAC Notes, 21, 1-16.Available online at: http://www.nectac.org/~pdfs/pubs/nnotes21.pdf

46 §303.111—State definition of developmental delay.

47 §303.321(a)(3)(ii)—Evaluation of the child and assessment of the child andfamily: General.

48 76 Fed. Reg. at 60199.

References

Slide 4B-8


Assessment (Slide 1 of 2)


If the child is found eligible as an“infant or toddler with a disability”—

A multidisciplinaryassessment of the child

must be conducted

OpeningView

• the child’s uniquestrengths & needs

• the services appropriateto meet those needs

to identify...

Slide operation continues on next page



If the child is found eligible as an“infant or toddler with a disability”—

A multidisciplinaryassessment of the child

must be conducted

Click 1

• the child’s uniquestrengths & needs

• the services appropriateto meet those needs

to identify...


A family-directed assessmentmust be conducted

• the resources, priorities, &concerns of the family

• the services necessary to enhancethe family’s capacity to meet theirchild’s developmental needs

to identify...


Click 1:The right picturelifts away, revealingall text related tothe family-directedassessment.



The slide gives a tidy summary of what happens next if achild is found eligible for Part C services.

First, Parental Consent for Assessment

• Parents will be asked to provide their consent for amultidisciplinary assessment of their child’s uniquestrengths and needs, which will also identify theservices appropriate to meet their needs.

• Parents will also be asked to participate in a family-directed assessment of the family’s resources, priorities,and concerns, an assessment which includes identify-ing the services and supports needed to enhance thefamily’s capacity to meet their child’s developmentalneeds.


Given parental consent, the assessments of childand family may be conducted.

These requirements can be seen in the Part Cregulations provided in the box (referparticipants to page 2 of Handout 6).

What does each of these assessments involve?What do the Part C regulations require? The nextslide will answer these questions.

If the Child is Found Eligible for Part C

(ii) If the child is determined eligible asan infant or toddler with a disability asdefined in §303.21—

(A) A multidisciplinary assessment ofthe unique strengths and needs of thatinfant or toddler and the identification ofservices appropriate to meet those needs;

(B) A family-directed assessment of theresources, priorities, and concerns of thefamily and the identification of thesupports and services necessary to enhancethe family’s capacity to meet thedevelopmental needs of that infant ortoddler. The assessments of the child andfamily are described in paragraph (c) ofthis section and these assessments mayoccur simultaneously with the evaluation,provided that the requirements ofparagraph (b) of this section are met.49

49 §303.321(a)(1)(ii)—Evaluation ofthe child and assessment of thechild and family: General.

References

Slide 4B-9


Assessment (Slide 2 of 2)


OpeningView


The assessment of thechild must include—

• review of theevaluation results

• personal observationsof the child

• identification of thechild’s needs in each ofthe 5 developmental areas


Screening | Evaluation | AssessmentClick 1


The family-directedassessment must—


Click 1:The right picturelifts away, revealingall text related tothe family-directedassessment.



The assessment of thechild must include—

• review of theevaluation results

• personal observationsof the child

• identification of thechild’s needs in each ofthe 5 developmental areas

• be voluntary for each memberwho participates

• be based on info gained throughan assessment tool and alsothrough an interview with eachfamily member who participates

• include the family’s descriptionof its resources, priorities, &concerns for enhancing thechild’s development

This slide’s design mirrors the design of the previous slide,with information about the child’s assessment on the left

and the family’s assessment on the right. Its brevity allowsyou to summarize quickly what’s required with respect to eachassessment, what type of information is collected, and howit’s put to use in identifying needed services.

Assessment of the Child

The information on the slide closely tracks the verbatimregulations regarding the assessment of the child. Participantscan compare the two by looking at the very top of page 4 (leftcolumn) of Handout 6, where the regulations state:


The assessment of the child mustinclude the following—

(i) A review of the results ofthe evaluation conducted underparagraph (b) of this section;

(ii) Personal observations ofthe child; and

(iii) The identification of thechild’s needs in each of the developmentalareas in §303.21(a)(1).50

Each of these elements contributes valuableinformation about the child’s needs, which in turncan be used to identify the types of early interven-tion services appropriate to address those needs.

Assessment tools and instruments | There’s awealth of information online about assessmentinstruments used with very young children, muchof it made available by the early interventionsystems of individual States. There are also usefulanalyses of the features of commonly used assess-ment instruments, which can help early interven-tion systems and EI providers select effective toolsto use with the infants and toddlers (and families)referred to the Part C system. For examples, see theresources listed in the box below.

The Part C regulations do not mandate or evensuggest specific instruments to be used during theassessment of children in early intervention. Theseare decisions left to State lead agencies and earlyintervention systems. Even within a State there maybe different instruments or approaches used toconduct child assessments.

Developmental screening tools for children 0-5 years of age recommended by theAmerican Academy of Pediatrics.http://www.earlychildhoodmichigan.org/articles/7-03/DevScrTools7-03.htm#recommendations

Best Practices in Play Assessment and Intervention.From the National Association of School Psychologists.http://www.nasponline.org/publications/booksproducts/bp5samples/549_bpv71_33.pdf

An Assessment Primer: Effective Assessment in the Early Childhood Classroom.http://nieer.org/sites/nieer/files/Assessment%20Primer%207-8-12.pdf

Example Resources: Assessment Tools and Instruments

What’s used in your State? | Participantscan benefit from seeing and discussing

the instruments and assessment toolsused in your State. Visit your State’searly intervention website and seewhat’s posted there in support of the

assessment process. In many cases,there are links to the actual forms that

early intervention providers use to collectinformation about children and from families,

procedures manuals, and materials in other lan-guages. While the State may not mandate the useof any one instrument (such as an observationguide or a developmental measurement tool),having an example can do much to illuminatewhat assessment of children in early interventionmay involve.

Family-Directed Assessment

The purpose of the family-directed assessmentwas discussed on the previous slide. Remindparticipants that this assessment is conducted toidentify:

• the resources, priorities, and concerns of thefamily; and

• the services necessary to enhance the family’scapacity to meet their child’s developmentalneeds.

Here, on this slide, we’re looking at what theregulations require in terms of the family-directedassessment. The text on the slide closely tracks the


regulations themselves, whichappear on Handout 6 and read asfollows:

The family-directedassessment must—

(i) Be voluntary on thepart of each family memberparticipating in theassessment;

(ii) Be based on informationobtained through anassessment tool and also through aninterview with those family members whoelect to participate in the assessment; and

(iii) Include the family’s description of itsresources, priorities, and concerns relatedto enhancing the child’s development.51

Voluntary | Not surprisingly, the first require-ment is that each member of the family participat-ing in the assessment does so voluntarily. What’sbeing discussed and shared is obviously personal,and possibly upsetting, to the family member.

Interviews and assessment tools | The point ofconducting the family assessment is to find outwhat the family views as its resources, concerns,

and priorities. Therefore, it’s considered best practice to hold the family interviews more asconversations than as formal sessions that includethe filling out of a needs assessment tool. Familytrust and comfort levels are critical factors inopening a continuing dialogue about

• the family’s daily routines;

• perceptions of their child’s development;

• what challenges the family faces day to day;

• the resources they have available to addressthose challenges; and

• what they consider most important for theirchild to learn or be able to do in the nearfuture.

Instruments and tools for the family-directedassessment | As with assessments of children, thetools and instruments that might be used to con-duct the family-directed assessment will vary fromState to State and, sometimes, within the State.What’s used in your State would be appropriate toshare with the audience, perhaps designing anactivity that guides them in exploring the type ofinformation gathered from families.

For a scholarly article on family-assessment within early intervention programs.http://www.bc.edu/content/dam/files/schools/lsoe/pdf/EICS/FamilyAssessmentWithinEarlyInterventionPrograms.pdf

What Families Want to Know About Assessment.http://tactics.fsu.edu/pdf/HandoutPDFs/TaCTICSHandouts/Module1/WhatFamiliesWant.pdf

ECTA Center’s page of resources | Family Assessment: Gathering Information From Families.http://ectacenter.org/topics/families/famassess.asp

For More Information on the Family-Directed Assessment


Interesting Tidbit!

The 2011 Part C regulations made a smallchange in its language about familyassessments, but a big point that’s worthnoting. Following the release of proposedregulations, many comments were receivedfrom the public about what was proposed,and several related to family assessments.As the Department explains:

A number of commenters statedthat the language in proposed§303.320(c) regarding voluntaryfamily assessments appeared to besomething that is done “to”families and not “with” families.The commenters encouraged theDepartment to consider the term“family-directed assessment” in theregulations when referring to afamily assessment in order to makeit clear that the family is a primarypartner in the process.52

The Department agreed with thecommenters and made the suggestedchange “to ensure that the identification ofa family’s resources, priorities, andconcerns are family-directed.”

50 §303.321(c)(1)—Evaluation of the child and assessment of the child andfamily: Procedures for assessment of the child and family.


52 76 Fed. Reg. at 60200.

References


Slide 4B-10


Click 1:Picturelifts away,leaving thetext about“Personnel”in bothevaluationandassessment.

CLICK 1

Both Evaluation and Assessment

OpeningView


QualifiedPersonnel

Both evaluation & assessment:

Nondiscriminatory

Use ofnative

language

Both evaluation & assessment:

Nondiscriminatory

Use ofnative

language

• Include procedures usedby qualified personnel

• Require qualifiedpersonnel to use“informed clinical opinion”

Pers

on

nel


Slide 4B-10: Background and Discussion3 Clicks



• Evaluate the child

Click 2:Picture lifts away, leaving the textabout “Nondiscriminatory”practices in both evaluation andassessment.

CLICKS 2-3Both evaluation & assessment:

Use of native language

• Include procedures usedby qualified personnel

• Require qualifiedpersonnel to use“informed clinical opinion”

Pers

on

nel

No

nd

iscr

imin

ato

ry

• Must be conducted in anondiscriminatory manner

• Must be selected &administered so as not to beculturally or raciallydiscriminatory

• Of the child | Must beconducted in the child’snative language *

• Of the family | Must beconducted in the family’snative language *

* Unless clearly notfeasible to do so

Click 3:Picture lifts away, leaving thetext about “Use of the nativelanguage” in both evaluationand assessment.

You’ve been itching to get to this slide, haven’t you? I know we have!That’s because this slide is especially important. It summarizes

three critical requirements that apply to the entire evaluation andassessment process in early intervention—meaning, common elementsthat are required with respect to:

• the evaluation of the child,

• the assessment of the child, and

• the family-directed assessment.


• Evaluation of the child | “(i) Evaluation meansthe procedures used by qualified personnel todetermine a child’s…”54

• Assessment of the child | “(ii) Assessmentmeans the ongoing procedures used by quali-fied personnel to identify the child’s…”55

• Assessment of the child | “(1) An assessmentof each infant or toddler with a disability mustbe conducted by qualified personnel…”56

• Evaluation and assessment of the child | “(ii)Qualified personnel must use informedclinical opinion when conducting an evalua-tion and assessment of the child.”57

• Evaluations and assessments of the childand family | “(4) All evaluations and assess-ments of the child and family must be con-ducted by qualified personnel…”58

• Family-directed assessment | “(2) A family-directed assessment must be conducted byqualified personnel…”59

How much clearer can the regulations make it?!Qualified personnel must be involved throughoutthe steps of screening, evaluation, and assessment.Period.

Who decides who’s qualified? | The State does,via its certification, licensing, or other policies forprofessionals and personnel. In fact, the regulationsinclude an express definition of “qualified person-nel” that reads as follows:

§303.31 Qualified personnel.

Qualified personnel means personnel whohave met State approved or recognizedcertification, licensing, registration, orother comparable requirements that applyto the areas in which the individuals areconducting evaluations or assessments orproviding early intervention services.

Let’s have a look at what’s so important that wesaved it for last.

Quick Overview of How the Slide Operates

When the slide first loads, there are only threepictures, each marked with a phrase (as follows):Qualified Personnel. Nondiscriminatory. Use ofnative language. With each click you make, one ofthe pictures will lift away, text beneath will berevealed, and you can discussthe issue at hand. Each timereiterate that these require-ments apply to each phaseof the evaluation andassessment process.

Qualified Personnel

This item responds to thequestion that many parents and families wouldnaturally have about screening, evaluation, andassessment of their child, not to mention their ownfamily-directed assessment: Who is going to con-duct the procedure? Do they know what they’redoing? Are they trained?

Activity SuggestionBefore discussing the issue of qualifiedpersonnel, you might ask participantsto take out a pen, pencil, or yellowhighlighter and find every instance inHandout 6 where the phrases “quali-fied personnel” or “personnel trainedto” are used. After that, you won’t needto say a thing! The point will be veryclear.

As this slide indicates (and the suggested activitywill demonstrate in spades), the Part C regulationsrequire that screening, evaluation, and assessmentprocesses all involve qualified personnel. We’vebolded specific words below, to illustrate this.

• Screening | Involves activities “carried out by,or under the supervision of, the lead agency orEIS provider” and “includes the administrationof appropriate instruments by personneltrained to administer those instruments.”53


Nondiscriminatory

The second picture on the slide showstwo babies laying on their backs, talkingto one another. With a click, the picturewill lift away and reveal the text be-neath. Use the lead-in phrase at the topof the slide as you click, so that you say,“Both evaluation and assessment…”(CLICK) and the bullet points finish thesentence.

• Must be conducted in a nondiscriminatorymanner

• Must be selected and administered so as not tobe culturally or racially discriminatory

Context | IDEA has long required that evalua-tion and assessment procedures and tools benondiscriminatory. This is true in both Part C andPart B of the law. The Part C regulations at§303.321(a)(4) state:

(4) All evaluations and assessments ofthe child and family must be conducted byqualified personnel, in a nondiscriminatorymanner, and selected and administered soas not to be racially or culturallydiscriminatory.

Participants can see this provision on Handout6 (top of page 3, right column).

Why | When evaluating children who’ve beenreferred to the Part C system, it’s obviously impor-tant that the results yielded are reliable so that acomprehensive and accurate understanding can bebuilt of the child’s strengths and needs. Eligibilitydeterminations are based in large part on the resultsof the child’s evaluation, as are discussions anddecisions about what early intervention services areappropriate to address the child’s needs. If themethods or tools used to collect information aboutthe child are flawed, culturally or racially biased, orinappropriate for the child, then the results will bequestionable at best.

Talk about it | What makes an inventory, anobservation, an interview, or an instrumentdiscriminatory or biased in terms of race, ethnicity,or culture? Talk with participants about their ownexperiences or knowledge in this regard. Inparticular, explore how bias can unintentionallycreep into interactions with families and children,especially those who come from a different

background, culture, or country. Considerfactors that can affect how the parentsor the child communicate, behave, orrespond during the evaluation orassessment process, including:

• Primary language of the parents andchild (English? Another?)

• Level of acculturation to United States(if not born here)

• Familiarity with objects or activities usedduring evaluation or assessment

• Explanations concerning the causes andsolutions of problems

• Social, cultural, or religious mores that governbehavior, eye contact, dress, response to au-thority, and such like

Use of the Native Language

The third picture on the slide comes with theheader “use of the native language.” When youclick, the picture lifts away, and reveals the last itemto be discussed--what the Part C regulations requirein terms of using the native language during bothevaluation and assessment. As the slide indicates:

• Evaluation and assessment of the child | Must beconducted in the child’s native language,unless it’s clearly not feasible to do so

• Assessment of the family | Must be conducted inthe family’s native language, unless it’s clearlynot feasible to do so

Considering Part C’s requirement that evaluationand assessment be nondiscriminatory, it’s notsurprising that the regulations also require use ofthe native language during evaluation andassessment. What could be more discriminatorythan conducting every evaluation or assessmentinterview or procedure in English, if that’s not theprimary language of the child or the family?

What the regulations say | Let’s start with theregulations at §303.321(a)(5) and (6), whichappear on Handout 6 (page 3, top of the rightcolumn) and read as follows:

(5) Unless clearly not feasible to do so,all evaluations and assessments of a childmust be conducted in the native language


of the child, in accordance with thedefinition of native language in §303.25.

(6) Unless clearly not feasible to do so,family assessments must be conducted inthe native language of the family membersbeing assessed, in accordance with thedefinition of native language in §303.25.

Definition of native language | Both of theprovisions just cited refer to the definition of nativelanguage in §303.25. What is that definition? It’sclearly relevant in this discussion. We’ve providedthat definition in the box below.

As you can see, there are actual multiplemeanings of the term “native language.”

• For parents whose proficiency in English is limited |“Native language” is the language the parentsnormally use.

• For a child being evaluated or assessed | “Nativelanguage” is the language that the child nor-mally uses (if that’s considered developmen-tally appropriate by the personnel conductingthe evaluation or assessment).

• For an individual who is deaf or hard of hearing,blind or visually impaired, or with no writtenlanguage | “Native language” is the mode ofcommunication the individual normally uses,such as sign language, brille, or oral communi-cation.

The child’s native language? | Perhaps the onlysurprise in this definition is that, when evaluatingor assessing the child, the native language to beused might very well be the language that the childnormally uses, which may not necessarily be thelanguage of his or her parents.

The variability inherent in this requirementacknowledges the sometimes tricky nature oflanguage development. While many children inearly intervention won’t have developed muchreceptive or expressive language yet, others willhave, especially toddlers between the ages of oneand three. For these latter children, a decision willneed to be made by the personnel conducting eachchild’s evaluation and assessment. Should theevaluation and assessment be conducted in thelanguage the child normally uses? Would doing so

§303.25 Native language.

(a) Native language, when used withrespect to an individual who is limitedEnglish proficient or LEP (as that term isdefined in section 602(18) of the Act),means—

(1) The language normally used by thatindividual, or, in the case of a child, thelanguage normally used by the parents ofthe child, except as provided in paragraph(a)(2) of this section; and

(2) For evaluations and assessmentsconducted pursuant to §303.321(a)(5) and(a)(6), the language normally used by thechild, if determined developmentallyappropriate for the child by qualifiedpersonnel conducting the evaluation orassessment.

(b) Native language, when used withrespect to an individual who is deaf or hardof hearing, blind or visually impaired, orfor an individual with no written language,means the mode of communication that isnormally used by the individual (such assign language, braille, or oralcommunication).

be developmentally appropriate for the child? If so,then the evaluation/assessment would need to beconducted in the child’s language.

“Unless it’s clearly not feasible to do so” | As theslide indicates, the native language of the childand/or the family must be used during evaluationand assessment, unless it’s clearly not feasible to doso. This is an important point. As the Departmentobserves:

The “unless clearly not feasibleto do so” standardacknowledges that theremay be instances whenconducting evaluations orassessments in the nativelanguage of the child,parent, or family member is


53 §303.320(b)—Screening procedures (optional): Definition of screeningprocedures.

54 §303.321(a)(2)(i)—Evaluation of the child and assessment of the child andfamily: General.




58 §303.321(a)(4)—Evaluation of the child and assessment of the child andfamily: General.


60 76 Fed. Reg. at 60198.

References

not possible because, for example,interpreters for a particular languagecannot be located, despite best efforts. Ifon-site interpreters cannot be located for aparticular language despite best efforts,other methods of communication in thenative language, such as using telephonicinterpreters, should also be explored whenan interpreter is needed and appropriate,for the evaluation and assessment.60


Slide 4B-11Last Slide: Round-up Time!

Slide loads fully. Noclicks are necessaryexcept to END theslideshow.

CLICK to END the slideshow.

You’ve done it, you’re through with this module! Well, almost…

Depending on how much time you still have available for yourtraining session, you can use this slide:

• for a quick review and recap of your own devising;

• to open the floor up for a question and answer period; or

• by having participants complete a closing activity of your choice anddiscuss in the large group afterwards.


This training curriculum is designed and produced byNICHCY, the National Dissemination Center for Childrenwith Disabilities, at the request of our funder, the Officeof Special Education Programs (OSEP) at theU.S. Department of Education.

NICHCY Lead: Lisa Küpper

OSEP Lead: Rhonda Spence

OGC Lead: Kala Surprenant

Funding for NICHCY officially ended on September 30,2014. All training materials in this Part C trainingcurriculum are now available at the website of the Centerfor Parent Information and Resources, at:

http://www.parentcenterhub.org/repository/legacy-partc/

Documents

Module 4 Screening, Evaluation, and Assessment Procedures€¦ · The U.S. Department of ... developmental delay and, there- ... Screening, Evaluation, and Assessment Procedures 4-5