SW 644: Issues in Developmental DisabilitiesEarly Intervention Birth to SixPart ILecture Presenters:Linda Tuchman-Ginsberg, Ph.D. (Dir. Of WI Personnel Development Project), Beth Wroblewski (WI Dept. of Health and Family Services), and Arianna Keil

Video of Arianna Keil

Video of Linda Tuchman

Federally Funded ProgramsBirth to 3/Early Intervention ProgramEarly Childhood Special EducationU.S. Department of Education

Early Childhood Makes a DifferenceInfluences child development outcomesHelps families build hope for futureImpacts a child and familys progress through:School systemTransitions into adulthood

History of Early Childhood Programs1960s Community-based programs for young children with disabilities since 1960s1970s in WISchool districts began ECSE (3-5) servicesHome visiting and centered based programs for infants and toddlers1986 Federal law creates early intervention mandate through Individuals with Disabilities Education Act (IDEA)

Unifying ThemesDerived from educational and psychological theoriesSupported by researchAdapted from:A Unified Theory of Practice in Early Intervention/Early Childhood Special Education: Evidence-Based PracticesSamuel L. Odom & Mark Wolery (2003)The Journal of Special Education, 37(3), 164-173

Unifying Early Intervention/Early Childhood Special Education ThemesFamilies and home are the primary context for nurturing a childs growth and development.Building relationships with families, children and other adults is important.Honor unique culture and experience of each partnerChildren learn through active exploration and observation of their environments.Supported by adult mediated learning experiences

Unifying Early Intervention/Early Childhood Special Education Themes (cont.)Children develop through opportunities to learn in natural contexts.Supports inclusion in home, school and community settings.Individualized interventions are necessary for each child and familyTransition planning is necessary Prepare for changes between programs

Early Intervention/Early Childhood Special Education TransitionsAdministered and carried out by different state departmentsRequires transitions at age 3State collaborations supports a coordinated Birth to six system with:Integration across EI,ECSE and other community programs

Accountability SystemsNew U.S. Department of Education requirementDemonstrate outcomes for funds investedMeasures child and family outcomesWI committed to a coordinated Birth to Six system

Meet Sophia, Claire, and Erica

State of Wisconsin Birth to 3 Program

Video of Beth Wroblewski

Federal (P.L. 99-457) & State Law (HFS 90)Individuals with Disability Education Act (IDEA)- Part Cwww.cec.sped.org/law_res/doc/law/regulations/indexPartC.php

HFS 90www.waisman.wisc.edu/birthto3/OVERVIEW.HTML

Purpose of Birth to 3Provide resources, supports and services to meet the developmental needs of infants and toddlers who have delayed development or have a physical or mental condition which is likely to result in delayed development.

Address family needs related to their childs development.--HFS90 (Wisconsin Administrative Code)

Birth to 3: Guiding PrinciplesChildren's optimal development depends on their being viewed first as children and second as children with a problem or disability. Children's greatest resource is their family.Parents are partners in any activity that serves their children. Children are best supported within the family, the family is best supported within the community.

Birth to 3: Guiding Principles (cont.)Professionals are most effective when they can work as a team member with parents and others. Collaboration is the best way to provide services. Early intervention enhances childrens development.

http://dhfs.wisconsin.gov/bdds/b3fdn/fdn.htm

Program ImplementationThe Department of Health and Family Services supervises and monitors local Birth to 3 Programs (HFS90.05 pg. 264)County boards must designate a county agency or contract with another public agency to administer their local Birth to 3 Program (HFS90.06 pg. 265)

What Are the Steps in the Birth to 3 Process?Identification and referralProcedural safeguardsEvaluationDetermination of eligibilityAssessmentIndividualized Family Service Plan (IFSP)Periodic review of IFSPTransition

How Do Families Find Their Way to Birth to 3?Outreach education

Informed referral network

Coordinated community efforts

Referral SourcesWho Might Referral Sources Include?

What are Procedural Safeguards?Locate HFS90.12 pg. 274

Read Two Ways to Introduce Families to Procedural Safeguards

Which method would you choose? Why?

Why is it important for all team members to know this information?

Assuring the Familys Role - http://www.nectac.org/~pdfs/pubs/assuring.pdf

Who Is Eligible for Birth to 3?HFS90 90.08A child is eligible if he or she meets one or more of the following criteria:Diagnosed Condition Developmental Delay Atypical Development

What Areas of Development Are Considered for Eligibility?Cognitive development Physical developmentSpeech, language and communication development Social and emotional developmentAdaptive behavior and self-help development

What Services are Provided in Birth to 3?Core Services No CostIdentification and ReferralEvaluation and AssessmentIndividual Family Service Plan DevelopmentProcedural Safeguards Service Coordination(HFS 90.11 pg. 272)

What Other Services Can Be Provided with Birth to 3 Funds?Assistive technologyAudiologyCommunicationFamily education and counselingHealth careMedicalNursing

NutritionOccupational therapyPhysical therapySocial workSpecial instructionTransportationVision(HFS 90.11 pg. 272)

How Are Birth to 3 Services Funded?Sources of FundingU.S. Department of EducationState of Wisconsin Biennial BudgetLocal County Funds, MOEPublic and Private 3rd Party FundsParental Cost Share - (HFS 90.06 pg. 266)Others designated by each county/program.

Video of Beth Wroblewski

Who Is Qualified to Evaluate and Determine Eligibility?AudiologistsNutritionistsOccupational therapistsPhysical therapistsPhysiciansPsychologistsRehab. counselorsReg. nursesSchool psychologistsSpecial educatorsEC, VI,DHHSpeech & lang. Others: qualified to determine eligibility (HFS 90.08 pg. 267)

What Is Service Coordination?finding out what a family needs and helping them get it.Morton, 1988, p. 13

an active process that promotes and supports a familys capacities and competencies to identify, obtain, coordinate, monitor and evaluate resources and services to meet its needsMcGonigel, Kaufman, Johnson, 1991, p.86

Why Do We Have Service Coordinators?Assist parents in gaining access to services Coordinate the provision of services Facilitate the timely delivery of services and continually seek appropriate services and situations(HFS 90.11 pg. 271)

Service Coordinator FunctionsEvaluations & AssessmentsDevelopment, Review & Evaluation of IFSPIdentifying ProvidersAccess to and Provision of ServicesInforming of Advocacy ServicesCoordinating with Health CareTransition Planning

Who Can Be a Service Coordinator?Person from list of qualified personnel

Person with experience and training

A parent facilitator

(HFS 90.11 pg. 271)

Next Step: The IFSP & ServicesEvaluationProcedural Safeguards DiscussedChild is Found EligibleDevelop the IFSP

The IFSP isA promise to familiesA way to build a trusting relationshipA vehicle for empowermentA mechanism for interagency collaboration between a family & B-3A guide to program implementation and evaluationRosin, 1996

The Written IFSPIs possibly the least important aspect of the entire IFSP process. Far more important are the interactions, collaborations, and partnerships between families and professionals that are necessary to develop and implement the IFSP.McGonigel & Johnson, 1991, p.1

Parent ParticipationParents are full team members and decision makersInformed decision making

In all aspects of the programEligibilityIFSP development and reviewServices

IFSP Team MembershipParent*

Other family members requested by parents

Service coordinator*

Advocate (requested by parents)

At least 1 qualified person who participated in the eval/assessment*

At least 1 professional with expertise in*assessment of typical development/ child development and program planning*

Other service providers*required members

Editorial NoteSlide numbers 42 and 43 are expanded material of Slide numbers 16 & 17 Guiding Principles of Birth to 3. The Guiding Philosophy below enhances the previous slides with program design values and concepts, and also aids in giving expanded detail/stages in the implementation of services for children and families.

Guiding PhilosophyIndividualizedComprehensiveCoordinatedCommunity-based in Natural EnvironmentsCulturally Competent

Birth to 3:Guiding PhilosophyFamily-Centered Meaningful to the familyPart of a vision for their childBased on the familys priorities, resources and concernsStrategies developed around family routines and activities

What Are Family-Based IFSP Outcomes?State an end point that can be observedsleep through the nighteat independentlycommunicate using a combination of words, signs & simple deviceshave mobility to explore the environmentplay with brotherhave knowledge and resources about......

What Are Family-Based IFSP Outcomes? (2)Include parent priorities and concerns, and also provider information gained from assessments.

Integrate information across developmental domains.

Have language that the parent understands or helped to write.

What Are Family-Based IFSP Outcomes? (3)Address family and child outcomes.State why the outcome is important to the family.Include a statement about how the outcome will be measured:How you will know you accomplished the outcome?Can be revised, eliminated or added to when agreed by family and team.Enhance a familys optimism about the future.

What types of outcomes might an IFSP include?Child DevelopmentFuture Activities Related to Childs Needs/ConcernsSupport to the Family to Enhance Their Childs Development

Where Might Services Be Provided?

Birth to 3 Services are Provided in Natural EnvironmentsThe team encourages a childs development in everyday activities and places where children are already present.

Natural Environments Can Be:Family homeFamily day carePreschool programRespiteParent child groupsHead StartLibrary story hourChurch/SynagogueOthers identified by the family

For More Information WI Dept. of Health and Family Services Birth to 3 Program Website:http://www.dhfs.state.wi.us/bdds/b3.htm

Wisconsin has a long history of supporting children with developmental delays or disabilities and their families. We have had early intervention programs since the 1970s. Our program has been shaped to meet federal requirements under the Individuals with Disabilities Education Act since 1986. With statewide implementation of these requirements since 1991. 34 CFR Part 303, Early Intervention Program for Infants and Toddlers with Disabilities (Part C of the Individuals with Disabilities Education Act)Federal law entitles infants and toddlers who meet the eligibility criteria, established by each state, and their families to receive services that target their specific developmental needs without delay.

HFS90 Includes specific regulations for Wisconsin further explanation of how federal law will be carried out.

Why is Knowing About the Law Important to my Work?Important to understand why paperwork is necessary; what families are entitled to; how programs are monitored and held accountable. How to explain rights to families; Know where to look for answers; understand that as law changes with reauthorization may be changes in practice.. Begin to understand opportunities to provide comment on the law.

The Birth to 3 Program supports families in meeting their childs unique developmental needs. IDEA and HFS 90 (Wisconsin Administrative Code) were the first pieces of legislation at the state and federal level that not only outlined program requirements, but also set a philosophical foundation of the provision of supports and services to young children and their families.The Birth to 3 Program has an Interagency Coordinating Council to advise the Department of Health and Family Services related to the implementation of the early intervention program in Wisconsin. The Council has developed core Guiding Principles as a landmark for all that we do.Detailed information about the Birth to 3 Program in a family friendly format can be found in our Families are the Foundation Booklet. The web link for this booklet is noted below. DHFS is responsible for supervising and monitoring local Birth to 3 Programs to ensure that they comply with federal and state requirements Each Wisconsin county board is responsible for designating a county agency or contracting with another public agency to be the administrative agency for their local Birth to 3 Program

The Birth to 3 Program follows a federally proscribed process and specific federal regulations related to timelines for each step of this process.Outreach educationInformed referral networkAssists in identifying children in our community with developmental needsCoordinated community effortsScreeningHealth CheckHealth care providers (e.g., physicians)SchoolsFamily child careChildcare centers ParentsTeachersClinics

Procedural Safeguards are intended to protect the interests of families with children with special needs and of the early intervention system. They are the checks and balances of the system not a piece separate from the system. For families the service coordinator ensure that an IFSP is developed that addresses their priorities and concerns. For E.I. - rights and safeguards assure quality and equity. Families must understand their role as partners and decision-makers. P.S. consist of 5 elements:Prior NoticeInformed ConsentConfidentialityRecordsDispute ResolutionMediationHearings(HFS90.12 pg. 274)

Why is it important for all team members to know this information?A way to introduce families to their role in Birth to 3. If you understand the familys role, you can better communicate that in your work. Some may think that explaining p.s. is just a service coordinator responsibility. However, understanding that familys need ongoing descriptions of their role and rights in Birth to 3 is important.

Recommend reading Assuring the Familys Role.

Cognitive development Physical developmentFine motorGross motorVision/hearingSpeech, language and communication development Social and emotional developmentAdaptive behavior and self-help development (HFS90.08 pg. 268)

This is from federal law.The specific services that are provided to eligible children and their families are based upon the individual child and family outcomes but may include these types of services.

These are others that might be included on a childs IFSP and may be paid for with Birth to 3 funds if other funding is not available. Birth to 3 is payor of last resort.Birth to 3 is funded from a variety of sources. It is a mandated program which means children who are found eligible must be served without waiting lists.

However, Birth to 3 is always the payor of last resort for a service. Programs should look for other parties Medicaid, insurance, WIC, and other potential programming to participate. Service coordination is inherently a simple servicefinding out what a family needs and helping them get it.Morton, 1988, p. 13)

Service coordination is an active process for implementing the IFSP that promotes and supports a familys capacities and competencies to identify, obtain, coordinate, monitor and evaluate resources and services to meet its needsMcGonigel, Kaufman, Johnson, 1991, p.86Service Coordination is a PROCESS not necessarily JUST an individual. Is a necessary element of Birth to 3. Each team member has a role in the s.c. process but there are specific duties for the service coordinator.

Assist parents in gaining access to early intervention services and other services identified in the IFSP.Coordinate the provision of early intervention services and others that the child needs or is being provided.Facilitate the timely delivery of available services and continually seek the appropriate services and situations necessary to benefit the development of each child.

From the point of referral, an IFSP must be developed for eligible children within 45 days.Each child and familys plan for services and supports is unique. Each IFSP looks different. Not every child with the same diagnosis or delay criteria would have the same outcomes or services.The Birth to 3 Program addresses all needs and concerns that a family may have. In some instances, they will provide direct services and supports. In other instances, they will help the family make needed connections within their community to address broader needs such as health care, housing, and employment.Services are provided in the home and other community settings. This is known as Natural Environments which simply means Where would the child spend his/her day if didnt have a disability?As part of individualized approach, Birth to 3 staff strive to learn about and be respectful of each familys culture, language, and values.Birth to 3 Programs work in partnership with families to enhance the child's development and support the family's knowledge, skills, and abilities as they interact with and raise their child. Birth to 3 is not solely about the providers concerns and priorities for a child its based on the familys priorities.Family-Centered = understanding the familys vision for both their child and family and developing small steps to get there...to the maximum extent appropriate, early intervention services are provided in natural environments; and the provision of early intervention services for any infant and toddler occurs in a setting other than the natural environment only when early intervention cannot be achieved satisfactorily for the infant or toddlers in a natural environment.

Family homeFamily day carePreschool programRespiteParent child groupsHead StartLibrary story hourChurch/SynagogueOthers identified by the family

Go here to sign up for list-serv also check for list-serv info on the Birth to 6 EVENTS flyer in your folder.Wisline schedule continuing ed. Opportunity.State and county contacts.General DHFS program info.