Early Intervention IDEA Part C
Kevin is my first born. Like many new moms with internet access, I was um, shall we say ‘hypervigilant’ about his infancy and development. One of the first milestones that parents look forward to is rolling over at 3 months. And yep, you guessed it, he missed it.
I frequently voiced my concerns at his visits to the pediatrician, and she just kept saying “at 6 months, we’ll worry; at 6 months, we’ll worry.” Six months came, and nope, no rolling over. It was then that we were referred to Early Intervention Services and told that our son would be receiving an IFSP.
First, if you are a parent to a child 0-3 and you’ve found this post, give yourself a pat on the back! I mean it! I spend a tremendous amount of time writing about IDEA part B on this blog, and very little about IDEA part C. I think I speak for many parents when I say this–that time, 0-3 is just such a whirlwind, it’s hard to get your feet under you.
We were dealing with multiple specialist visits, diagnostics, and well, just being a first time parent and trying to enjoy that! It was hard.
But what I do have is the gift of hindsight, which is always 20/20 as they say. I can look back now at our IFSP Early Intervention time, and learn from it. I cannot redo the past, but you might just be starting this journey.
IDEA Part C
In a nutshell, IDEA part C is the Federal Regs for Early Intervention or 0-3 Services. IDEA part B is 3-21. I’ll highlight some of it below.
303.13 Early intervention services.
3) Are provided at no cost, except, subject to §§303.520 and 303.521, where Federal or State law provides for a system of payments by families, including a schedule of sliding fees;
(4) Are designed to meet the developmental needs of an infant or toddler with a disability and the needs of the family to assist appropriately in the infant’s or toddler’s development, as identified by the IFSP Team, in any one or more of the following areas, including—
(5) Meet the standards of the State in which the early intervention services are provided, including the requirements of part C of the Act;
(6) Include services identified under paragraph (b) of this section;
(7) Are provided by qualified personnel (as that term is defined in §303.31), including the types of personnel listed in paragraph (c) of this section;
(8) To the maximum extent appropriate, are provided in natural environments, as defined in §303.26 and consistent with §§303.126 and 303.344(d); and
(9) Are provided in conformity with an IFSP adopted in accordance with section 636 of the Act and §303.20.(b) Types of early intervention services. Subject to paragraph (d) of this section, early intervention services include the following services defined in this paragraph:(1) Assistive technology device and service are defined as follows:(i) Assistive technology device means any item, piece of equipment, or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve the functional capabilities of an infant or toddler with a disability. The term does not include a medical device that is surgically implanted, including a cochlear implant, or the optimization (e.g., mapping), maintenance, or replacement of that device.(ii) Assistive technology service means any service that directly assists an infant or toddler with a disability in the selection, acquisition, or use of an assistive technology device.
The term includes—(A) The evaluation of the needs of an infant or toddler with a disability, including a functional evaluation of the infant or toddler with a disability in the child’s customary environment;
(B) Purchasing, leasing, or otherwise providing for the acquisition of assistive technology devices by infants or toddlers with disabilities;(C) Selecting, designing, fitting, customizing, adapting, applying, maintaining, repairing, or replacing assistive technology devices;(D) Coordinating and using other therapies, interventions, or services with assistive technology devices, such as those associated with existing education and rehabilitation plans and programs;
(E) Training or technical assistance for an infant or toddler with a disability or, if appropriate, that child’s family; and
(F) Training or technical assistance for professionals (including individuals providing education or rehabilitation services) or other individuals who provide services to, or are otherwise substantially involved in the major life functions of, infants and toddlers with disabilities.(2) Audiology services include—(i) Identification of children with auditory impairments, using at-risk criteria and appropriate audiologic screening techniques;(ii) Determination of the range, nature, and degree of hearing loss and communication functions, by use of audiological evaluation procedures;(iii) Referral for medical and other services necessary for the habilitation or rehabilitation of an infant or toddler with a disability who has an auditory impairment;(iv) Provision of auditory training, aural rehabilitation, speech reading and listening devices, orientation and training, and other services;(v) Provision of services for prevention of hearing loss; and(vi) Determination of the child’s individual amplification, including selecting, fitting, and dispensing appropriate listening and vibrotactile devices, and evaluating the effectiveness of those devices.(
3) Family training, counseling, and home visits means services provided, as appropriate, by social workers, psychologists, and other qualified personnel to assist the family of an infant or toddler with a disability in understanding the special needs of the child and enhancing the child’s development.(4) Health services has the meaning given the term in §303.16.
(5) Medical services means services provided by a licensed physician for diagnostic or evaluation purposes to determine a child’s developmental status and need for early intervention services.(6) Nursing services include—(i) The assessment of health status for the purpose of providing nursing care, including the identification of patterns of human response to actual or potential health problems;(ii) The provision of nursing care to prevent health problems, restore or improve functioning, and promote optimal health and development; and(iii) The administration of medications, treatments, and regimens prescribed by a licensed physician.
(7) Nutrition services include—(i) Conducting individual assessments in—(A) Nutritional history and dietary intake;(B) Anthropometric, biochemical, and clinical variables;(C) Feeding skills and feeding problems; and(D) Food habits and food preferences;(ii) Developing and monitoring appropriate plans to address the nutritional needs of children eligible under this part, based on the findings in paragraph (b)(7)(i) of this section; and(iii) Making referrals to appropriate community resources to carry out nutrition goals.(8) Occupational therapy includes services to address the functional needs of an infant or toddler with a disability related to adaptive development, adaptive behavior, and play, and sensory, motor, and postural development. These services are designed to improve the child’s functional ability to perform tasks in home, school, and community settings, and include—(i) Identification, assessment, and intervention;(ii) Adaptation of the environment, and selection, design, and fabrication of assistive and orthotic devices to facilitate development and promote the acquisition of functional skills; and(iii) Prevention or minimization of the impact of initial or future impairment, delay in development, or loss of functional ability.
(9) Physical therapy includes services to address the promotion of sensorimotor function through enhancement of musculoskeletal status, neurobehavioral organization, perceptual and motor development, cardiopulmonary status, and effective environmental adaptation. These services include—(i) Screening, evaluation, and assessment of children to identify movement dysfunction;(ii) Obtaining, interpreting, and integrating information appropriate to program planning to prevent, alleviate, or compensate for movement dysfunction and related functional problems; and(iii) Providing individual and group services or treatment to prevent, alleviate, or compensate for, movement dysfunction and related functional problems.(10) Psychological services include—(i) Administering psychological and developmental tests and other assessment procedures;(ii) Interpreting assessment results;(iii) Obtaining, integrating, and interpreting information about child behavior and child and family conditions related to learning, mental health, and development; and(iv) Planning and managing a program of psychological services, including psychological counseling for children and parents, family counseling, consultation on child development, parent training, and education programs.
(11) Service coordination services has the meaning given the term in §303.34.
(12) Sign language and cued language services include teaching sign language, cued language, and auditory/oral language, providing oral transliteration services (such as amplification), and providing sign and cued language interpretation.
(13) Social work services include—(i) Making home visits to evaluate a child’s living conditions and patterns of parent-child interaction;(ii) Preparing a social or emotional developmental assessment of the infant or toddler within the family context;(iii) Providing individual and family-group counseling with parents and other family members, and appropriate social skill-building activities with the infant or toddler and parents;(iv) Working with those problems in the living situation (home, community, and any center where early intervention services are provided) of an infant or toddler with a disability and the family of that child that affect the child’s maximum utilization of early intervention services; and(v) Identifying, mobilizing, and coordinating community resources and services to enable the infant or toddler with a disability and the family to receive maximum benefit from early intervention services.
(14) Special instruction includes—(i) The design of learning environments and activities that promote the infant’s or toddler’s acquisition of skills in a variety of developmental areas, including cognitive processes and social interaction;(ii) Curriculum planning, including the planned interaction of personnel, materials, and time and space, that leads to achieving the outcomes in the IFSP for the infant or toddler with a disability;(iii) Providing families with information, skills, and support related to enhancing the skill development of the child; and(iv) Working with the infant or toddler with a disability to enhance the child’s development.(15) Speech-language pathology services include—(i) Identification of children with communication or language disorders and delays in development of communication skills, including the diagnosis and appraisal of specific disorders and delays in those skills;(ii) Referral for medical or other professional services necessary for the habilitation or rehabilitation of children with communication or language disorders and delays in development of communication skills; and(iii) Provision of services for the habilitation, rehabilitation, or prevention of communication or language disorders and delays in development of communication skills.(16) Transportation and related costs include the cost of travel and other costs that are necessary to enable an infant or toddler with a disability and the child’s family to receive early intervention services.
(17) Vision services mean—(i) Evaluation and assessment of visual functioning, including the diagnosis and appraisal of specific visual disorders, delays, and abilities that affect early childhood development;(ii) Referral for medical or other professional services necessary for the habilitation or rehabilitation of visual functioning disorders, or both; and(iii) Communication skills training, orientation and mobility training for all environments, visual training, and additional training necessary to activate visual motor abilities.(c) Qualified personnel. The following are the types of qualified personnel who provide early intervention services under this part:(1) Audiologists.(2) Family therapists.(3) Nurses.(4) Occupational therapists.(5) Orientation and mobility specialists.(6) Pediatricians and other physicians for diagnostic and evaluation purposes.(7) Physical therapists.(8) Psychologists.(9) Registered dieticians.(10) Social workers.(11) Special educators, including teachers of children with hearing impairments (including deafness) and teachers of children with visual impairments (including blindness).(12) Speech and language pathologists.(13) Vision specialists, including ophthalmologists and optometrists.(d) Other services. The services and personnel identified and defined in paragraphs (b) and (c) of this section do not comprise exhaustive lists of the types of services that may constitute early intervention services or the types of qualified personnel that may provide early intervention services. Nothing in this section prohibits the identification in the IFSP of another type of service as an early intervention service provided that the service meets the criteria identified in paragraph (a) of this section or of another type of personnel that may provide early intervention services in accordance with this part, provided such personnel meet the requirements in §303.31.
IDEA Part C Procedural Safeguards
Yes, just as with IDEA part B, Part C gives parent protections.
What is an IFSP?
An IFSP is yes, like an IEP for babies. IFSP stands for Individualized Family Service Plan. And, per IDEA part c, most agencies follow a model of engaging the entire family in the process. If you read Part C, you will see that it calls for services to be provided in the ‘natural environment.’ My son’s providers always came here or to his daycare.
My son’s services included OT, PT, SLP and an early childhood special education teacher to come to the home. When he was around 2, we added vision and orientation and mobility.
The IFSP is a document that outlines the EI 0-3 services that your child and family will receive. Note, it says family! Parents tend to receive more training during 0-3 services than any other time. Even though IEPs can and do include Parent Training.
Another main tenet of IDEA Part C is that the family is a child’s greatest resource. The best way to support children and meet their needs is to support and build upon the individual strengths of their family. So, the IFSP is a whole family plan with the parents as major contributors in its development. Much like an IEP, adding other supports and services depends on what the child needs. A list of possible service providers is above in the segment of IDEA part C that I posted..
And, much like an IEP, IFSPs can vary by state.
Eligibility for an IFSP
Hey, let’s be honest. Babies don’t do much! So eligibility is one area where an IFSP is a little different from an IEP. An IFSP can be diagnosis-driven. If your baby is born with a known health issue, such as low birth weight, prematurity, down syndrome or any other genetic condition, you may be referred to Early Intervention Services.
A developmental delay isn’t going to appear until a baby “should” have some skills, so talk to your pediatrician if you have concerns. This is one area where Kevin didn’t have a ton of red flags. He was born a normal weight, he had great eye contact. He lacked core strength, but that was all we had to go on for a few months.
Side note: Genetic Screenings are a part of ACA. This is why, 14 years ago, Kevin did not receive them. There was no ACA then. Again, hindsight is always 20/20, but had he been genetic screened, we would have found his genetic condition and started services right away. And not at 6 months. Now that he’s 14, do those 6 months really matter? We’ll never know. We know that Early Intervention works, which is why I will continue to support ACA.
What is an IFSP plan?
This is all clearly defined in IDEA Part C. You will see many similarities between an IEP vs an IFSP. An IFSP must include the following:
- A present levels of functioning section; a listing of all strengths and areas of need in all areas of development (cognitive, speech, social, etc)
- Family information including the resources, priorities, and parent concerns
- The Results or Goals expected to be achieved for your child and family
- The specific EI services your child will be receiving; frequency, duration, location, etc.
- LRE Component-if the services will not be provided in the natural environment, the IFSP must include a statement justifying why not
- Who will pay for the services
- The name of the service coordinator overseeing the implementation of the IFSP (I fired my first one, lol, I was in a bad place! ‘nother story for ‘nother day!)
- IFSP to IEP transition details, when the time comes.
The IFSP must be fully explained to the parents, and their suggestions must be considered. Parental written consent is required before services can start. If you do not give your consent in writing, your child will not receive services.
The process is very similar. Either you (as a parent) or another professional (pediatrician, day care teacher) will refer your child to EI services in your state or county. Again, this can vary a little bit by state. But generally the next step is that a Service Coordinator will come out to your home. He/she will interview the parents and gather your concerns.
From there she will develop a plan for evaluations by professionals, and those folks will come out and evaluate your child. They will compile evaluation reports with their findings.
Yes, along the way, talk with your service coordinator if you disagree with their evaluations or have any questions.
IFSP Service Delivery
Most IFSP teams follow the same service delivery model. Remember, we are talking about babies, so a parent or trusted adult (grandparent, day care provider) must be present.
But the service delivery model is that yes, they provide direct services to your child. However, they also teach and train the adults in that baby’s life so that you can practice.
Yes, much like an IEP, you will have a team. Your service providers may or may not be the same people who did your evaluations.
- the parent or parents of the child
- other family members, if requested by the parent (my mother-in-law was present for lots of ours)
- an advocate or person outside of the family, if requested by parent (our day care provider often attended)
- the service coordinator designated by the system to be responsible for implementing the IFSP (you can switch if it’s not a good fit)
- professionals who conducted the evaluations and assessments of the child and family
- persons who will be providing early intervention services under this part to the child or family (may or may not be same people who did evaluations)
Parent Tips for IFSP Development
Just going to throw out some random stuff I’ve learned from my own experience and from friends.
- Don’t beat yourself up over what you didn’t know. When we know better, we do better. Just focus on doing better as you gain more knowledge.
- It’s ok to be overwhelmed and confused. Ask questions. Seek out support.
- Enjoy this time! Having a child from ages 0-3 is still a phenomenally fun and exciting time. Make sure you enjoy your baby. I’d hate for anyone to look back on the 0-3 time and all you remember is doctor appointments and therapies.
- You do you. Learn all you can about your baby’s prognosis and expectations, but go with your gut. Don’t let anyone else tell you how to feel.
- Find your people. If your child does have a disability that is going to affect them long term, find your people. This may or may not be people who have babies with the same diagnosis as yours. It may not be the first similarly-situated parents you find. It may be online and not in real life. But they’re out there, your people, find them.
Transition from IFSP to IEP
It’s a little confusing, but it has to do with funding. But in most states, once your child turns 3, he/she becomes the responsibility of your local school district (LEA) and gets an IEP instead of an IFSP. That being said, they usually have specific people who handle the preschool services.
IDEA Part B covers 3-21, which is why this happens.
Your IFSP team will likely begin preparing you for this when your child is only 2. The best tip I can give: When your child begins the 3-21 services, now is really the time to buckle down, learn the system and be your child’s best advocate you can be.
You really need a strong, solid preschool IEP and have demonstrated meaningful progress. This makes it more difficult to reduce services when the child enters kindergarten.