DHS 90.06 Note
Note: Section 46.985, Stats., was repealed by 2015 Wis. Act 55 rendering Chapter DHS 65 unenforceable and without effect. Chapter DHS 65 will be repealed in future rulemaking.
Local birth to 3 program records are maintained, including interagency agreements, records of how funds were budgeted and expended, records of personnel qualifications, records related to state training plan implementation and copies of contracts and agreements with service providers, and these are made available for inspection by representatives of the department; and
The department is provided, on request, with information on use of funds, system development, number of children needing and receiving early intervention services, types of services needed, types of services provided and such other information the department requires to describe and assess the operation of the local program.
DHS 90.06 History
Cr. Register, June, 1992, No. 438
, eff. 7-1-92; emerg. am. (1), (2) (c), (g) and (n), renum. (2) (m) to be (2) (m) 1., cr. (2) (m) 2., eff. 1-1-93; am. (1), (2) (c), (g) and (n), renum. (2) (m) to be (2) (m) 1., cr. (2) (m) 2., Register, June, 1993, No. 450
, eff. 7-1-93;
am. (2) (g), renum. (2) (h) to (o) to be (2) (i) to (p), cr. (2) (h), Register, April, 1997, No. 496
, eff. 5-1-97; corrections in (2) (h) and (n) made under s. 13.93 (2m) (b) 7., Register, September, 1999, No. 525
; emerg. renum. (1) to be (1m) and (2) (i) to (p) to be (2) (j) to (q), cr. (1) and (2) (i), am. (2) (h), eff. 10-1-01. CR 01-106
: renum. (1) to be (1m) and (2) (i) to (p) to be (2) (j) to (q), cr. (1) and (2) (i), am. (2) (h), Register February 2002 No. 554
, eff. 3-1-02; CR 03-033
: r. (2) (m) Register December 2003 No. 576
, eff. 1-1-04; corrections in (1) (a) and (2) (o) 2. made under s. 13.92 (4) (b) 7., Stats., Register November 2008 No. 635
DHS 90.07 Identification and referral. DHS 90.07(1)
Establishment of child find system.
Each county administrative agency shall establish a comprehensive child find system to ensure that all children who may be eligible for the birth to 3 program are identified and referred for screening or for evaluation to determine eligibility for the birth to 3 program. The system shall include public awareness activities and an informed referral network.
A county administrative agency shall establish a formal system of communication and coordination among agencies and others within the community serving young children. This referral network shall identify and include local providers of services related to early intervention, enhance each provider's knowledge of eligibility criteria under this chapter and coordinate referrals to the local birth to 3 program.
The informed referral network shall be made up of all primary referral sources. Primary referral sources include but are not limited to:
All agencies which receive funds directly or through a subcontract under relevant federal programs;
Health care providers such as neonatal intensive care units, perinatal follow-through clinics, hospitals, physicians, public health agencies and facilities, and rehabilitation agencies and facilities;
Other qualified personnel and local providers of services to young children and their families.
If the primary referral source suspects that an infant or toddler has a developmental delay, the primary referral source shall conduct or request a formal screening to determine if there is reason to refer the child for an evaluation.
If the primary referral source has reasonable cause to believe that a child has a diagnosed physical or mental condition which has a high probability of resulting in a developmental delay or has a developmental delay, the primary referral source shall refer the child for an evaluation. The primary referral source shall ensure that referral for evaluation is made no more than 2 working days after a child has been identified.
DHS 90.07 Note
Note: Referral sources should differentiate between a request or need for a formal screening and referral for an evaluation. For example, a child diagnosed as having Down syndrome, which has a high probability of resulting in a developmental delay, should be referred for an evaluation rather than a formal screening, whereas a child who seems slow in speech or motor development may first be formally screened to determine if there is need for an evaluation.
A service provider may do informal or formal screening of a child as part of the service provider's routine observations or intake procedures.
Following either a formal or informal screening, the primary referral source or the service provider shall inform the parent of the reason, procedures and results of the screening.
DHS 90.07 Note
Note: While parental consent is not required to screen a child, the service provider is encouraged to give the parent information about the screening process before conducting the screening.
DHS 90.07 History
Cr. Register, June, 1992, No. 438
, eff. 7-1-92;
am. (1), (3) (b) 2., Register, April, 1997, No. 496
, eff. 5-1-97; am (1), r. and recr. (3), Register, September, 1999, No. 525
, eff. 10-1-99.
Designation of service coordinator.
When a child is referred to the birth to 3 program for evaluation and possible early intervention services, the county administrative agency shall as soon as possible designate a service coordinator for that child and the child's family.
(2) Determination of eligibility.
A referred child shall be evaluated in accordance with the criteria under sub. (4)
to determine the child's eligibility for early intervention services under the program.
In consultation with the parent and based on the child's suspected needs, the service coordinator shall select at least 2 qualified personnel from those under par. (b)
who, with the parent and service coordinator, will make up the EI team to perform the evaluation and make the determination of eligibility. Qualified personnel may be from different agencies and shall be from at least 2 different disciplines in areas of suspected need. The service coordinator may be one of the qualified personnel if the service coordinator is qualified as required under par. (b)
. At least one of the qualified personnel shall have expertise in the assessment of both typical and atypical development and expertise in child development and program planning.
Qualified personnel who are qualified to serve on the EI team are the following:
Audiologists with at least a master's degree in audiology from an accredited institution of higher education who are registered or licensed under ch. 459, Stats.
Nutritionists registered as dietitians by or eligible for registration as dietitians by the American dietetic association;
Rehabilitation counselors employed by the department's division of vocational rehabilitation as coordinators of hearing impaired services who have at least a master's degree in rehabilitation counseling or a related field;
Registered nurses with at least a bachelor's degree in nursing from an accredited institution of higher education and licensed under s. 441.06
Special education teachers, including early childhood special education needs teachers, vision teachers and hearing teachers, licensed through the department of public instruction;
Speech and language pathologists with at least a master's degree in speech and language pathology from an accredited institution of higher education and who are registered under ch. 459, Stats.
, or licensed under ch. 115, Stats.
, and ch. PI 34
Other persons qualified by professional training and experience to perform the evaluation and determine eligibility.
A child is eligible for early intervention services under the birth to 3 program if the EI team determines under sub. (5)
that the child is developmentally delayed or under sub. (6)
that the child has a diagnosed physical or mental condition which will likely result in developmental delay.
A determination of developmental delay shall be based upon the EI team's clinical opinion supported by:
A developmental history of the child and other pertinent information about the child obtained from parents and other caregivers;
Observations made of the child in his or her daily settings identified by the parent, including how the child interacts with people and familiar toys and other objects in the child's environment; and
Except as provided under par. (b)
, a determination of at least 25% delay in one or more areas of development as measured by a criterion referenced instrument, or a score of 1.3 or more standard deviation below the mean in one or more areas of development as measured by a norm-referenced instrument, and interpreted by a qualified professional based on informed clinical opinion. In this subdivision, “areas of development" mean:
If the results of the formal testing under par. (a) 3.
closely approach but do not equal the standard in par. (a) 3.
for a developmental delay but observation by qualified personnel or parents indicates that some aspect of the child's development is atypical and is adversely affecting the child's overall development, the EI team may use alternative procedures or instruments that meet acceptable professional standards to document the atypical development and to conclude, based on informed clinical opinion, that the child should be considered developmentally delayed.
DHS 90.08 Note
Note: Examples of atypical developments are asymmetrical movement, variant speech and language patterns, delay in achieving significant interactive milestones such as exhibiting a pleasurable response to a caregiver's attention, and presence of an unusual pattern of development such as a sleep disturbance or eating difficulties.
(6) Determination of diagnosed condition.
A determination of high probability that a child's diagnosed physical or mental condition will result in a developmental delay shall be based upon the EI team's informed clinical opinion supported by a physician's report documenting the condition. High probability implies that a clearly established case has been made for a developmental delay.
DHS 90.08 Note
Note: Examples of these diagnosed conditions are chromosomal disorders such as Down syndrome, birth defects such as spina bifida, significant or progressive vision or hearing impairment, neuromotor disorders such as cerebral palsy, postnatal traumatic events such as severe head injuries, severe emotional disturbances, dysmorphic syndromes such as fetal alcohol syndrome, addiction at birth, a maternal infection transmitted to the fetus such as AIDS, neurological impairments of unknown etiology such as autism, untreated metabolic disorders such as PKU and certain chronic or progressive conditions.
The service coordinator shall ensure that the parents of the child are involved and consulted throughout the entire evaluation process.
The EI team shall examine all relevant available data concerning the child, including the following:
Medical records and other health records concerning the child's medical history and health status, including physical examination reports, results of vision and hearing screenings, hospital discharge records and specialty clinic reports;
Any records and screening results of the child's developmental functioning in the following areas:
Records of any previous interventions provided to the child, including therapy reports, treatment records and service plans.
The EI team shall use additional observation, screening results and other testing instruments and procedures as needed, to determine the child's level of functioning in each of the following areas of development:
Cognitive development, as evidenced by play skills, manipulation of toys, sensorimotor schemes, attention, perceptual skills, memory, problem solving and reasoning;
Physical development, including hearing and vision, as evidenced by gross motor and fine motor coordination, tactility, health and growth. If there has not been a physical examination of the child in the past 2 months, one shall be requested if appropriate;
Communication development, as evidenced by understanding, expression, quantity and quality of speech sounds or words, and communicative intent through gestures. Communication development includes the acquisition of communications skills during pre-verbal and verbal phases of development; receptive and expressive language, including spoken, non-spoken and sign language means of expression; oral-motor development; auditory awareness skills and processing; the use of augmentative communication devices; and speech production and awareness.
Social and emotional development, as evidenced by temperament, mood attachment, self-soothing behaviors, adaptability, activity level, awareness of others and interpersonal relationships; and
Adaptive development which includes self-help skills, to include drinking, eating, eliminating, dressing and bathing.
Testing instruments and other materials and procedures employed by the EI team shall meet the following requirements:
They shall be administered or provided in the child's or family's primary language or other mode of communication. When this is clearly not possible, the circumstances preventing it shall be documented in the child's early intervention record;
They shall be validated for the specific purpose and age group for which they are used;
They shall be administered by trained personnel in accordance with instructions of the developer;
They shall be tailored to assess the specific area of development and not simply provide a single general intelligence quotient; and
In regard to tests, they shall be selected to ensure that when they are administered to a child with impaired sensory, manual or speaking skills, the test results accurately reflect what the tests purport to measure.
No single procedure may be used as the sole criterion for determining eligibility.
With the parent's consent, members of the EI team may consult with persons not on the EI team to help the EI team members determine if the child needs early intervention services.
Following the evaluation, all members of the EI team shall jointly discuss their findings and conclusions and determine if there is documentation, data or other evidence that the child is developmentally delayed or has a condition which has a high probability of resulting in delayed development. If a member cannot be present, that member shall be involved through other means, such as participating in a conference call, or be represented by someone who is knowledgeable about the child and about the member's findings and conclusions.
At the conclusion of the joint discussion under par. (g)
, the EI team shall prepare a report which shall include each member's findings and conclusions and be signed by all members of the team. If a member participated through a conference call, the signature may be by proxy. The report shall include:
A determination of either eligibility or non-eligibility, with a determination of eligibility accompanied by documentation of the child's developmental delay or diagnosed condition.
The service coordinator shall provide the child's parent with a copy of the EI team's report.