(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.
If the EI team finds that the child is not eligible, the EI team report shall in addition include:
Information about community services that may benefit the child and family, such as day care, parent support groups or parenting classes; and
A statement that, if the parent requests it and consents to it, referral will be made to other programs from which the child and family may benefit and that the service coordinator will assist the parent in locating and gaining access to other services.
If the parent chooses not to take part in the evaluation process or development of the report, the service coordinator shall meet with the parent upon completion of the evaluation to discuss the findings and conclusions of the EI team. The service coordinator shall document in the child's early intervention record why the parent was not involved and the steps taken to share the findings and conclusions of the EI team with the parent.
(8) Effect of relocation of eligible child.
When the family of a child who has been determined eligible for early intervention services based on an EI team evaluation moves to another county, the child shall remain eligible for services in the new county of residence on the basis of the original determination of eligibility. The services identified in the IFSP in effect on the date that the family moves to the new county shall be provided until a new IFSP is developed.
DHS 90.08 History
Cr. Register, June, 1992, No. 438
, eff. 7-1-92; emerg. am. (3) (b) 11., 12. and (8), cr. (3) (b) 13., r. (7) (h) 2., eff. 1-1-93; am. (3) (b) 11., 12. and (8), cr. (3) (b) 13., renum. (7) (h) 1. (intro.) to be (7) (h) (intro.), r. (7) (h) 2., Register, June, 1993, No. 450
, eff. 7-1-93; am. (1), (3) (a), (b) 10., (5) (a) 3., (7) (b) 1., (g), (h) (intro.), Register, April, 1997, No. 496
, eff. 5-1-97;
am. (7) (k), Register, September, 1999, No. 525
, eff. 10-1-99; CR 03-033
: am. (3) (b) 3. and 11. Register December 2003 No. 576
, eff. 1-1-04; corrections in (3) (b) 9. and 12. made under s. 13.93 (2m) (b) 7., Stats., Register December 2004 No. 588
Once a child is determined under s. DHS 90.08
to be eligible for early intervention services, the EI team shall, as needed, carry out additional observations, procedures and testing to assess and determine the child's unique developmental needs. All assessment tests and other materials and procedures shall comply with s. DHS 90.08 (7) (d)
Following the assessment under subd. 1.
, the EI team shall prepare a report. This report need not be a separate document but may be made part of the EI team's report under s. DHS 90.08 (7) (h)
or the IFSP under s. DHS 90.10
. The report shall include:
A summary of the assessment, including the child's strengths and needs; and
The service coordinator shall provide the child's parent with a copy of the assessment report.
(b) Ongoing assessment.
Ongoing assessments shall be carried on as needed by either the EI team or the IFSP team. All ongoing assessments shall meet the requirements in par. (a)
(c) Discussion with nonparticipating parent.
If the parent chooses not to take part in the assessment or development of the report, the service coordinator shall meet with the parent upon completion of the assessment to discuss the findings and recommendations. The service coordinator shall document in the child's early intervention record why the parent was not involved and the steps taken to share the findings and recommendations of the assessment report with the parents.
Any assessment of the child's family shall be with the family's permission. The assessment shall be directed by the family and shall focus on the family's strengths, resources, concerns and priorities related to enhancing development of the child.
Be completed by the family alone with a choice of assessment tools offered to the family, or be completed by the family in collaboration with other personnel trained to make use of appropriate formal or informal methods and procedures;
Be based on information provided by family members through personal interviews; and
Incorporate the family members' description of the family's strengths, resources, concerns and priorities as these are related to enhancing the child's development.
DHS 90.09 History
Cr. Register, June, 1992, No. 438
, eff. 7-1-92; am. (2) (a), Register, June, 1993, No. 450
, eff. 7-1-93; am. (1) (a), 2., Register, April, 1997, No. 496
, eff. 7-1-97.
DHS 90.10 Development of service plan. DHS 90.10(1)
Except as provided in sub. (2) (a)
, within 45 days after receiving a referral for initial evaluation of a child, the county administrative agency shall complete the evaluation under s. DHS 90.08
and the assessment under s. DHS 90.09
and the service coordinator shall convene a meeting to develop the initial IFSP.
DHS 90.10(2)(a)(a) Delay in completing evaluation and assessment.
If exceptional circumstances directly affecting the child or the child's family, such as illness of the child or a parent or the parent's refusal to consent to a procedure, make it impossible to complete the evaluation and assessment within 45 days, the county administrative agency shall:
Document the exceptional circumstances in the child's early intervention record;
Ensure that the service coordinator, the parent, at least one of the qualified personnel directly involved in the child's evaluation and assessment and, as appropriate, persons who will be providing services for the child and family develop and implement an interim IFSP which includes the service coordinator's name, the early intervention services that are needed immediately and the circumstances and reasons for development of the interim IFSP;
Obtain the parent's written consent to the services, and to a revised deadline for completion of the evaluation and assessment; and
Complete the evaluation within the extended period agreed upon by the family and EI team.
(b) Provision of services before completing evaluation and assessment.
Provision of early intervention services to a child and the child's family may be started before the evaluation and assessment are completed if there is a clear and obvious need that can be addressed without waiting for completion of the formal evaluation and assessment and if the following conditions are met:
An interim IFSP is developed and implemented by the service coordinator, parent, at least one of the qualified personnel directly involved in the child's evaluation and assessment and, as appropriate, persons who will be providing services for the child and family, which includes the service coordinator's name, the early intervention services that are needed immediately and the circumstances and reasons for development of the interim IFSP; and
The evaluation and assessment are completed within the time period prescribed in sub. (1)
(3) IFSP team.
The IFSP team shall consist of the parent, other family members requested by the parent, the service coordinator, an advocate if requested by the parent, at least one of the qualified personnel who took part in the evaluation and assessment of the child, at least one professional who has expertise in assessment of both typical and atypical development and expertise in child development and program planning, and appropriate service providers. If a professional who took part in the evaluation and assessment cannot be present at a meeting to develop the IFSP, the service coordinator shall ensure that the professional is involved through some other means.
(4) Meeting to develop ifsp.
The IFSP shall be developed on the basis of the evaluation and assessment by the IFSP team and with attention to the concerns and priorities of the parent. All meetings shall be conducted in settings and at times that are convenient to families, and the service coordinator shall ensure that written notice of a meeting is provided to all participants early enough before the meeting date so that they will be able to attend. If the parent wishes to attend but cannot attend at the scheduled time, the meeting shall be rescheduled.
The IFSP may have several different sections that are completed at various times throughout the process. All sections of the IFSP shall be maintained in one file or binder. The parents shall be given a copy, the contents of which shall be fully explained to the parents and kept current. The IFSP shall contain:
Information about the child's developmental status, including statements concerning the child's present levels of cognitive development, physical development, to include vision, hearing and health status, communication development, social and emotional development and adaptive development such as self-help skills, based on professionally acceptable objective criteria. This information shall be assembled from the initial evaluation and assessment reports and the results of any ongoing assessments.
With the concurrence of the parent, a summary of the family's strengths, resources, concerns and priorities related to enhancing the development of the child;
A statement of the outcomes expected to be achieved for the child and family, as identified by the IFSP team, and the criteria, procedures and timelines used to determine:
Identification of the specific early intervention services necessary to achieve the outcomes identified in par. (e)
The frequency and intensity of a service, to include the number of days or sessions it will be provided, the length of time the service will be provided during a session and whether the service will be provided on an individual or group basis;
The locations where early intervention services will be provided. This list shall be accompanied by a statement that describes the environments in which early intervention services are provided, with justification if a specific early intervention service will not be provided in a natural environment.
If appropriate, medical and other services that the child needs that are not required under the birth to 3 program and the steps that will be taken to secure those services from public or private sources. This does not apply to routine medical services such as immunizations and well baby care unless a child needs those services and they are not otherwise available or being provided; and
The projected dates for initiating the services and the expected duration of the services;
The name of the service coordinator who will be responsible for the implementation of the IFSP and coordination with other agencies and individuals. This may be the same service coordinator who was originally designated at the time the child was initially referred for evaluation or a new service coordinator;
A written plan for the steps to be taken to support the child and family through transitions, including the transition upon reaching the age of 3 to a preschool program under subch. V of ch. 115
, Stats., or to other appropriate services for children who may not be eligible for a preschool program under subch. V of ch. 115
, Stats. These steps shall include:
Discussing a prospective transition in advance with the parents and giving them information about the new setting and other matters related to the child's transition including the role of the family;
Implementing procedures to prepare the child for changes in service delivery, including helping with adjustment to and functioning in the new setting;
With parental consent, forwarding of information about the child to the local educational agency or other service agency to assure continuity of services; and