The Early Intervention Process

The early intervention process starts with each Family's very first contact with EDIS.  This contact marks the beginning of the early intervention journey.  This journey may be short or long-lasting, shifting and adjusting in response to the needs of each Family and its individual circumstances.  While the process respects each Family's unique needs and demands, the steps in the process are well-defined.  Because Children change so quickly during this early period of development, EDIS has a 45-day timeline from when a referral is received to when a determination of Eligibility is made and, if the Child qualifies for services, an Individualized Family Service Plan (IFSP) is completed.

This section provides detailed information and resources associated with the eight steps in the early intervention process. These steps include: 

Because EDIS provides statutory services in accordance with IDEA, Families are entitled to certain procedural safeguards and due process rights, described in our Parent Rights and Procedural Safeguards brochure and summarized below:

PROCEDURAL SAFEGUARDS

Families eligible for EIS have rights for procedural safeguards afforded to them by the law.  The military medical departments are responsible for ensuring these safeguards.  Should a Family believe their procedural safeguards were denied, they may request a formal conference or mediation to resolve these disagreements.  If this is unsuccessful, the Family may request a formal hearing through the Defense Office of Hearings and Appeals (DOHA).  Families may also request a hearing without using the other methods to resolve their disagreement.  

FAMILIES HAVE RIGHTS TO:

Confidentiality

You have the right to confidentiality of information.  EDIS will safeguard all personally identifiable Family Information.

Consent to Release Information

Personally identifiable information concerning anyone in your Family cannot be released outside the Department of Defense (DOD) without your written approval.  If the requesting agency is also a DOD agency, and there is a rightful need for the requested information, the information may be released.

Right to Examine Records

You have the right to examine records concerning the early intervention services your child and Family receive.  These records include screening, assessment, eligibility, the development and implementation of the Individualized Family Service Plan (IFSP), and progress notes written by the provider(s).

Prior Written Notice

EDIS must provide you with written notification (Notice of Proposed Action) whenever EDIS proposes to initiate or change the identification, evaluation, or any aspect of the early intervention services.

Understand

Information must be provided in a language understandable to you or via other modes of communication you understand.  This information includes prior written notifications (Notice of Proposed Action) and procedural safeguards.

Accept or Decline

You can accept or decline any or all early intervention services.  Choosing to refrain from participating in one service will not affect the delivery of other services you have chosen to accept.

Disagree

You have the right to file a complaint about any aspect of the early intervention services your child and Family receive.

Continued Services During Dispute

During any action involving a complaint, you and your child will continue to receive the early intervention services currently provided unless otherwise agreed upon between you and EDIS.

Referrals to EDIS

Referrals may come to EDIS from any military medical provider or the Parents.  Upon receipt of a referral to EDIS, an Initial Service Coordinator is assigned to contact and assist the Family.  The Initial Service Coordinator gathers information to understand the Family's concern, shares information about early intervention, and makes arrangements to proceed with the process, provided the Family is interested.  In EDIS, any member of the Early Intervention team can serve as an Initial Service Coordinator.

Some Military department regulations specify the minimum number of days between receipt of the referral and initial contact with the Family.  In EDIS, communication must occur within seven days.  Within that timeframe, an EDIS-assigned Initial Service Coordinator will contact the Family to make an appointment for the Intake / Screening.

EDIS Forms

Use the Entry/Entitlement form to document Family and Child demographic and referral information.

About Intake / Screening

The intake / screening step in the early intervention process is typically the first face-to-face contact with the Family.  The intake involves an interview with the Parents to understand what concerns the Family may have for their Child.  While the referral concerns may have been noted on the referral consult or briefly discussed during the first phone call with the Family, reviewing these concerns in greater detail during the first visit is helpful.  The intake / screening process begins by asking the Family what brings them to Early Intervention and how, or if, they would like to proceed with the referral.  During the intake / screening step, the Service Coordinator provides additional information about Early Intervention Services, the evaluation process, eligibility determination, and Family Rights and Procedural Safeguards.

The developmental screening helps determine whether further assessment is needed, and it initiates the developmental evaluation process.  Depending on the information received as part of the referral, conducting a formal developmental screening (e.g., completing the Ages and Stages Questionnaire [ASQ]) may be recommended.  If a screening was conducted as part of a Child Find activity, a re-screening may be unnecessary, and the Family may elect to move directly to a developmental evaluation.  However, if a developmental screening was not completed, and it is unclear whether further assessment is warranted, as in the case of a child without a biological risk or notable developmental delays, a formal developmental screening should be conducted.

Based on the information shared and the screening results, the Service Coordinator and the Family determine the next steps.  The process concludes if there are no developmental concerns, and an evaluation is not needed.  If a re-screening is recommended, the team plans to re-screen in the future (e.g., in two months).  If there are concerns about the child's development and the Family wants to proceed, the team makes a plan to conduct the developmental evaluation.

EDIS Forms

Parent Rights & Procedural Safeguards are discussed with a Family at initial visits and thereafter, as requested by the Family; however, the Parent Rights & Procedural Safeguards trifold is provided to the Family at each step in the Early Intervention Process (and more often if requested by the Family). 

Before conducting a Screening or Evaluation, Parents are given a Notice of Proposed Action, indicating that the Family collaborated with EDIS on a time and date for the Screening.  The Family grants EDIS permission to conduct the Screening or Evaluation by signing the Permission to Screen / Evaluate form.  Lastly, the Individualized Family Service Plan -- Process Document (IFSP-PD) documents the screening results and indicates the next steps in the Early Intervention process.

About Evaluation

The Child's development must be evaluated to determine whether they are eligible for Early Intervention Services from EDIS.  The evaluation includes the Parents and Child, and it is conducted by at least two early interventionists of different disciplines (i.e., multidisciplinary), such as an Early Childhood Special Educator and Occupational Therapist or a Physical Therapist and a Speech-Language Pathologist.  The evaluation must cover all five domains of child development: 

     Cognition - problem-solving / attending to toys and people / memory
     Communication - using sounds and words to express self and listening to and following directions and gestures
     Motor - using hands to play with toys, turning pages of a book, using large muscle groups to sit, crawl, stand, walk, and run
     Self-care - feeding self and drinking, taking an interest in cleaning up, taking first steps toward dressing 
     Social / Emotional - regulating emotions, awareness of self and others, interest in and forming relationships

The evaluation should include naturalistic observation of the child doing things they typically do.

Based upon the evaluation results, observation, and information shared, the team, including the Family, determines whether the Child (and Family) are eligible for early intervention services from EDIS.

EDIS Forms

Parents are given the Parent Rights & Procedural Safeguards trifold as well as the opportunity to further discuss this information prior to the Evaluation.
Parents are provided the Notice of Proposed Action form, indicating that the Family and EDIS agreed in advance upon the date and time to complete the action (e.g., Evaluation).  It is not unusual for EDIS and the Family to discuss the possibility of completing the Eligibility Meeting immediately following the Evaluation (i.e., on the same date); in this case, the Notice of Proposed Action form will include the actions of both Evaluation and Eligibility.
Parents provide their consent to conduct the Evaluation by signing the Permission to Screen / Evaluate form. 
Results of the Evaluation are documented on the Individualized Family Service Plan - Process Document (IFSP-PD), sections 1-5.

 

About Eligibility

After the developmental evaluation has been completed, an eligibility meeting is held.  The evaluation results and observations of the Child will be compared with Early Intervention eligibility criteria (listed below) to determine whether the Child qualifies for services.  Eligibility is a team decision that always includes the Family.

Eligibility Criteria

There are two categories of eligibility for early intervention services from EDIS:

     1.  Eligibility is based on a documented Developmental Delay
     2.  Eligibility is based on a medical condition with a high probability of resulting in a developmental delay, called a Biological Risk.

A Developmental Delay is considered when a Child scores as either of the following:
     1.  Two or more standard deviations below the mean or demonstrates a 25% delay in one area of development
     2.  1.5 standard deviations below the mean or presents with a 20% delay in two or more areas of development.

A Biological Risk is present when a child has a diagnosed physical or mental condition that has a high probability of resulting in a developmental delay.  The determination of biological risk must be based on a physician's diagnosis.

Once a Child is found eligible and the Family chooses to participate in services, the next step is to develop the IFSP.

If the Child is not eligible, but the Family and team feel that some degree of continued support is needed, the Family may elect to participate in Tracking services as a safety net to monitor their Child's developmental progress.  Tracking becomes an option only after completing both the evaluation and eligibility processes.  Ongoing contact with a Family who chooses to track their Child's development typically occurs once every two months unless the Family initiates the contact.

EDIS Forms

Meeting to determine whether a child is eligible for Ealy Intervention services may happen immediately following the evaluation, in which case, the eligibility is documented on the Individualized Family Service Plan - Process Document (IFSP-PD) in section five; and the supporting forms for the Evaluation carry over to the Eligibility Meeting (Parent Rights & Procedural Safeguards and Notice of Proposed Action).

If, however, the Eligibility Meeting is held on a different date, the Family will be provided with another copy of the Parents Rights & Procedural Safeguards (and the chance to review it), the Notice of Proposed Action (indicating that the Family and EDIS agreed upon the time/date for the Eligibility meeting), and the IFSP-PD is used to document the eligibility status.
 

 

About the Individualized Family Service Plan (IFSP)

Together, the Family and early intervention providers develop an Individualized Family Service Plan (IFSP).  The IFSP must be completed promptly; for our program, that means within 45 calendar days of the date of referral.

The guiding principle of the IFSP is that the Family is a Child’s most significant resource and that a Child’s needs are closely tied to those of the Family. The best way to help Children and meet their needs is to support and build upon the individual strengths of their Family.  As you can see, the IFSP is a Family plan with the Parents as the most essential part of the IFSP team.

The IFSP includes the following components, which is why it is understood to be a Process document:

  • Information about the Child’s current development
  • Information about Family resources, priorities, and concerns
  • Outcomes the Family desires for their Child and Family
  • A description of the services and supports needed to help the Family reach those outcomes
  • A statement about the natural environment where the services will be provided
  • A start date for services and the expected duration of those services
  • The name of the Service Coordinator (the person who will help the Family throughout the early intervention process)
  • A Transition Plan for the Child and Family for when a Family transitions out of / away from EDIS (e.g., the Child turns three years old, the Family moves out of the catchment area, or the Child and Family no longer require EDIS support).

EDIS Forms

EDIS uses the Individualized Family Service Plan-Process Document (IFSP-PD) to track a Family's journey through Early Intervention Services from beginning to end.

About IFSP Service Delivery

Because Families know their Children best and spend the most time with them, Families naturally have the most significant capacity to promote their Children's development.  Accordingly, the primary focus of Early Intervention is supporting Families in enhancing their Children's development; this is best accomplished by working in partnership with Families and caregivers and supporting them in the context of their typical routines and activities.

Early Intervention Services can be provided in various locations where Families and Children typically spend their time; the actual location of services is individually determined for each Family based on their unique mix of daily routines and activities.

In EDIS, a Primary Service Provider approach is used, which means that each Family primarily works with one consistent provider who can understand and keep abreast of the changing interests, strengths, and demands in the Family’s life.  The Primary Service Provider brings in and consults with other service providers as needed.

Working in partnership with Families remains a keystone of early intervention, as does supporting the whole Family and ensuring the provided services are based on the agreed-upon outcomes defined in the IFSP.  The IFSP becomes the “curriculum” for the intervention that the early intervention provider and the Family collaboratively address.

EDIS Forms

The Individualized Family Service Plan – Process Document (IFSP-PD) guides services and tracks progress.  

About the Individualized Family Service Plan (IFSP) Review

Changes or proposals to change any aspect of the Individualized Family Service Plan (IFSP) can be made anytime.  However, any change to the IFSP must be made with the Family's agreement.  At a minimum, meetings to discuss changes must include the Family and the Service Coordinator.

In addition to periodic changes, the IFSP must be reviewed every six months; at this time, the Parents and Service Coordinator review the progress toward each IFSP outcome.  The Service Coordinator facilitates this process.

Additionally, once a Child has been in the program for a year, a new IFSP will be developed from a new evaluation.

EDIS Forms

About the Transition

Within Early Intervention, a Transition occurs anytime a Child and Family formally leave the program.  A transition often represents a significant life event or milestone for the Family.  Because of this, EDIS engages with Families to support their transition beyond EDIS and into another service or program.


Transitions can take many forms.  Some transitions are Child-focused, others are based on Family circumstances, and others may include a combination of both.  A transition may happen because a Child is approaching three years (Early Intervention Services are for Children from birth to three years.) or because a Child no longer qualifies for services.  A transition may also occur when a Family experiences a permanent change of station (PCS), moves onto or off post, or even when the Family leaves the Military.

How EDIS Helps with Transition

EDIS may assist the Family during the transition process in various ways.  A common transition happens when the Child approaches age three and may continue to require some level of support.  The Child may be eligible for Department of Defense Education Activity (DODEA) Preschool Services for Children with Disabilities (PSCD) or Special Education in the Public Schools.  Since the special education services the schools provide differ from those in early intervention, Parents are encouraged to participate actively in the school transition process.  Six months before the Child turns three, the Service Coordinator begins preparing the Family for the transition by scheduling family visits with the school personnel and arranging any necessary evaluations or updates.  With the Family's permission, this information will be shared with the school to help determine the Child's eligibility status for school services and, if eligible, to help develop the Child's IEP.

EDIS can help the Family understand the school's eligibility criteria, learn about what the services might look like, and discuss the differences between the EDIS IFSP and the school's Individualized Education Program (IEP).  EDIS may also help identify the points of contact for the local school program, ensure the Family has the Individualized Family Service Plan document to share with the school, and assist the Family in closing any loops on any referrals that may have been made (e.g., audiology).  EDIS may even attend a school meeting – if that is something the Family would find beneficial.

When a family relocates to another military assignment, transition activities could involve finding early intervention services at the new location.  When a child no longer qualifies for services, EDIS can help the family identify possible follow-up support services (e.g., movement classes, group childcare, etc.).

EDIS Forms