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What Is Early Intervention?

Credits Early intervention applies to children of school age or younger who are discovered to have or be at risk of developing a handicapping condition or other special need that may affect their development. Early intervention consists in the provision of services such children and their families for the purpose of lessening the effects of the condition. Early intervention can be remedial or preventive in nature--remediating existing developmental problems or preventing their occurrence. Early intervention may focus on the child alone or on the child and the family together. Early intervention programs may be center-based, homebased, hospital-based, or a combination. Services range from identification--that is, hospital or school screening and referral services-to diagnostic and direct intervention programs. Early intervention may begin at any time between birth and school age; however, there are many reasons for it to begin as early as possible. Back to the Table of Contents

Source
U.S. Department Of Education

Contents
Why Intervene Early? Is Early Intervention Really Effective? Is Early Intervention Cost Effective? Are There Critical Features To Include In Early Intervention? For More Information

Why Intervene Early?


There are three primary reasons for intervening early with an exceptional child: to enhance the child's development, to provide support and assistance to the family, and to maximize the child's and family's benefit to society. Child development research has established that the rate of human learning and development is most rapid in the preschool years. Timing of intervention becomes particularly important when a child runs the risk of missing an opportunity to learn during a state of maximum readiness. If the most teachable moments or stages of greatest readiness are not taken advantage of, a child may have difficulty learning a particular skill at a later time. Karnes and Lee (1978) have noted that "only through early identification and appropriate programming can children develop their potential" (p. 1).

Early intervention services also have a significant impact on the parents and siblings of an exceptional infant or young child. The family of a Forums young exceptional child often feels disappointment, social isolation, Education and added stress, frustration, and helplessness. The compounded stress of the presence of an exceptional child may affect the family's well-being and Kids

interfere with the child's development. Families of handicapped children Related Articl are found to experience increased instances of divorce and suicide, and the handicapped child is more likely to be abused than is a es A Parent's Guide to Accessing Programs for Infants, Toddlers, and A third reason for intervening early is that society will reap maximum Preschoolers benefits. The child's increased developmental and educational gains and with decreased dependence upon social institutions, the family's increased Disabilities ability to cope with the presence of an exceptional child, and perhaps the child's increased eligibility for employment, all provide economic as well as social benefits. Back to the Table of Contents nonhandicapped child. Early intervention can result in parents having improved attitudes about themselves and their child, improved information and skills for teaching their child, and more release time for leisure and employment. Parents of gifted preschoolers also need early services so that they may better provide the supportive and nourishing environment needed by the child.

Is Early Intervention Really Effective?


After nearly 50 years of research, there is evidence--both quantitative (data-based) and qualitative (reports of parents and teachers)--that early intervention increases the developmental and educational gains for the child, improves the functioning of the family, and reaps long-term benefits for society. Early intervention has been shown to result in the child: (a) needing fewer special education and other habilitative services later in life; (b) being retained in grade less often; and (c) in some cases being indistinguishable from nonhandicapped classmates years after intervention. Disadvantaged and gifted preschool-aged children benefit from early intervention as well. Longitudinal data on disadvantaged children who had participated in the Ypsilanti Perry Preschool Project showed that they had maintained significant gains at age 19 (Berrueta-Clement, Schweinhart, Barnett, Epstein, Weikart, 1984). These children were more committed to schooling and more of them finished high school and went on to postsecondary programs and employment than children who did not attend preschool. They scored higher on reading, arithmetic, and language achievement tests at all grade levels; showed a 50% reduction in the need for special education services through the end of high school; and showed fewer anti-social or delinquent behaviors outside of school. Karnes (1983) asserts that underachievement in the gifted child may be prevented by

early identification and appropriate programming. Back to the Table of Contents

Is Early Intervention Cost Effective?


The available data emphasize the long-term cost effectiveness of early intervention. The highly specialized, comprehensive services necessary to produce the desired developmental gains are often, on a short-term basis, more costly than traditional school-aged service delivery models. However, there are significant examples of long-term cost savings that result from such early intervention programs.

A longitudinal study of children who had participated in the Perry Preschool Project (Schweinhart and Weikart, 1980) found that when schools invest about $3,000 for 1 year of preschool education for a child, they immediately begin to recover their investment through savings in special education services. Benefits included $668 from the mother's released time while the child attended preschool; $3,353 saved by the public schools because children with preschool education had fewer years in grades; and $10,798 n projected lifetime earnings for the child. Wood (1981) calculated the total cumulative costs to age 18 of special education services to child beginning intervention at: (a) birth ; (b) age 2; (c) age 6; and (d) at age 6 with no eventual movement to regular education. She found that the total costs were actually less if begun at birth! Total cost of special services begun at birth was $37,273 and total cost if begun at age 6 was between $46,816 and $53,340. The cost is less when intervention is earlier because of the remediation and prevention of developmental problems which would have required special services later in life. A 3-year follow-up in Tennessee showed that for every dollar spent on early treatment, $7.00 in savings were realized within 36 months. This savings resulted from deferral or special class placement and institutionalization of severe behavior disordered children (Snider, Sullivan, and Manning, 1974). A recent evaluation of Colorado's state-wide early intervention services reports a cost savings of $4.00 for every dollar spent within a 3-year period (McNulty, Smith, and Soper, 1983).

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Are There Critical Features To Include In Early Intervention?


While there have been too few attempts to determine critical features of effective early intervention programs, there are a few factors which are present in most studies that report the greatest effectiveness. These program features include: (a) the age of the child at the time of intervention; (b) parent involvement; and (c) the intensity and/or the amount of structure of the program model.

Many studies and literature reviews report that the earlier the intervention, the more effective it is. With intervention at birth or soon after the diagnosis of a disability or high risk factors, the developmental gains are greater and the likelihood of developing problems is reduced (Cooper, 1981; Garland, Stone, Swanson, and Woodruff, 1981; Maisto and German, 1979; Strain, Young, and Horowitz, 1981). The involvement of parents in their child's treatment is also important. The data show that parents of both handicapped and gifted preschool-aged children need the support and skills necessary to cope with their child's special needs. Outcomes of family intervention include: (a) the parent's ability to implement the child's program at home; and (b) reduced stress that facilitates the health of the family. Both of these factors appear to play an important role in the success of the program with the child (Beckman-Bell, 1981; Cooper, 1981; Garland and others, 1981; Karnes, 1983; Lovaas and Koegel, 1973; Shonkoff and HauserCram, 1987). Certain "structural" features are also related to the effectiveness of early intervention, regardless of the curriculum model employed. Successful programs are reported to be more highly structured than less successful ones (Shonkoff and Hauser-Cram, 1987; Strain and Odom, in press). That is, maximum benefits are reported in programs that: (a) clearly specify and frequently monitor child and family behavior objectives; (b) precisely identify teacher behaviors and activities that are to be used in each lesson; (c) utilize task analysis procedures; and (d) regularly use child assessment and progress data to modify instruction. In addition to structure, the intensity of the services, particularly for severely disordered children, appears to affect outcomes. Individualizing instruction and services to meet child needs also is

reported to increase effectiveness. This does not necessarily mean one-to-one instruction. Rather, group activities are structured to reflect the instructional needs of each child. Back to the Table of Contents

For More Information


Beckman-Bell, P. "Needs of Parents with Developmentally Disabled Children." In A National Review Project Of Child Development Services: A State-Of-The-Art Series, edited by R. Wiegerink and J. M. Bartel. Chapel Hill, NC: University of North Carolina, Frank Porter Graham Child Development Center, l981. Berrueta-Clement, J. R., and others. Changed Lives: The Effects Of The Perry Preschool Project On Youths Through Age 19. Ypsilanti, MI: High/Scope Educational Research Foundation, 1984. Cooper, J. H. An Early Childhood Special Education Primer. Chapel Hill, NC: Technical Assistance Development System (TADS), 1981. Garland, C., N. W. Stone, J. Swanson, and G. Woodruff, eds. Early Intervention For Children With Special Needs And Their Families: Findings And Recommendations. Westar Series Paper No. 11. Seattle, WA: University of Washington, 1981. ED 207 278. Karnes, M. B., ed. The Undeserved: Our Young Gifted Children. Reston, VA: The Council for Exceptional Children, 1983. Karnes, M. B., and R. C. Lee. Early Childhood. Reston, VA: The Council for Exceptional Children. Lovaas, O. I. and R. L. Koegel "Behavior Modification with Autistic Children." In M. C. Thoresen ed., Behavior Modification In Education. Chicago: University of Chicago Press, 1973. Maisto, A. A., and M. L. German. "Variables Related to Progress in a Parent-Infant Training Program for High-Risk Infants." Journal Of Pediatric Psychology 4 (1979): 409-419. McNulty, B., D. B. Smith, and E. W. Soper. Effectiveness Of Early Special Education For Handicapped Children. Colorado Department of Education, 1983. Schweinhart, L. J., and D. P. Weikart. Young Children Grow UP: The 5

Effects Of The Perry Preschool Program On Youths Through AGe 19. Ypsilanti, MI: High/Scope Educational Research Foundation. 1980. Shonkoff, J. P. and P. Hauser-Cram. "Early Intervention for Disabled Infants and Their Families: A Quantitative Analysis." Pediatrics 80 (1987): 650-658. Snider, J., W. Sullivan, and D. Manning. "Industrial Engineering Participation in a Special Education Program." Tennessee Engineer 1 (1974): 21-23. Strain, P. S., and S. Odom. "Innovations in the Education of Preschool Children with Severe Handicaps." In R. H. Horner, L. M. Voeltz, and H. B. Fredericks, eds., Education Of Learners With Severe Handicaps: Exemplary Service Strategies. (In press). Strain, P. S., C. C. Young, and J. Horowitz. "Generalized Behavior Change During Oppositional Child Training: An Examination of Child and Family Demographic Variables." Behavior Modification 1 (1981): 15-26. Wood, M. E. "Costs of Intervention Programs." In C. Garland and others, eds., Early Intervention For Children With Special Needs And Their Families: Findings And Recommendations. Westar Series Paper No. 11. Seattle, WA: University of Washington, 1981. ED 207 278.

Credits
This publication was prepared with funding from the Office of Educational Research and Improvement, U.S. Department of Education, under OERI contract. The opinions expressed in this report do not necessarily reflect the positions or policies of OERI or the Department of Education. Back to the Table of Contents
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Overview of Early Intervention

Broadly speaking, early intervention services are specialized health, educational, and therapeutic services designed to meet the needs of infants and toddlers, from birth through age two, who have a developmental delay or disability, and their families. At the discretion of each State, services can also be provided to children who are considered to be at-risk of developing substantial delays if services are not provided. Sometimes it is known from the moment a child is born that early intervention services will be essential in helping the child grow and develop. Often this is so for children who are diagnosed at birth with a specific condition or who experience significant prematurely, very low birth weight, illness, or surgery soon after being born. Even before heading home from the hospital, this childs parents may be given a referral to their local early intervention office. Some children have a relatively routine entry into the world, but may develop more slowly than others, experience set backs, or develop in ways that seem very different from other children. For these children, a visit with a developmental pediatrician and a thorough evaluation may lead to an early intervention referral, as well. However a child comes to be referred, assessed, and determined eligibleearly intervention services provide vital support so that children with developmental needs can thrive and grow.

What areas of child development is Early Intervention services designed to address?


In a nutshell, early intervention is concerned with all the basic and brand new skills that babies typically develop during the first three years of life, such as: physical (reaching, rolling, crawling, and walking)

cognitive (thinking, learning, solving problems); communication (talking, listening, understanding); social/emotional (playing, feeling secure and happy); or, self-help (eating, dressing).

What if I have a Concern?


My child seems to be developing much slower than other children. Would he/she be eligible for early intervention services? It is possible that your child may be eligible for early intervention, but more investigation is necessary to determine that. If you think that your child is not developing at the same pace or in the same way as most children his or her age, it is often a good idea to talk first to your childs pediatrician. Explain your concerns. Tell the doctor what you have observed with your child. Your child may have a disability or what is known as a developmental delay, or he or she may be at risk of having a disability or delay.

Developmental delay is a term that means an infant or child is developing slower than normal in one or more areas (Anderson, Chitwood, & Hayden, 1997). For example, he or she may not be sitting up (or walking or talking) when most children of that age are. The term at risk means that a childs development may be delayed unless he or she receives early intervention services. So, if you are concerned about your childs development, you will need to have your child evaluated to find out if he or she is eligible for early intervention services. This evaluation is provided at no cost to you. There are many people who can help you with this.

Where do I go for help?


There are a number of ways you can find help for your child. Since you are reading this article, we recommend that you go to the NICHCY State Specific Resources page, select your state, select "Early Intervention Program" located in the right navigation bar entitled Popular Searches. There, we have listed the main contact number for early intervention services in your state. Call the agency listed. Explain that you want to find out about early intervention services for your child. Ask for the name of a contact person in your area. If you dont have a State Resource Sheet for your state, visit our Web site at http://www.nichcy.org/Pages/StateSpecificInfo.aspx. All State Resource Sheets are available there. You can also call NICHCY at 1.800.695.0285 and ask one of our information specialists to give you the number for early intervention services in your state. How else might you find out about early intervention services in your community? Here are two ways: Ask your childs pediatrician to put you in touch with the early intervention system in your community or region; Contact the Pediatrics branch in a local hospital and ask where you should call to find out about early intervention services in your area. It is very important to write down the names and phone numbers of everyone you talk to. You can use the Parent's Record-Keeping Worksheet found further down on this page. Having this information available will be helpful to you later on. Back to top

What do I say to the early intervention contact person?


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Explain that you are concerned about your childs development. Say that you think your child may need early intervention services. Explain that you would like to have your child evaluated under IDEA. Write down any information the contact person gives you. The person may refer you to what is known as Child Find. One of Child Finds purposes is to identify children who need early intervention services. Child Find operates in every state and conducts screenings to identify children who may need early intervention services. These screenings are provided free of charge. Each state has one agency that is in charge of the early intervention system for infants and toddlers with special needs. This agency is known as the lead agency. It may be the state education agency or another agency, such as the health department. Each state decides which agency will serve as the lead agency. The agency listed on the NICHCY State Resource Sheet under the heading Programs for Infants and Toddlers: Birth Through 2 is your states lead agency.

What Happens Next?


Once you are in contact with the early intervention system, the system will assign someone to work with you and your child through the evaluation and assessment process. This person will be your temporary service coordinator. He or she should have a background in early childhood development and ways to help young children who may have developmental delays. The service coordinator should also know the policies for early intervention programs and services in your state. The early intervention system will need to determine if your child is eligible for early intervention services. To do this, the staff will set up and carry out a multidisciplinary evaluation and assessment of your child. Read on for more information about this process.

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What is a Multidisciplinary evaluation and Assessment?


IDEA requires that your child receive a timely, comprehensive, multidisciplinary evaluation and assessment. The purposes of the evaluation and assessment are to find out:

the nature of your childs strengths, delays, or difficulties, and whether or not your child is eligible for early intervention services.

Multidisciplinary means that the evaluation group is made up of qualified people who have different areas of training and experience. Together, they know about childrens speech and language skills, physical abilities, hearing and vision, and other important areas of development. They know how to work with children, even very young ones, to discover if a child has a problem or is developing within normal ranges. Group members may evaluate your child together or individually. Evaluation refers to the procedures used by these professionals to find out if your child is eligible for early intervention services. As part of the evaluation, the team will observe your child, ask your child to do things, talk to you and your child, and use other methods to gather information. These procedures will help the team find out how your child functions in five areas of development: cognitive development, physical development, communication, social-emotional development, and adaptive development. Following your childs evaluation, you and a team of professionals will meet and review all of the data, results, and reports. The people on the team will talk with you about whether your child meets the criteria under IDEA and State policy for having a developmental delay, a diagnosed physical or mental condition, or being at risk for having a substantial delay. If so, your child is generally found to be eligible for services. If found eligible, he or she will then be assessed. Assessment refers to the procedures used throughout the time your child is in early intervention. The purposes of these ongoing procedures are to: identify your childs unique strengths and needs, and determine what services are necessary to meet those needs. With your consent, your familys needs will also be identified. This process, which is family-directed, is intended to identify the resources, priorities, and concerns of your family. It also identifies the supports and services you may need to enhance your familys capacity to meet your childs developmental needs. The family assessment is usually conducted through an interview with you, the parents. When conducting the evaluation and assessment, team members may get information from some or all of the following:

Doctors reports;

Results from developmental tests and performance assessments given to your child; Your childs medical and developmental history; Direct observations and feedback from all members of the multidisciplinary team, including you, the parents; Interviews with you and other family members or caretakers; and Any other important observations, records, and/or reports about your child.

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Who pays for the evaluation and Assessment?


It depends on your states policies or rules. Ask your local contact person or service coordinator about this. However, evaluations and assessments must be done by qualified personnel. As was said above, a multidisciplinary group of professionals will evaluate your child. The group may include a psychologist or social worker, an early interventionist or special educator, and an occupational or physical therapist. All assessments must be performed in your childs native language.
Who pays for the evaluation and Assessment? Under IDEA, evaluations and assessments are provided at no cost to parents. They are funded by state and federal monies.

Who is eligible for services?


Under the IDEA, infants and toddlers with disabilities are defined as children from birth through age two who need early intervention services because they are experiencing developmental delays, as measured by appropriate diagnostic instruments and procedures, in one or more of the following areas:

cognitive development. physical development, including vision and hearing. communication development. social or emotional development. adaptive development; or

...have a diagnosed physical or mental condition that has a high probability of resulting in developmental delay. The term may also include, if a state chooses, children from birth through age two who are at risk of having substantial developmental delays if early intervention services are not provided. (34 Code of Federal Regulations 303.16) My child has been found eligible for services. Whats next? If your child and family are found eligible, you and a team will meet to develop a written plan for providing early intervention services to your child and, as necessary, to your family. This plan is called the Individualized Family Service Plan, or IFSP. It is a very important document, and you, as parents, are important members of the team that develops it

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What is an Individualized Family Service Plan, or IFSP?


The IFSP is a written document that, among other things, outlines the early intervention services that your child and family will receive. One guiding principal of the IFSP is that the family is a childs greatest resource, that a young childs needs are closely tied to the needs of his or her family. 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. Involvement of other team members will depend on what the child needs. These other team members could come from several agencies and may include medical people, therapists, child development specialists, social workers, and others. Your childs IFSP must include the following:

your childs present physical, cognitive, communication, social/emotional, and adaptive development levels and needs; family information (with your agreement), including the resources, priorities, and concerns of you, as parents, and other family members closely involved with the child;

the major results or outcomes expected to be achieved for your child and family; the specific services your child will be receiving; where in the natural environment (e.g., home, community) the services will be provided (if the services will not be provided in the natural environment, the IFSP must include a statement justifying why not);

when and where your son or daughter will receive services;

the number of days or sessions he or she will receive each service and how long each session will last; whether the service will be provided on a one-on-one or group basis; who will pay for the services;

the name of the service coordinator overseeing the implementation of the IFSP; and the steps to be taken to support your childs transition out of early intervention and into another program when the time comes.

The IFSP may also identify services your family may be interested in, such as financial information or information about raising a child with a disability. The IFSP is reviewed every six months and is updated at least once a year. The IFSP must be fully explained to you, the parents, and your suggestions must be considered. You must give written consent before services can start. If you do not give your consent in writing, your child will not receive services. Each state has specific guidelines for the IFSP. Your service coordinator can explain what the IFSP guidelines are in your state 12

Whats included in early intervention services?


Under IDEA, early intervention services must include a multidisciplinary evaluation and assessment, a written Individualized Family Service Plan, service coordination, and specific services designed to meet the unique developmental needs of the child and family. Early intervention services may be simple or complex depending on the childs needs. They can range from prescribing glasses for a two-year-old to developing a comprehensive approach with a variety of services and special instruction for a child, including home visits, counseling, and training for his or her family. Depending on your childs needs, his or her early intervention services may include:

family training, counseling, and home visits; special instruction;

speech-language pathology services (sometimes referred to as speech therapy); audiology services (hearing impairment services); occupational therapy; physical therapy;

psychological services; medical services (only for diagnostic or evaluation purposes); health services needed to enable your child to benefit from the other services; social work services; assistive technology devices and services; transportation; nutrition services; and service coordination services.

How are early intervention services delivered? Early intervention services may be delivered in a variety of ways and in different places. Sometimes services are provided in the childs home with the family receiving additional training. Services may also be provided in other settings, such as a clinic, a neighborhood daycare center, hospital, or the local health department. To the maximum extent appropriate, the services are to be provided in natural environments or settings. Natural environments, broadly speaking, are where the child lives, learns, and plays. Services are provided by qualified personnel and may be offered through a public or private agency. Will I have to pay for services? Whether or not you, as parents, will have to pay for any services for your child depends on the policies of your state. Under IDEA, the following services must be

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provided at no cost to families: Child Find services; evaluations and assessments; the development and review of the Individualized Family Service Plan; and service coordination. Depending on your states policies, you may have to pay for certain other services. You may be charged a sliding-scale fee, meaning the fees are based on what you earn. Check with the contact person in your area or state. Some services may be covered by your health insurance, by Medicaid, or by Indian Health Services. Every effort is made to provide services to all infants and toddlers who need help, regardless of family income. Services cannot be denied to a child just because his or her family is not able to pay for them.

Parent's Record-Keeping Worksheet


The sample record-keeping worksheet below can help you start a file of information about your child. As you contact different people and places, it's a good idea to keep records of people you've talked with and what was said. As time goes by, you will want to add other information to your file, such as: Letters and notes (from doctors, therapists, etc.); Medical records and reports; Results of tests and evaluations; Notes from meetings about your child; Therapist(s') reports; IFSP and IEP records; Your child's developmental history, including personal notes or diaries on your child's development; Records of shots and vaccinations; and Family medical histories. Make sure you get copies of all written information about your child (records, reports, etc.). This will help you become an important coordinator of services and a better advocate for your child. Remember, as time goes on, you'll probably have more information to keep track of, so it's a good idea to keep it together in one place.

Transition to Preschool from Early Intervention


Families of children transitioning from 'birth to three' early intervention center programs, or home based services, to preschool programs, may find several options available in their communities. Many early intervention centers offer transition planning services and evaluations within half a year of a child's third birthday. School districts may have transition information available, and will work with your child's early intervention professionals to plan appropriate support and placement in preschool classes. Support services should be provided to eligible children who enroll in a mainstream preschool or whose families choose to keep them at home until kindergarten, or choose homeschooling.

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Children who have grown up in mainstream parks department programs or Mommy and Me classes while receiving therapy services through private providers and/or early intervention programs often must investigate their local school district policies to continue receiving services after a child turns three years old. Some families chose to invite early intervention professionals familiar with their child to participate in transition IEP planning meetings at the school district, and others feel the need to bring a professional advocate, or a trusted friend who will take notes and be available to talk with later. Some school districts have policies about recording meetings, visiting classrooms, and other activities that parents may wish to do. Choosing a preschool for a child with a developmental disability, chronic health condition, specific delays or other special needs is much the same activity as choosing a preschool for any other child. In addition to learning about the services that can be provided that speak to a child's diagnosis, learning style or other challenges, parents should feel free to ask questions about ordinary concerns and their special preferences. Just as some mainstream preschools offer a focus on music, art, foriegn language or other interests, some special education preschools have classrooms known for sign language, or signing and speech, sometimes known as 'total communication,' positive behavior management, inclusion, or other specialties. Many parents prefer that their children start out with the children from their neighborhood, in mainstream programs, and attend preschool as well as kindergarten and elementary school with classmates whose families are friends or neighbors. Often, a preschool that is highly regarded for ordinary children will offer a child with special needs a welcoming and encouraging environment with many opportunities and adequate support. Parents who search out these gems will also be the parents who know the best teachers to request when their children turn five and go to kindergarten, which will often be the best inclusive classrooms for all our sons and daughters. Teachers in special education as well as mainstream preschools often appreciate being loaned books that parents have found helpful in explaining strategies that work best for their son or daughter.

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Although they may have had previous experience, education or training in teaching or supporting children with a specific diagnosis or learning style, each child is different no matter what diagnosis they may have in common with a previous student. Many strategies developed to encourage and support children with a developmental disability or other learning challenge are quite effective with their mainstream classmates. Although the transition process might be complicated, frustrating or confusing, remember that these milestones are events to be celebrated, and every child should be recognized and congratulated for reaching each one. Families of mainstream children often have the same concerns and hopes as we do. Many school districts invite preschool children to a 'kindergarten roundup' that may be scheduled a full year before children will attend their first day, and some have a day or two scheduled in the early Spring of the same year when preschoolers visit kindergarten classrooms and meet teachers.

Children with disabilities and their families should be welcome at any pre-kindergarten orientation programs, so you may wish to ask about activities that may be planned even during your child's first year of preschool. Our sons and daughters can do so much with the opportunities we find for them, every effort we make can result in something that will amaze and delight us, as well as the teachers and other team members who take the time to plan these transitions for the benefit of each child.

REFERRAL, ASSESSMENT, & IEP PROCESS


1. The multidisciplinary evaluation team A. Function and Purpose - A team approach (many values, perspectives, ideas) provides greater accuracy in the decision making process of identifying the student's academic, social, and vocational needs and in developing an individualized educational program to meet those needs. The team functions to support students needing special education and related services, and to help keep students in the regular educational settings. Membership requires a shared responsibility and open communication in the form of collaboration and not just coordination.

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Membership may vary, but regular, special, and vocational education are represented by teachers, administrators, and appropriate specialists serving in selected roles such as therapists, counselors, psychologists, bilingual teachers, and curriculum specialists. Parents, students, student's peers, and others can also serve on the team. Continuity of team membership is important and the team should be school based with some freedom to adjust membership in response to the perceived needs of referred pupils. Major functions of the team include: 1. Determining if the student is a student with a disability and requires special education services; 2. Planning and evaluating educational experiences of students who have been identified as in need of special education services; and 3. Developing a plan of action that meets the educational, social, and vocational needs of students with disabilities without placing them in special education and, if necessary, identifying the student's unique needs in order to develop an individualized educational program. Basic multidisciplinary team activities include: 1. Receiving and evaluating initial referrals of students who are experiencing difficulty in the regular class or who are in need of special education on entering the educational system. 2. Developing intervention strategies that may be used in the regular class for those students who will benefit most from regular education with provided modifications. 3. Initiating the assessment process for students who are suspected of having a disability. 4. Reviewing student assessment data and existing information. 5. Developing an individualized educational program for the student. 6. Deciding on the appropriate placement for the student. 7. Acting as a support system for educators who serve students with special needs. Note: Exact purposes of the multidisciplinary team may vary among local school districts. Some teams work only during the prereferral stage attempting to keep the student in the regular classroom (S-Team), some teams work on both prereferral (informal stage) and referral (formal stage) (S-Team), and some teams work on formal assessment, IEP development, and placement (IEP Team). B. Multidisciplinary evaluation team members

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(a) Administrators - The site administrator, principal or assistant principal is an essential member of the team. Why? The administrator should be aware of specific resources and expertise within the school building. In addition, administrators are qualified to supervise the program and can commit necessary resources. Specific responsibilities include: Completing administrative arrangements for team meetings, such as scheduling the date, time, and place for meetings. Preparing an organized agenda for the meeting. Identifying critical personnel and inviting them to the meeting. Inviting parents to the meeting. Chairing the meeting or appointing a designee. Encouraging each team member to participate actively during the meeting. Ensuring that each person knows what action the team recommends, who is responsible for implementation, and what resources are needed to support implementation adequately. Communicating administrative support of the team to all members of the school community. Promoting and committing resources to secure needed technical assistance. Identifying needed topics for in-service and developmental training. (b) Regular education teachers - The regular education teacher and the special education teacher should have a shared and equal responsibility to all the children in the classroom. Typically, the regular education teacher's role is devoted to the presentation of subject matter in the classroom, and is ultimately in charge of instruction in the classroom. However, the role of the regular education teacher is expanded to include: helping to develop, review, and revise the IEP determining appropriate positive behavioral interventions and strategies for the student helping to determine supplementary aids and services, and program modifications for the student

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identifying supports that school personnel need to help the student progress in the general curriculum The teacher typically assumes responsibility for maintaining communication between the school and home. The teacher keeps parents informed about the student's educational achievement and reports grades and explains the educational program. (c) Special education teachers - the special educator's role is that of individualizing, diagnosing, and modifying curriculum. Historically, the special education teacher taught students with disabilities in self-contained classes. The role of the special education teacher in inclusive schools has shifted to include: 1. providing assessment and instructional planning for the student in the mainstream setting; 2. conducting remedial and tutorial instruction; 3. providing consultation to the regular class teacher (team teaching); 4. participating in the school's assessment and eligibility teams; and, 5. searching for ways of integrating special education students into all aspects of the schools program including extracurricular activities. As a member of the multidisciplinary team, the special education teacher can offer suggestions for modifying instruction, consulting with the regular education teacher, identifying resources, alternative learning materials, and assistive devices. Working together, the special education and regular education teachers can help parents in the following ways: Learn as much as possible about the student from the parents. Provide information regarding the student's disability as well as the rights of the parents in the IEP process and their role as team members. Explain the process and terms of the eligibility and IEP meeting (many school districts have parent manuals or brochures). Help the parents during the IEP process making sure their ideas, concerns, and views are expressed and heard. Provide parents with narrative reports and suggestions on how to work with their child at home. Assist the student and the student's parents in the planning of the student's future after leaving school (transition services).

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Act as the student's advocate, i.e., represent the interests, preferences, and rights of the student or parents. (e) Students - Students should be invited and taught to be active participants in their own IEP process. They should be taught self-determination skills and how to set their own life goals and objectives. (f) School psychologists - The school psychologist may assume the following responsibilities: Complete a thorough assessment of the child to determine eligibility for special programs and services. Analyze and interpret assessment data for parents and other team members. Participate in identification of curricula modifications and instructional interventions appropriate to the identified needs of the pupil. Conduct follow-up observations to determine the success of modifications and interventions. (g) Related Services personnel - Related support people (to assist the regular education and special education teachers) include: Speech-language therapists Occupational therapists Physical therapists Vision specialists Medical personnel, such as nurses and dietitians Social workers Counselors and mental health personnel Adaptive physical education teachers Vocational specialists Others C. Rights of parents and students - Students with disabilities and their parents are guaranteed due process rights in determining special education eligibility, evaluation of their child, placement in the LRE, and provision of a free appropriate public education (FAPE). A copy of the procedural safeguards must be made available to the parents of a child with a disability upon: (a) initial referral for an evaluation; (b) upon each notification of an individualized education program meeting; (c) upon reevaluation of the child; and (d) upon registration of a complaint.

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Procedural safeguards include: independent educational evaluation prior written notice parental consent access to educational records opportunity to present complaints the childs placement during pendency of due process proceedings procedures for students who are subject to placement in an interim alternative educational setting; requirements for unilateral placement by parents of children in private schools at public expense; mediation (a system in which parents and schools may voluntarily participate); due process hearings, including requirements for disclosure of evaluation results and recommendations; state-level appeals civil actions; and attorneys fees Note: Policies and procedures on such things as time lines for assessment, eligibility determination and placement, composition of educational teams, procedures for parental notice and consent, and the process for examination of student records may vary from state to state. It is important to know Tennessees regulations. 2. Functional Phases of the Team

Prereferral: The first step


Prereferral is not mandated, it is suggested by experts. The primary purpose of the prereferral process is to reduce inappropriate referral of students for formal assessment, thereby enabling students to remain in regular class settings and avoid the possible mislabeling of students as having a disability. Note: teachers typically and routinely conduct Preferral activities. That is, the teacher modifies instruction, learning environment, instructional day, learner tasks, or manages classroom behavior. Several positive effects of prereferral: 1. A decrease in the number of students traditionally referred for special education services. 2. A decrease in the cost of funding for special education programs.

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3. Improved instructional outcomes resulting from the prereferral procedures. 4. Improved school climate. 5. Reduces the delay between referral and intervention (shortens the diagnostic process). 6. Uses existing, current student data or information. 7. It relies on the expertise of classroom teachers who know the students best. 8. Prereferral affords direct benefit to the students with mild disabilities by increasing their opportunities in mainstream settings, improving their chances of success with the regular curriculum, and helping them avoid the stigma that is often associated with a disability label.

Phase I: The initial referral


If a student continues to have difficulty after prereferral activities, referral to the multidisciplinary team for formal assessment is made. This begins the formal special education process. The initial referral may come from sources other than the prereferral team. Classroom teachers, parents or guardians or other professionals may refer a student for assessment. Students problem is identified. The regular education teacher, typically, will make the referral for special assistance. Accordingly, the regular education teacher identifies a learning problem and then collects as much information as possible relative to the student's specialized needs. The student's difficulties should be based on recorded observations. The teacher should make a clear statement of the students needs, (i.e., primary purpose of the request for assistance). The referral should include: A clear and concise description of the student's present level of functioning A brief summary of the student's learning strengths The students unique learning style A prioritized list of the student's learning needs A brief description of the student's social interactions with peers A description of the problem that is interfering with school success A summary of the interventions that have been tried -- what worked and what did not work

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After prior parental notice and consent have been given and an individual assessment is under way, the teacher should continue to observe the student in a variety of learning situations. A history of the student's problem can provide valuable information by describing the frequency with which the behavior occurs and under what conditions. It is recommended that teachers collect representative samples of the student's work, particularly if the student's problem is poor academic achievement.

Phase II: Team meeting


Typically, an administrator assumes responsibility for calling the team meeting, arranging for physical space for the meeting, setting the team agenda, and notifying all prospective participants. The team meets primarily to review the referral, clarify the problem, and determine the next step in the process (i.e., provide suggestions for instructional and/or behavioral modifications and return the student to the regular class or refer the student for special assessment).

Phase III: Assessment


When modifications of the program result in failed student performance and achievement, the team may refer the students to be evaluated to determine if the child is a child with a disability and requires special educational services. At this time, formal assessment of the student takes place. The law requires: 1. Written notice is given to all parents and guardians. 2. Parents must give written permission for the team to evaluate and place their child. 3. In conducting an evaluation, the local educational agency shall: A) use a variety of assessment tools and strategies to gather relevant functional and developmental information, including information provided by the parent, that may assist in determining whether the child is a child with a disability and the content of the childs individualized education program, including information related to enabling the child to be involved in and progress in the general curriculum or, for preschool children, to participate in appropriate activities; [Note that the emphasis is on gathering information that is instructionally relevant, i.e., information that can be used to determine the content of the IEP and to help the student progress in the general curriculum.] B) not use any single procedure as the sole criterion for determining whether a child is a child with a disability or determining an appropriate educational program for the child; and 23

C) use technically sound instruments that assess the relative contribution of cognitive and behavioral factors, in addition to physical or developmental factors. 4. In addition, the local educational agency shall ensure that: A) tests and other evaluation materials used to assess a child under this section are: (a) selected and administered so as not to be discriminatory on a racial or cultural basis; and (b) provided and administered in the childs native language or other mode of communication, unless it is clearly not feasible to do so; and B) any standardized tests that are given to the child (a) have been validated for the specific purpose for which they are used; (b) are administered by trained and knowledgeable personnel; and (c) are administered in accordance with any instructions provided by the producer of such tests; C) the student is assessed in all areas of suspected disability; and D) assessment tools and strategies provide relevant information that directly assists personnel in determining the educational needs of the child are provided. Upon completion of administration of tests and a review of other existing evaluation materials, the team determines whether the child is a child with a disability. A copy of the evaluation report and the documentation of determination of eligibility are then given to the parent. In summary, when parental permission for assessing the student is obtained, the assessment is conducted, results are analyzed and a report of findings is written. Based on this assessment, the multidisciplinary evaluation team determines eligibility for special education service.

Phase IV: IEP development


IEP Team - When the student is determined eligible for special education services; the IEP team meets (not necessarily the same multidisciplinary team) to develop an individualized education program (IEP). IEP team means a group of individuals comprised of: 1. The parents of the student; 2. At least one regular education teacher of the student, (if the student is or may be participating in the regular education environment); 3. At least one special education teacher, or where appropriate, at least one special education service provider of the student;

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4. A representative of the school district who is (a) qualified to provide or supervise the provision of special education; (b) knowledgeable about the general curriculum; and (c) knowledgeable about the availability of resources of the district. 5. An individual who can interpret the instructional implications of evaluation results (can be one on the other members of the IEP team); 6. At the discretion of the parent or the school district, others who have knowledge or special expertise regarding the child, including related services personnel, as appropriate; and 7. Where appropriate the student with the disability.

Required components of the IEP


1. A statement of the student's present level of educational performance; 2. A statement of measurable annual goals, including benchmarks or short-term objectives related to: (a) meeting the students needs that result from the childs disability to enable the student to be involved in and progress in the general curriculum; and (b) meeting each of the students other education needs that result from the students disability; 3. A statement of the specific special education and related services and supplementary aids and services to be provided to the student in order for the student to: (a) advance appropriately toward attaining the annual goals; (b) be involved and progress in the general curriculum and to participate in extracurricular and other nonacademic activities; and (c) be educated and participate with nondisabled students in the general curriculum and in extracurricular and other non-academic activities; 4. An explanation of the extent, if any, to which the child will not participate with nondisabled children in the regular class, in the general curriculum and in other activities (extracurricular and other nonacademic activities); 5. A statement of any individual modifications needed for the student to participate in state- and district-wide assessments and if the IEP team determines that the child will not participate in such assessments, a statement of why such assessments are not appropriate and how the child will be assessed; Tennessee currently requires that all students be assessed, either through the TCAP or TCAP-Alternative which is a portfolio assessment for the profoundly or severely disabled who cannot communicate via a written state assessment. The state anticipates that this number will be less than 2% statewide. 6. The projected dates for initiation of services and anticipated duration of the services;

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7. Beginning at age 14, a statement of the students transition service needs focusing on the students course of study (such as participation in advance-placement courses or vocational education programs); Beginning at age 16 (or younger if appropriate),a statement of needed transition services, including interagency responsibilities and linkages; Beginning at least one year before the child reaches age of majority under state law, a statement that the child has been informed of his or her rights that will transfer to the child on reaching age of majority; and 8. A statement of how the students progress toward the annual goals will be measured, and how parents will be regularly informed (by such means as report cards), at least as often as parents of nondisabled students are informed, of their nondisabled students progress toward goals, and the extent to which the progress is sufficient to enable the student to achieve the goals by the end of the year. (emphasis on general education ) Factors to Consider when Developing the IEP The IDEA Amendments of 1997 add specific factors that the IEP team must consider when developing a childs IEP. Most notably, the team must consider behavior issues and the specific communication needs of the child; if he or she is blind or visually impaired, of limited English proficiency, or deaf or hard of hearing. A. In general, when developing each childs IEP, the IEP Team shall consider (a) the strengths of the child and the concerns of the parents for enhancing the education of their child; and (b) the results of the initial evaluation or most recent evaluation of the child. B. Special Factors a) in the case of a child whose behavior impedes his or her learning or that of others, consider, when appropriate, strategies, including positive behavioral interventions, strategies, and supports to address that behavior; b) in the case of a child with limited English proficiency, consider the language needs of the child as such needs relate to the childs IEP; c) in the case of a child who is blind or visually impaired, provide for instruction in Braille and the use of Braille unless the IEP Team determines, after an evaluation of the childs reading and writing skills, needs, and appropriate reading and writing media, that instruction in Braille or the use of Braille is not appropriate for the child; d) consider the communication needs of the child, and in the case of a child who is deaf or hard of hearing, consider the childs language and communication needs, opportunities for direct communications with peers and professional personnel in the childs language and communication mode, academic level and full range of needs, including opportunities for direct instruction in the childs language and communication mode; and

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e) consider whether the child requires assistive devices and services. C. Role of the Regular Education Teacher The regular education teacher of the child, as a member of the IEP Team, shall, to the extent appropriate, participate in the development of the IEP of the child, including the determination of appropriate positive behavioral interventions, and strategies and the determination of supplementary aids and services, program modifications, and support for school personnel.

Review and revision of the IEP


Sevier County School System shall ensure that the IEP Team (a) reviews the childs IEP periodically, but not less than annually to determine whether the annual goals for the child are being achieved; and (b) revises the IEP as appropriate to address (I) any lack of expected progress toward the annual goals and in the general curriculum, where appropriate; (II) the results of any reevaluation; (III) information about the child provided to, or by, the parents; (IV) the childs anticipated needs; or (V) other matters. The regular education teacher of the child, as a member of the IEP Team, shall, to the extent appropriate, participate in the review and revision of the IEP of the child.

IEP - Purposes
1. To ensure professional accountability for providing appropriate educational services to individuals with disabilities. 2. To ensure an individualized educational program to meet the academic, social, and vocational needs of individuals with disabilities in the least restrictive environment. 3. To ensure parent participation 4. To ensure collaborative and open communication among all personnel working with an individual with a disability. Note: The IEP is a written agreement of resources, special education, and related services to be provided. It is also a vehicle for determining if a child is progressing toward the stated educational outcomes. The IEP represents a commitment of resources to the student and should reflect the best thinking of every member of the IEP Team. Phase V: Support in the mainstream IDEA mandates the placement of pupils with disabilities in settings with peers without disabilities to the maximum extent possible, and requires an explanation of why they are not in the regular education setting when

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excluded. The IEP team has the legally mandated responsibility to monitor the student's special education program. A monitoring plan should be built into the student's IEP.

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