EARLYINTERVENTIONSERVICES
Federal Authority:20U.S.C.1432(4),1435(a)(2),1436(a)(2),1436(d)(4)and(5);34C.F.R.,
Sections 303.13, 303.16,303.32, 303.442(d)(i)and 303.444
StateAuthority:27-10.5-702(7) and (17),C.R.S. (2014)
RULE12 CCR 2509-10
7.950 EARLYINTERVENTIONSERVICES
A.EarlyInterventionServices shall be:
1.Provided onlyafterthedevelopment of anIndividualized FamilyServicePlan and written parental consent is obtained forthoseservices identifiedin the Individualized FamilyServicePlan; and,
2.Provided tomeet thedevelopmental needs of an eligibleinfant ortoddler, and theneeds ofaparent orother caregivers, to achievetheoutcomes identified in the Individualized FamilyServicePlan; and,
3.Based onappropriatepeer-reviewed,evidence-based practices,tothe extent which is practical; and,
4.Relatedto functional outcomes and developmentallyappropriatepractices to support participation in everydayroutines, activities and places; and,
5.Provided byqualifiedproviders who meet thestatepersonnelstandards foreachearly intervention service;and,
6.Provided in aculturallyrelevantmanner, includinguseof an interpreter,ifneeded; and,
7.Provided inthenatural environments ofthe childand familyto themaximum extent appropriate.Ifthereis adeterminationthat an earlyintervention service cannot be provided in anatural environment, written justificationshall beprovided in the Individualized FamilyServicePlan; and,
8.Provided inphysical settings wherecommunity-based earlyintervention services are accessed thatmeet all fire, building, licensingand health regulations, as applicable.
B.Earlyinterventionservices shall includethe following:
1."Assistive TechnologyServices":
a.Meansthedirect selection, acquisition oruseofassistivetechnologydevices and includes:
1)Functional evaluationofthedevelopmental needs oftheinfant ortoddler in his orherusual environments; and,
2)Selection, acquisition,modification orcustomization and maintenanceof assistivetechnologydevices; and,
3)Coordinatingand usingothertherapies, interventions orservices with assistivetechnologydevices, such as those associated with existing intervention plans and programs; and,
4)Trainingortechnicalassistanceforprofessionals providingearly intervention services orotherindividualsidentified as providing earlyintervention services to, or areotherwisesubstantiallyinvolved in themajorlife functions of, aninfant ortoddleron theuseof assistivetechnologydevices; and,
5)Trainingortechnicalassistancefor an infant ortoddlerreceivingearly intervention services or, if appropriate, the child’s family; and,
6)Anyitem, pieceof equipment, orproduct system,whether acquired commerciallyofftheshelf, modified orcustomized,that is used to increase,maintain, orimprovethefunctional,developmental capabilities of an infant ortoddlerin his orherusual environments.
a)Thedevicemust beidentified in theIndividualized Family ServicePlan; and,
b)Priorto purchaseorleaseof anassistivetechnologydevice, an assessment shall be conducted byaqualifiedearly intervention providerto assurethat thedeviceis appropriate forthechild and family’sneeds.
b.Does notmean, adevicethat is primarilyintendedto treat amedical condition, to meet life-sustainingneeds, oramedical devicethat issurgically implanted,includinga cochlearimplant.Italso does not mean the optimization,maintenanceorthe replacement ofsuch adevice.
2."AudiologyServices":
a.Means, services fortheidentification of an infant ortoddlerwith an auditory impairment, usingat-riskcriteria and appropriate audiologicscreening techniques, and includes:
1)Loss and communicationfunctions, byuseof audiological evaluation procedures; and,
2)Auditorytraining,aural rehabilitation, speech readingand listening devices,orientation, and othertrainingto increasefunctional communication skills; and,
3)Thedetermination oftheneed forindividual amplification,including
selecting,fittingand dispensinganappropriatelisteningand vibrotactiledevice,and evaluatingthe effectiveness ofthedevice; and,
4)Referral formedical andotherservices necessaryforthehabilitation or rehabilitation of aninfant ortoddlerwith adisabilitywhich is an auditoryimpairment; and,
5)Familytraining, education, and support provided to assist aparent or other caregivers ofa child eligibleforservices inunderstandingthe specialneeds oftheinfant ortoddleras related to audiologyand aural rehabilitation services; and,
6)Theprovision ofservicesforprevention ofhearingloss.
b.Does notmean, therapeuticservicesrequired for an infant ortoddlerto recover frommedical procedures such as surgery, etc., orpre-surgerytherapeutic services requiredbyaphysician to preparea childforsurgeryand that are beyond thescopeofthe earlyinterventionservices identified inthe child’s Individualized FamilyServicePlan as beingneeded to meet the child’s developmental outcomes.
3."DevelopmentalInterventionServices", in thissectionoftherules, means developmental assessment andspecial instructionto address thefunctional developmental needs of an infant ortoddlerand includes:
a.Thedesign or adaptationoflearningenvironments, activities andmaterials to enhancedevelopmental and learningopportunitiesthat promotetheinfant’s ortoddler’s acquisition ofskills in avarietyofdevelopmental areas, includingcognitiveprocesses and socialinteraction; and,
b.Curriculumplanning, includingtheplanned interaction ofpersonnel, materials, and timeandspace, that leads to achievingtheoutcomes in the child’s Individualized FamilyServicePlan; and,
c.Workingwith the child to enhancethe child’sdevelopment; and,
d.Familytraining,education andsupportprovided toassist aparent orother caregiversin understandingthespecial needs ofthe child relatedto enhancingtheskill development ofthe child.
4."Health Services":
a.Meansservices byalicensed health careprofessional that enableaneligible infant ortoddlerto benefit fromotherallowable earlyintervention services and includes:
1)Assessment todeterminethehealth status and specialhealth careneeds
that will impact theprovision ofother earlyintervention services; and,
2)Services suchas clean intermittent catheterization,tracheostomycare, tube feeding, the changingofdressings or colostomybags,and other healthservices; and,
3)Consultationbyahealthcareprofessionalwithaparentorotherservice providerregarding theimpactoftheinfantortoddler’shealthstatus on theprovision ofother earlyintervention services.
b.Does notmean:
1)Services that are:
a)Purelymedicalin nature,such as hospitalization, orthe prescribingofmedicineorotherdrugs for anypurpose; or,
b)Surgical innature, such as cleft palatesurgeryorshuntingfor hydrocephalus; or,
c)Medicaldiagnosticprocedures, services that areprimarily intended totreat amedical condition;or,
d)Relatedto theimplementation, optimization,maintenance, or replacement ofamedical devicethat is surgicallyimplanted.
2)Devices necessarytocontrol ortreatamedicalcondition, orthat are medical orhealthservices routinelyrecommended forall infants and toddlers.
c.Nothingin this section ofthe ruleslimitsthe rightsof an infant ortoddlerwith a disability, that has asurgicallyimplanted device, to receivetheearly intervention services identified in the child’sIndividualized FamilyService Plan asbeingneeded to meetthe child’sdevelopmentaloutcomes.
d.Nothingin thissection ofthe rulesprevents the earlyinterventionservices provider fromroutinelycheckingthat eitherthehearingaid orthe external components ofasurgicallyimplanteddevice,such as a cochlearimplant, used byan infant ortoddler with adisabilityare functioningproperly.
5.“MedicalServices”means servicesprovided byalicensed physicianfordiagnosticor evaluation purposes, to determinea child’s developmental statusandneed for early intervention services.
6.“NursingServices”means:
a.Assessment ofhealth status forthepurposeofprovidingnursingcare, including
theidentification ofpatterns ofhuman responsetoactual orpotential health problems; and,
b.Nursingcareto prevent health problems, restoreorimprovefunctioning,and promotehealth and development; and,
c.Theadministration ofmedications,treatments,andregimens prescribed bya licensedphysician.
7."Nutrition Services"means development ofaplanto address thenutritionaland feeding needs ofan infant ortoddler related to his orherdevelopment, and includes:
a.Theassessment ofthenutritionalhistory, dietaryintake, bodymeasurements such as height and weight, and feedingstatus; and,
b.Consultation to develop,implement andmonitor appropriateplans to address the nutritional needs; and,
c.Referral to appropriate communityresources to carryout nutritional plans;and,
d.Familytraining,education andsupportprovided toassist aparent orother caregiversin understandingthespecial needs ofthe child relatedto nutrition and feedingand enhancingthe child’sdevelopment.
8."Occupational TherapyServices":
a.Means assessment and intervention serviceswith an emphasis on adaptiveskills, motor and sensorydevelopment,mobility, playand oral-motorfunctioning and includes:
1)Interventionstrategies toaddress thefunctional developmentalneeds, includingoralmotor functioningof an infant ortoddler, minimizing theimpact ofinitial or futureimpairment,and delayin development orloss of functional ability; and,
2)Consultation to adapt theenvironment to promotedevelopment, access and participation in everydayroutines, activities and places; and,
3)Theselection, designor fabrication ofassistive and orthoticdevices to promotemobilityorparticipation in everydayroutines, activities and places; and,
4)Familytraining, education, and support provided to assist aparent or other caregiversin understandingthespecial needs ofthe child as related to occupational therapystrategiesand enhancingthe child’s motordevelopment.
b.Does notincludetherapeuticservices requireddueto, or as part of, amedical
procedure, amedical intervention oran injurythat is expected toheal without along-term impact to child development and that arebeyond the scopeofthe earlyintervention services identified in the child’s Individualized FamilyServicePlan as beingneeded to meet the child’ developmental outcomes.
9."Physical TherapyServices":
a.Meansassessmentandinterventionserviceswithanemphasisonmobility, positioning,motordevelopment,andbothstrengthandenduranceand includes:
1)Interventionstrategies toaddress thefunctional developmentalneeds of an infant ortoddler; and,
2)Through individual orgroupservices, to obtain,interpret and integrate informationforprogram planningto prevent, alleviate, or compensateformovement dysfunction and related functional problems; and,
3)Thedesign or acquisitionof assistiveandorthoticdevices andeffective adaptation ofthe child’s environment topromotemobilityand participation in everydayroutines, activities and places, and minimizetheimpact ofinitial orfutureimpairment, delayin development orloss of functional ability;and,
4)Familytraining, education, and support provided to assist aparent or other caregiversin understandingthespecial needs ofthe child as related to physical therapystrategies and enhancingthe child’smotor development.
b.Does notincludetherapeuticservices requireddueto, or as part of, amedical procedure, amedical intervention oran injurythat is expected toheal without along-term impact to child development and that arebeyond the scopeofthe earlyintervention services identified in the child’s Individualized FamilyServicePlan as beingneeded to meet the child’s developmental outcomes.
10."PsychologicalServices"meansassessmentandinterventionservicesthataddressthe development,cognition,behaviorandsocialoremotionaldevelopmentofaninfant ortoddlerandincludes:
a.Theadministration ofpsychological anddevelopmental tests and other assessment procedures to identifythedevelopmental, cognitive, behavioral and social emotional status;
b.The acquisition,integration and interpretation oftest results,otherinformation about development and behavior and the familyand livingsituation related
to learning, social or emotional development and behavior; and,
c.Theprovision ofindividual orparentcounseling, activities; and,
d.Planningand managingachild’sprogram ofpsychologicalservices; and,
e.Consultation on child behavior, child andfamilyconditions related tolearning, mentalhealth, and development to aparent, other caregivers and other serviceproviders; and,
f.Familytraining, education, and support provided to assist aparent orother caregiversin understandingthespecial needs ofthe child as related to psychological strategies and enhancingthe child’spsychological and cognitivedevelopment.
11.“SignLanguage and CuedLanguageServices”meansinstruction that includes sign language, cued language, auditoryororal language, providingoral transliteration services, andprovidingsign andcued languageinterpretationforan infant or toddler.
12."Social and Emotional Services"meansassessmentand intervention servicesthat address socialand emotional development inthecontext ofa familyand parent- childinteraction and includes:
a.Homevisitsto evaluateaninfant’s ortoddler’slivingconditions and patterns of parent-child interaction; and,
b.Thecompletion ofsocial or emotional developmental assessment; and,
c.Theprovision ofindividual orgroup counselingto an infant ortoddlerora parent in orderto understand theparentalneedsrelated to his orherchild’s development and howto enhancethedevelopmentofthe child; and,
d.Theprovision ofsocial skill buildingactivities with the child and parent;and,
e.Interventionstrategiestoaddressissues in thelivingor caregivingsituationthat mayaffect the child’s development and/orutilization ofotherallowable earlyintervention services; and,
f.Theidentification, mobilization andcoordination of communityresources and services to enable aninfant ortoddlerand his orherparentto receive maximumbenefit from otherearlyintervention services; and,
g.Familytraining,education,andsupportprovidedtoassistaparentorother caregiversinunderstandingthespecialneedsofthechildasrelatedto strategies for enhancingthe child’s social or emotionaldevelopment.
13."SpeechLanguagePathologyServices":
a.Means assessment and intervention services toaddress thefunctional and communicationneeds of an infant ortoddler,and includes:
1)Language and speechdevelopment; and,
2)Oral motorfunctioning, includingtheidentification ofspecific communicationdisorders; and,
3)Consultationtoadaptanenvironmentandactivitiestopromotespeech andlanguagedevelopmentandparticipationineveryday routines, activities and places; and,
4)Habilitation, rehabilitation orprevention of communication disorders, and delays in language and speeddevelopment; and,
5)Referral formedical orotherprofessionalservicesnecessaryforthe habilitation or rehabilitation of aninfant ortoddler with communicationdisorders ordelays; and,
6)Familytraining, education and support provided toassist aparent or other caregiversin understandingthespecial needs ofthe child as related tospeechlanguagepathologystrategies and enhancingthe child’s communication development.
b.Does notincludetherapeuticservices requireddueto, or as part of, amedical procedure, amedical intervention oran injurythat is expected toheal without along-term impact to child development and that arebeyond the scopeofthe earlyintervention services identified in the child’s Individualized FamilyServicePlan as beingneeded to meet the child’s developmental outcomes.
14."Transportation Services"means reimbursement forthecost oftravel, including mileage, taxis, commoncarriers, and tolls orparking, that arenecessarytoenable an infant ortoddler and his orherparent to receiveanother EarlyIntervention Serviceidentifiedin theIndividualized FamilyServicePlan.
15."VisionServices":
a.Means evaluationandassessment ofvisualfunctioning,includingthediagnosis and appraisal ofspecificvisual disorders and delaysthat affect child development, andtheinterventionservicesto address thefunctional visual needs ofan infant ortoddler with significant visionimpairment and includes:
1)Communication skillstraining; and,
2)Orientation and mobilitytrainingfor all environments; and,
3)Visual andothertrainingnecessarytoactivatevisual motorabilities; and,
4)Referral formedical orotherprofessionalservicesnecessaryforthe habilitation or rehabilitation ofvisual functioningdisorders,orboth; and,
5)Consultation to adapt anenvironment andactivities fora child with a visual impairment to promotedevelopment, access and participation in everydayroutines, activities and places; and,
6)Familytraining, education and support provided toassist aparent or other caregiversin understandingthespecial needs ofthe child as related to vision strategies and enhancingthe child’s overall development.
b.Does notmeantherapeuticservices required dueto, or as part of, amedical procedure, amedical intervention oran injuryandthat arebeyond thescope ofthe earlyintervention services identified in the child’sIndividualized FamilyServicePlan as beingneeded to meet the child’s developmental outcomes.
PROCEDURES –Early InterventionServices
A.Planning for earlyintervention services shallinclude:
1.Withparentalconsentfortheuseoffamilyassessment,theidentificationofafamily's lifestyle,routines,schedule,prioritiesandtheenvironmentsthatarenaturaland typical for that family;
2.Identification offunctional outcomes that arerelevantto thenatural environments and routines identified bythefamily;
3.Development ofstrategies and activities that address thefunctional outcomes;
4.Determination ofwhich earlyintervention servicesareneeded, as identified bythe Individualized FamilyServicePlanteam. Thepreferenceof anysingleteam memberis not a justificationfor services to beprovided in an environment other than onethat is naturaland normalfor the everydayroutines andactivitiesof that child andfamily;
5.Selection ofservicesettings that arenot chosen based solelyon factors,such as categoryof disability,severityofdisability, configuration of thedeliverysystem, age,availabilityofservices, availabilityofspace,availabilityof equipmentor administrativeconvenience;and,
6.Identification ofqualifiedEarlyIntervention personnel to support specificstrategies and activities in consultationwithfamily members and other caregivers.
B.If a natural environmentrequirement createsa barrier totheimplementation of a child’s Individualized FamilyServicePlan dueto unique communityorfamilycircumstances, the Departmentwillworkwith theCommunityCentered Boardto developcreativestrategies
that are consistent withthenatural environment policyand responsiveto theneeds of the child andfamily.
OtherEarlyIntervention Services Documents
“ColoradoIndividualizedFamilyServicePlanForm (English and Spanish)” “InstructionManual: CompletingColorado’s Individualized FamilyServicePlan” “Personnel Standards”(AppendixF)