Qualifying for Early Intervention Services

In Wisconsin the entry criteria are more reasonable than I have seen in some other states.  The 25% delay refers to criterion-referenced tests which give an age equivalent score.  If a child is 24 months old, for example, a 25% delay is 6 months, or an 18 month age equivalent score.  We all know that age equivalent scores can be very unreliable and misleading.  With criterion referenced tests, however, they are more reliable because the score is based on achieving specific criterion behaviors rather than on the total number of items.  On the Rossetti, for example, the manual specifies that for a child to meet a specific age level, s/he must pass all items at that level.

The -1.3 standard deviation score refers to norm-referenced tests which give a standard score.

I find the "atypical development" entry criterion a very valuable one for children who have severe phonological or articulation disorders.  It is very hard to find a test to measure speech skills accurately at this age, particularly conversational skills.  Being able to qualify them under "atypical development" has allowed me to provide services much earlier than might otherwise be possible.  I don't use it a lot because I feel there is a real potential for abuse, but for some kids it is a lifesaver.

Dear Alexandra of Tumwater, WA,

At the facility that I work at, with, we attempt to tell the parent that we have some concerns and that we would like for them to speak to their pediatricians about.  We are not allowed to tell them that we feel their child may be on the autism spectrum since we are not Phd's but we can tell them that we see some red flags that concern us. If they feel that their pediatrician does not understand their concerns that they make an appointment with a Developmental Pediatrican, who could look at the whole child, from birth on and including all developmental areas.  This would include possible syndromes, disorders, etc.

EI in California is totally different and the law is changing now, so that less children qualify for services.  At this point, the eligibility criterion calls for a 33.33% delay in one or more areas prior to 24 months and 50% in one area or a continued 33.33% in two or more areas after 24 months.  It's actually putting lots of OTs, PTs, and SLP's in danger of losing their jobs.

Stephanie

I have a question for you. I work in a developmental preschool at an elementary school.

We struggle with how much to tell parents, in as far as if we think the child may be on the spectrum, have language delays as a result of a developmental syndrome, etc. If you feel there is an undiagnosed medical cause for developmental delays, do you talk to parents about this in a direct manner?  

I'd be interested in your input!

I, agree, that each state will likely differ somewhat.  In Illinois, the percent of delay is 30%.  However, there are approximately 5 other ways a child can meet eligibility requirements.

The criteria in SD changed a year ago to:

Infants and toddlers, birth to 36 months of age, inclusive, are eligible for services under this chapter if identified by providers of licensed health care and education services as:

         (1)  Demonstrating at least a 1.5 standard deviation below the mean; or

         (2)  Children who are born at 28 weeks gestation or less; or

         (3)  Having a diagnosed physical or mental condition that has a high probability of resulting in developmental delay.

         Determinations of developmental delay shall be based on medical diagnoses, including Down's syndrome and other chromosomal abnormalities; sensory impairments, including vision and hearing; inborn errors of metabolism; microcephaly; severe attachment disorders, including failure to thrive; seizure disorders; and fetal alcohol syndrome.

When we were allowed to use 25% delay to qualify a child, it meant that a child who was 24 months was only performing at an 18 month age equivalency or less. Or, say a 14 month old would only be performing at 10-11 months. You calculate 25% of the child's chronological age and that's the cut-off point.