I have two jobs. My main gig is working for a local school system as the Augmentative Alternative communication (AAC) Specialist. It sounds fancy, but I really just evaluate kiddos to see if they would benefit from AAC strategies and work with SLPs and teachers to help them implement those strategies and systems. I’m going to do a blog series soon on all things AAC, so keep an eye out for that.
Since I’m single and work in the school system, I pretty much need a second job. Am I right? My part-time job is as an early intervention SLP. That means I get to work with the babies from birth to age 3. I go into the home and train parents on how to help their children learn language and communication skills. This job has a special place in my heart because I get to meet some great families and help those sweet babies get started on the right track.
Today, I want to talk to the parents of young kids who are concerned that their little one isn’t quite where he or she is supposed to be. I want to help those families out there who may not know what services are available to them or may not know where to start. If you’re a teacher or SLP, still give it a read. You never know when you might need a refresher or introduction to these topics.
Here are some things you need to know first:
1) You and your child have rights.
Back in 1975, the Individuals with Disabilities Education Act (IDEA) was put into action. Originally, it required that all children receive a free and appropriate education regardless of their disability or delay. In 2011, IDEA required that children from ages birth through two-years-old receive early intervention (EI) services. (FYI: This is through Part C of IDEA 2011). In layman’s terms, this means that your child is eligible for early intervention services anywhere in the US—as long as they qualify (more on that later).
2) Early intervention varies from state to state.
The federal government places certain regulations on states such as requiring that they provide services for every eligible child, but many of the logistics are up to the state. As much as I would love to give you state-specific info, that could get pretty convoluted. Visit http://ectacenter.org/contact/ptccoord.asp to get the contact information for your state’s EI department.
A note for Alabama Residents:
Alabama will provide services for any child who has a medical diagnosis that can delay normal development or who has a developmental delay that causes the child not to meet developmental milestones (info taken from http://www.rehab.alabama.gov/individuals-and-families/early-intervention). You can call the state wide EI Child Find number at 1-800-543-3098.
3) Someone has to start the process.
And that someone will probably be you. Let’s say you notice that your son is 18 months old and hasn’t begun using words yet. Or maybe your niece has trouble making eye contact or playing with other kids. Your first step is to contact your pediatrician or get in touch with your state’s EI department (see #2). Pediatricians are sometimes the first to notice a problem and mention EI services. Parents—I want to make sure you hear this. You do not have to wait for an outside source (i.e. doctor, hospital staff) to refer your child for EI services! You have every right to request an EI evaluation yourself.
4) It may go without saying, but you need to know what your child should be doing at their age.
I’ve worked with parents who haven’t been around many kids besides their own. It’s often hard for these parents to know what their 1-2 year old should be doing. Other parents have a “first child” who meets and exceeds all their developmental milestones and are confused when their second or third child is way behind. Sometimes we have too high or too low expectations for our kids and don’t realize that they are behind. My free PDF gives you a comprehensive guide to what your child should be doing. You can download that here.
Okay. So now you know the basics of early intervention.
A few things you can expect once the process gets started:
Your child will be assigned to a service coordinator.
At least, this is what’s done in Alabama. Here in AL, service coordinators (SC) are assigned kids as they are referred into the system. Some coordinators have certain areas of town they will accept kids in, while others may work in a county wide area. The coordinator is responsible for making sure parents understand Early Intervention and that their rights are protected. SC’s also either do the evaluation or bring in other therapists to complete the evaluation. They are then in charge of creating the Individualized Family Service Plan (IFSP) if your child qualifies for services (again, more on that in a sec). Other duties of a service coordinator include writing new goals, making changes to the IFSP, keeping up with when your child needs to be re-evaluated (each year), and other similar duties.
Your child is evaluated and either qualifies or doesn’t.
So, here’s the meat and potatoes of it. As I’ve said before, different states do this differently, but hopefully this will give you an idea of what to expect. In Alabama, the evaluation process is as follows:
1) There will be some forms for you to sign. When is there not a form for you to sign? There will probably be a form where you give permission for your child to be evaluated and you should be given a written copy of your rights as a parent.
2) If your child has a medical diagnosis (i.e. cerebral palsy, Down syndrome, etc.), you will need to provide a written report for the pediatrician
3) A vision and hearing screening will be completed to make sure neither are delaying development. If a problem is detected during the screening, you will be referred to another health professional for a more in-depth evaluation
4) Two standardized/formal evaluations that assess all five areas of development are completed:These areas include language, physical development, social/emotional, adaptive skills, and cognition.
At least 2 disciplines will be involved in the evaluation. That could include a speech therapist, occupational therapist, physical therapist, or special instructor (which you could think of as a preschool teacher).
5) There will most likely be an informal interview so the evaluators can get an idea of what your concerns are. This is voluntary in Alabama, but I’m not sure why you wouldn’t want to give details.
6) Once all the evaluations are complete, the service coordinator will determine if there is a 25% or greater delay in any of the five developmental areas on the standardized tests. This is how it works:
Example: Your child is 22 months old. After the little precious one was asked to do all the silly things on the evaluation (seriously, one test asks if a kid can walk backwards for 10 feet—uh, who cares), we get her developmental age for each section. Her scores read something like this:
Language: 13 months
Physical Development: 21 months
Cognition: 14 months
Adaptive: 17 months
Social/Emotional: 20 months
In this example, the kiddo would qualify in the areas of Language and Cognition because there is a 25% delay in those areas. She’s still within “normal” limits in the other areas, so she doesn’t qualify for services in those areas.
Got it? Yeah, I know it’s a lot. Don’t worry if it makes no sense. The folks who evaluate your little one will explain it all.
Does my child get services or not? Well, borrowing from the previously used example:
This little girl would most likely receive services from a speech therapist only. Depending on the state and the individual needs of your child, a special instructor may also be involved.
If she had qualified in physical development and not in language, a physical or occupational therapist would be seeing her instead of the speech therapist.
Once it’s been decided what your child qualifies for, the IFSP will be created. This is a legal document that states what your concerns are and what goals the therapist(s) will be working on to address those concerns.
The IFSP is good for one year. This means that your kiddo will be re-evaluated each year and will either qualify for another year or have done so great that she no longer qualifies!
NOTE: Re-evaluations are only completed until your child turns 3 years old. Once she turns 3, Early Intervention no longer provides services (more on that later).
At this point, the therapist(s) who will be seeing your child should be contacting you to set up your first therapy session. They will come to your house or go to the preschool/daycare depending on what your state allows and what you prefer. I always recommend most visits being in the home, but it’s also a good idea for a therapist to visit a preschool/daycare to provide strategies and tips to the staff.
Now you’re in business! A year from the date your IFSP was created, your kiddo will be up for their annual re-eval–if they don’t turn 3 first. Someone will come back out and do the same or similar evaluations as were just done for the initial evaluation.
When your child turns 3, a whole other set of circumstances will take place. My next post will fill you in on that.
If you’re in Alabama, this website may answer some questions. http://www.rehab.alabama.gov/individuals-and-families/early-intervention/ei-general-information
And there we have it!
Yeah, okay. That was a lot of information. I would recommend saving this post so you can look back to answer any questions you may have. If your questions aren’t answered here, I would love to take a crack at them. Comment below, if you please.