EARLY INTERVENTION SERVICES

Audiology services include:

1. Identification of children with auditory impairments, using at-risk criteria and appropriate audiological screening techniques; 
2. Determination of the range, nature, and degree of hearing loss and communication functions, by use of audiological evaluation procedures; 
3. Referral for medical and other services necessary for the habilitation or rehabilitation of an infant or toddler with a disability who has an auditory impairment; 
4. Provision of auditory training, aural rehabilitation, speech reading, and listening devices, orientation and training, and other services;
5. Provision of services for prevention of hearing loss; and 
6. Determination of the child’s individual amplification, including selecting, fitting, and dispensing appropriate listening and vibrotactile devices, and evaluating the effectiveness of those devices.

Examples of Audiology Services

• Information about a potential hearing problem (screening) 
• Detailed information about hearing ability and loss (evaluation) 
• Referral to or information about medical personnel, teacher of the deaf and hard of hearing, and other specialists and their services
• Counseling and guidance for families regarding hearing loss and amplification options 
• Guidance and feedback on the effectiveness of a device to assist the child 
• Auditory training, aural rehabilitation, speech reading

Autism resource services mean specially designed services provided to children with learning and behavior patterns like autism or autism spectrum disorders provided by qualified personnel.

Examples of Autism Resource Services

• Provision of collaborative consultation activities provided by an Autism Specialty Team member

Deaf/hard of hearing instruction means specially designed instruction provided by a teacher of the deaf or hard of hearing.

Examples of Deaf/Hard of Hearing Instruction: 

• Assessment of the child’s learning strengths and needs across developmental areas 
• Information and training on different ways you can communicate with your child 
• Information and training on how to develop language with your child 
• Adaptation of early care and education/home curriculum activities to meet the child’s specific learning needs 

Family training, counseling, and home visits mean services provided, as appropriate, by social workers, psychologists, and other qualified personnel to assist the family of an eligible infant or toddler in understanding the special needs of the child and enhancing the child’s development.

Examples of Family Training/Counseling Services

• Group or individual counseling for a family in understanding the special needs of the child 
• Guidance, feedback and emotional support for the family in understanding the special needs of the child 
• Information, guidance, feedback, teaching provided to the family on how to help the child grow and develop

Health services mean health services necessary to enable a child to benefit from the other early intervention services during the time that the child is eligible to receive early intervention services. Health services include: 

1. Such services as clean intermittent catheterization, tracheostomy care, tube feeding, the changing of dressings or colostomy collection bags, and other health services; and  
2. Consultation by physicians with other service providers concerning the special health care needs of eligible infants and toddlers that will need to be addressed in the course of providing other early intervention services. 

Health services do not include the following: 

1. Services that are surgical in nature, such as cleft palate surgery, surgery for clubfoot, the shunting of hydrocephalus; 
2. Services that are purely medical in nature, such as hospitalization for management of congenital heart ailments, or the prescribing of medicine or drugs for any purpose; 
3. Services that are related to the implementation, optimization (e.g. mapping), maintenance, or replacement of a medical device that is surgically implanted, including cochlear implant; 
4. Devices, such as heart monitors, respirators and oxygen, and gastrointestinal feeding tubes and pumps, necessary to control or treat a medical condition; and 
5. Medical-health services, such as immunizations and regular well-child care that are routinely recommended for all children.

Examples of Health Services 

• Someone to provide the needed health support (i.e. catheterization, tracheotomy, tube feeding colostomy collection) to the child to participate in early intervention services 
• Someone to consult with the family and IFSP team members regarding medical/health considerations and accommodations that are needed during other early intervention services

Medical services mean services provided by a licensed physician for diagnostic or evaluation purposes to determine a child’s developmental status and need for early intervention services.

Examples of Medical Evaluations to Determine Eligibility

• A licensed physician, physician’s assistant, advanced registered nurse practitioner, or other licensed health care provider provide the following resources:  information about the specific condition and the developmental status of the child and/or a medical opinion about the need for early intervention services

Nursing services include: 

1. The assessment of health status for the purpose of providing nursing care, including the identification of patterns of human response to actual or potential health problems; 
2. The provision of nursing care to prevent health problems, restore or improve functioning, and promote optimal health and development; and 
3. The administration of medications, treatments, and regimens prescribed by a licensed physician.

Examples of Nursing Services

• Information to the family about the health status of the child 
• Nursing care for the child to prevent, restore or improve health and development 
• An individual to carry out a physician’s orders for treatment, care, and medications

Nutrition services includes: 

1. Conducting individual assessments in: nutritional history and dietary intake; anthropometric, biochemical, and clinical variables; feeding skills and feeding problems; and food habits and food preferences; 
2. Developing and monitoring appropriate plans to address the nutritional needs of eligible infants and toddlers; and 
3. Making referrals to appropriate community resources to carry out nutrition goals.

Examples of Nutrition Services

• Information about child’s feeding skills
• Information about a child's physical make-up that affects growth and development (height, weight, blood profile, etc.) 
• Assessment of child’s food habits and preferences 
• Support in developing a nutrition plan and checking progress 
• Referral to or information about community programs that can help with nutrition goals 

Occupational therapy includes services to address the functional needs of an eligible infant or toddler related to adaptive development, adaptive behavior, and play, and sensory, motor, and postural development. These services are designed to improve the child’s functional ability to perform tasks at home, school, and community settings, and include:

1. Identification, assessment, and intervention;
2. Adaptation of the environment, and selection, design, and fabrication of assistive and orthotic devices to facilitate development and promote the acquisition of functional skills; and 
3. Prevention or minimization of the impact of initial or future impairment, delay in development, or loss of functional ability.

Examples of Occupational Therapy Services

• Information about potential problems in physical ability affecting playing and learning (screening) 
• Detailed information about child’s sensory, perceptual-motor, motor and posture development (evaluation and assessment) 
• Someone to provide guidance and feedback on how to help a child eat, play with toys, move and learn 
• Help in adapting the child’s environment to meet the child’s needs 
• Selecting, designing, and making devices that help a child move, play, eat and learn 
• Someone to provide guidance and feedback to prevent or minimize physical problems

Orientation and mobility services include services provided to blind or visually impaired infants and toddlers by qualified personnel to enable those children to attain systematic orientation to and safe movement with their environments in the home, community, and school, and includes teaching children the following, as appropriate:

1. Spatial and environmental concepts and use of information received by the senses (such as sound, temperature, and vibrations) to establish, maintain or regain orientation and line of travel 
2. Use the long cane or a service animal to supplement visual travel skills or as a tool for safely negotiating the environment for children with no available travel vision; 
3. To understand and use remaining vision and distance low vision aids; and 
4. Other concepts, techniques, and tools.
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Examples of Orientation and Mobility Services

• Assessment of the child’s orientation and movement strengths and needs 
• Information and training on preparing safe environments for child movement and exploration 
• Information and training on how to develop safe movement and exploration skills 
• Information and training to use remaining vision and distance low vision aids

Physical therapy includes services to address the promotion of sensorimotor function through enhancement of musculoskeletal status, neurobehavioral organization, perceptual and motor development, cardiopulmonary status, and effective environmental adaptation. These services include: 

1. Screening, evaluation, and assessment of children to identify movement dysfunction; 
2. Obtaining, interpreting, and integrating information appropriate to program planning to prevent, alleviate, or compensate for movement dysfunction and related functional problems; and 
3. Providing individual and group services or treatment to prevent, alleviate, or compensate for movement dysfunction and related functional problems. 

Examples of Physical Therapy Services

• Information about potential problems of child’s physical ability affecting moving, sitting, standing or positioning for motor development (screening)
• Information about potential problems of child’s physical ability affecting moving, sitting, standing or positioning for motor development (screening) 
• Detailed information about child’s motor, sensory or posture development including the ability to move and position self for play (evaluation and assessment)
• Someone who can interpret medical and physical information and develop a plan to help the child develop
• Someone who can provide guidance and feedback to caregivers on how to help the child learn a variety of ways to move and position during routines and activities through continued motor development and/or assistive technology (including braces, walking devices, positioning devices) and/or, 
• Help in adapting the child’s environment to meet the child’s needs

Psychological services includes:

1. Administering psychological and developmental tests and other assessment procedures; 
2. Interpreting assessment results; 
3. Obtaining, integrating, and interpreting information about child behavior and child and family conditions related to learning, mental health, and development; and 
4. Planning and managing a program of psychological services including psychological counseling for children and parents, family counseling, consultation on child development, parent training, and education programs. 

Examples of Psychological Services

• Psychological and developmental testing of the child 
• Information about child’s thinking, learning, and behavior 
• Information about child’s behavior and child/family relationship 
• Counseling for child and/or family 
• Guidance and feedback to the child’s family and/or other caregiver of the child  on child development 
• Training and information on parenting
• Someone to plan and do interventions for a specific child behavior 

Service coordination services mean services provided by a service coordinator to assist and enable an eligible infant or toddler and the child’s family to receive the services and rights, including procedural safeguards, required in Early ACCESS. Each eligible infant or toddler and the child’s family must be provided with one service coordinator.  For more info on the roles and responsibilities of Service Coordinator, click here.  

Examples of Services Coordination

• Someone who serves as the single point of contact in helping parents obtain the services and assistance that the parents need
• Someone who assists the family in accessing early intervention services and resources from a variety of formal and informal community agencies or providers 
• Someone who partners with the family in coordinating all early intervention and other services identified on the IFSP across agencies
• Someone who partners with each family to continuously seek appropriate services, resources needed to help the child grow and develop and the family support their child/family
• Someone who enables families to receive and understand the rights, procedural safeguards, and services they have under IDEA Part C
• Someone who facilitates communication among early intervention service providers across agencies

Sign language and cued language services include teaching sign language, cued language, and auditory/oral language, providing oral transliteration services (such as amplification), and providing sign and cued language interpretation. 

Note: This service is to be used only for children who are deaf/hard of hearing.

Examples of Sign Language and Cued Language Services

• Facilitating communication by interpreting or transliterating spoken language into signed or cued language and signed or cued language into speech.
• For children who are deafblind, special interpreting services are needed to help the child communicate and understand his/her environment. Note: Interpreters must hold a current license from the Iowa Department of Public Health. 

Note: Interpreters and Translators are used with children who already have a signed or cued language base. 

Social work services includes: 

1. Making home visits to evaluate a child’s living conditions and patterns of parent-child interaction; 
2. Preparing a social or emotional developmental assessment of the infant or toddler within the family context; 
3. Providing individual and family group counseling with parents and other family members, and appropriate social skill-building activities with the infant or toddler and parents; 
4. Working with those problems in the living situation (home, community, and any center where early intervention services are provided) of an eligible infant or toddler and the family of that child that affect the child’s maximum utilization of early intervention services; and 
5. Identifying, mobilizing, and coordinating community resources and services to enable the eligible infant or toddler and the family to receive maximum benefit from early intervention services.

Examples of Social Work Services

• A home visit to evaluate a child’s living conditions related to growth and development
• A home visit to evaluate how parent and child relate to one another 
• Information about how to develop a positive relationship with child and the child’s relationship with other family members
• Information about child’s social/emotional growth and development (assessment)
• Individual or group counseling for family members to learn appropriate social/emotional skills 
• Someone to help solve problems in a child’s and family’s living situation (home, community, and any center where early intervention services are provided) that affect the child’s maximum use of early intervention services 
• Information about community resources and services that could help child and family 
• Someone who assists the family in obtaining and coordinating resources and services so they can benefit from other early intervention services

Note: This is the same service called Developmental Services in the Medicaid Infant Toddler Program and IFSP data system.

Special instruction includes: 

1. The design of learning environments and activities that promote the infant’s or toddler’s acquisition of skills in a variety of developmental areas, including cognitive processes and social interaction; 
2. Curriculum planning, including the planned interaction of personnel, materials, and time and space, that leads to achieving the outcomes in the IFSP for the eligible infant or toddler; 
3. Providing families with information, skills, and support related to enhancing the skill development of the child; and 
4. Working with the eligible infant or toddler to enhance the child’s development

Examples of Special Instruction

• Someone who designs activities that help the child to grow, learn, communicate and play with others 
• Someone who can provide guidance and feedback to caregivers on how to do learning activities that help the child grow and learn
• Someone who can adapt early care and education curriculum activities to meet a child’s specific learning needs

Speech-language pathology services include: 

1. Identification of children with communication or language disorders and delays in the development of communication skills, including the diagnosis and appraisal of specific disorders and delays in those skills; 
2. Referral for medical or other professional services necessary for the habilitation or rehabilitation of children with communication or language disorders and delays in the development of communication skills; and 
3. Provision of services for the habilitation, rehabilitation, or prevention of communication or language disorders and delays in the development of communication skills.

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Examples of Speech and Language Pathology Services

• Information about potential problems with communication skills (screening) 
• Detailed information and a diagnosis of a child’s speech-language problems (evaluation and assessment) 
• Referral to or information about specialists of speech-language (communication) disorders and their services 
• Someone who can provide guidance and feedback to caregivers  to improve and/or prevent a child’s communication problems

Transportation services include the cost of travel and other costs that are necessary to enable an infant or toddler with a disability and the child’s family to receive early intervention services.

Vision instruction means specially designed instruction and services provided by a teacher of the visually impaired and includes adapting, as appropriate to the needs of the child, the content, methodology, or delivery of instruction to: 

1. Address the unique needs of the child that result from the child’s disability;
2. Ensure access of the child to the general curriculum, so that the child can meet the educational standards within the jurisdiction of the public agency that apply to all children
3. Evaluation and assessment of visual functioning, including the diagnosis and appraisal of specific visual disorders, delays, and abilities; and 
4. Referral for medical or other professional services necessary for the habilitation or rehabilitation of visual functioning disorders, or both.

Examples of Vision Instruction

• Designing activities that help the child to grow, learn, communicate and play with others
• Coaching  family members on how to do learning activities 
• Adapting early care and education curriculum activities to meet a child’s specific learning needs 
• Coaches child care provider on how to carry out activities that help the child
• Provides detailed information about vision ability and loss (evaluation and assessment including functional visual assessment)
• Diagnoses visual problems 
• Making referrals to or providing information about specialists in visual problems