Variations in Criteria for Eligibility Determination for Early Intervention Services with a Focus on Eligibility for Children with Neonatal Complications

Abstract

Objective: The purpose of this policy review is to describe data on eligibility determination practices for early intervention (EI) services across the United States as they particularly relate to eligibility determination for children seen in neonatal follow-up clinics. Method: Policy information was gathered from posted information on state EI websites and confirmed through follow-up phone calls. Information collected included definition of delay, approved measures for developmental assessment, and inclusion criteria for medically at-risk status based on birth weight, prematurity, and/or neonatal abstinence syndrome/prenatal exposure. Results: States varied widely across enrollment practices and policies. Forty percent of states defined eligibility based on percent delay (vs SD). Thirty-five states had criteria for enrollment based on birth weight and/or prematurity, and 19 states specifically allowed enrollment for an infant with neonatal abstinence syndrome. Conclusion: Providers working in neonatal follow-up clinics should be carefully educated about the eligibility criteria and approved tests for assessing development in the states in which they practice, recognizing that there is obvious and significant variability across states.

Initial Evaluation Practices to Identify Young Children with Delays and Disabilities

“…The least common methods for determining eligibility were MTSS/RTI and a discrepancy model. EI eligibility was more likely to use a percentage delay and clinical judgment, aligning with prior research that has also found that percent delay was commonly used for determining EI eligibility (Dempsey et al, 2020). Although federal IDEA (2004) policies are meant to be interpreted and further defined at the state-level, the present results suggest that location in a particular state still holds a large influence on whether a child is eligible for EI or preschool special education.…”

“…Participants suggested that their state’s guidance regarding approved assessment tools influenced their choice of assessments to use during the initial evaluation. Recent findings revealed that there are 19 suggested or approved assessments in 39 US states (Dempsey et al, 2020 ). Interestingly, respondents in the present study reported the use of a wider range of tools than in prior research, which might be due to the present study including evaluations for both EI and preschool special education.…”

Early Childhood Professionals’ Reported Use of Culturally and Linguistically Responsive Practices During Initial Evaluations: A Mixed Methods Study

“…Further, the number of responses from each state was highly variable. Given that state-level policy is highly influential in assessment and eligibility practices (Dempsey et al, 2020), this likely impacted our findings and may not represent this work across all U.S. states. Second, the respondents primarily identified as White and female.…”

Enhancing access to early intervention by including parent navigators with lived experience in a pediatric medical home.

“…If the PN were unable to reach a family, she would contact the local EI office to determine if the child had been evaluated and/or found eligible for services. At the time of this study, eligibility for EI in our state was determined by a 33% delay in one or more developmental areas, or a combination of biomedical risk factors (Dempsey et al, 2020).…”

“…Part C of the Individuals with Disabilities Education Act (IDEA) provides states with funding to offer early intervention (EI) services to children who have or are at risk for DD "to enhance the development of infants and toddlers with disabilities, to minimize their potential for DD and to recognize the significant brain development that occurs during a child's first 3 years of life" (Office of the Federal Register, National Archives and Records Administration, 2004). Although all 50 states have EI programs as mandated by IDEA, each state determines the degree of delay a child must demonstrate to qualify for EI, which results in a substantial variation across states (Dempsey et al, 2020). EI has the potential to improve developmental outcomes and decrease the need for future intervention (Dawson et al, 2010(Dawson et al, , 2012Howlin et al, 2009;McCormick et al, 2006;Walker et al, 2011).…”