Evaluation and Assessment BCW Standards: Evaluation and Assessment Welcome to this Babies Can’t Wait online presentation focused on standards for conducting Part C evaluation and assessment activities for infants and toddlers and their families. Presentation to: Babies Can’t Wait (BCW) Providers Presented by: BCW Technical Assistance Unit Date: April 2012

Babies Can’t Wait Technical Assistance Georgia’s Babies Can’t Wait Hello, I’m Jade Coston, a member of the Babies Can’t Wait Technical Assistance Unit through my faculty work at Valdosta State University (VSU). At VSU, I serve as a faculty member in the Department of Communication Sciences and Disorders. As an SLP, I, along with the other members of Georgia’s Babies Can’t Wait Technical Assistance unit, have focused my career on developing expertise in Early Intervention including the requirements of Part C of the Individuals with Disabilities Education Act (IDEA). As the statute and its associated regulations change, and as our knowledge base of effective evidence-based practices grows, Georgia’s Babies Can’t Wait Program standards are continuously reviewed and revised as appropriate. Please allow me to serve as your guide today as we take a brief overview of the highlights of Georgia’s revised standards.

Babies Can’t Wait Technical Assistance Bookmark Icon Bookmarks In the next few minutes, you will learn more about the 2011 standards for conducting appropriate evaluation and assessment activities for infants and toddlers and their families in BCW. Bookmarks have been added to each section of the standards linked to this presentation to facilitate navigation. Once the file has opened, click on the bookmark icon located to the left of the text to open the Bookmarks pane.

Babies Can’t Wait Technical Assistance Standard Time Review questions entitled “Standard Time” have been included in the presentation to encourage viewers to read and reflect upon important sections of the standards.

Overview of Evaluation Essential Requirements Timely Comprehensive Multidisciplinary Developmental Nondiscriminatory Procedures Every child, birth through age two, referred to Babies Can’t Wait must be provided with a timely, comprehensive and multidisciplinary developmental evaluation. Evaluation procedures include activities to determine if an infant or toddler is initially, or continues to be, eligible for services through the Babies Can’t Wait program under Georgia’s definition of eligibility. Evaluations are conducted by qualified personnel using nondiscriminatory procedures. The evaluation must be timely, that is, if a child is eligible for Part C services, an initial IFSP must be developed within 45 calendar days of receipt of referral by BCW. Timely evaluation activities are necessary in order to meet this timeline. The evaluation conducted by qualified BCW providers is comprehensive, incorporating multiple procedures, to determine the child’s status in the following developmental domains: cognitive, communication, adaptive, physical, and social-emotional development.

Overview of Assessment Essential Requirements Timely Comprehensive Multidisciplinary Developmental Nondiscriminatory Procedures Family Assessment (with family consent) Essential requirements of assessment procedures under Part C of IDEA are the same as those for evaluation: they must be timely, comprehensive, conducted by a multidisciplinary team, address developmental strengths and needs of the child, and reflect nondiscriminatory assessment practices. With family consent, assessment activities related to the child’s family will also be conducted. Assessment under Part C of IDEA refers to both the initial and ongoing procedures used by qualified providers to identify the child's unique strengths and needs as well as services appropriate to address those needs in all developmental domains (cognitive, communication, adaptive, physical, and social-emotional development). Additionally assessment also includes, with family consent, the initial and ongoing procedures used to identify the resources, priorities, and concerns of the child’s family as well as the services and supports necessary to enhance the family’s capacity to meet the developmental needs of their infant and toddler with a disability. Both evaluation and assessment activities are conducted by the multidisciplinary team / primary service provider team. The membership of the multidisciplinary team is typically the same as the PSP team. This team includes at a minimum two professionals from two different disciplines, in addition to the family.

Evaluation and Assessment Procedures Multiple Sources Quantitative Information Qualitative Information Informed Clinical Opinion Evaluation and assessment activities for every child participating in the BCW program must reflect information gathered from a variety of sources. The evaluation and assessment of the developmental skills and functional levels of infants and toddlers cannot rely solely on standardized scores and/or measures (quantitative information). Through the use of informed clinical opinion, the multidisciplinary or PSP Team must also integrate qualitative information with traditional evaluation and assessment procedures (e.g., systematic observations, interviews, neonatal medical histories, etc.) through the use of informed clinical opinion. Informed clinical opinion is used by MDT/PSP Teams when making Part C eligibility and assessment decisions. In using informed clinical opinion, a team integrates all gathered information (both qualitative and quantitative) and determines the status of a child’s development and need for early intervention services and supports. A team may use informed clinical opinion independently to establish eligibility even when other instruments used do not establish eligibility. A child’s eligibility for services can not be based on a single criterion or procedure.

Family Assessment Definition of “family” Purpose Voluntary Requirements Assessment under Part C of IDEA includes a family assessment, with the consent of the family. BCW standards define “family” as each family defines itself. The family assessment is designed to assist families in identifying their resources, priorities, and concerns related to enhancing the development of their infant or toddler. This process is family-directed and based on the family's determination of which aspects of the child’s developmental delays are of high priority, relevance and importance to them. This family assessment is strictly voluntary on the part of the family and a family's decision not to participate in this process does not affect the child's eligibility for BCW services. If the family desires to participate in a family assessment, the assessment must: be conducted by qualified personnel be based on information provided by the family through a personal interview incorporate the family's description of its resources, priorities, and concerns and the identification of supports and services necessary to enhance the family’s capacity to meet the developmental needs of the child

Eligibility Criteria Age range Residence Eligibility categories In determining eligibility for BCW services, a child must: Be between the ages of 0 and 36 months. However, if a child is referred to the BCW program fewer than 45 days before the toddler's third birthday, BCW is not required to conduct the initial evaluation, assessment, or IFSP meeting. Under these circumstances, if the child may be eligible for preschool services or other services under part B of IDEA, BCW, with the parental consent, must refer the toddler to the local school system’s preschool program. Live in the state of Georgia Meet the eligibility criteria as an infant or toddler with established risk for developmental delay (Category 1 eligibility) or as an infant or toddler with a significant developmental delay (Category 2 eligibility). Tools and procedures to be used in determining eligibility under Category 1 and Category 2 are described in the standards. Let’s discuss those

Eligibility and Assessment Category 1 Click Here Babies Can’t Wait Category 1 Conditions List Medical Report ICD-9 Code Evaluation 5 Domain Family Assessment Other Information Assessment Evaluation Requirements Infants and toddlers who have a diagnosed disability that has a high probability of resulting in a developmental delay are eligible for BCW early intervention services under a Category 1 eligibility. The list of Category 1 disabilities is available on the BCW website. It is not necessary that the child evidence any developmental delay at the time of identification. To determine eligibility, the team must have a medical report from a physician that includes a written medical diagnosis that is included on the Category I Conditions List. The medical diagnosis must include the ICD-9 Code. If the child has any other medical diagnoses (with accompanying codes), that information should be included in the medical report from the physician. Assessment Requirements In order to identify the child's unique strengths and needs, identify services appropriate to address those needs in all developmental domains, develop the content of the IFSP, and to track the child’s ongoing developmental progress and obtain federally required information about child outcomes the child must be assessed in all five developmental domains using one of the following instruments: The Assessment, Evaluation, and Programming System for Infant and Children (AEPS); The Battelle Developmental Inventory The Bayley Scales of Infant Development The Hawaii Early Learning Profile (HELP) The Carolina Curriculum for Infants and Toddlers with Special Needs Developmental Assessment of Young Children (DAYC) Family assessment, as described previously, will provide additional information to assist the team in determining supports and services necessary for the family to enhance its capacity to meet the developmental needs of the child. For all children evaluated or assessed for BCW services, the collection and review of a set of information is required. This information is necessary for children identified for eligibility under both Category 1 or Category 2. This information includes: Reason for referral/statement of concern and referral source Parent(s) information which may include interview, questionnaire or developmental checklist, and other information collected during intake Review of pertinent records, by a nurse or other trained medical professional, related to child’s current health status and medical history, which includes a written statement from the primary health care provider; and other diagnostic codes available in the medical record Vision and hearing screening In determining the strengths and needs of the child as well as the services and supports necessary for the child and family, the team should use informed clinical opinion by integrating quantitative and qualitative information gathered. If a child with a Category 1 condition requires immediate services, an Interim IFSP may be developed prior to the team completing the initial assessment. Developmental assessments must be completed within the required 45 day timeline. Other required Components Evaluation and Assessment

Eligibility and Assessment Category 2 1 Standardized Norm-Referenced Tool Other tools Informed Clinical Opinion Evaluation Additional Tools Family Assessment Other Information Assessment Evaluation Requirements Infants and toddlers who do not have an established risk condition or diagnosis who exhibit a significant developmental delay are eligible for BCW early intervention services under a Category 2 eligibility. This eligibility decision is made by the MDT team based on the use of a variety of appropriate tools and procedures. Every child referred for evaluation consideration under Category 2 eligibility must be evaluated by qualified personnel using one of the following standardized norm-referenced tools: the Bayley Scales of Infant Development, the Battelle Developmental Inventory or the Developmental Assessment of Young Children (DAYC). Qualified professionals must participate in the evaluation; according to the regulations released in 2011, it is permissible for one evaluator to represent two or more separate disciplines, as long as that evaluator meets the definition of qualified personnel in each different discipline. A child is considered to have a significant developmental delay when the child’s score on the standardized norm-referenced tool is 2 standard deviations below the mean in one or more of the five developmental domains or at least one and a half (1.5) standard deviations below the mean in two or more of the five developmental domains and/or the child’s developmental issues interfere with his or her functional ability when compared with peers. To determine eligibility, other tools may be used in addition to the standardized tool. These include, but are not limited to, curriculum based measures, behavior checklists, systematic observation of the child’s functional abilities in daily routines, etc. The determination that the child’s developmental issues interfere with his or her functional ability when compared to peers may be made by the team using informed clinical opinion even if the child’s performance on the standardized norm-referenced measure does not document the criteria for a significant delay. This informed clinical opinion is made based on review of all available data. The eligibility decision is made by the consensus of the MDT/PSP Team using informed clinical opinion synthesizing qualitative and quantitative information about the child’s development and need for early intervention services and supports. The team must use its knowledge of the multiple domains of development characteristic of infants and toddlers; the expected sequence of development; and the broad range of individual variations that may be seen in infants and toddlers experiencing typical development. Assessment Requirements In order to identify the child's unique strengths and needs as well as services appropriate to address those needs in all developmental domains and to develop the content of the IFSP, the team may use additional tools including the Pre-School Language Scale (PLS), the Peabody Developmental Motor Scale, the Receptive-Expressive Emergent Language Test (REEL), the Assessment, Evaluation, and Programming System for Infants and Children (AEPS), the Hawaii Early Learning Profile (HELP), or the Carolina Curriculum for Infants and Toddlers with Special Needs. Again, Family assessment will provide additional information to assist the team in determining supports and services necessary for the family to enhance its capacity to meet the developmental needs of the child. Family assessment activities are conducted if families provide informed consent. For all children evaluated or assessed for BCW services, the collection and review of a set of information is required. This information is necessary for children identified for eligibility under both Category 1 or Category 2. This information includes: Reason for referral/statement of concern and referral source Parent(s) information which may include interview, questionnaire or developmental checklist, and other information collected during intake Review of pertinent records, by a nurse or other trained medical professional, related to the child’s current health status and medical history, which includes a written statement from the primary health care provider; and other diagnostic codes available in the medical record, and Vision and hearing screening In order to track the child’s ongoing developmental progress and obtain federally required information about child outcomes the child must be assessed in all five developmental domains using one of the following instruments: The Assessment, Evaluation, and Programming System for Infant and Children (AEPS); The Battelle Developmental Inventory The Bayley Scales of Infant Development The Hawaii Early Learning Profile (HELP) The Carolina Curriculum for Infants and Toddlers with Special Needs Developmental Assessment of Young Children (DAYC) Other required Components Evaluation and Assessment

Review of Prior Data Written, informed consent Standardized or curriculum based data Less than 6 months old Some children referred to BCW for evaluation may have been recently evaluated by other providers. With written informed parental consent, the multidisciplinary team/PSP team must consider any standardized or curriculum based assessment data meeting Georgia requirements (e.g., assessment conducted by qualified personnel) that is less than 6 months old. This review of prior data is intended to prevent children and families from undergoing unnecessary assessments and avoid duplicating already existing evaluation and assessment information.

Nondiscriminatory Procedures Native Language / Mode of Communication Culturally Sensitive and Effective Accommodate Physical and Sensory Needs Administered by Qualified Personnel Interpretation services Evaluation and assessment procedures used to determine eligibility and identify services and supports must be nondiscriminatory in nature. To meet this expectation, there are several requirements. First, the evaluation and assessment tools and procedures must be conducted in the native language or other mode of communication of the family unless is it clearly not feasible to do so. According to the Part C regulations (Section 303.25(a)(2), “For evaluations and assessments of a child, the native language of a child with limited English proficiency is the language normally used by the child if qualified personnel conducting the evaluation or assessment determine that this language is developmentally appropriate for the child given the child’s age and communication skills.” Second, the selection and administration of tools or procedures must occur in a culturally sensitive and effective manner Third, the tools and procedures must accommodate the physical and sensory needs of the child. Fourth, the developmental evaluations and assessments must be conducted by trained and qualified personnel. Finally, interpretation services must be offered and made available to families to ensure active participation in the IFSP process.

Standard Time The terms “evaluation” and “assessment” are two different terms that refer to the same activities and serve the same purpose. q True q False The terms “evaluation” and “assessment” are two different terms that refer to the same activities and serve the same purpose. True or False

Sorry, that answer is incorrect Sorry, that answer is incorrect. Please review the standards and try again.

Outstanding!!! The Standards define evaluation and assessment. Evaluation means the procedures used by appropriate qualified personnel to determine a child’s initial and continuing eligibility …, (2) Assessment means the ongoing procedures used by appropriate qualified personnel throughout the period of a child’s eligibility … to identify: (i) The child’s unique strengths and needs and the services appropriate to meet those needs; and (ii) The resources, priorities and concerns of the family and the supports and services necessary to enhance the family’s capacity to meet the developmental needs of their infant or toddler with a disability.

Standard Time The membership of the Multidisciplinary Team (MDT) responsible for completing the developmental evaluation and assessment A. must include a developmental therapist B. should include an expert in every service provided by Babies Can’t Wait C. must include involvement of either two or more individuals from separate disciplines or professions OR one individual who is qualified in more than one discipline or profession The membership of the Multidisciplinary Team (MDT) responsible for completing the developmental evaluation and assessment A. must include a developmental therapist B. should include an expert in every service provided by Babies Can’t Wait C. must include involvement of either two or more individuals from separate disciplines or professions OR one individual who is qualified in more than one discipline or profession

Sorry, that answer is incorrect Sorry, that answer is incorrect. Please review the standards and try again.

Sorry, that answer is incorrect Sorry, that answer is incorrect. Please review the standards and try again.

Outstanding!!! The Standards state that the MDT Multidisciplinary Team (MDT Team) must include involvement of either two or more individuals from separate disciplines or professions OR one individual who is qualified in more than one discipline or profession.

Standard Time r TRUE r FALSE r DO NOT KNOW Sarah was evaluated by the MDT team to determine eligibility under Category 2: Infants and Toddlers with a Significant Developmental Delay. According to her performance on the Battelle Developmental Inventory, her lowest score was 1.5 standard deviations below the mean in the motor area. Sarah is not eligible for Babies Can’t Wait Services   Sarah was evaluated by the MDT team to determine eligibility under Category 2: Infants and Toddlers with a Significant Developmental Delay. According to her performance on the Battelle Developmental Inventory, her lowest score was 1.5 standard deviations below the mean in the motor area. Sarah is not eligible for Babies Can’t Wait Services TRUE FALSE or DO NOT KNOW   r TRUE r FALSE r DO NOT KNOW

Sorry, that answer is incorrect Sorry, that answer is incorrect. Please review the standards and try again. Make sure you focus on the information needed in order to determine a child’s eligibility for BCW services under Category 2.

Sorry, that answer is incorrect Sorry, that answer is incorrect. Please review the standards and try again. Make sure you focus on the information needed in order to determine a child’s eligibility for BCW services under Category 2.

Outstanding!!! It is not possible to determine eligibility based on the given information. There is no information that Sarah has a Category 1 disability. In determining eligibility under Category 2, no single procedure may be used as the only criterion for determining a child’s eligibility. Since the only information provided relates on the use of one procedure (norm-referenced test, the BDI), the team does not have enough information to determine Sarah’s eligibility.

Standard Time For the purpose of eligibility determination under Category 2 for an infant or toddler, which of the following tool(s) must be completed? A. At least ONE standardized, norm-referenced instrument appropriate for the child’s age B. At least TWO curriculum-based measures appropriate for the child’s age. C. At least ONE standardized and ONE curriculum-based measure appropriate for the child’s age. For the purpose of eligibility determination under Category 2 for an infant or toddler, which of the following tool(s) must be completed? A. At least ONE standardized, norm-referenced instrument appropriate for the child’s age B. At least TWO curriculum-based measures appropriate for the child’s age. C. At least ONE standardized and ONE curriculum-based measure appropriate for the child’s age.

Outstanding!!! The Standards state… To make the eligibility determination for children with Category 2 conditions, evaluators must use at least one standardized, norm-referenced instrument appropriate for the child’s age… A delay is considered significant when standardized measures yield a score of 2 standard deviations below the mean in one or more of the five developmental domains or at least 1.5 standard deviations below the mean in two or more of the five developmental domains and/or the child’s developmental issues interfere with his or her functional ability when compared with peers. An evaluation tool must be completed for the purposes of eligibility determination by using, either the Bayley Scales of Infant Development, the Battelle Developmental Inventory or the Developmental Assessment of Young Children (DAYC).

Sorry, that answer is incorrect Sorry, that answer is incorrect. Please review the standards and try again.

Sorry, that answer is incorrect Sorry, that answer is incorrect. Please review the standards and try again.

Standard Time One important component of assessment of infants and toddlers with disabilities involves determination of specific aspects of the child’s developmental delays that are of high priority, relevance and importance. This determination is made by A. The Early Intervention Coordinator B. The Service Coordinator C. The child’s family One important component of assessment of infants and toddlers with disabilities involves determination of specific aspects of the child’s developmental delays that are of high priority, relevance and importance. This determination is made by A. The Early Intervention Coordinator B. The Service Coordinator C. The child’s family

Sorry, that answer is incorrect Sorry, that answer is incorrect. Please review the standards and try again.

Sorry, that answer is incorrect Sorry, that answer is incorrect. Please review the standards and try again.

Outstanding!!! The Standards state: Family assessment refers to a process designed to assist families in identifying their resources, priorities, and concerns related to enhancing the development of the child. This process is family-directed and based on the family's determination of which aspects of the child’s developmental delays are of high priority, relevance and importance.

Standard Time In order to track each child’s ongoing progress and to obtain federally required information about child outcomes, which of the following is required? A. Comprehensive re-evaluation every 6 months B. On-going use of one of the following tools for every child: The Carolina Curriculum for Infants and Toddlers with Special Needs, Hawaii Early Learning Profile (HELP), Assessment, Evaluation and Programming System (AEPS), The Trans-Disciplinary Play-based Assessment, Battelle Developmental Inventory, OR Developmental Assessment of Young Children C. On-going use of at least one norm-referenced measure (e.g., Battelle Developmental Inventory) AND at least one curriculum-based measure (e.g., Assessment, Evaluation and Programming System- AEPS) for every child. In order to track each child’s ongoing progress and to obtain federally required information about child outcomes, which of the following is required? A. Evaluation of every child’s IFSP every 6 months B. On-going use of one of the following tools for every child: The Carolina Curriculum for Infants and Toddlers with Special Needs, Hawaii Early Learning Profile (HELP), Assessment, Evaluation and Programming System (AEPS), The Trans-Disciplinary Play-based Assessment, Battelle Developmental Inventory. OR Developmental Assessment of Young Children C. On-going use of at least one norm-referenced measure (e.g., Battelle Developmental Inventory) AND at least one curriculum-based measure (e.g., Assessment, Evaluation and Programming System- AEPS) for every child.

Sorry, that answer is incorrect Sorry, that answer is incorrect. Please review the standards and try again.

Outstanding!!! The Standards state… In order to track the child’s ongoing developmental progress in the context of everyday routines and activities and obtain federally required information about child outcomes, one of the tools listed below must be utilized for all children: 1. The Carolina Curriculum for Infants and Toddlers with Special Needs 2. Hawaii Early Learning Profile (HELP) 3. Assessment, Evaluation and Programming System (AEPS) 4. The Trans-Disciplinary Play-based Assessment 5. Battelle Developmental Inventory 6. Developmental Assessment of Young Children

Sorry, that answer is incorrect Sorry, that answer is incorrect. Please review the standards and try again.

Babies Can’t Wait Technical Assistance Click to View Babies Can’t Wait Standards: Evaluation and Assessment Thank you for allowing me to serve as your guide today as we completed a brief overview of the highlights of Georgia’s revised standards for implementing evaluation and assessment activities with Georgia infants and toddlers and their families through the Babies Can’t Wait program. A printable PDF version of the Evaluation and Assessment section of the standards as well as this presentation have been provided for you on the References and Resources slide. If you have any questions after reviewing the standards, please contact the Early Intervention Coordinator for your district.

References & Resources Babies Can’t Wait Program Standards Evaluation and Assessment pdf IDEA Part C Federal Regulations http://www.federalregister.gov/articles/2011/09/28/2011-22783/early-intervention-program-for-infants-and-toddlers-with-disabilities PowerPoint Handout BCW Standards: Evaluation and Assessment PowerPoint pdf Public Law 108-446: Individuals with Disabilities Education Improvement 2004 http://idea.ed.gov/download/statute.html IDEA website http://idea.ed.gov/ Babies Can’t Wait Program Standards: Provides a link to a printable version of the BCW Standards for Evaluation and Assessment dated July 2011. IDEA Part C Federal Regulations provides a direct link to the Federal Register as published by the United States Government. These final regulations were issued on September 28, 2011 to reflect the changes made to IDEA as amended in 2004. PowerPoint Handout links to a printable pdf version of this presentation. Public Law 108-446: Individuals with Disabilities Education Improvement 2004 links to a copy of the actual Act from 2004 reauthorizing the Individuals with Disabilities Education Act. IDEA website: Maintained by the U.S. Department of Education, Office of Special Education Programs (OSEP), this site contains both Part B and Part C of The Individuals with Disabilities Education Act (IDEA).