Early intervention services.
As used in this part, early intervention services means services that—
Are designed to meet the developmental needs of each child eligible under this part and the needs of the family related to enhancing the child's development;
Are selected in collaboration with the parents;
Under public supervision;
By qualified personnel, as defined in § 303.21, including the types of personnel listed in paragraph (e) of this section;
In conformity with an individualized family service plan; and
At no cost, unless, subject to § 303.520(b)(3), Federal or State law provides for a system of payments by families, including a schedule of sliding fees; and
Meet the standards of the State, including the requirements of this part.
(b) Natural environments.
To the maximum extent appropriate to the needs of the child, early intervention services must be provided in natural environments, including the home and community settings in which children without disabilities participate.
(c) General role of service providers.
To the extent appropriate, service providers in each area of early intervention services included in paragraph (d) of this section are responsible for—
Consulting with parents, other service providers, and representatives of appropriate community agencies to ensure the effective provision of services in that area;
Training parents and others regarding the provision of those services; and
Participating in the multidisciplinary team's assessment of a child and the child's family, and in the development of integrated goals and outcomes for the individualized family service plan.
(d) Types of services; definitions.
Following are types of services included under “early intervention services,” and, if appropriate, definitions of those services:
Assistive technology device means any item, piece of equipment, or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve the functional capabilities of children with disabilities. Assistive technology service means a service that directly assists a child with a disability in the selection, acquisition, or use of an assistive technology device. Assistive technology services include—
The evaluation of the needs of a child with a disability, including a functional evaluation of the child in the child's customary environment;
Purchasing, leasing, or otherwise providing for the acquisition of assistive technology devices by children with disabilities;
Selecting, designing, fitting, customizing, adapting, applying, maintaining, repairing, or replacing assistive technology devices;
Coordinating and using other therapies, interventions, or services with assistive technology devices, such as those associated with existing education and rehabilitation plans and programs;
Training or technical assistance for a child with disabilities or, if appropriate, that child's family; and
Training or technical assistance for professionals (including individuals providing early intervention services) or other individuals who provide services to or are otherwise substantially involved in the major life functions of individuals with disabilities.
Identification of children with auditory impairment, using at risk criteria and appropriate audiologic screening techniques;
Determination of the range, nature, and degree of hearing loss and communication functions, by use of audiological evaluation procedures;
Referral for medical and other services necessary for the habilitation or rehabilitation of children with auditory impairment;
Provision of auditory training, aural rehabilitation, speech reading and listening device orientation and training, and other services;
Provision of services for prevention of hearing loss; and
Determination of the child's need for individual amplification, including selecting, fitting, and dispensing appropriate listening and vibrotactile devices, and evaluating the effectiveness of those devices.
Family training, counseling, and home visits means services provided, as appropriate, by social workers, psychologists, and other qualified personnel to assist the family of a child eligible under this part in understanding the special needs of the child and enhancing the child's development.
Health services (See § 303.13 ).
Medical services only for diagnostic or evaluation purposes means services provided by a licensed physician to determine a child's developmental status and need for early intervention services.
Nursing services includes—
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;
Provision of nursing care to prevent health problems, restore or improve functioning, and promote optimal health and development; and
Administration of medications, treatments, and regimens prescribed by a licensed physician.
Nutrition services includes—
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;
Developing and monitoring appropriate plans to address the nutritional needs of children eligible under this part, based on the findings in paragraph (d)(7)(i) of this section; and
Making referrals to appropriate community resources to carry out nutrition goals.
Occupational therapy includes services to address the functional needs of a child 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 in home, school, and community settings, and include—
Identification, assessment, and intervention;
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
Prevention or minimization of the impact of initial or future impairment, delay in development, or loss of functional ability.
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—
Screening, evaluation, and assessment of infants and toddlers to identify movement dysfunction;
Obtaining, interpreting, and integrating information appropriate to program planning to prevent, alleviate, or compensate for movement dysfunction and related functional problems; and
Providing individual and group services or treatment to prevent, alleviate, or compensate for movement dysfunction and related functional problems.
Psychological services includes—
Administering psychological and developmental tests and other assessment procedures;
Interpreting assessment results;
Obtaining, integrating, and interpreting information about child behavior, and child and family conditions related to learning, mental health, and development; and
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.
Service coordination services means assistance and services provided by a service coordinator to a child eligible under this part and the child's family that are in addition to the functions and activities included under § 303.23.
Social work services includes—
Making home visits to evaluate a child's living conditions and patterns of parent-child interaction;
Preparing a social or emotional developmental assessment of the child within the family context;
Providing individual and family-group counseling with parents and other family members, and appropriate social skill-building activities with the child and parents;
Working with those 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 utilization of early intervention services; and
Identifying, mobilizing, and coordinating community resources and services to enable the child and family to receive maximum benefit from early intervention services.
Special instruction includes—
The design of learning environments and activities that promote the child's acquisition of skills in a variety of developmental areas, including cognitive processes and social interaction;
Curriculum planning, including the planned interaction of personnel, materials, and time and space, that leads to achieving the outcomes in the child's individualized family service plan;
Providing families with information, skills, and support related to enhancing the skill development of the child; and
Working with the child to enhance the child's development.
Speech-language pathology includes—
Identification of children with communicative or oropharyngeal disorders and delays in development of communication skills, including the diagnosis and appraisal of specific disorders and delays in those skills;
Referral for medical or other professional services necessary for the habilitation or rehabilitation of children with communicative or oropharyngeal disorders and delays in development of communication skills; and
Provision of services for the habilitation, rehabilitation, or prevention of communicative or oropharyngeal disorders and delays in development of communication skills.
Transportation and related costs includes the cost of travel (e.g., mileage, or travel by taxi, common carrier, or other means) and other costs (e.g., tolls and parking expenses) that are necessary to enable a child eligible under this part and the child's family to receive early intervention services.
Vision services means—
Evaluation and assessment of visual functioning, including the diagnosis and appraisal of specific visual disorders, delays, and abilities;
Referral for medical or other professional services necessary for the habilitation or rehabilitation of visual functioning disorders, or both; and
Communication skills training, orientation and mobility training for all environments, visual training, independent living skills training, and additional training necessary to activate visual motor abilities.
(e) Qualified personnel.
Early intervention services must be provided by qualified personnel, including—
Orientation and mobility specialists;
Pediatricians and other physicians;
Special educators; and
Speech and language pathologists.
20 U.S.C. 1401(1)
and (2); 1432(4))
The lists of services in paragraph (d) and qualified personnel in paragraph (e) of this section are not exhaustive. Early intervention services may include such services as the provision of respite and other family support services. Qualified personnel may include such personnel as vision specialists, paraprofessionals, and parent-to-parent support personnel.
[58 FR 40959, July 30, 1993, as amended at 63 FR 18294, Apr. 14, 1998; 64 FR 12535, Mar. 12, 1999]