Chapter DHS 90

DHS 90.08(3)(b)12. 12. Speech and language pathologists with at least a master’s degree in speech and language pathology from an accredited institution of higher education and who are registered under ch. 459, Stats., or licensed under ch. 115, Stats., and ch. PI 34; and

DHS 90.08(3)(b)13. 13. Other persons qualified by professional training and experience to perform the evaluation and determine eligibility.

DHS 90.08(4) (4) Eligibility. A child is eligible for early intervention services under the birth to 3 program if the EI team determines under sub. (5) that the child is developmentally delayed or under sub. (6) that the child has a diagnosed physical or mental condition which will likely result in developmental delay.

DHS 90.08(5) (5) Determination of developmental delay.

DHS 90.08(5)(a) (a) A determination of developmental delay shall be based upon the EI team’s clinical opinion supported by:

DHS 90.08(5)(a)1. 1. A developmental history of the child and other pertinent information about the child obtained from parents and other caregivers;

DHS 90.08(5)(a)2. 2. Observations made of the child in his or her daily settings identified by the parent, including how the child interacts with people and familiar toys and other objects in the child’s environment; and

DHS 90.08(5)(a)3. 3. Except as provided under par. (b), a determination of at least 25% delay in one or more areas of development as measured by a criterion referenced instrument, or a score of 1.3 or more standard deviation below the mean in one or more areas of development as measured by a norm-referenced instrument, and interpreted by a qualified professional based on informed clinical opinion. In this subdivision, “areas of development” mean:

DHS 90.08(5)(a)3.a. a. Cognitive development;

DHS 90.08(5)(a)3.b. b. Physical development, including vision and hearing;

DHS 90.08(5)(a)3.c. c. Communication development;

DHS 90.08(5)(a)3.d. d. Social and emotional development; and

DHS 90.08(5)(a)3.e. e. Adaptive development which includes self-help skills.

DHS 90.08(5)(b) (b) If the results of the formal testing under par. (a) 3. closely approach but do not equal the standard in par. (a) 3. for a developmental delay but observation by qualified personnel or parents indicates that some aspect of the child’s development is atypical and is adversely affecting the child’s overall development, the EI team may use alternative procedures or instruments that meet acceptable professional standards to document the atypical development and to conclude, based on informed clinical opinion, that the child should be considered developmentally delayed.

DHS 90.08 Note Note: Examples of atypical developments are asymmetrical movement, variant speech and language patterns, delay in achieving significant interactive milestones such as exhibiting a pleasurable response to a caregiver’s attention, and presence of an unusual pattern of development such as a sleep disturbance or eating difficulties.

DHS 90.08(6) (6) Determination of diagnosed condition. A determination of high probability that a child’s diagnosed physical or mental condition will result in a developmental delay shall be based upon the EI team’s informed clinical opinion supported by a physician’s report documenting the condition. High probability implies that a clearly established case has been made for a developmental delay.

DHS 90.08 Note Note: Examples of these diagnosed conditions are chromosomal disorders such as Down syndrome, birth defects such as spina bifida, significant or progressive vision or hearing impairment, neuromotor disorders such as cerebral palsy, postnatal traumatic events such as severe head injuries, severe emotional disturbances, dysmorphic syndromes such as fetal alcohol syndrome, addiction at birth, a maternal infection transmitted to the fetus such as AIDS, neurological impairments of unknown etiology such as autism, untreated metabolic disorders such as PKU and certain chronic or progressive conditions.

DHS 90.08(7) (7) EI team procedure.

DHS 90.08(7)(a) (a) The service coordinator shall ensure that the parents of the child are involved and consulted throughout the entire evaluation process.

DHS 90.08(7)(b) (b) The EI team shall examine all relevant available data concerning the child, including the following:

DHS 90.08(7)(b)1. 1. Medical records and other health records concerning the child’s medical history and health status, including physical examination reports, results of vision and hearing screenings, hospital discharge records and specialty clinic reports;

DHS 90.08(7)(b)2. 2. Any records and screening results of the child’s developmental functioning in the following areas:

DHS 90.08(7)(b)2.a. a. Cognitive development;

DHS 90.08(7)(b)2.b. b. Physical development, including vision and hearing;

DHS 90.08(7)(b)2.c. c. Communication development;

DHS 90.08(7)(b)2.d. d. Social and emotional development; and

DHS 90.08(7)(b)2.e. e. Adaptive development which includes self-help skills; and

DHS 90.08(7)(b)3. 3. Records of any previous interventions provided to the child, including therapy reports, treatment records and service plans.

DHS 90.08(7)(c) (c) The EI team shall use additional observation, screening results and other testing instruments and procedures as needed, to determine the child’s level of functioning in each of the following areas of development:

DHS 90.08(7)(c)1. 1. Cognitive development, as evidenced by play skills, manipulation of toys, sensorimotor schemes, attention, perceptual skills, memory, problem solving and reasoning;

DHS 90.08(7)(c)2. 2. Physical development, including hearing and vision, as evidenced by gross motor and fine motor coordination, tactility, health and growth. If there has not been a physical examination of the child in the past 2 months, one shall be requested if appropriate;

DHS 90.08(7)(c)3. 3. Communication development, as evidenced by understanding, expression, quantity and quality of speech sounds or words, and communicative intent through gestures. Communication development includes the acquisition of communications skills during pre-verbal and verbal phases of development; receptive and expressive language, including spoken, non-spoken and sign language means of expression; oral-motor development; auditory awareness skills and processing; the use of augmentative communication devices; and speech production and awareness.

DHS 90.08(7)(c)4. 4. Social and emotional development, as evidenced by temperament, mood attachment, self-soothing behaviors, adaptability, activity level, awareness of others and interpersonal relationships; and

DHS 90.08(7)(c)5. 5. Adaptive development which includes self-help skills, to include drinking, eating, eliminating, dressing and bathing.

DHS 90.08(7)(d) (d) Testing instruments and other materials and procedures employed by the EI team shall meet the following requirements:

DHS 90.08(7)(d)1. 1. They shall be administered or provided in the child’s or family’s primary language or other mode of communication. When this is clearly not possible, the circumstances preventing it shall be documented in the child’s early intervention record;

DHS 90.08(7)(d)2. 2. They may not be racially or culturally discriminatory;

DHS 90.08(7)(d)3. 3. They shall be validated for the specific purpose and age group for which they are used;

DHS 90.08(7)(d)4. 4. They shall be administered by trained personnel in accordance with instructions of the developer;

DHS 90.08(7)(d)5. 5. They shall be tailored to assess the specific area of development and not simply provide a single general intelligence quotient; and

DHS 90.08(7)(d)6. 6. In regard to tests, they shall be selected to ensure that when they are administered to a child with impaired sensory, manual or speaking skills, the test results accurately reflect what the tests purport to measure.

DHS 90.08(7)(e) (e) No single procedure may be used as the sole criterion for determining eligibility.

DHS 90.08(7)(f) (f) With the parent’s consent, members of the EI team may consult with persons not on the EI team to help the EI team members determine if the child needs early intervention services.

DHS 90.08(7)(g) (g) Following the evaluation, all members of the EI team shall jointly discuss their findings and conclusions and determine if there is documentation, data or other evidence that the child is developmentally delayed or has a condition which has a high probability of resulting in delayed development. If a member cannot be present, that member shall be involved through other means, such as participating in a conference call, or be represented by someone who is knowledgeable about the child and about the member’s findings and conclusions.

DHS 90.08(7)(h) (h) At the conclusion of the joint discussion under par. (g), the EI team shall prepare a report which shall include each member’s findings and conclusions and be signed by all members of the team. If a member participated through a conference call, the signature may be by proxy. The report shall include:

DHS 90.08(7)(h)1. 1. Results of the evaluation, including levels of functioning in the areas of development under sub. (5) (a) 3.; and

DHS 90.08(7)(h)2. 2. A determination of either eligibility or non-eligibility, with a determination of eligibility accompanied by documentation of the child’s developmental delay or diagnosed condition.

DHS 90.08(7)(i) (i) The service coordinator shall provide the child’s parent with a copy of the EI team’s report.

DHS 90.08(7)(j) (j) If the EI team finds that the child is not eligible, the EI team report shall in addition include:

DHS 90.08(7)(j)1. 1. An offer to re-screen the child within 6 months;

DHS 90.08(7)(j)2. 2. Information about community services that may benefit the child and family, such as day care, parent support groups or parenting classes; and

DHS 90.08(7)(j)3. 3. A statement that, if the parent requests it and consents to it, referral will be made to other programs from which the child and family may benefit and that the service coordinator will assist the parent in locating and gaining access to other services.

DHS 90.08(7)(k) (k) If the parent chooses not to take part in the evaluation process or development of the report, the service coordinator shall meet with the parent upon completion of the evaluation to discuss the findings and conclusions of the EI team. The service coordinator shall document in the child’s early intervention record why the parent was not involved and the steps taken to share the findings and conclusions of the EI team with the parent.

DHS 90.08(8) (8) Effect of relocation of eligible child. When the family of a child who has been determined eligible for early intervention services based on an EI team evaluation moves to another county, the child shall remain eligible for services in the new county of residence on the basis of the original determination of eligibility. The services identified in the IFSP in effect on the date that the family moves to the new county shall be provided until a new IFSP is developed.

DHS 90.08 History History: Cr. Register, June, 1992, No. 438, eff. 7-1-92; emerg. am. (3) (b) 11., 12. and (8), cr. (3) (b) 13., r. (7) (h) 2., eff. 1-1-93; am. (3) (b) 11., 12. and (8), cr. (3) (b) 13., renum. (7) (h) 1. (intro.) to be (7) (h) (intro.), r. (7) (h) 2., Register, June, 1993, No. 450, eff. 7-1-93; am. (1), (3) (a), (b) 10., (5) (a) 3., (7) (b) 1., (g), (h) (intro.), Register, April, 1997, No. 496, eff. 5-1-97; am. (7) (k), Register, September, 1999, No. 525, eff. 10-1-99; CR 03-033: am. (3) (b) 3. and 11. Register December 2003 No. 576, eff. 1-1-04; corrections in (3) (b) 9. and 12. made under s. 13.93 (2m) (b) 7., Stats., Register December 2004 No. 588.

DHS 90.09 DHS 90.09 Assessment.

DHS 90.09(1) (1) Assessment of child.

DHS 90.09(1)(a) (a) Initial assessment.

DHS 90.09(1)(a)1. 1. Once a child is determined under s. DHS 90.08 to be eligible for early intervention services, the EI team shall, as needed, carry out additional observations, procedures and testing to assess and determine the child’s unique developmental needs. All assessment tests and other materials and procedures shall comply with s. DHS 90.08 (7) (d).

DHS 90.09(1)(a)2. 2. Following the assessment under subd. 1., the EI team shall prepare a report. This report need not be a separate document but may be made part of the EI team’s report under s. DHS 90.08 (7) (h) or the IFSP under s. DHS 90.10. The report shall include:

DHS 90.09(1)(a)2.a. a. A summary of the assessment, including the child’s strengths and needs; and

DHS 90.09(1)(a)2.b. b. A list of potential services needed.

DHS 90.09(1)(a)3. 3. The service coordinator shall provide the child’s parent with a copy of the assessment report.

DHS 90.09(1)(b) (b) Ongoing assessment. Ongoing assessments shall be carried on as needed by either the EI team or the IFSP team. All ongoing assessments shall meet the requirements in par. (a).

DHS 90.09(1)(c) (c) Discussion with nonparticipating parent. If the parent chooses not to take part in the assessment or development of the report, the service coordinator shall meet with the parent upon completion of the assessment to discuss the findings and recommendations. The service coordinator shall document in the child’s early intervention record why the parent was not involved and the steps taken to share the findings and recommendations of the assessment report with the parents.

DHS 90.09(2) (2) Family-directed assessment.

DHS 90.09(2)(a) (a) Any assessment of the child’s family shall be with the family’s permission. The assessment shall be directed by the family and shall focus on the family’s strengths, resources, concerns and priorities related to enhancing development of the child.

DHS 90.09(2)(b) (b) An assessment of the family shall:

DHS 90.09(2)(b)1. 1. Be completed by the family alone with a choice of assessment tools offered to the family, or be completed by the family in collaboration with other personnel trained to make use of appropriate formal or informal methods and procedures;

DHS 90.09(2)(b)2. 2. Be based on information provided by family members through personal interviews; and

DHS 90.09(2)(b)3. 3. Incorporate the family members’ description of the family’s strengths, resources, concerns and priorities as these are related to enhancing the child’s development.

DHS 90.09 History History: Cr. Register, June, 1992, No. 438, eff. 7-1-92; am. (2) (a), Register, June, 1993, No. 450, eff. 7-1-93; am. (1) (a), 2., Register, April, 1997, No. 496, eff. 7-1-97.

DHS 90.10 DHS 90.10 Development of service plan.

DHS 90.10(1) (1) Time limit. Except as provided in sub. (2) (a), within 45 days after receiving a referral for initial evaluation of a child, the county administrative agency shall complete the evaluation under s. DHS 90.08 and the assessment under s. DHS 90.09 and the service coordinator shall convene a meeting to develop the initial IFSP.

DHS 90.10(2) (2) Interim ifsp.

DHS 90.10(2)(a) (a) Delay in completing evaluation and assessment. If exceptional circumstances directly affecting the child or the child’s family, such as illness of the child or a parent or the parent’s refusal to consent to a procedure, make it impossible to complete the evaluation and assessment within 45 days, the county administrative agency shall:

DHS 90.10(2)(a)1. 1. Document the exceptional circumstances in the child’s early intervention record;

DHS 90.10(2)(a)2. 2. Ensure that the service coordinator, the parent, at least one of the qualified personnel directly involved in the child’s evaluation and assessment and, as appropriate, persons who will be providing services for the child and family develop and implement an interim IFSP which includes the service coordinator’s name, the early intervention services that are needed immediately and the circumstances and reasons for development of the interim IFSP;

DHS 90.10(2)(a)3. 3. Obtain the parent’s written consent to the services, and to a revised deadline for completion of the evaluation and assessment; and

DHS 90.10(2)(a)4. 4. Complete the evaluation within the extended period agreed upon by the family and EI team.

DHS 90.10(2)(b) (b) Provision of services before completing evaluation and assessment. Provision of early intervention services to a child and the child’s family may be started before the evaluation and assessment are completed if there is a clear and obvious need that can be addressed without waiting for completion of the formal evaluation and assessment and if the following conditions are met:

DHS 90.10(2)(b)1. 1. The parent gives written consent for the services;

DHS 90.10(2)(b)2. 2. An interim IFSP is developed and implemented by the service coordinator, parent, at least one of the qualified personnel directly involved in the child’s evaluation and assessment and, as appropriate, persons who will be providing services for the child and family, which includes the service coordinator’s name, the early intervention services that are needed immediately and the circumstances and reasons for development of the interim IFSP; and

DHS 90.10(2)(b)3. 3. The evaluation and assessment are completed within the time period prescribed in sub. (1).

DHS 90.10(3) (3) IFSP team. The IFSP team shall consist of the parent, other family members requested by the parent, the service coordinator, an advocate if requested by the parent, at least one of the qualified personnel who took part in the evaluation and assessment of the child, at least one professional who has expertise in assessment of both typical and atypical development and expertise in child development and program planning, and appropriate service providers. If a professional who took part in the evaluation and assessment cannot be present at a meeting to develop the IFSP, the service coordinator shall ensure that the professional is involved through some other means.

DHS 90.10(4) (4) Meeting to develop ifsp. The IFSP shall be developed on the basis of the evaluation and assessment by the IFSP team and with attention to the concerns and priorities of the parent. All meetings shall be conducted in settings and at times that are convenient to families, and the service coordinator shall ensure that written notice of a meeting is provided to all participants early enough before the meeting date so that they will be able to attend. If the parent wishes to attend but cannot attend at the scheduled time, the meeting shall be rescheduled.

DHS 90.10(5) (5) Content. The IFSP may have several different sections that are completed at various times throughout the process. All sections of the IFSP shall be maintained in one file or binder. The parents shall be given a copy, the contents of which shall be fully explained to the parents and kept current. The IFSP shall contain:

DHS 90.10(5)(a) (a) Information about the child’s developmental status, including statements concerning the child’s present levels of cognitive development, physical development, to include vision, hearing and health status, communication development, social and emotional development and adaptive development such as self-help skills, based on professionally acceptable objective criteria. This information shall be assembled from the initial evaluation and assessment reports and the results of any ongoing assessments.

DHS 90.10(5)(b) (b) With the concurrence of the parent, a summary of the family’s strengths, resources, concerns and priorities related to enhancing the development of the child;