Individualized Family Service Plan (IFSP) Evaluation and Assessment Results

1. Purpose: This section is required to document the child’s general health and medical information, the child’s level of functioning in each developmental area and the information that supports this determination. Information from the evaluation or assessment of the child is documented in this section. For children found eligible because of a significant delay in development, documentation must clearly indicate the significant delay along with a written description of the individual skills the child has achieved or that are absent. These pages represent the results of all information obtained through the multidisciplinary assessment team. For the Initial and Annual IFSP, qualitative and quantitative information about the child in each developmental domain is stated in terms of an equivalency of a percentage of delay.

2. Process: A child referred to EI Colorado because of a development concern is entitled to a multidisciplinary evaluation and if the child is eligible, a multidisciplinary assessment. A child who is determined to be eligible based on a diagnosed condition associated with a high probability of resulting in significant delays in development (established condition) is entitled to a multidisciplinary assessment. Qualified personnel from at least two different disciplines, one in the area of the child’s primary concern, conduct the multidisciplinary evaluation and/or assessment.

3. EI Data System: This information is populated to the IFSP to an Evaluation and Assessment Results tab within IFSP Home Visual Force from the creation of and Early Intervention screening in EI Data System.

1. General Health and Medical Information

   1. This section of the IFSP documents information about the child’s birth history, the child’s medical home, physicians and specialists connected to the child and general health concerns. This information must be filled out completely and updated as needed and is required information for the IFSP. This information is entered on the Evaluation and Assessments Tab in the EI Data System IFSP Home visual force page.

      • If a child was born prematurely, enter the number of weeks that the child was gestationally at birth based on the typical gestational period of 40 weeks. For example, if a child was born 8 weeks early the gestational age is 32 weeks.

      • An infant born at fewer than 37 weeks gestation is considered to have been born prematurely. A corrected or adjusted age should be applied up to the time that the child reaches the chronological age of two years (24 months). The corrected or adjusted age is computed by subtracting the number of weeks of prematurity, (the difference between 40 weeks of full-term gestation and the number of actual weeks of gestation at birth) from the child’s current chronological age. The result is the child’s corrected or adjusted age. For example, a child is born at 32 weeks of gestation (eight weeks less than full-term gestation) and is now the chronological age of ten months. In this instance the child has a corrected or adjusted age of eight months, which is calculated as follows: 40 weeks (full term gestation) minus 32 weeks (actual weeks of gestation at birth) equals eight weeks or two months. Two months are subtracted from the current chronological age resulting in the child’s corrected or adjusted age.

Enter information about the child’s Primary Care Practice or Medical home here. This information is important to support service coordination, and for providers to obtain necessary information to ensure the correct funding source is utilized. Document any medical diagnosis (primary, secondary etc.) if applicable, and if the child sees any medical specialists. Any time a new diagnosis is provide, update this as part of an IFSP review.

General Health Concerns: Enter any additional information about the health of the child, anything about the child’s health that the team should know about to better plan and provide service to the child and family, including any medication the child is taking and the reason why the medication is needed, special equipment, allergies, etc.

Nutrition and Growth: Enter details of concerns about the child’s nutrition and growth. If there are no concerns, indicate this with N/A on the IFSP.

Dental: Document if the child has been seen by a dentist and if there are any concerns or information needed for the team on the child’s dental health. Indicate N/A on the IFSP is this is not an area of concern.

Vision: This section of the IFSP documents information about the child’s vision, including the results of screening or testing and corrections to the child’s vision.

Note: Evaluation and assessment team members should follow recommendations outlined in the document

“Visual Screening Guidelines: Children Birth through Five Years”, referenced below*

What were the results? If the child fails the vision screen or there is a vision concern identified when screening, the Fail/Refer box should always be checked.

• Comments: Document any comments or concerns of the family, physicians, assessors, or others related to the child’s vision. These must include plans for follow-up testing if the child does not pass the vision screen. The service coordinator will support the family in accessing follow-up screening or evaluation, document the results of the rescreen in case notes and update this information at the next IFSP review.

• When a vision screening is conducted and the child does not pass, a full multidisciplinary evaluation and/or assessment and the development of the IFSP is not advisable until the vision concern is fully medically evaluated. If the multidisciplinary developmental evaluation and/or assessment is conducted before the medical evaluation of vision has been completed, which is not recommended, the results should be interpreted with extreme caution.

*See the resource developed by the Colorado Department of Education “Visual Screening Guidelines: Children Birth through Five Years" (PDF en espanol) for recommended early childhood vision screening procedures. For your reference, the Guidelines are posted on the EI Colorado website.

Hearing: This section of the IFSP documents information about the child’s hearing, including the results of screening or testing, corrections made to the child’s hearing and the concerns of the family or others.

Note: Evaluation and assessment team members should follow recommendations outlined in the document “Colorado Early Childhood Hearing Screening Guidelines”, referenced below*.

Enter the month and year of the most recent hearing screen or test and results.

• Left Ear results: If the child passes or fails the hearing screen or there is a hearing concern identified when screening, identify that here. •

• Right Ear results: If the child passes or fails the hearing screen or there is a hearing concern identified when screening, identify that here.

• Comments regarding follow up: Document any comments or concerns of the family, physicians, assessors, or others related to the child’s hearing. These must include plans for follow-up testing if the child does not pass the hearing screen. The service coordinator will support the family in accessing follow-up screening or evaluation, document the results of the rescreen in case notes and update this information at the next IFSP review.

• When a hearing screening is conducted and the child does not pass, a full multidisciplinary evaluation and/or assessment and the development of the IFSP is not advisable until the hearing concern has been evaluated by an audiologist or medical professional. If the multidisciplinary evaluation and/or assessment is conducted before the medical evaluation of hearing has been completed, which is not recommended, the results should be interpreted with extreme caution.

*See the resource “Colorado Early Childhood Hearing Screening Guidelines” for recommended early childhood hearing screening procedures. For your reference, the Guidelines are posted on the EI Colorado website.

B. Present Levels of Development Determined through Evaluation and/or Assessment

1. This section of the IFSP documents information about the child’s current level of development in each of the five developmental areas: adaptive, cognitive, communication, physical and social and emotional. In each area, examples of skills that may be observed in that area are noted, as well as additional child and family information that is important in order to give a complete picture of the child and family.

2. Enter the Methods and Procedures used to collect information. At a minimum, a multidisciplinary evaluation and/or assessment team gathers information from a review of pertinent medical records, interviewing the parent about the child’s history, personal observation of the child, a hearing and vision screening or assurance that a hearing and vision screen has been done and administering an evaluation instrument. These required procedures are carried out during the initial evaluation and/or assessment for any child referred for EI services.

Developmental Domain:

• Adaptive Development: Self-help skills such as eating, drinking and dressing. For infants, this may include reacting to their surroundings through changes in color, breathing or digestion.

• Cognitive Development – Thinking, learning and reasoning, playing and paying attention to people, tasks and details. For infants, this may include falling asleep and waking up and finding voices and sounds in their surroundings.

• Communication Development - Interactions with others such as looking, listening, smiling, sharing emotions, using sounds, gestures and words to express thoughts and feelings, and understanding the words of caregivers.

• Physical Development – Body movements to change position or location such as rolling over, sitting, creeping, crawling, standing, walking and using hands for reaching, playing or eating.

• Social or Emotional Development – Developing relationships, self-soothing strategies for becoming and remaining calm, getting along with others, and expressing feelings.

Note: When a child has sensory concerns, the way in which these concerns impact developmental skills and participation in daily activities is noted within the relevant developmental domain

Range of Delay: Results are based on consideration of all evaluation and/or assessment information gathered from the selected methods and procedures and noted in terms of an equivalency of a percentage of delay in each developmental domain.

Document one of the following for each developmental domain:

• Within Age Expectation

• 25 – 32% Does not meet initial eligibility criteria

• 25 - 32% (This is no longer applicable for evaluations conducted after 07/2020)

• 33 - 50%

• >50%

• Informed Opinion

  • When through an analysis of qualitative and quantitative information obtained during evaluation or assessment, a child is determined to have a delay in a developmental area that is equal to or greater than Colorado’s definition through informed clinical opinion, choose informed opinion for each developmental area in which a delay is present. This option is not used for documenting a risk of delay. Sufficient documentation must be included in the Results Summary Including Qualitative Information to indicate the presence of a significant delay.

Note: An infant or toddler found eligible due to an established condition may not be demonstrating a current developmental delay. EI services should be provided at a level sufficient to monitor the developmental progress of the child and identify a delay if it should become present

Developmental Level Min/Max Age: Documentation of this information is required. This is used to record the developmental range of skills the child is demonstrating in the area, which starts the process for age-anchoring the child for Global Outcomes.

Results Summary Including Qualitative Information: Enter any information regarding the child’s development needed to further clarify specific evaluation and/or assessment results in every domain, such as specific details about fine motor, gross motor, expressive communication, receptive communication, or the quality of skills demonstrated. Information entered should be adequate to support the range of delay and the developmental levels documented.

Vision Screen for Initial Evaluation or Assessment: Entered in EI Data System under Vision section of Evaluation or Assessment Results tab of IFSP Home visual force page.

Hearing Screen for Initial Evaluation or Assessment: Entered in EI Data System under Hearing section of Evaluation or Assessment Results tab of IFSP Home visual force page.

Evaluation Comments: Document any additional information gathered from the evaluation that may not have been documented elsewhere. Indicate N/A if no additional information is obtained.

Evaluation Team Participants: Enter the first and last name and discipline of each multidisciplinary team member who participated in the evaluation or assessment. This is required information. Select “Add Contact” under Evaluation Team Participants section of Evaluation or Assessment Results tab.

I participated in the evaluation and/or assessment and the results were discussed with me: The parent initials here on the document to acknowledge their full participation and that the results of the evaluation or assessment were discussed with them.

C. Eligibility

Eligibility Determination is used for initial evaluation only. The results of the evaluation or assessment are reviewed with and explained to the parent(s) or guardian(s). This page is populated from the information entered on the Evaluation or Assessment Results tab in EI Data System under IFSP Home.

Not Eligible: This section is completed for children who are not found eligible for EI services. The results of the evaluation are reviewed with and explained to the parent(s) or guardian(s), documenting that the child does not meet the eligibility criteria for EI services.

• Eligibility has been explained to you and this document serves as your prior written notice. You have received a copy of your rights and you understand them: The parent(s) or guardian(s) mark here to document understanding of their rights in the determination that the child is not eligible for EI services.

• Parent/Guardian Signatures: Each parent or guardian of the child participating in the evaluation signs here.

• Date: Enter the date that the child was found not to be eligible.

Eligible: This section is completed for a child who is found eligible for EI services based on the results of the evaluation process.

The results of the evaluation or assessment are reviewed with and explained to the parent(s) or guardian(s). Select the appropriate eligibility determination for the child. Eligibility is based on the ONE category that is checked below:

Significant Delay in Development: Mark each area in which the child is demonstrating a delay in development greater than 33% or greater. Choose all that apply:

• Adaptive

• Cognitive

• Communication

• Physical

• Social and Emotional

Informed Opinion of Delay: Mark each area in which the child is demonstrating a quality of skill or behavior that demonstrates a significant delay in development. Choose all that apply:

• Adaptive

• Cognitive

• Communication

• Physical

• Social and Emotional

Established Condition: Document that the child has a diagnosed established condition approved by EI Colorado as being associated with a high probability of resulting in significant delays in development. Conditions that meet this criterion are listed within the EI Colorado Established Condition Database. When using an established condition to determine eligibility, all of the following sections are required to be completed:

• Name of Condition or Diagnosis: Enter the primary name of the diagnosed established condition as it appears in the Established Conditions Database located on the EI Colorado website.

• Qualified Health Professional: Enter the name of the health professional that verified the condition.

• Hospital/Practice: Enter the name of the hospital or primary care practice that facilitated the referral.

• Credential of Health Professional Confirming Diagnosis: Enter the credentials of the health professional.

For steps to search and enter an Established Condition, reference Eligibility under ENTERING AN EVALUATION section. All established conditions that have been reviewed can be found under the Medical Diagnosis tab in EI Data System To add this tab to your navigation bar, reference Section TABS AND LIST VIEWS.

Living with a parent with a developmental disability determined by the CCB and is not already under a category listed above. Choose this option for a child who lives with a parent with a developmental disability. If the child does not reside with the parent, they are not eligible under this category. This eligibility category is chosen only if the child does not have a current developmental delay of 33% or greater in any developmental area or an established condition.8

Eligibility has been explained to you and this document serves as your prior written notice. You have received a copy of your rights and you understand them: The parent(s) or guardian(s) mark this box to document understanding of their rights in the determination of eligibility.

Parent/Guardian Signatures: Each parent or guardian of the child participating in the evaluation signs and dates here.