Informed Opinion of Delay in Early Intervention Colorado

When to use Informed Opinion of Delay (IOD):

For infants and toddlers referred to early intervention (EI) because of a concern in development, informed opinion of delay can be used as the determining criteria for initial eligibility, especially when norm-referenced evaluation instruments cannot be used to adequately identify the presence or absence of a developmental delay.

Possible reasons for using IOD to establish eligibility for early intervention services include:

• The child has a significant health concern or illness that makes testing difficult

• The child has a limited ability to participate in the evaluation

• Using a norm-referenced evaluation instrument would require significant adaptations for the child to perform the required items, which would invalidate the results

• The evaluation instrument is not sensitive enough

• Cultural considerations might invalidate the results of a norm-referenced evaluation instrument

The use of IOD requires the evaluation team to consider and analyze ALL data related to the current developmental status of the child. This includes:

• Review of medical records and/or the results of previous developmental testing

• Information obtained through parent reporting

• Observation of the child

• The results of any evaluation or assessment tools conducted

All sources of information used in this determination must be documented.

When NOT to use IOD:

• To make a child who is at risk for developmental delay due to environmental or biological conditions eligible for EI services

  • Examples of of these conditions are:

    • Pre or postnatal exposure to illegal substances

    • Parent/caregiver age, education or economic status

    • Housing arrangements of family

• To establish levels of functioning for annual assessment

  • IOD is used only as a basis for initial eligibility determination. Children enrolled in EI Colorado do not have eligibility redetermined annually.

Documentation of IOD:

It is necessary to document the reasons for using IOD in eligibility determination. This documentation describes the reasons that a child was determined eligible through IOD.

This documentation may include:

• Atypical developmental or behaviors

• Lack of progress or skill regression documented in prior medical or developmental records

This information should be detailed on the IFSP in the Evaluation or Assessment section, under Summary Including Qualitative Information for the related developmental area.

Example 1:

Developmental Domain: Physical Nathaniel, 10 months of age

Example 2

Developmental Domain: Communication Daisy, 16 months of age

Additional resources for using “informed opinion of delay” (also referred to as informed clinical opinion) as a basis for eligibility:

https://ectacenter.org/~pdfs/pubs/nnotes28.pdf http://www.puckett.org/Trace/endpoints/endpoints_vol2_no3.pdf

(Adapted in part from Early Access for Infants, Toddlers and Families, Iowa Dept of Education)