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To accompany the DVD Program: Minnesota’s Infant and Toddler Early Intervention

An IEIC Regions 11 East & West Project With grant funds provided by the Minnesota Department of Education

Developed by Jolene Pearson – B.E.S, M.S. IMH-E® (IV), Infant Mental Health Mentor

Updated August-2009

A PRESENTER’S GUIDE

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Contents: Introduction - 2 Suggested ways to use the DVD in your community - 3 For Parent Audiences: Facilitating a discussion before viewing the DVD Talking Points for Parents (discussion leader’s guide) - 5 Parent Guide (reproducible handout) - 7 For Professional Audiences: Providing additional information after viewing the DVD Talking Points for Professionals (presenter’s guide) - 12 Professional Guide (reproducible handout) - 15 Continuing Education Post Test – 19 References – 20 Answers to the Continuing Education Post Test - 20

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INTRODUCTION: Help at an early age can make a difference in the lives of all children. In 2007, changes were made to Minnesota’s early intervention eligibility criteria. These changes allow more children ages birth to three to qualify for and receive early intervention services. This DVD was developed to help parents and professionals learn more about these important services by hearing from families who have participated in early intervention. This user’s guide has been prepared to expand upon the information contained in the DVD. We want to ensure children who are potentially eligible for early intervention are referred as soon as possible by educating our communities about early intervention services and the benefits to parents and children. SUGGESTED WAYS TO USE THIS DVD IN YOUR COMMUNITY: Actively seek out opportunities to share the DVD and facilitate discussions. Venues where groups of parents or pediatric professionals are gathered are an ideal time to show the DVD. In addition, providing written materials along with a viewing of the DVD will enhance the viewers understanding of the components and value of the Help Me Grow early intervention system. ECFE (Early Childhood Family Education)

• Meet with individual ECFE educators and show them the DVD. Offer to visit their infant /toddler parents groups to show the DVD and provide additional information.

• Show the DVD at an ECFE staff meeting. Provide the staff with the Talking Points for Parents and reproducible handouts. Encourage them to show the DVD in their parent groups and distribute the handouts using the Talking Points for Parents.

• Give the DVD and parent handouts and encourage ECFE educators to use the materials one time per semester or trimester so all families are made aware of early intervention.

HEALTH CARE AND OTHER FAMILY SERVICE CENTERED PROVIDERS:

• Who provides health care to young children in your community? Child care? Home visits? Offer to meet with these providers to show the DVD and discuss how to refer children to the early intervention system.

• Ask about any opportunities to provide a short in-service as part of a staff meeting.

• Give these professionals a copy to share with parents they would like to refer.

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A PRESENTATION FOR PARENTS versus PROFESSIONALS

NOTES FOR THE DISCUSSION LEADER: The first set of Parent Talking Point NOTES have been prepared to accompany the Parent Guide (handout) for presentations to parents. It is recommended you show the DVD following the presentation using the parent guide and talking points. This is because the presentation is designed to appeal to parents in general. The DVD program focuses on families where a child has a developmental delay or condition and receives early intervention services. As a way to tie the presentation to the DVD and engage all parents, you can say something like this, “As parents, you get to know other parents and their children. The information in this DVD could help someone you know find services for their child – or if you ever become concerned about your own child’s development, you’ll know what services are available to help you.” Both sets of Talking Points have a ‘Slide number’ in front of each paragraph. The numbers correspond to the slide numbers on the handouts. It is recommended that you make a copy of the Parent Guide and view them as you review these notes in preparation for a presentation to parents. It is recommended you copy each page of the handouts directly from this booklet for the highest quality copy. When giving this presentation to professionals, it is recommended you show the DVD program first. The emphasis for professionals is learning more about the criteria that qualifies children for early intervention and how to refer children. A short discussion after showing the DVD could highlight the ways parents in the Early Intervention DVD program describe the benefits of early intervention for themselves and their child. Professionals can benefit from hearing the parent testimonials as they will know how to describe what parents and children gain from participating in early intervention. The Professional Talking Points NOTES cite research supporting prompt identification and referral of children who are delayed or meet criteria for early intervention.

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Slide 1. As parents we want to be sure our children are growing and developing well. This presentation will focus on how children develop and why it’s important to know if your child is developing the skills expected at each age and stage. Slide 2. The developmental process involves learning and mastering skills like sitting, walking, talking, skipping, and tying shoes. Most children learn these skills, called developmental milestones during predictable time periods. Slide 3. The five areas in which children develop skills are:

Slide 4. Large muscle or Gross Motor Skill Development. This is the child's ability to use large muscles.

For example, a six-month-old baby learns how to sit up with some support, a 12-month-old baby learns

to pull up to a stand holding onto furniture, and a five-year-old learns to skip.

Slide 5. Small muscle or Fine Motor Skill Development. This is the child's ability to use small muscles,

specifically their hands and fingers, to pick up small objects, hold a spoon, turn pages in a book, or

use a crayon to draw.

Slide 6. Speech and Language Development. Examples include the child's ability to both understand

and use language and communicate with others. For example, a 12-month-old baby saying his first

words, a two-year-old naming parts of her body, and a five-year-old learning to say "feet" instead of

"foots".

Slide 7. Cognitive Development. This is the child's ability to learn and solve problems. For example, a

two-month-old baby learns to explore the environment with her hands or eyes or a five-year-old learns

how to count or identify letters of the alphabet.

Slide 8. Social and Emotional Development. This is the child's ability to interact with others, including

helping themselves and gaining some control over their impulses and behaviors. Examples of this type

of development would include: a six-week-old baby smiling when she sees her parents, a twelve-

month-old baby waving bye-bye, and a five-year-old boy knowing how to take turns in games.

Slide 9. A developmental milestone is a skill that a child acquires within a specific time frame. For

instance, one developmental milestone is learning to walk. Most children learn this skill or

developmental milestone somewhere between the ages of 9 and 15 months.

Each child is an individual and may meet the developmental milestone of walking a little earlier or later than other children around the same age. You may have heard people say things like, "he was walking before he turned ten months, much earlier than his older brother" or "she didn't say much until she was about two years old and then she talked in full sentences." Each child is unique and will develop at his or her own pace. However, there are definitely blocks of time when most children will meet a milestone. For example, children learn to walk anytime between nine and 15 months of age. So, if your child is 13 months of age and not yet walking, there is no need to worry if he is crawling and pulling to a stand. He has acquired the skills he needs to learn to walk and may begin walking soon.

Parent Talking Points – NOTES

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However, if you have a child 15 months of age who is not yet walking or trying to walk, it would be a good idea to talk with your child's pediatrician to make sure there aren't any medical or developmental problems impacting your child’s development. Slide 10. During the first three years of a child’s life there are many foundational skills he or she needs to acquire. The child’s brain will grow 90 % during her first three years. This rapid development comes from all of the new experiences. If a child is missing skills or developing them too slowly, it could impact their future learning. Slide 11. The term Early Intervention refers to services given to very young children with special needs and their families from birth until the child turns three. For this reason, these programs are sometimes called "Birth to 3" or "Zero to 3." Services, depending on the child’s individual needs, may include special instruction, speech therapy, occupational therapy and physical therapy, usually provided in the child's home. The hope is that these services, provided early, will address any delays in development so that the child will not need services later on. At age 3, if a child still needs help, he or she might be referred to the school district’s special-education program. In Minnesota, the lead agency for these services is the Minnesota Department of Education (MDE). Early intervention services for eligible children ages birth to 3 and their families are federally mandated through the Individuals with Disabilities Education Act (IDEA).

Slide 12.Some children will automatically qualify because they were born at a very low birth weight or

have a condition that has a very high probability of resulting in developmental delays. For example a

child with Down’s Syndrome.

Slide 13. For children who are eligible, early intervention services are provided at no cost through an Individualized Family Service Plan. By working closely with the family, early intervention professionals ensure that both services and community supports, including family supports, are brought together to meet a child’s and family’s unique needs. All interventions should be designed to enhance a child’s development within the family’s daily routines. Participation in early intervention services is voluntary. Slide14. As a parent you are the best person to observe your child’s development. Learn about developmental milestones your child should be achieving on the MNparentsknow.info website.

Slide15. Remember to call for a FREE screening if you have concerns. Share this information with other

parents who may not know about HELP ME GROW.

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Slide 1

Hey Look Me Over!

Ensuring Infants and Toddlers are achieving at every stage and every age.

Slide 2

What is child development?

� Child development refers to how a child becomes able to do more complex things as they get older.

� Development is different than growth.

� Growth only refers to the child getting bigger in size.

� When we talk about normal development, we are talking about developing skills.

Slide 3

The 5 areas of development are:

� Large muscle

� Small muscle

� Communication

� Cognition

� Social Emotional

Lets look at each of these in more depth…

Parent

Guide

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Slide 4

Large Muscle:

Using large groups of muscles to sit, stand, walk, run, etc., balancing, and changing positions.

Slide 5

Small muscle:

Using hands to be able to eat, draw, dress, play, write, and do many other things.

Slide 6

Language and Communication:

Speaking, using body language and gestures, communicating, and understanding what others say.

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Slide 7

Cognitive:

Thinking skills including learning, understanding, problem-solving, reasoning, and remembering.

Slide 8

Social:

Interacting with others, having relationships with family, friends, and teachers.

Cooperating and responding to the feelings of others.

Slide 9 What are developmental milestones?

� Developmental milestones are a set of functional skills or age-specific tasks that most children can do at a certain age range.

� Although each milestone has an age level, the actual age when a typically developing child reaches that milestone can vary quite a bit.

� Every child is unique!

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Slide 10 The first three years of a child's life are an

amazing time of development …

� What happens during those years stays with a child for a lifetime.

� It's so important to watch for signs of delays in development.

� Get help if you suspect problems. The sooner a child gets early intervention the better their progress will be.

Slide 11

What is Early Intervention?

� Early intervention refers to a special program designed to help parents learn how to help their children develop optimally when the child is showing a delay – or there is potential for a child to develop delays based on various conditions.

� A child may qualify if they show a delay in one area of development.

� Or if the child meets state criteria to automatically qualify because the child has certain diagnosed conditions.

Slide 12 Children who are automatically eligible for Part C Early Intervention in Minnesota…

A child with certain:

1. Chromosomal/Genetic Disorders

2. Neuro-developmental disorders

3. Prenatal/perinatal conditions infants born weighing under <1500 grams

4. Physical conditions

5. Sensory losses

6. Social-emotional conditions

Minnesota Children with Special Health Needs Website has further information on conditions that result in automatic eligibility.

www.health.state.mn.us/mcshn

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Slide 13 If a child qualifies, he/she may receive some of these services based on his/her need:

� Core services available at NO cost:

� Determining eligibility:

� Referral, Screening, Evaluation, Assessment

� Specialized instruction

� Parent training

� Related Services

� Service Coordination

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Your role is very important!

� Help you child develop skills in all areas.

� Note what your child can do well.

� Note anything that seems hard for your child.

� Discuss any concerns with your child’s doctor or care provider.

Slide 15

Remember…

FREE assistance is available by calling:

HELP ME GROW

1-866-693-4769

Visit MNparentsknow.info for more information about developmental milestones.

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Slide1. Minnesota's Infant and Toddler Intervention system (HELP ME GROW) is a partnership between the Departments of Education, Health and Human Services and families with young children, ages birth to three. Families who have an eligible infant or toddler with developmental delays, disabilities, or certain diagnosed conditions work together with local service providers to access services and resources to help their child grow and develop.

HELP ME GROW is the new logo for all infant and toddler early intervention programs in Minnesota. Interagency Early Intervention Committees (IEICs) have been serving as local interagency infrastructures since 1985. IEICs were the first infrastructure designed by the legislative process requiring collaboration between local agencies to build local systems capacity to address the multiple and complex needs of families. Currently, there are 96 IEICs throughout Minnesota. Up until this point each had their own logo causing some confusion – the new Help Me Grow logo gives all of the programs

a uniform identity.

Slide 2. Part C of the Individuals with Disabilities Education Act (IDEA) is a federal program designed to provide, facilitate and coordinate early intervention services for disabled infants, toddlers, and their families. Funds for early intervention come mainly from the federal government to the state. The state has a process where by local Interagency Early Intervention Committee’s (IEIC’s) are allocated funds to provide early intervention services. Slide 3. Research shows that growth and development is most rapid in the early years. Learning begins at birth and involves a constant interaction between the child and the environment. A child with a developmental delay may be more limited in his or her ability to interact with the environment than a typically developing child and therefore may not acquire many basic skills. The sooner problems or potential risks are identified, the greater the chance of eliminating or minimizing existing problems or preventing future problems. Studies confirm the effectiveness of early intervention programs.

Slide 4. The criteria of “High probability” means that current research findings indicate that at least fifty percent of children with a given condition will experience a developmental delay in one or more areas of development at school age. Young children with developmental delays or with certain diagnosed physical or mental condition or disorder with a high probability of resulting in a delay may qualify regardless of whether the child is currently demonstrating a need or delay. Conditions include, but are not limited to:

• Hearing or vision loss • Infants born at < 3 lbs 5 oz • Sickle cell disease • Phenylketonuria (PKU) • Spina bifida • Down syndrome • Infant depression • Cerebral palsy

Professional Talking Points - NOTES

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Slide 5. The absence of a specific diagnosis or condition listed on this Minnesota Children with Special Health needs website does not automatically rule out a child's eligibility status. Technical assistance regarding eligibility is available from the Minnesota Department of Health at (651)201-3641 or health.mcshn@state.mn This Website gives more of a complete overview of eligibility criteria.

Slide 6. Minnesota children from birth to three-years-old who are eligible for the Help Me Grow program can receive services in their home, child care setting or school. These services are free to all families regardless of income or immigrant status. Early childhood specialists will work with eligible children and families to plan the services and supports they need. These may include: special instruction and other services, such as speech, physical and occupational therapy; support to a family to enhance their child’s development at home; and connections to community services and programs.

Slide 7. Rosenberg’s study OBJECTIVES. The objective of this study was to use a nationally

representative longitudinal sample of children born in the United States in 2001 to estimate rates of eligibility for Part C early intervention, to estimate rates of access to services for developmental

delays, and to examine factors that are associated with access to services. Slide 8. Data for this study were collected as part of the Early Childhood Longitudinal Study, Birth Cohort, which obtained data from participants when children were 9 and 24 months of age. Descriptive analyses were used to generate national estimates of the prevalence of developmental delays that would make children eligible for Part C services and rates of participation in early intervention services. RESULTS. Results indicated that 13% of children in the sample had developmental delays that would likely make them eligible for Part C early intervention. “At 24 months, only 10% of children with delays received services. Children with developmental delays were more likely to receive services than those who do not have delays. Black children were less likely to receive services than children from other ethnic and racial groups.” Slide 9. CHILD FIND CONCLUSIONS. The prevalence of developmental delays that make children eligible for Part C services is much higher than previously thought according to this study. They also found the majority of children who are eligible for Part C services are not receiving services for their developmental problems. They suggested strategies need to be developed to monitor patterns of enrollment in early intervention services and reach out to more minority children. We need your help to ensure children in need of early intervention are referred. Slide 10. Families' First Experiences with Early Intervention: National Early Intervention Longitudinal Study Report describes several aspects of families' experiences in beginning early intervention services using data from the National Early Intervention Longitudinal Study is following a nationally representative sample of 3,338 infants and toddlers and their families from the time they enter early intervention services until the children complete kindergarten. The report describes the timing of concerns, diagnosis, and entry into early intervention services, as well as parent perceptions of the identification process, the professionals with whom they interacted, and the resulting plan for goals and services. Slide 11. The findings indicate that the process of entering early intervention services is working well for many families. There also is evidence, however, to suggest that the process does not work equally well for all families and that how well it works is related to characteristics of the child and family. The percentage of children with disabilities receiving special education by race/ethnicity is not proportionate to the percentage of children by race/ethnicity in the general population. That is why it

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is important for professionals who work with children to help families connect with services such as early intervention. Slide 12. This study should give professionals confidence that families will appreciate being referred to early intervention services!

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Slide 1

For Infants and Toddlers

Early Intervention in Minnesota

Slide 2

What is Part C of I.D.E.A?

Part C of the Individuals with Disabilities Education Act was established in 1986 to ensure that infants and toddlers with developmental delays and their families receive appropriate early intervention.

In Minnesota this program is called HELP ME GROW…..

Slide 3 Part C services of I.D.E.A are designed to:

� Enhance the development of infants and toddlers with disabilities.

� Reduce future educational costs by minimizing special education through early intervention.

� Minimize institutionalization and maximize independent living.

� Enhance the capacity of families to meet their child’s needs.

Professional Guide

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Slide 4 IDEA 2004: Infant or Toddler with a Disability:

(A) An individual under 3 years of age who needs early intervention services because the individual:

(i) Is experiencing developmental delays as measured by appropriate diagnostic instruments in 1 or more of the areas of development or

(i) Has a diagnosed physical or mental condition that has a high probability of resulting in developmental delay

Slide 5 Children who are automatically eligible for Part C Early Intervention in Minnesota…

A child with certain:

1. Chromosomal/Genetic Disorders

2. Neuro-developmental disorders

3. Prenatal/perinatal conditions infants born weighing under <1500 grams

4. Physical conditions

5. Sensory losses

6. Social-emotional conditions

Minnesota Children with Special Health Needs Website has further information:

www.health.state.mn.us/mcshn

Slide 6 If a child qualifies he/she may receive some of these services based on his/her need:

� Core services available at NO cost:

� Determining eligibility:

� Referral, Screening, Evaluation, Assessment

� Specialized instruction

� Parent Training

� Related Services

� Service Coordination

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Slide 7 Prevalence of Developmental Delays: Participation in Early Intervention.

� A study by: Rosenberg, D., Robinson, C. (2008) Pediatrics Vol.121, 1503-1509.

� Objective: to use a nationally representative longitudinal sample of children born in 2001 to estimate rates of access to Part C early intervention services.

Slide 8

What did the study reveal?� The prevalence of developmental delays that make children eligible for Part C services is much higher than previously thought.

� The study indicated that as many as 13% of children at 9 and 24 months have developmental delays that are likely to make them eligible for Part C early intervention.

� Many Part C-eligible children do not receive early intervention because they are not identified and referred.

Slide 9 Part C of I.D.E.A 2004 Early Intervention for the youngest children

� Identifying children (birth to three) who maybe eligible for Part C services. WE NEED YOUR HELP!

� Developing plans for eligible children.

� Providing Services to eligible children and their parents.

� The benefit to the child, family and community.

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Slide 10 First Experiences with Early Intervention:PEDIATRICS No. 4 April 2004

� Designed to determine families’ initial experiences and perceptions.

� Sample based on a national representation of families.

� Interviewed 3338 parents with children receiving Part C services.

Slide 11 Conclusions drawn from interviews with parents:

� 98% of families reported Early Intervention personnel helpful.

� Families reported the services were related to their perceived needs.

� Parents felt they had been given a key role in decisions.

� 98% of families rated the services they received as good or excellent!

Slide 12 Conclusion drawn by the authors of this article:First Experiences – PEDIATRICS April 2004

“We conclude that the beginning of early intervention services generally is highly successful and responsive… a finding which should give pediatricians more confidence in referring families for early intervention services.”

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1. Part C of the Individuals with Disabilities Education Act was established in 1986 to ensure infants and toddlers with developmental delays receive appropriate early intervention. ____TRUE ____FALSE 2. Services are designed to help ‘enhance the capacity of families to meet their child’s needs’. _____TRUE ____FALSE 3. A child who is experiencing developmental delays, as measured by appropriate diagnostic instruments, in one or more areas of development is eligible to receive early intervention. ____TRUE _____FALSE 4. An infant or toddler who has a physical or mental condition that has a high probability of resulting in developmental delay is eligible to receive early intervention. ____TRUE _____FALSE 5. Babies born weighing three pounds five ounces or less are automatically eligible for early intervention. ____TRUE _____FALSE 6. A national study conducted by Rosenberg and Robin (Pediatrics 2008) concluded that many children eligible for early intervention do not participate in early intervention. ____TRUE _____FALSE 7. Early intervention has core services that are free to families. ____TRUE _____FALSE 8. Early intervention is a voluntary service. ____TRUE _____FALSE 9. Help Me Grow is the new statewide identity for all early intervention programs. ____TRUE _____FALSE 10. Parents can refer their child to early intervention. ____TRUE _____FALSE

Continuing Education – Post Test

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Bailey, D., Hebbleler, K. Scarborough, A. Spiker, D.& Mallik, S. (2004). First Experience in Early Intervention: A National Perspective. Pediatrics. 4. 887-896.

Berns, S., Boyle, M., Popper, B. & Gooding, J. (2007). Results of the premature birth national need gap study. Perinatology, 27. 38-44.

Minnesota Department of Education, Minnesota Part C Annual Performance Report, 2002-2003.

National Survey of Children with Special Health Needs.” Data Resource Center for Child and Adolescent Health. 4/15/2004. http://www.kpchr.org/cshcndrc/

Meisels, S. J. & Shonkoff, J. P. (1990). Handbook of Early Childhood Intervention. New York: Cambridge University Press. Minnesota Department of Education, Minnesota Part B Annual Performance Report, 2002-2003.

Rosenberg, R., Zhang, D. & Robinson, C. (2008). Prevalence of Developmental Delays and Participation in Early Intervention Services for Young Children. Pediatrics, 6, 1503-1509.

Troster, H. & Brambring, M. (1993). Early Motor Development in Blind Infants. Journal of Applied Developmental Psychology, 14, 83-106.

Perrin, J. M. & Ireys H. T. (1984). Development of Children with a Chronic Illness. Pediatric Clinics of North America, 31, 235-257. Ramey, C. T., Bryant D. M., Wasik, B. H., et al. (1992). Infant Health and Development Program for low birth weight, premature infants: program elements, family participation, and child intelligence. Pediatrics 3, 454-65. Shonkoff, J. P. & Phillips, D. A. (Eds.) (2000). From Neurons to Neighborhoods: The Science of Early Childhood Development. National Research Council and Institute of Medicine. Washington DC: National Academy Press.

The answers to all of the questions are TRUE. This post test was designed to highlight key points about early intervention that are covered in the DVD, Professionals guide and the presentation.

References

Continuing Education Post- Test Answers