First Steps Early Intervention Services

Introduction and Overview

What is First Steps Early Intervention Services?

Early Intervention is a system of services for young children, birth to age three, and for their families.  In Indiana, the statewide early intervention system is called First Steps.  Sometime, the early intervention system is called the “Part C” program.  Part C of the Individuals with Disabilities Education Act (IDEA) is the federal law that encourages states to provide services to infants and toddlers with special needs and their families.

First Steps is designed for children who have a disability, a delay in their development, a special health care need that maybe cause a delay in development or for children who have a medical or biological risk factor that might cause a developmental delay without the benefit of early intervention services.

First Steps services are provided by many different professionals in your community.  If your child is eligible for First Steps services, there are many federal and state rules, regulations and policies to help see that your child and family can get the services you want and need.

Why is there a need for First Steps Services?

¨       Helping children while they are very young may help prevent later developmental difficulties.

¨       Research and experience has shown that working with children who have a disability early in life can help reduce the effects of the disability.

¨       Early Intervention programs and services help families with the practical and emotional tasks that may come from having a child with special needs or disabilities.

¨       While many children will reach their developmental milestones without any extra help, some children need that extra help.  First Steps services can help families become more familiar with what they can do to encourage their children’s development.

¨       First Steps programs and services can help families link up with other families who have similar needs, concerns, and priorities.

Who does First Steps Serve?

Every state has different rules for determining who is eligible for early intervention services.  In Indiana, First Steps serves:

¨       Children from birth to their third birthday

¨       Children who have an identifiable disability or disabilities

¨       Children who have special health concerns that may result in developmental delay

¨       Children who have a developmental delay of 25% in at least one area of development or a delay of 20% in two or more areas of development

¨       Children who have one of eight biological risk factors that may result in a delay of development if early intervention services are not provided.  (Experience and research shows that biological risk factors may contribute to developmental delays in children and that early intervention services ma prevent delays in children who are biologically at risk.  That’s what early intervention is all about!)

What are the areas of development?

Areas of children development include:

¨       Physical development – including vision, hearing and health

¨       Cognitive development – how a child thinks and learns

¨       Communication development – what a child understands and how they use sounds, gestures, and words

¨       Social / emotional development – how a child plays and interacts with other people

¨       Adaptive / self-help development – how a child eats, sleeps, toilets, dresses, etc.

Delays in development can be detected by using several developmental assessment tests.  Most of these assessments can be completed quickly and easily, in a play-like atmosphere that children enjoy.  No one assessment alone will ever be used to determine whether or not a child has a developmental delay.

What are the biological risk factors that may make a child eligible for First Steps services?

The biological risk factors that may cause substantial developmental delay if early intervention services are not provided are:

¨       Limited prenatal care

¨       Maternal prenatal substance abuse

¨       Severe prenatal, perinatal or postnatal complications

¨       Asphyxia (loss of oxygen)

¨       Very low birth weight (less than 3.3 pounds)

¨       Small for gestational age

Who refers children to First Steps?

Anyone can make a referral to First Steps.  Most referrals come from:

¨       Pediatricians and other doctors

¨       Health Care workers

¨       Parents themselves

Other community agencies who may refer to First Steps include:

¨       Social service agencies

¨       Public health agencies

¨       Child evaluation clinics

¨       Mental health programs

¨       Public schools

¨       Hospitals

¨       Public screening clinics and other child find activities

¨       Any public or private program or agency interested in children and their families

What’s CRO and what does it do?

In Indiana, the Central Reimbursement Office, sometimes called the CRO, is a cooperative process for authorizing and paying for services for your child and family.  The CRO ensures that the correct funding sources are tapped to pay for the services your child needs.  Through an electronic record, the CRO keeps track of your child’s services, service providers and handles all the billing and reimbursement for services.  All records and information obtained and kept by the CRO are protected for confidentiality under the Family Educational Rights and Privacy Act (FERPA) as well as state an federal regulations under IDEA. No one can look at or get a copy of any of your child’s records without your informed, written permission beforehand.

What is the SPOE ?

The SPOE, or System Point of Entry, is established throughout Indiana to access information, funding, and service options for families, providers, and community resources.  The SPOE, along with local planning and coordinating councils (LPCCs) and Cluster Advisory Work Groups, encourages the referral of infants and toddlers to the First

Steps system. 

The SPOE intake coordinators for your county ensures a consistent and visible point of access within your community for a parent with a child who has special needs or a parent with concerns about their child’s development.

What can the SPOE do to assist my family?

The Intake Coordinator from the SPOE can provide information about:

¨       First Steps early intervention services

¨       The Children with Special Health Care Services program

¨       Service providers who can assist with your child’s development and therapy

¨       Local and state resources

¨       Advocacy services

¨       Family-to-Family networks of support

The Intake Coordinator from the SPOE will:

¨       Assist with the application, eligibility and enrollment for First Steps and CSHCS

¨       Meet with you at a convenient location and time to discuss your family’s concerns, priorities, and resources

¨       Explain your rights, opportunities, and responsibilities available to you through federal and state law

¨       Ensure that service coordination options are provided to eligible children and families

¨       Offer options and information about the wide variety of services and supports available to families throughout Indiana

¨       Facilitate the completion of your child’s initial Individualized Family Service Plan (IFSP)

¨       Electronically link your child’s record and service needs with the CRO

What else do Intake Coordinator’s do?

The Intake Coordinator with your county’s SPOE is an individual trained to provide information on eligibility and available services for First Steps.  Intake Coordinators assist each family in identifying their concerns and needs and in accessing available resources to help meet these needs.

What should I expect?

Families should expect timely and accurate information on programs and services available for their child.  They should also expect that these services will be made available to families in a setting that is convenient and comfortable to the family.  If an Intake Coordinator is unable to answer a question, families should expect that they will research the question and locate a response as quickly and accurately as possible.

If your child is eligible for services, you should expect to receive copies of documents that are used to plan and provide services for your child and family.  Families can expect the Intake Coordinator to assist them in linking up with all the necessary services and service providers their child needs in helping them select an ongoing Service Coordinator who will continue to assist the family.

What is the process for beginning First Steps Early Intervention Services?

Everything starts with a referral. Whether you call First Steps or some other service provider calls for you, the process begins at that point.  A referral form is completed which includes:

¨       Your child’s name and date of birth

¨       Family information, including address and phone number

¨       The Referral source’s contact information, if different from the parent

¨       The reasons for the referral

Once this form is completed, you will be contacted by telephone or through a home visit to talk with you about your concerns and to see if you agree with the reason for the referral.

During this first visit with the SPOE Intake Coordinator, you will be beginning the process to determine if your child is eligible for First Steps Services and learning more about the First Steps process.  You will also learn about the rights and responsibilities of families who participate in Fist Steps.

As with any program, there are lots and lots of papers which have to be signed.  Many of these papers allow your permission for information to be shared and exchanged between the First Steps program and other service providers who have worked with your child and your family, such as your child’s doctor.  All information is held in the strictest confidence and is never shared without your informed, written approval.  That’s why there are so many pieces of paper for you to sign.

The Intake Coordinator will begin the process of collecting together al the available information abut your child.  With this information, which includes any developmental testing that may have been done previously, or health and

medical summaries, and information you provide to the Intake Coordinator, we can begin to set up a multidisciplinary eligibility determination team, a group of providers who have the experience, knowledge, and training about child development.  This team, along with you, will look at all the information that is available and determine if you child is eligible and in need of First Steps services.

The Intake Coordinator will also help you fill out the applications for other programs which may be beneficial in providing services or funding to pay for your child’s early intervention services.

If needed, the Intake Coordinator will arrange for your child to have additional developmental testing.  Eligibility information is included on the First Steps Eligibility Determination Document, which will include your signature as well as other members of the eligibility determination team.

If you child is eligible for First Steps, then the process of developing the IFSP or Individualized Family Service Plan, will begin.  The IFSP is the “map” for planning and providing the services that will provide the most benefit to your child and family.  This document is reviewed by you and your ongoing service coordinator every six months and is rewritten at least once a year to allow for an up-to-date guide for your child’s services.  More information about the IFSP, it’s components, and its purpose are included in an additional fact sheet that the Intake Coordinator can give to you.

At some point in the process, and as early as possible, the Intake Coordinator will help you in choosing an ongoing service coordinator who will be your partner in First Steps services after the intake process has ended.  The ongoing service coordinator may assist in the development of the IFSP.

Once all the information is gathered to help write the IFSP, the Intake Coordinator will schedule an IFSP conference which includes your child’s IFSP team and together you will all develop the plan that will guide your child’s services.

Who might be on the IFSP team?

The IFSP team includes as many people as possible who will be actively involved in your child’s First Steps early intervention services.  Unfortunately, not every team member will be able to make it to the IFSP meeting, but the Intake Coordinator will get input from those who cannot be in attendance.

The most important team members include:

¨       YOU – As your child’s parent and the person who knows your child the best, you are one of the most important members of your child’s team

¨       The Intake Coordinator

¨       The ongoing Service Coordinator

¨       Providers who will be doing your child’s First Steps services

By federal law and state regulation, the process from referral to the development and signing of the IFSP should take no more than 45 days.  If this process is too quick for you, be sure to discuss this with your Intake Coordinator.

What is an Ongoing Service Coordinator?

The Service Coordinator you select will be a very important part of your child’s and family’s First Steps team.  It will be the Service Coordinator’s job to make sure that all the First Steps services in your child’s IFSP are provided and that they work well together.  A Service Coordinator is able to:

¨       Coordinate evaluation and assessments

¨       Help plan for and take part in developing, reviewing and evaluating the IFSP

¨       Help you identify available service providers

¨       Tell you about advocacy services and training opportunities

¨       Coordinate and monitor the delivery of First Steps services

¨       Coordinate with medical and health care providers

¨       Help to develop a transition plan that will assist your child and family after your child turns three

When the needs of your child and family change, the Service Coordinator can help you to change the IFSP, make changes with the electronic record and the CRO, and keep everything running as smoothly as possible.  Your Service Coordinator is the link between your family and your service providers.

What if I’m not pleased with the way things are going in my child’s services?

When Congress created the early intervention program, they felt very strongly that parents have rights.  The First Steps early intervention service providers in your community agree with the steps that federal law and state regulation took to ensure parent’s rights.

If, at any time, you are not pleased with the way things are going, talk to your service providers, your service coordinator or call the First Steps office at 812-231-8337 or toll free, 1-877-860-0413.

Everyone knows that the success of the First Steps system and the success of your child depends on our ability to work together.  Don’t hesitate to make those phone calls or have those discussions if you have any questions about anything or are unhappy with the way things are going.  You have the right to change your provider and can do so by calling your Service Coordinator or the SPOE office.

What are my parents’ rights?

A number of informational fact sheets and brochures have been developed around the country and throughout Indiana that explain your rights under First Steps services.  Your Intake Coordinator and ongoing Service Coordinator can give you copies of these documents. 

In brief, these are the rights guaranteed by law:

¨       Families have the right to a timely evaluation by a multidisciplinary team of two ore more qualified professionals who examine the child’s medical history, development, and current abilities.

¨       Eligible children have the right to a coordinated plan, the IFSP, which includes your family’s concerns, priorities, and resources as well as major outcomes for your child and family.

¨       Families have the right to consent or provide permission before an evaluation, assessment, or the beginning or ending of services.

¨       Families have the right to prior notice before any changes in First Steps services.

¨       Families have the right to privacy, at all time, of their information held in early intervention records and must give their permission before that information can be shared or exchanged with another provider.

¨       Families have the right to review records relating to their child and family.

¨       Families have the right to participate in all meetings that deal with the developing, reviewing, or revising of their child’s IFSP.

¨       Families have the right to understand all information and that information should be presented in such a way that families do understand.  This may include providing information in a different language or format.

¨       Families have the right to an advocate or friend to assist them through the process.

¨       Families have the right to disagree, to file a complaint and have it resolved in a timely fashion.

To find out more about your rights, you can always talk to your service provider(s), your Service Coordinator, your local First Steps council coordinator or the First Steps of West Central Indiana office at 877-860-0413.