Phase 2 Module 1: Evaluation is the first in a series of modules for Phase 2 offering information about Evaluations, Family-Directed Assessments, and Child Assessments. This module focuses on Evaluation. Information about Family-Directed Assessments and Child Assessments will be covered in the next Phase 2 modules.

1. PHASE 2/Module 1
EVALUATION
“Be Ready”

2. A Different Way of Thinking
• Understand the regulatory DIFFERENCES between
evaluation, initial child assessment and family directed
assessment
• Understand the REQUIREMENTS of an evaluation
• Understand the INTEGRATION of evaluation
information into IFSP
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EVALUATION

3. EVALUATION
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4. REFRESHER
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5. DIFFERENCES
New in IDEA Part C
Evaluation versus child and family directed assessment
Multidisciplinary
ICO cannot negate evaluation results
Native language
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6. DIFFERENCES
3 Distinct Processes
Evaluation –
 Eligibility Determination - If eligible then the
following is required:
Initial Child Assessment – Focus is intervention
planning. Observe how child is using
developmental skills in home and community
(natural settings).
Family-Directed Assessment – Personal
interview (using a tool) with family regarding
routines/daily activities. Leads to discovery of
Concerns, Priorities and Resources related to
enhancing child‟s development.
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7. DIFFERENCES
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New in NC ITP
5 specific standardized, norm-referenced testing
instruments
Consistent implementation of required components
Revised Referral Form (Section II deleted)
NEW UPDATE: Eligibility Determination Form
Revised Intake/Child History Form (optional)
How to document evaluation results for all children

8. DIFFERENCES
Screening, Referral and Intake
Referral Form (Revised)
Intake
Screening (No implementation)
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9. 8

10. DIFFERENCES
Discussion Questions
For each discussion question :
Compare the CDSA‟s current practices vs.
requirements outlined in the evaluation presentation.
Describe what CDSA practices and/or procedures
are consistent with the evaluation requirements.
Outline what CDSA practices and/or procedures
need to change based upon the evaluation
requirements.
What additional information does the CDSA
want/need to learn based upon these comparisons?
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11. DIFFERENCES
Discussion Questions
Family-Directed Assessment is required after eligibility
determination. How would this change your initial
meeting with families?
What information would you consider when deciding to
complete the evaluation process first and then only
complete child and family assessments if the child is
eligible?
What are the benefits to only completing child and family
assessments if the child is already determined eligible?
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12. 11

13. 12

14. REQUIREMENTS
Revised Referral Form
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15. 14
REQUIREMENTS
Example
Ava’s Referral Form

16. REQUIREMENTS
EVALUATION
“Means the procedures used by appropriate
qualified personnel to determine a child‟s initial
and continuing eligibility . . . including
determining the status of the child in each of
the developmental areas” *303.321
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17. 16
Each Process
in More Detail

18. REQUIREMENTS
Evaluation Process
Required Components
 Eligibility through record review
or
 Administering an evaluation instrument;
 Taking the child‟s history by parent interviews;
 Identifying child‟s level of functioning in all 5 domains;
 Understanding the full scope of the child„s unique
strengths and needs; and
 Reviewing medical, educational, or other records.
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19. REQUIREMENTS
Evaluation, cont’d
Gathering information from other sources
Timely, comprehensive, nondiscriminatory,
multidisciplinary evaluation
Synthesis of all relevant information:
Informed clinical opinion
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20. REQUIREMENTS
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Eligibility through record review
• A child’s medical or other records may be used to
establish eligibility (without conducting an
evaluation of the child) if those records indicate that
the child’s functioning in one or more of the
developmental areas constitutes
• a developmental delay or
• established health condition

21. REQUIREMENTS
Evidence for established condition or
developmental delay(s)
Referral source/parent information
Recent evaluation
Written evidence
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22. REQUIREMENTS
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Review of records for established
condition
• Review of written evidence
• Diagnostic statement from MD, hospital
records, hospital discharge summary, and
records from primary care physician
• No requirements regarding “who” must review
records
• Ability to review & synthesize available
information
• Consult with qualified CDSA staff or medical
provider when unclear

23. REQUIREMENTS
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Review of records for developmental delays
• Clear and complete
• Tool(s) used
• Can be considered if they are reported by
standard scores or age equivalencies (if
instrument allows)
• Percent delay only when a standard score is
unavailable
• Parent interview, observations and scores
• Current and relevant content
• Within the past 6 months from referral to ITP
• Information that is reliable and valid for eligibility
determination

24. REQUIREMENTS
DISCUSSION QUESTIONS
What local procedures are in place to determine
if a child is eligible based upon the review of
records?
How does the CDSA expedite gathering medical
or other records in order to use this eligibility
determination process in a timely manner?
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25. 24
REQUIREMENTS
Need to Determine Eligibility
No single procedure may be used as the sole
criterion for determining a child„s eligibility.

26. REQUIREMENTS
Evaluation Process
Administering an evaluation instrument
 5 instruments recommended to ensure consistency
 Consider how the instruments may allow for scoring
of items.
 Gather information in most authentic/natural way
Parent report of skills
Be open to observe skills/test items that can be
scored based on functional use of a skill.
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27. REQUIREMENTS
Evaluation Tools
Brigance
Developmental Assessment of Young Children
(DAYC)
Bayley Scales of Infant and Toddler
Development – III
Battelle Developmental Inventory II (BDI II)
The Mullen Scales of Early Learning
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28. REQUIREMENTS
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Discussion Questions
Next week after support call

29. REQUIREMENTS
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Qualified evaluation personnel
 Consider qualifications outlined by the
evaluation instrument‟s manual.
 Educational and/or professional training in
evaluations of infants and toddlers.

30. REQUIREMENTS
Qualified Personnel for Evaluations,
cont’d
Understand qualitative and quantitative measures
and knowledgeable of multiple developmental
domains.
Ensure staff appropriately qualified via
educational and professional experience, ongoing
training, and performance monitoring.
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31. REQUIREMENTS
Child history
Taking the child‟s history (including
interviewing the parent)
Child History Form
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32. 31
OPTIONAL
Intake/Child
History Form

33. 32
OPTIONAL
Ava’s
Intake/Child History Form

34. 33
REQUIREMENTS
Identifying child’s functioning level in 5 domains
• Cognitive
• Physical (including vision and hearing)
• Communication
• Social –Emotional
• Adaptive

35. 34
REQUIREMENTS
Evaluation Process
• Gathering information from other sources
 Other Sources = family members, other care-givers,
medical providers, social workers, and educators, if
necessary, to understand the full scope of the child„s
unique strengths and needs

36. 35
REQUIREMENTS
Discussion Questions
When is it necessary to gather information from
other sources?
When would discussions with others occur in the
evaluation process?
How does the CDSA currently incorporate
information beyond scores into the evaluation
process?

37. REQUIREMENTS
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Informed Clinical Opinion
Necessary safeguard against eligibility
determination based upon isolated information or
test scores alone.

38. REQUIREMENTS
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Informed Clinical Opinion
NECTAC – Informed Clinical Opinion (ICO)
 Meaning in the context of Part C
 Effect on eligibility determination
 Why necessary to document ICO

39. REQUIREMENTS
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Meaning in the context of Part C
 Makes use of qualitative and quantitative information
 Knowledge and skill of the multidisciplinary team, which includes
parent(s)
Relevant questions
 Which staff might have an ICO?
 What might these staff have an ICO about?
 How the ICO can be integrated into the evaluation process?

40. REQUIREMENTS
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How ICO affects eligibility determination?
Individual -
 Clinical interviews with parents
 Evaluation of the child at play
 Observation of parent-child interaction
 Information from other sources (child care providers,
family members)
 Medical records

41. REQUIREMENTS
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How ICO affects eligibility determination?
Multidisciplinary Team -
 Synthesizes quantitative and qualitative information
 Impressions of the “whole child”- goes beyond test
scores

42. REQUIREMENTS
Why necessary to document ICO?
Provides baseline to measure progress and
changing needs of child and family over time.
Assure procedural safeguards were provided.
Support that multiple information sources
were used.
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43. REQUIREMENTS
Informed Clinical Opinion
Informed clinical opinion may be used
independently to establish eligibility even when
other instruments do not establish eligibility;
however, at no time may informed clinical opinion
be used to negate the results of evaluation
instruments used to establish eligibility.
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44. REQUIREMENTS
Informed Clinical Opinion
Explain why evaluation standards and procedures,
used with the majority of children resulted in
inconclusive findings for this child.
Indicate what objective data was used to conclude that
the child has a developmental delay and in need of
early intervention services.
Indicate which data had the greatest relative
importance for the eligibility decision.
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45. REQUIREMENTS
Discussion Questions:
How does the CDSA staff document the sources and
use of informed clinical opinion for each child
evaluated?
How does the CDSA currently document ICO when
used as an independent basis to establish a child‟s
eligibility for the Infant Toddler Program?
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46. REQUIREMENTS
Continuing Eligibility
What are prompts that might signal an IFSP team
to notify the CDSA to examine a child‟s
continuing eligibility for the NC ITP?
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47. REQUIREMENTS
Continuing Eligibility
Parent or IFSP team members express that a
child has made progress on meeting outcomes
on IFSP and no other concerns noted.
COSF rating near exit documents child is at level
as same aged peers.
Other examples?
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48. REQUIREMENTS
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Discussion Questions
What are other prompts that might signal and
IFSP team to notify the CDSA to examine a child‟s
continued eligibility for the ITP?
What local procedures are in place to evaluate the
continued eligibility of an enrolled child?

49. PUTTING IT
ALL
TOGETHER
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50. DOCUMENTATION
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Ava’s Evaluation

51. DOCUMENTATION
Eligibility Determination Documentation
Ava’s eligibility documentation
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52. DOCUMENTATION
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Documentation of eligibility determination
through record review
Important to clearly document how eligibility determination was
made
If through record review:
 Copy of the records reviewed
 Narrative of the CDSA staff completing review
 Type of record(s) reviewed
 Date of evaluation(s) and /or information reviewed to
determine eligibility
 Any relevant information why the results were or were
not accepted as reliable and valid for current eligibility
determination (if not accepted, can be documented in a
service note)
• Eligibility Category (e.g. eligible for the NC ITP based
upon the Established Condition of Down Syndrome)

53. DOCUMENTATION
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Documentation of evaluation conducted for eligibility
determination to include:
• Name of evaluation instrument(s), date administered,
name and credentials of all evaluators
• Documentation of all required components of the
evaluation process
• Documentation of the relevant information and
procedures used in determining the child‟s eligibility ,
including information related to ICO
• Eligibility determination and the category of eligibility

54. WHAT’S NEXT?
Discussion Questions
Submit questions to Core Team email address
Support Calls planned based upon themes
 Phase 2 Support Call: May 28
 Phase 2 Family Assessment: June 4
 Phase 2 Support Call: June 11
 Phase 2 Child Assessment Webinar/Support Call: June
18
 Phase 2 Support Call: June 25
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