III. Evaluation Reports and Documentation Requirements
The evaluator is responsible for sharing the results of the child's evaluation and assessment with his/her parents, in a manner that is understandable to parents. The parent must have the opportunity to discuss the results of the evaluation with the evaluation team, or a designated member of the evaluation team, who conducted the evaluation, including any concerns the parent has about the evaluation process and the extent to which the parent believes the evaluation accurately reflects the child's abilities and needs.38 The evaluator is responsible for helping parents to understand the results and ensuring the evaluation has addressed the parent's concerns and observations about the child.39 The evaluator cannot recommend any specific service provider to the parent and should refrain from making recommendations regarding frequency, intensity, and duration of specific services until such time as the family's total priorities, concerns, and resources have been identified and the IFSP is under discussion. The evaluator is responsible for using the results of the developmental assessment to identify the types of services that are clinically appropriate to meet the unique developmental needs of the child.
The evaluator must provide the written and oral summary of the evaluation to the parent in the parent's dominant language or other mode of communication, to the extent feasible, and within confidentiality requirements and the parent's preference and consent to using an interpreter.40
EIP regulations also require the evaluation team to prepare an evaluation report and written summary and submit the summary, and upon request the report, to the following individuals within sufficient time to ensure completion of the IFSP within 45 days of a child's referral to the EIP:
- the child's parent(s);
- the EIO; and,
- the initial service coordinator.
Because the EIP regulations at 10 NYCRR §69-4.8(a)(9) require the evaluator to fully share the results of the child's evaluation and assessment with the parent, it is appropriate for all parents to receive a copy of their children's full multidisciplinary evaluation reports. In addition, EIOs must receive a copy of children's multidisciplinary evaluation reports to ensure that eligibility for the EIP has been established and assist them in preparing for IFSP meetings for children eligible for the EIP. With parent consent, the evaluation summary and report should also be shared with the child's primary health care provider41 and the local social services commissioner or designee for those children in the care and custody, or custody and guardianship, of such commissioner.42
The evaluation report and summary must include the following information:
- the names, titles, and qualifications of the persons performing the evaluation and assessment;
- a description of the assessment process;
- the child's responses to the procedures and instruments used as part of the evaluation process, and the family's belief about whether the responses were optimal;
- the developmental status of the child in each of the five developmental domains, including the unique strengths and needs in each area;
- documentation of how clinical opinion was used by the evaluation team in evaluating and assessing the child's developmental status and potential eligibility for the EIP; and,
- measures and/or scores that were used, if any; and, an explanation of these measures or scores.43 The evaluation report should also include diagnostic information and ICD-9 codes related to the child's eligibility, where appropriate.
In addition, the evaluation report must include a clear statement of the child's eligibility. The eligibility statement must include either a diagnosed condition with a high probability of resulting in developmental delay and associated ICD-9 code; or, a statement of developmental delay consistent with the state definition of developmental delay and associated ICD-9 code for developmental delay.44 When a diagnosis is made by the evaluation team, one or more members of the team must be qualified under the practice acts in the education law governing their profession to render a diagnosis (see Appendix B). If the results of the multidisciplinary evaluation indicate the child is not eligible for the EIP, the evaluation report should also clearly document reasons why the child is not eligible (for example, the child's development is within normal range, or the child is not experiencing a developmental delay consistent with the State's definition of developmental delay). When children are found eligible for the EIP, the evaluation team should submit written summaries and reports in a timely manner, so that information from the multidisciplinary evaluation is available for review and consideration at the time of the IFSP meeting. See Appendix D for an example of an evaluation report format.
Upon receipt of an evaluation report from an evaluator, the EIO should review the evaluation report to ensure that the evaluator has followed regulatory requirements and Department standards and procedures explicated in this document, in performing the child's evaluation. If the EIO determines that the evaluation report indicates that the evaluator has not followed PHL, regulatory, and/or Department issued standards when performing the child's evaluation, the EIO may require that the evaluator immediately submit additional documentation to support the eligibility determination made by the multidisciplinary evaluation team. If the multidisciplinary evaluation team does not provide the requested documentation, or the documentation provided continues to be inconsistent with PHL, regulatory requirements, and/or Department standards and procedures, the child's eligibility has not been established and the EIO can require that the parent select another evaluator to complete a multidisciplinary evaluation to determine whether the child is eligible for the EIP. Under these circumstances, if a parent does not consent to another evaluation, the EIO must inform the parent of the right to due process, including mediation or an impartial hearing, regarding the child's eligibility determination. The child's eligibility for the EIP is not established until either another multidisciplinary evaluation or due process proceedings have been completed.
If the evaluator determines the child is eligible for the EIP, the EIO is responsible for convening a meeting within 45 days of the child's referral to the EIO, to develop an initial IFSP. The evaluator is responsible for participating in the IFSP meeting. If the evaluator is unable to attend the meeting, arrangements must be made for the evaluator's involvement in the meeting by participating in a telephone conference call, or having a knowledgeable, authorized representative attend the meeting.45 A person or persons directly involved in conducting the child's multidisciplinary evaluation must participate in the IFSP meeting.46 An employee of the evaluation agency who did not participate in the evaluation is not considered a knowledgeable representative and is not an acceptable substitute.
EIP regulations require that the IFSP, including the outcomes to be achieved for the child and family, the services needed to meet the unique strengths and needs of the child and family, and, the frequency, intensity, location, and method of delivering early intervention services, be jointly developed by the following members of the IFSP team:
- the EIO;
- initial service coordinator;
- the evaluator (i.e., a person or persons involved in the child's evaluation); and,
- any other persons, such as the child's primary health care provider, or child care provider, who the parent or the initial service coordinator, with parent consent, invite.
Other individuals requested by the parent, or who may be appropriate (such as persons providing services to the child or family), may also participate in the IFSP meeting. For children in the care and custody, or custody and guardianship of the local social services commissioner or such commissioner's designee should be invited to participate in the IFSP meeting.
As previously mentioned, although evaluators make recommendations about the type of services that may be needed by the child and family, based on the results of the evaluation, the EIP regulations at 10 NYCRR §69-4.8(a)(4)(iv) require evaluators to avoid making recommendations regarding the frequency, duration, and intensity of specific services until such time as the family's total priorities, resources, and concerns have been assessed, and the total plan for services under the IFSP is under discussion with the IFSP team. The multidisciplinary evaluation team is responsible for making clinically appropriate service recommendations, based on their evaluation and assessment of the child's developmental strengths and needs, to inform the IFSP decision-making process. The evaluation and assessment of the child cannot include any reference to a specific service provider.47 Municipal staff, service coordinators, and service providers should also refrain from making recommendations about the frequency, duration, and intensity of services to parents prior to IFSP meetings.
In contrast to the evaluation process, parents do not select providers of early intervention services included in their IFSPs. Once an IFSP is agreed upon, the municipality is responsible for ensuring the provision of services included in the child's IFSP, including identifying and arranging for service providers to deliver these services.48 Municipalities must maintain contracts with a sufficient number of service providers to deliver timely and effective services to eligible children and their families. Municipalities should not select providers to deliver services to an eligible child based on a provider's position on a list. Such a practice does not ensure adequate consideration of the child's and family's individual needs. Municipalities should consider the extent to which it is appropriate for evaluators to deliver early intervention services to children whom they evaluated. In all cases, when arranging for services included in a child's IFSP, the EIO must consider the individualized needs of each child and family, and should consider a range of factors when identifying an appropriate service provider(s) for the child and family, such as the:
- the child's specific diagnosed condition(s) and/or areas of developmental delay, include level of delay;
- unique developmental strengths and needs of the child;
- goals, strategies, outcomes, and intervention modalities included in the child's and family's IFSP;
- strengths and needs of the family with respect to enhancing their child's development;
- expertise and experience of the provider relative to the child's and family's needs;
- language and cultural considerations;
- provider capacity to deliver the services the child and family needs;
- setting/location in which services are to be provided (e.g., the proximity of a provider to the home or community-based setting, transportation needs of the child, etc.); and,
- other factors related to the quality and consistency of services to be included in the IFSP.
When the results of the multidisciplinary evaluation show that children are typically developing, or developing at a level above the EIP eligibility criteria, the multidisciplinary evaluation team and the service coordinator should ensure that the child's parents receive practical information regarding possible next steps as appropriate. For example, the multidisciplinary evaluation team can provide parents with information about child development milestones and what to look for as their child grows and develops to ensure they continue to make age-appropriate progress. If a child does not meet the threshold for eligibility for service delivery under the Early Intervention Program, but there are concerns about the child's progress, it may be reasonable for the family to seek assistance through other service delivery systems or other early childhood programs (e.g., Early Head Start, community-based programs). The multidisciplinary evaluation team is responsible for providing clinical information and making recommendations about alternative resources or services that may be beneficial to the child and family. For children who appear to be at-risk for developmental problems in the future, the multidisciplinary evaluation team may recommend that the child be included in municipal child find activities for at-risk children (screening and tracking), with parent consent. Service coordinators can provide parents with information about available resources in their communities, including contact information for such programs and services.
38 10 NYCRR §69-4.8(a)(9)(ii)
39 10 NYCRR §69-4.8(a)(9)(iv)
40 10 NYCRR §69-4.8(a)(9)(v)
41 10 NYCRR §69-4.8 (a)(9)(i)
42 10 NYCRR § 69-4.8 (a)(9)(i)
43 10 NYCRR §69-4.8(a)(9)(ii)
44 10 NYCRR §69-4.8(a)(9)(iii)
45 10 NYCRR §69-4.11(a)(2)(iii)(a)
46 34 CFR §303.343(a)(1)(v)
47 PHL §2544(5)
48 PHL §2552(1)