New Regulations Affect Early Intervention Clinicians Recently announced regulatory changes to Part C of the Individuals With Disabilities Education Act (IDEA) affect speech-language pathologists and audiologists working with infants and toddlers, especially in nine critical areas, according to an ASHA analysis of the changes. The changes deal with several issues, including personnel standards, use of native ... Policy Analysis
Free
Policy Analysis  |   November 01, 2011
New Regulations Affect Early Intervention Clinicians
Author Notes
  • Catherine D. Clarke, director of education and regulatory advocacy, can be reached at cclarke@asha.org or 800-498-2071, ext. 5611.
    Catherine D. Clarke, director of education and regulatory advocacy, can be reached at cclarke@asha.org or 800-498-2071, ext. 5611.×
Article Information
Regulatory, Legislative & Advocacy / Policy Analysis
Policy Analysis   |   November 01, 2011
New Regulations Affect Early Intervention Clinicians
The ASHA Leader, November 2011, Vol. 16, 8-9. doi:10.1044/leader.PA3.16142011.8
The ASHA Leader, November 2011, Vol. 16, 8-9. doi:10.1044/leader.PA3.16142011.8
Recently announced regulatory changes to Part C of the Individuals With Disabilities Education Act (IDEA) affect speech-language pathologists and audiologists working with infants and toddlers, especially in nine critical areas, according to an ASHA analysis of the changes.
The changes deal with several issues, including personnel standards, use of native language, service coordination, and evaluation and assessment.
IDEA Part C final regulations [PDF], which were issued in September, establish rules to implement changes made to IDEA Part C as amended by the Individuals With Disabilities Education Improvement Act of 2004 (commonly known as IDEA 2004). Part C provides early intervention services for infants and toddlers ages 0–2 years.
The analysis, which includes ASHA commentary, identifies nine areas as important to SLPs and audiologists (and notes changes in other areas that also affect speech and hearing clinicians):
  • Personnel standards and qualifications and use of paraprofessionals and assistants.

  • Extension of Part C services beyond age 3.

  • Definitions of terms, including early intervention services, multidisciplinary, natural environment, scientifically based research, and native language.

  • Native language and related issues.

  • Links with early hearing detection and intervention programs.

  • Service coordination.

  • Individualized family service plan.

  • Traditionally underserved groups.

  • Evaluation and assessment.

Qualified Personnel/Personnel Standards
IDEA 2004 removed the requirement that states must employ only personnel who meet the highest requirement of the profession in the state. Under the Part C final regulations, which parallel the Part B (services for ages 3–22) regulations, states must now establish and maintain qualification standards to ensure that personnel are “appropriately and adequately prepared and trained” and that qualifications for Part C providers are consistent with any state-approved certification, licensing, or regulation for their profession or discipline. There is no prohibition on the use of paraprofessionals and assistants.
ASHA continues to be concerned with the definition of personnel qualifications in both Part B and Part C of the Act, which allow each state to determine its own requirements for qualified personnel. Despite ASHA’s advocacy for detailed definitions of paraprofessionals and assistants consistent with ASHA guidelines, no changes were made in defining these personnel or specifying the amount of supervision or who provides it.
Extension of Part C Services
States may now opt to provide early intervention services to children beginning at 3 years old and continuing until they enter, or are eligible to enter, kindergarten or elementary school. States may opt to serve a subset of children in this age group, but cannot limit the subset to a certain disability group. A child older than 3 receiving Part C services also must have the right to receive a free appropriate public education (FAPE) under IDEA Part B instead of Part C early intervention services. Nevertheless, a state is not required to provide Part B services while the child’s family has opted to receive Part C early intervention services. States must obtain written consent from parents of children who continue in Part C services, and parents retain the right to opt out of Part C services “at any time.”
ASHA advocated that parents choosing extension of Part C services be required to sign a specific consent form, acknowledging the effect of the extension on a child’s right to FAPE, and that they be allowed to opt out at any time.
Definitions
The new regulations revise some key definitions, add new definitions, and retain the language of others.
Sign language and cued services have a new, separate definition that includes auditory/oral language and transliteration services. It defines sign language and cued language services to include “teaching sign language, cued language, and auditory/oral language, providing oral transliteration services (such as amplification), and providing sign and cued language interpretation.”
Although ASHA unsuccessfully advocated for a new definition of sign language and cued language services to be separated from speech-language pathology services, this change offers more clarity regarding the nature of these services.
Speech-language pathology services continue to be listed as a type of early intervention service; services included in this definition remain the same, despite ASHA’s recommendation to add dysphagia and audiologic habilitation or rehabilitation to the list of speech-language pathology services. These services are not, however, precluded.
Audiology services continue to be listed as a type of early intervention service; definitions of audiology services remain the same. The definitions continue to underscore the importance of appropriate audiologic screening techniques and the responsibility of audiologists to determine the range, nature, and degree of hearing loss.
Multidisciplinary has been revised as it relates to the composition of an Individualized Family Services Plan (IFSP)—the team must include the parent and two or more individuals from separate disciplines or professions, one of whom is the service coordinator. Previously, one professional with expertise in two different disciplines could serve on the IFSP as the sole professional. ASHA views the change as positive because it provides more checks and balances and may reduce conflicts of interest.
Natural environments are now defined as settings that are natural or typical for a same-aged infant or toddler without a disability and may include the home, community, or other settings that are typical for an infant or toddler without a disability. The addition of “community” settings follows ASHA’s recommendation to broaden the definition of natural environments, as does the change in terminology to “typical” from “normal” in describing settings.
Native language for an individual with limited English proficiency is now defined to be the language normally used by the parents of the child. When conducting an evaluation and assessment, qualified personnel may determine that it is developmentally appropriate to use the language normally used by the child, depending on the child’s age and communication skills. For children who are deaf, native language is defined as the mode of communication normally used by the individual (including sign language). ASHA supports the recognition that it is important to evaluate a child’s abilities using the language(s) most appropriate for that child.
Native Language and Related Issues
The general notice that lead agencies (the entities that administer the state’s responsibilities under Part C, such as school districts or health departments) provide to parents must indicate that the notice is provided in languages native to the various populations in the state and specify those languages. This requirement parallels the Part B final regulations. ASHA agrees that providing information to parents in their native languages is critical to ensure their understanding and active participation, especially in areas with many different language communities. Parents and advocacy personnel also may be better positioned to advocate for children when they are aware what information is available in their native languages.
Child Find
EHDI. Part C lead agencies must add state early hearing detection and intervention (EHDI) systems to the list of programs to be coordinated with Child Find (the program to identify, locate, and evaluate all children with disabilities). ASHA advocated for the addition of EHDI systems to help ensure that children identified with hearing loss through newborn hearing screening are transitioned into early intervention services in a timely fashion.
Screening procedures. Personnel who conduct disability screenings must be trained to administer appropriate screening instruments. The regulations do not include ASHA’s recommendation for specific language identifying the need to provide services by qualified bilingual personnel or with the assistance of professional interpreters, when appropriate, to yield the most accurate information about a child’s abilities. It is critical, however, that interpreters, translators, or paraprofessionals have appropriate training.
Service Coordination
Service coordination, provided by a primary service provider, helps families receive services and supports they need. Service coordination ensures that referrals are made and assessments and services delivered in a timely manner, and that families have been advised of their rights and procedural safeguards. Service coordinators may follow up to ensure that families are receiving services identified in the IFSP in a timely, coordinated manner. ASHA supports the definition and identification of service coordination activities as part of the multidisciplinary team. ASHA cautions, however, that service coordination activities do not constitute service delivery, and that a primary service provider whose responsibility includes service coordination, referral, and conducting follow-up activities should not be expected to provide professional services outside of his or her realm of expertise.
Individualized Family Service Plan
The multidisciplinary team that develops the IFSP must include not only the parent, but also a service coordinator who is designated by the lead education agency and tasked with implementing the IFSP. The regulations outline the IFSP meeting process and describe the IFSP content, including whether services will be delivered in a natural environment, provisions for children who will continue to receive IFSP services beyond age 3, and identification of the service coordinator. ASHA remains concerned that the service coordinator may be expected to implement the IFSP even if those activities include delivering discipline-specific services for which the service provider is not trained.
Traditionally Underserved Groups
All families of an infant or toddler with a disability must be provided with access to culturally competent services when those services are necessary to meet the needs of the child. States must ensure that traditionally underserved groups have access to culturally competent services within their local areas and be meaningfully involved in planning and implementing services. ASHA supports the clarification that this provision is not limited to providing culturally competent services, but also focuses on the access of traditionally underserved groups to culturally competent services.
Evaluation and Assessment
Requirements specify that unless it is clearly not feasible to do so, all evaluations and assessments of a child must be conducted in the native language of the child. Also, unless clearly unfeasible, family assessments must be conducted in the native language of those being assessed. Consistent with ASHA policy, additional information clarifies the expectation that every effort be made to exhaust options for providing services in the native language.
For the full text of ASHA’s analysis of the 2011 IDEA Part C final regulations, visit ASHA’s advocacy webpage. ASHA is developing additional information to help members implement the regulations.
0 Comments
Submit a Comment
Submit A Comment
Name
Comment Title
Comment


This feature is available to Subscribers Only
Sign In or Create an Account ×
FROM THIS ISSUE
November 2011
Volume 16, Issue 14