Monday, May 30, 2016

First Steps Best Practice

Early Intervention Services 

 1. Early intervention services should be provided in the natural environment and reflect the routines and activities of the child/family. At the initial IFSP team meeting, opportunities for service delivery in the child's natural environment should be identified. Strategies or interventions outside of the natural environment should not be considered before services provided in the child's natural environment have been determined not to be effective. When early intervention cannot be achieved satisfactorily for an infant and toddler in a natural environment, federal law does allow the IFSP team to decide on an individual basis, that services may be provided in a setting other than the natural environment. The Indiana First Steps system also allows the IFSP team, (on which parents are participating members), to make the decisions regarding the provision of early intervention services. As written in the Bureau of Child Development Services - Natural Environments Policy Statement of April 2000, “Only when a team cannot effectively provide services within the child’s routines is discussion to occur regarding the provision of services in another setting. Personal preferences and/or convenience for providers or family are not acceptable justification. Justification must discuss how efforts to provide services in the natural environment were conducted and why these have been determined by the team to be unsuccessful. The justification must include a plan for how services will be generalized into the child’s daily routines and activities.” 

2. Only Early Intervention services needed to meet the IFSP outcomes should be written in the IFSP. Duplication of services should be avoided. Consultative services should be considered when additional input is required to determine if the current IFSP strategies/providers are appropriate and/or need reconsideration. Changes to the IFSP plan must be justified and approved by the child’s ED Team. The inclusion of more than one provider from the same discipline on a child’s IFSP must be requested by the IFSP team with justification and be prior approved by the Bureau of Child Development Services. Providers listed on the IFSP who cannot provide the level or specific type of service that is necessary to meet the IFSP outcomes, should remove themselves from the IFSP. Specific modalities, outside of the natural routines, activities and places of the child/family are not routinely covered services of the First Steps Program and must be individually determined by the IFSP team and be supported with written documentation of the justification for service delivery outside of the natural environment. 
a. This includes specifically named modalities such as HIPPO Therapy, Aquatic Therapy, and others that are not provided in the child’s natural environment as part of the family’s daily routine. 
b. When a specific modality, individually authorized and justified for a child, has a certification requirement, (such as HIPPO therapy), the provider of the modality may be required to have documentation of all appropriate certification on file at the Provider Enrollment Unit. 
c. This includes assistive technology not specific to developmental function. 

3. Frequency or duration of therapy must be appropriate to meet the IFSP outcomes, developmentally appropriate for infants and toddlers, and not be disruptive to family routine. 

4. All services should be documented, including date, time in and out, outcomes addressed, strategies used and parent signature concurring with all written documentation. 

5. Children/families meeting their goals, objectives and outcomes should be transitioned from the First Steps Program in a timely manner. 

entire document found here: http://www.in.gov/fssa/files/BestPractice_July_2006.pdf

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