Family & Community Special Communities
Special Education

OSEP’s Report on the Monitoring of Massachusetts

II. Part C: Child Find and Public Awareness

The needs of infants and toddlers with disabilities and their families are generally met through a variety of agencies. However, prior to the enactment of Part C of IDEA, there was little coordination or collaboration of service provision, and many families had difficulty locating and obtaining needed services.

With the passage of Part C in 1986, Congress sought to assure that all children needing services would be identified, evaluated, and served, especially those children who are typically underrepresented, (e.g., minority, low-income, inner-city, Indian and rural populations) through an interagency, coordinated, multidisciplinary system of early intervention services.

Each State's early intervention system must include child find and public awareness activities that are coordinated and collaborated with all other child find efforts in the State. Part C recognizes the need for early referral and short timelines for evaluation as development occurs at a more rapid rate during the first three years of life than at any other age.

Early brain development research has demonstrated what early interventionists have known for years, that children begin to learn and develop from the moment of birth. Therefore, the facilitation of early learning and the provision of timely early intervention services to infants and toddlers with disabilities is critical.

Validation Planning and Data Collection

The Part C Self-Assessment identified numerous accomplishments related to the State's efforts to locate and identify infants and toddlers with disabilities:

1. effective parent-to-parent outreach;
2. DPH development of other programs for young children such as Healthy Families, Teen Parenting, and FIRSTLink;
3. the DPH Early Intervention Information System which collects statewide early intervention services data;
4. increased awareness of early intervention among community providers because of the use of natural community settings for service delivery;
5. increased interaction between early intervention and child care providers; and
6. the Parent Leadership Initiative at the State level which promotes full parent participation in policy development and implementation.

OSEP reviewed Federal child count tables from December 1, 1997 and noted that Massachusetts served 4.3 percent of the birth through three year old population with over two percent of children served by age two. OSEP also reviewed the State's data from the Early Intervention Information System, which validate a strong referral effort that comes from physicians and hospitals, with 49 percent of all referrals coming from the medical community.

One of the focus questions asked during the public meetings was: "Are all infants and toddlers with developmental delays or disabilities identified, evaluated and referred for services?" Responses indicated those young children with autism or mental health needs are not identified and referred by the medical community early enough. Participants stated that the medical centers are doing a good job of referral but that the physicians in private practice are not. Many parents at the meetings indicated that physicians needed additional education about the range and types of early intervention services that are available. One parent described being given the telephone number of an early intervention program by her child's pediatrician with no further explanation as to who she was to call or why. Local administrators described successful efforts at outreach, through childbirth education classes, homeless shelters for women, and screenings at child care centers. Several providers indicated concerns related to the need for specific outreach activities to non-English speaking families.

At the end of the Validation Planning process, the steering committee identified the following as issues that OSEP should investigate during the data collection week: (1) variability in understanding of early intervention by physicians; and (2) increased intra-agency coordination of early identification and referral.

In order to investigate the child find and awareness issues, OSEP collected data from parents, local program administrators, service providers/service coordinators, interagency representatives, and State personnel.

OSEP reviewed and analyzed the data and identified the following strengths. OSEP did not find areas of noncompliance or identify suggestions for improvement.

A. Strengths

1. Early Identification and Linkage of Infants and Toddlers and Their Families to Services
   DPH has successfully implemented a variety of strategies to provide information and access to the early intervention system, as well as access to other State prevention initiatives such as FIRSTLink. FIRSTLink establishes a statewide referral system for universal screening and identification of newborns and families who may be at risk for adverse health or developmental outcomes. Infants and their families are linked with a variety of community services, including early intervention for those who are eligible. FIRSTLink is a significant component of the State's child find efforts and underscores DPH's commitment to maintain a broad definition of eligibility for early intervention services. Massachusetts is one of only nine States in the nation to support these vulnerable at-risk infants and toddlers through Part C of IDEA.

2. Client-Based Referral Data System
   The State's Early Intervention Information System is excellent in providing data regarding specific referral sources, including: early intervention programs, community social service agencies, home health services, community health centers, child care centers, DPH Women, Infants and Children Program, DPH Case Management, DPH Hearing Aid Program, and adolescent parenting programs. This breakout of specific referral information provides DPH with an additional tool to monitor its outreach efforts across the State as well as a mechanism to provide guidance to local communities on improvements in child find activities.