8.3.0.1: Initial Assessment of the Child to Determine His or Her Special Needs

Children with disabilities and children with special health care needs and their families and caregivers/teachers should have access to and be encouraged to receive a multidisciplinary, interdisciplinary, or transdisciplinary assessment by qualified health providers before the child starts in the facility. This information needs to be shared, with the parents/guardians’ consent and agreement to disclose information if it is relevant to the health and safety concerns in the child care setting. If the parents/guardians consent to disclose the information and if the information is relevant to health and safety concerns in the child care setting, this evaluation should consist of the following:

1. A medical care plan developed by the child’s primary care provider/medical home;
2. Results of medical and developmental examinations;
3. Assessments of the child’s behavior, cognitive functioning, or current overall adaptive functioning;
4. Evaluations of the family’s needs, cultural and linguistic differences, concerns, and priorities;
5. Other evaluations as needed.

The multidisciplinary, interdisciplinary, or transdisciplinary assessment should also consider a family’s needs, cultural and linguistic differences, priorities, and resources as the team develops recommendations for interventions. Such recommendations should be focused on optimizing the child’s development, health, and safety.

RATIONALE

The definitive characteristic of services for children and their families is the necessity of individualizing their care to meet their needs. Therefore, individual assessments must precede services.

The family’s needs, values, and childrearing practices are highly relevant and respected in the provision of care to the child; however, the child’s special needs continue to be the central focus of intervention.

COMMENTS

This comprehensive assessment would be done largely by an outside center, clinic, school district, or professionals who conduct evaluations of this nature. The multi-disciplinary, interdisciplinary or transdisciplinary assessment must be administered by qualified individuals using reliable and valid age and culturally and linguistically appropriate instruments and methodologies. For young children with disabilities, the designated lead agency for Part C would be responsible for conducting the initial evaluation. Under Part B (three- through five-year-olds), the school district is responsible for conducting the initial evaluation. This evaluation forms the basis of planning for the child’s needs in the child care setting and for the pertinent information available to the staff. The comprehensive assessment should be used to develop a written plan for the child’s caregivers/teachers that they believe they can implement. Relevant medical information will form the basis of the health care plan for the child in the program. This may need to be created with help of parents/guardians, child care health consultants, and medical providers.

The facility should pursue the many funding mechanisms available to supplement funding for services in the facility. Even so, caregivers/teachers can and should discuss these options with the parents/guardians as potential sources of financial assistance for the needed services. These sources might include:

1. Medicaid, including waiver funding (Title XIX);
2. Private health insurance and state-subsidized private health insurance under programs such as SCHIP;
3. State or federal funds for child care, education, or for Children with Special Health Care Needs (Title V);
4. Individuals with Disabilities Education Improvement Act (IDEA) (particularly Part C funding);
5. Tax incentives (credits and deductions are available under federal law to most for-profit child care programs).

TYPE OF FACILITY

Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home

RELATED STANDARDS

3.5.0.1 Care Plan for Children with Special Health Care Needs
10.3.4.6 Compensation for Participation in Multidisciplinary Assessments for Children with Special Health Care or Education Needs
Appendix O: Care Plan for Children with Special Health Care Needs