8 Colo. Code Regs. § 1405-1-5.114

Current through Register Vol. 47, No. 20, October 25, 2024

Section 8 CCR 1405-1-5.114 - EARLY INTERVENTION SERVICES

This rule is promulgated pursuant to sections 26.5-3-403, 26.5-3-406, 26.5-3-408, and 26.5-3-409, C.R.S.

A. Early intervention services shall be:

1. Provided only after the development of an Individualized Family Service Plan and written parental consent is obtained for those services identified in the Individualized Family Service Plan;

2. Provided to meet the developmental needs of an eligible infant or toddler, parent or guardian, or other caregivers, to achieve the outcomes identified in the Individualized Family Service Plan;

3. Based on appropriate peer-reviewed, evidence-based practices, to the extent which is practical;

4. Related to functional outcomes and developmentally appropriate practices to support participation in everyday routines, activities, and places;

5. Provided by qualified providers who meet the state personnel standards for each Early Intervention Service;

6. Provided in a culturally relevant manner, including use of an interpreter, if needed;

7. Provided in the natural environments of the child and family to the maximum extent appropriate. If there is a determination that an Early Intervention Service cannot be provided in a natural environment, written justification shall be provided in the Individualized Family Service Plan; and

8. Provided in physical settings where community-based early intervention services are accessed that meet all fire, building, licensing, and health regulations, as applicable.

B. Early intervention services shall include the following:

1. Assistive Technology Services:

a. Means the direct selection, acquisition, or use of assistive technology devices and includes:

(1) Functional evaluation of the developmental needs of the infant or toddler in their usual environments;

(2) Selection, acquisition, modification, or customization and maintenance of assistive technology devices;

(3) Coordinating and using other therapies, interventions, or services with assistive technology devices, such as those associated with existing intervention plans and programs;

(4) Training or technical assistance for professionals providing early intervention services or other individuals identified as providing early intervention services to, or are otherwise substantially involved in the major life functions of, an infant or toddler on the use of assistive technology devices;

(5) Training or technical assistance for an infant or toddler receiving early intervention services or, if appropriate, the child's family; and

(6) Any item, piece of equipment, or product system, whether acquired commercially off the shelf, modified or customized, that is used to increase, maintain, or improve the functional, developmental capabilities of an infant or toddler in their usual environments.

(a) The device must be identified in the Individualized Family Service Plan; and

(b) Prior to purchase or lease of an assistive technology device, an assessment shall be conducted by a qualified early intervention provider to assure that the device is appropriate for the child and family's needs.

b. Does not mean a device that is primarily intended to treat a medical condition, meet life-sustaining needs, or a medical device that is surgically implanted, including a cochlear implant. It also does not mean the optimization, maintenance, or the replacement of such a device.

2. Audiology Services:

a. Means services for the identification of an infant or toddler with an auditory impairment, using at-risk criteria and appropriate audiologic screening techniques, and includes:

(1) Loss and communication functions, by use of audiological evaluation procedures;

(2) Auditory training, aural rehabilitation, speech reading and listening devices, orientation, and other training to increase functional communication skills;

(3) The determination of the need for individual amplification, including selecting, fitting and dispensing an appropriate listening and vibrotactile device, and evaluating the effectiveness of the device;

(4) Referral for medical and other services necessary for the habilitation or rehabilitation of an infant or toddler with a disability which is an auditory impairment;

(5) Family training, education, and support provided to assist a parent or guardian or other caregivers of a child eligible for services in understanding the special needs of the infant or toddler as related to audiology and aural rehabilitation services; and

(6) The provision of services for prevention of hearing loss.

b. Does not mean therapeutic services required for an infant or toddler to recover from medical procedures such as surgery, or pre-surgery therapeutic services required by a physician to prepare a child for surgery and that are beyond the scope of the early intervention services identified in the child's Individualized Family Service Plan as being needed to meet the child's developmental outcomes.

3. Developmental Intervention Services:

a. Means developmental assessment and special instruction to address the functional developmental needs of an infant or toddler and includes:

(1) The design or adaptation of learning environments, activities and materials to enhance developmental and learning opportunities that promote the infant or toddler's acquisition of skills in a variety of developmental areas, including cognitive processes and social interaction;

(2) Curriculum planning, including the planned interaction of personnel, materials, and time and space, that leads to achieving the outcomes in the child's Individualized Family Service Plan;

(3) Working with the child to enhance the child's development; and

(4) Family training, education and support provided to assist a parent or guardian or other caregivers in understanding the special needs of the child related to enhancing the skill development of the child.

4. Health Services:

a. Means services by a licensed health care professional that enable an eligible infant or toddler to benefit from other allowable early intervention services and includes:

(1) Assessment to determine the health status and special health care needs that will impact the provision of other early intervention services;

(2) Services such as clean intermittent catheterization, tracheostomy care, tube feeding, the changing of dressings or colostomy bags, and other health services; and

(3) Consultation by a health care professional with a parent or guardian or other service provider regarding the impact of the infant or toddler's health status on the provision of other early intervention services.

b. Does not mean:

(1) Services that are:

(a) Purely medical in nature, such as hospitalization, or the prescribing of medicine or other drugs for any purpose;

(b) Surgical in nature, such as cleft palate surgery or shunting for hydrocephalus;

(c) Medical diagnostic procedures, services that are primarily intended to treat a medical condition; or

(d) Related to the implementation, optimization, maintenance, or replacement of a medical device that is surgically implanted.

(2) Devices necessary to control or treat a medical condition, or that are medical or health services routinely recommended for all infants and toddlers.

c. Nothing in this section of the rules limits the rights of an infant or toddler with a disability, that has a surgically implanted device, to receive the early intervention services identified in the child's Individualized Family Service Plan as being needed to meet the child's developmental outcomes.

d. Nothing in this section of the rules prevents the early intervention services provider from routinely checking that either the hearing aid or the external components of a surgically implanted device, such as a cochlear implant, used by an infant or toddler with a disability are functioning properly.

5. Medical services means services provided by a licensed physician for diagnostic or evaluation purposes, to determine a child's developmental status and need for early intervention services.

6. Nursing Services:

a. Means assessment of health status for the purpose of providing:

(1) Nursing care, including the identification of patterns of human response to actual or potential health problems;

(2) Nursing care to prevent health problems, restore or improve functioning, and promote health and development; and

(3) The administration of medications, treatments, and regimens prescribed by a licensed physician.

7. Nutrition Services:

a. Means development of a plan to address the nutritional and feeding needs of an infant or toddler related to their development, and includes:

(1) The assessment of the nutritional history, dietary intake, body measurements such as height and weight, and feeding status;

(2) Consultation to develop, implement and monitor appropriate plans to address the nutritional needs;

(3) Referral to appropriate community resources to carry out nutritional plans; and

(4) Family training, education and support provided to assist a parent or guardian or other caregivers in understanding the special needs of the child related to nutrition and feeding and enhancing the child's development.

8. Occupational Therapy Services:

a. Means assessment and intervention services with an emphasis on adaptive skills, motor and sensory development, mobility, play and oral-motor functioning and includes:

(1) Intervention strategies to address the functional developmental needs, including oral motor functioning of an infant or toddler, minimizing the impact of initial or future impairment, and delay in development or loss of functional ability;

(2) Consultation to adapt the environment to promote development, access and participation in everyday routines, activities and places;

(3) The selection, design, or fabrication of assistive and orthotic devices to promote mobility or participation in everyday routines, activities, and places; and

(4) Family training, education, and support provided to assist a parent or guardian or other caregivers in understanding the special needs of the child as related to occupational therapy strategies and enhancing the child's motor development.

b. Does not include therapeutic services required due to, or as part of, a medical procedure, a medical intervention or an injury that is expected to heal without a long-term impact to child development and that is beyond the scope of the early intervention services identified in the child's Individualized Family Service Plan as being needed to meet the child's developmental outcomes.

9. Physical Therapy Services:

a. Means assessment and intervention services with an emphasis on mobility, positioning, motor development, and both strength and endurance and includes:

(1) Intervention strategies to address the functional developmental needs of an infant or toddler;

(2) Through individual or group services, to obtain, interpret, and integrate information for program planning to prevent, alleviate, or compensate for movement dysfunction and related functional problems;

(3) The design or acquisition of assistive and orthotic devices, and effective adaptation of the child's environment to promote mobility and participation in everyday routines, activities and places, and minimize the impact of initial or future impairment, delay in development or loss of functional ability; and

(4) Family training, education, and support provided to assist a parent or guardian or other caregivers in understanding the special needs of the child as related to physical therapy strategies and enhancing the child's motor development.

b. Does not include therapeutic services required due to, or as part of, a medical procedure, a medical intervention or an injury that is expected to heal without a long-term impact to the child's development and that is beyond the scope of the early intervention services identified in the child's Individualized Family Service Plan as being needed to meet the child's developmental outcomes.

10. Psychological Services:

a. Means assessment and intervention services that address the development, cognition, behavior, and social or emotional development of an infant or toddler and includes:

(1) The administration of psychological and developmental tests and other assessment procedures to identify the developmental, cognitive, behavioral and social emotional status;

(2) The acquisition, integration and interpretation of test results, other information about development and behavior and the family and living situation related to learning, social or emotional development and behavior;

(3) The provision of individual or parent or guardian counseling;

(4) Planning and managing a child's program of psychological services;

(5) Consultation on child behavior, child and family conditions related to learning, mental health, and development to a parent or guardian, other caregivers, and other service providers; and

(6) Family training, education, and support provided to assist a parent or guardian or other caregivers in understanding the special needs of the child as related to psychological strategies and enhancing the child's psychological and cognitive development.

11. Sign Language and Cued Language Services means instruction that includes sign language, cued language, auditory or oral language, providing oral transliteration services, and providing sign and cued language interpretation for an infant or toddler.

12. Social and Emotional Services:

a. Means assessment and intervention services that address social and emotional development in the context of a family and parent or guardian-child interaction and includes:

(1) Home visits to evaluate an infant or toddler's living conditions and patterns of parent or guardian-child interaction;

(2) The completion of social or emotional developmental assessment;

(3) The provision of individual or group counseling to an infant or toddler or a parent or guardian in order to understand the parental needs related to their child's development and how to enhance the development of the child;

(4) The provision of social skill building activities with the child and parent or guardian;

(5) Intervention strategies to address issues in the living or caregiving situation that may affect the child's development and/or utilization of other allowable early intervention services;

(6) The identification, mobilization and coordination of community resources and services to enable an infant or toddler and their parent or guardian to receive maximum benefit from other early intervention services; and

(7) Family training, education, and support provided to assist a parent or guardian or other caregivers in understanding the special needs of the child as related to strategies for enhancing the child's social or emotional development. "Social and emotional services" means assessment and intervention services that address social emotional development in the context of a family and parent or guardian-child interaction and includes:

(a) Home visits to evaluate an infant or toddler's living conditions and patterns of parent or guardian-child interaction;

(b) The completion of social or emotional developmental assessment;

(c) The provision of individual or group counseling to an infant or toddler or a parent or guardian in order to understand the parental needs related to their child's development and how to enhance the development of the child;

(d) The provision of social skill building activities with the child and parent or guardian;

(e) Intervention strategies to address issues in the living or caregiving situation that may affect the child's development and/or utilization of other allowable early intervention services;

(f) The identification, mobilization and coordination of community resources and services to enable an infant or toddler and their parent or guardian to receive maximum benefit from other early intervention services; and

(g) Family training, education, and support provided to assist a parent or guardian or other caregivers in understanding the special needs of the child as related to strategies for enhancing the child's social or emotional development.

13. Speech Language Pathology Services:

a. Means assessment and intervention services to address the functional and communication needs of an infant or toddler, and includes:

(1) Language and speech development;

(2) Oral motor functioning, including the identification of specific communication disorders;

(3) Consultation to adapt an environment and activities to promote speech and language development and participation in everyday routines, activities and places;

(4) Habilitation, rehabilitation or prevention of communication disorders, and delays in language and speed development;

(5) Referral for medical or other professional services necessary for the habilitation or rehabilitation of an infant or toddler with communication disorders or delays; and

(6) Family training, education and support provided to assist a parent or guardian or other caregivers in understanding the special needs of the child as related to speech language pathology strategies and enhancing the child's communication development.

b. Does not include therapeutic services required due to, or as part of, a medical procedure, a medical intervention or an injury that is expected to heal without a long-term impact to the child's development and that is beyond the scope of the early intervention services identified in the child's Individualized Family Service Plan as being needed to meet the child's developmental outcomes.

14. Transportation Services means reimbursement for the cost of travel, including mileage, taxis, common carriers, and tolls or parking, that are necessary to enable an infant or toddler and their parent or guardian to receive an Early Intervention Service identified in the Individualized Family Service Plan.

15. Vision Services:

a. Means evaluation and assessment of visual functioning, including the diagnosis and appraisal of specific visual disorders and delays that affect child development, and the intervention services to address the functional visual needs of an infant or toddler with significant vision impairment and includes:

(1) Communication skills training;

(2) Orientation and mobility training for all environments;

(3) Visual and other training necessary to activate visual motor abilities;

(4) Referral for medical or other professional services necessary for the habilitation or rehabilitation of visual functioning disorders, or both;

(5) Consultation to adapt an environment and activities for a child with a visual impairment to promote development, access and participation in everyday routines, activities, and places; and

(6) Family training, education and support provided to assist a parent or guardian or other caregivers in understanding the special needs of the child as related to vision strategies and enhancing the child's overall development.

b. Does not mean therapeutic services required due to, or as part of, a medical procedure, a medical intervention, or an injury and that is beyond the scope of the early intervention services identified in the child's Individualized Family Service Plan as being needed to meet the child's developmental outcomes.

8 CCR 1405-1-5.114

46 CR 01, January 10, 2023, effective 1/1/2023

46 CR 06, March 25, 2023, effective 4/14/2023

47 CR 13, July 10, 2024, effective 7/30/2024