Technical Assistance for Part C, Indicator 2

SPP/APR Indicator C-2: Percent of infants and toddlers with IFSPs who primarily receive early intervention services in the home or programs for typically developing children (Unrevised APR instructions).

1. Do you have valid and reliable data available on this indicator?
   • Have you made the necessary corrections to your data collection system to move from the eight previous categories to the three revised categories of the 618 data tables?
   • Have you developed clarifying documents regarding change in coding of “community-based” settings and the use of “other” category as defined in the revised data instructions?
   • Do you have a clear definition of “primary location” of services?
   • Do you have policies that specify how to code “service coordination only” families (code as NE)?
   • How have you communicated revised data definitions to programs and providers and data entry staff?
   • Are the data that you report for Indicator C-2 consistent with the data that you report under Section 618 of the IDEA?  If not, have you explained the difference?
   • Do you have effective methods for ensuring that the settings data that local programs report are timely and accurate?
2. Does your monitoring document determine whether settings decisions are made on an individualized basis and whether, when services are to be provided in settings that are not natural environments, the IFSP has an appropriate justification statement?
3. What opportunities do you make available for providers to receive training and TA on making individualized settings determinations and writing appropriate justification statements? 
4. If there is a problem in your State regarding serving infants and toddlers and their families in natural environments, what have you done to determine what is causing the problem and what is needed to fix it?
   • Do you have adequate numbers of personnel to provide services in natural environments?
   • In which disciplines are you experiencing personnel shortages?
   • What issues are providers identifying as barriers to providing services in home and community-based settings?
   • What solutions do they think will address this issue?
5. Do you have policies and procedures related to providing early intervention services in natural environments that reflect the evidence-based practices?
6. Do your providers and families understand the evidence-based practices that support services in natural environments?
7. What opportunities do you make available for providers and families to receive information, training and TA regarding services in natural environments?
8. How is your service delivery system designed to support the provision of evidenced based practices in natural environments?
9. What activities are you engaged in to increase inclusive community opportunities?

Original Word Document

The primary location of services, as documented on the 618 data tables, is used for the measurement of the percentage of children served in the “Natural Environment” for Indicator C2. While location, where services are provided, is an essential component for this indicator, State systems also are engaged in improvement activities regarding how these services are delivered to children and families.  This indicator is closely tied to Indicator C -1 (timely services) and C-7 (45 day timelines).

1. Resource for revised data definitions:

   Revised data tables (2007) and revised definitions of “primary service location,” “home,” “community-based,” and “other” settings.

2. Resources to support provider buy-in for practices in natural environments:

The following are position statements from Professional Organizations which support principles and evidence based practices for services in natural environments:

American Speech-Language- Hearing Association (ASHA)
Roles and Responsibilities of Speech Language Pathologist in Early Intervention (2008)
See also ASHA Feature Article:
Woods, J. (2008, March 25). Providing early intervention services in natural environments.The ASHA Leader, 13(4), 14-17, 23.

American Physical Therapy Association (APTA)
Vanderholf, M. (2004). Maximizing your role in early intervention.

American Occupational Therapy Association (AOTA)
Pilkington, K. (2007). Side by Side: Transdisciplinary early intervention in natural environments.

Infant and Toddler Coordinator Association (ITCA)
Position Paper on the Provision of Early Intervention Services in Accordance with Federal Requirements on Natural Environments. (2001)

3. Resources to support providers and practices
   

   A national workgroup on Principles and Practices of Services in Natural Environments began meeting in 2006-2O07 and reached consensus on a number of issues as they examined the various “models” of providing services in natural environments and described key principles (Foundations); identified the research-base on effective practices that the research, model development projects and the “wisdom”from the field suggests; described agreed upon practices that are “model neutral”; and described some examples of how would you know the principles and practices are being implemented. These documents can be used in training and program development
   

4. Resources for recruiting and retaining adequate personnel

ASHA has a listing of strategies used by several States to address shortages of SLPs. Innovative Programs to Address Personnel Vacancies in Health Care and Education

5. Resources for improving the efficiency of service models

   Service Delivery Models, presentation from the NECTAC 2008 National Meeting. Contains slides of "lessons learned" from two states changing their service delivery approach.

   Common Misperceptions about Coaching in Early Intervention clarifies selected aspects of implementing coaching practices.  With all service models, it is important to remember the individualized needs of each child when making decisions about settings and services.

    

 

The Community of Practice (CoP) on Natural Environments provides supports for effective practices in natural environments from referral throughout the IFSP process. Several products and resources have been developed to describe a growing national consensus on principles and effective practices in natural environments. Collections of these resources can be found on the TA Communities Website and the NECTAC Website, Family-centered Services Page. The TA Communities Website also has interactive features such as on-line discussions to facilitate networking and shared problem-solving.

CoP Facilitators: The National Early Childhood TA Center (NECTAC), the Southeast Regional Resource Center and the Region 6 Parent Technical Assistance Center.