TVR_106-3

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Part C of IDEA In 1975, Congress recognized that children with disabilities often did not receive the education and related services needed to make the developmental progress of which they were capable. As a result, Congress passed landmark legislation in 1975 (PL 94-142, The Education for All Handicapped Children Act), requiring states to provide all 5- to 21-year-old children with disabilities with a free and appropriate education in the least restrictive environment. In 1986, Congress amended that Act with PL 99-457, which was reauthorized and amended in 1997 as PL 105-17, and again in 2004 as PL 108-446. In the 1986 amendments, Congress called for the creation of statewide, coordinated, multidisciplinary, interagency programs for the provision of appropriate early intervention services for all infants and toddlers with disabilities. This section of the law, known as Part C (formerly known as Part H), did not actually require states to provide early intervention services but instead made partial reimbursement of the costs of services readily available to states that wished to participate. All states have chosen to participate and have established Part C programs for children ages birth to three years. Section 631 of the current law (the Individuals with Disabilities Education Improvement Act: Part C–Infants and Toddlers with Disabilities) is designed to: • enhance the development of infants and toddlers with disabilities to minimize the potential for developmental delay, • reduce the education costs to society by minimizing the need for special education and related services after infants and toddlers with disabilities reach school age, • minimize the likelihood of institutionalization and maximize the potential for independent living in society, • enhance the capacity of families to meet the needs of their children and • enhance the capacity of states and local programs to meet the needs of underrepresented populations, particularly minority, low income, inner city and rural populations. States choosing to participate in the Part C program (which all states have done) are required to meet a set of minimum requirements as outlined in Section 635 of the statute (NECTAC, 2006). Some of these requirements govern the system’s infrastructure and apply in about the same way for all children with disabilities (e.g., designating a lead agency for providing general administration and supervision, developing policies for contracting for services, providing procedures for timely reimbursement of funds, establishing procedural safeguards, compiling and reporting data about the early intervention system and creating a state interagency coordinating council). The remaining requirements call for the creation of components to be applied differently depending on the child’s disability. Better understanding of these Finishing the EHDI Revolution 243
components will contribute to improving the quality of early intervention services for DHH children. The following components are particularly relevant for creating a strong EHDI system and will each be discussed in the following sections: (1) eligibility criteria, (2) comprehensive child-find and referral systems (3) comprehensive systems of personnel development, (4) appropriate early intervention services and (5) public awareness programs. Section 634 of the law notes that: Eligibility Criteria in order to be eligible for a grant . . . a state shall provide assurances to the secretary that the state has adopted a policy that appropriate early intervention services are available to all infants and toddlers with disabilities in the state and their families. The federal regulations accompanying the law (34 CFR Part 303.16) require states to provide appropriate early intervention services to any infant or toddler: who is experiencing developmental delays as measured by appropriate diagnostic instruments and procedures in one or more of the areas of cognitive development, physical development, communication development, and adaptive development; or [who has] a diagnosed physical or mental condition that has a high probability of resulting in developmental delay. Infants and toddlers with permanent hearing loss will almost always exhibit developmental delays in one or more of the specified developmental areas if appropriate early intervention services are not provided. However, existing measures of development are not sensitive enough to measure these delays until children are at least a year old, which is far too late for early intervention programs to begin. (Kral & Tillein, 2006; Yoshinaga-Itano, Sedey, Coulter, & Mehl, 1998). Thus, if they are to be eligible, most DHH children will have to qualify for Part C services under the condition that they have “a diagnosed physical or mental condition that has a high probability of resulting in developmental delay.” In fact, the federal regulations for this section of the law use “severe sensory impairments, including hearing and vision” as one of the examples that would make a child with no measured delays eligible for Part C services. How the eligibility criteria are operationalized is left to the discretion of each state, but the criteria must be described in detail in a plan the state submits to the federal government. To better understand how states are providing services to DHH children, the written state plans submitted to the 244 White
Page 1 and 2: Volume 106, Number 3 ISSN 0042-8639
Page 3 and 4: The Volta Review Early Hearing Dete
Page 5 and 6: The Volta Review, Volume 106(3) (mo
Page 7 and 8: Center at Bar Ilan University, Rama
Page 9 and 10: identified the most significant pre
Page 11 and 12: Figure 1. Percentage of newborns sc
Page 13: Figure 2. Percentage of infants and
Page 17 and 18: that includes timelines and provide
Page 19 and 20: 1991, there is only about $1,000 av
Page 21 and 22: parents, when they are given an opt
Page 23 and 24: Historically, the federal Departmen
Page 25 and 26: with unilateral profound losses, bi
Page 27 and 28: Culbertson, J., & Gilbert, A.M. (19
Page 29 and 30: Office of Special Education and Reh
Page 31 and 32: University of North Carolina at Cha
Page 33 and 34: When children begin to walk and the
Page 35 and 36: years is attributable to partnershi
Page 37 and 38: hearing loss, including audiologic
Page 39 and 40: infants and toddlers who are deaf o
Page 41 and 42: early intervention program personne
Page 43 and 44: audiology symposium that brings tog
Page 45 and 46: Cyndie Bennett, superintendent of t
Page 47 and 48: 2001), places an emphasis on parent
Page 49 and 50: family involvement strongly influen
Page 51 and 52: Table 1. Demographic Characteristic
Page 53 and 54: In the self-efficacy section, mothe
Page 55 and 56: the Reynell Developmental Language
Page 57 and 58: Table 4. Definitions and Examples o
Page 59 and 60: Table 6. Relationships Between Mate
Page 61 and 62: Table 8. Summary of Regression Mode
Page 63 and 64: Roper & Dunst, 2003). Everyday occu
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References Akey, T., Marquis, J., &
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Lerner, G. (1952). Mr. Potato Head
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Appendix Scale of Parent Involvemen
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Parents want to know why their chil
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Incidence of UHL Impact of UHL Defi
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Children with UHL are at risk for a
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with this population of children to
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who have UHL and the BAHA implant s
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Progression of hearing loss is a co
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ongoing services because of a speci
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Environmental and Acoustic Modifica
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negative effects of unilateral hear
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of children with unilateral sensori
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The Volta Review, Volume 106(3) (mo
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Theories on Speech Development Theo
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indicating an interaction of a norm
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as Spanish, automatically there are
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In summary, young children with sev
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documenting speech production patte
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were determined by the child’s pr
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Table 1. Observed-to-Expected Ratio
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His Spanish language use did impact
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implants: Profiles and implications
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http://eire.census.gov/popest/data/
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Introduction Since the early 1980s,
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delayed, thereby increasing parenta
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fitting the second processor easier
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quickly and naturally. Children who
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Figure 2. Graphic example of a loud
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Table 2. Patients Patient ID Time L
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Speech Discrimination Tasks In addi
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The last two children with equal mo
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Figure 7. Loudspeaker arrangement f
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children will retain monaural stimu
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van Hoesel, R., Tong, Y., Hallow, R
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with hearing loss who receive early
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5 years (i.e., met the age cut-off
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location. Informed consent was obta
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Figure 1. Loneliness score and age
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analysis was conducted to determine
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eceive cochlear implants, significa
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effective public school programs fo
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for promoting EHDI in developing co
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Table 1. Levels of Prevention for C
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or unilateral hearing loss because
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were usually higher when babies wer
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Table 2. World Bank Classification
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total public expenditure (Gottret &
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is more cost effective to institute
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Figure 2. Proportion of births in h
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scant, although they are likely to
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a widely reported controversy conce
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their babies at such an early age b
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active, ongoing, culturally appropr
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this goal achievable. Reservations
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Clemens, C.J., Davis, S.A., & Baile
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Kale, R. (1995). Traditional healer
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A dream realized or nightmare in th
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Penn, C. (1998). The study of child
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Watkin, P.M., Baldwin, M., & McEner
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education or general education, the
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for both developmental and remedial
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Table 1. Type and Number of RSP Con
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process of closing the language gap
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phonologic and phonemic awareness;
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Westchester Institute for Human Ser
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Bohnert, Andrea; Spitzlei, Vera; Li
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TVR_106-3

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