[Code of Federal Regulations]
[Title 45, Volume 4]
[Revised as of October 1, 2005]
From the U.S. Government Printing Office via GPO Access
[CITE: 45CFR1308.21]
[Page 170-186]
TITLE 45--PUBLIC WELFARE
CHAPTER XIII--OFFICE OF HUMAN DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH
AND HUMAN SERVICES
PART 1308_HEAD START PROGRAM PERFORMANCE STANDARDS ON SERVICES FOR
CHILDREN WITH DISABILITIES--Table of Contents
Subpart G_Parent Involvement Performance Standards
Sec. 1308.21 Parent participation and transition of children into
Head Start and from Head Start to public school.
(a) In addition to the many references to working with parents
throughout these standards, the staff must carry out the following
tasks:
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(1) Support parents of children with disabilities entering from
infant/toddler programs.
(2) Provide information to parents on how to foster the development
of their child with disabilities.
(3) Provide opportunities for parents to observe large group, small
group and individual activities describe in their child's IEP.
(4) Provide follow-up assistance and activities to reinforce program
activities at home.
(5) Refer parents to groups of parents of children with similar
disabilities who can provide helpful peer support.
(6) Inform parents of their rights under IDEA.
(7) Inform parents of resources which may be available to them from
the Supplemental Security Income (SSI) Program, the Early and Periodic
Screening, Diagnosis and Treatment (EPSDT) Program and other sources and
assist them with initial efforts to access such resources.
(8) Identify needs (caused by the disability) of siblings and other
family members.
(9) Provide information in order to prevent disabilities among
younger siblings.
(10) build parent confidence, skill and knowledge in accessing
resources and advocating to meet the special needs of their children.
(b) Grantees must plan to assist parents in the transition of
children from Head Start to public school or other placement, beginning
early in the program year.
(c) Head Start grantees, in cooperation with the child's parents,
must notify the school of the child's planned enrollment prior to the
date of enrollment.
Appendix to Part 1308--Head Start Program Performance Standards on
Services to Children With Disabilities
This appendix sets forth guidance for the implementation of the
requirements in part 1308. This guidance provides explanatory material
and includes recommendations and suggestions for meeting the
requirements. This guidance is not binding on Head Start grantees or
delegate agencies. It provides assistance and possible strategies which
a grantee may wish to consider. In instances where a permissible course
of action is provided, the grantee or delegate agency may rely upon this
guidance or may take another course of action that meets the applicable
requirement. This programmatic guidance is included as an aid to
grantees because of the complexity of providing special services to meet
the needs of children with various disabilities.
Section 1308.4 Purpose and scope of disabilities service plan
Guidance for Paragraph (a)
In order to develop an effective disabilities service plan the
responsible staff members need to understand the context in which a
grantee operates. The Head Start program has operated under a
Congressional mandate, since 1972, to make available, at a minimum, ten
percent of its enrollment opportunities to children with disabilities.
Head Start has exceeded this mandate and serves children in integrated,
developmentally appropriate programs. The passage of the Individuals
With Disabilities Education Act, formerly the Education of the
Handicapped Act, and its amendments, affects Head Start, causing a shift
in the nature of Head Start's responsibilities for providing services
for children with disabilities relative to the responsibilities of State
Education Agencies (SEA) and Local Education Agencies (LEA).
Grantees need to be aware that under the IDEA the State Education
Agency has the responsibility for assuring the availability of a free
appropriate public education for all children with disabilities within
the legally required age range in the State. This responsibility
includes general supervision of educational programs in all agencies,
including monitoring and evaluating the special education and related
services to insure that they meet State standards, developing a
comprehensive State plan for services for children with disabilities
(including a description of interagency coordination among these
agencies), and providing a Comprehensive System for Personnel
Development related to training needs of all special education and
related service personnel involved in the education of children with
disabilities served by these agencies, including Head Start programs.
Each State has in effect under IDEA a policy assuring all children
with disabilities beginning at least at age three, including those in
public or private institutions or other care facilities, the right to a
free appropriate education and to an evaluation meeting established
procedures. Head Start is either:
The agency through which the Local Education
Agency can meet its obligation to make a free appropriate public
education available through a contract, State or local collaborative
agreement, or other arrangement; or
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The agency in which the family chooses to have
the child served rather than using LEA services.
Regardless of how a child is placed in Head Start, the LEA is
responsible for the identification, evaluation and provision of a free
appropriate public education for a child found to be in need of special
education and related services which are mandated in the State. The LEA
is responsible for ensuring that these services are provided, but not
for providing them all. IDEA stresses the role of multiple agencies and
requires their maintenance of effort.
The Head Start responsibility is to make available directly or in
cooperation with other agencies services in the least restrictive
environment in accordance with an individualized education program (IEP)
for at least ten percent of enrolled children who meet the disabilities
eligibility criteria. In addition, Head Start continues to provide or
arrange for the full range of health, dental, nutritional,
developmental, parent involvement and social services provided to all
enrolled children. Head Start has a mandate to recruit and enroll
income-eligible children and children with disabilities who are most in
need of services and to coordinate with the LEA and other groups to
benefit children with disabilities and their families. Serving children
with disabilities has strengthened Head Start's ability to individualize
for all children. Head Start is fully committed to the maintenance of
effort as required for all agencies by the IDEA and by the Head Start
Act (Section 640(a)(2)(A)). Head Start is committed to fiscal support to
assure that the services which children with disabilities need to meet
their special needs will be provided in full, either directly or by a
combination of Head Start funds and other resources.
These Head Start regulations facilitate coordination with the IDEA
by utilizing identical terms for eligibility criteria for the most part.
However, Head Start has elected to use the term ``emotional/behavioral
disorder'' in lieu of ``serious emotional disturbance,'' which is used
in the IDEA, in response to comments and concerns of parents and
professionals. Children who meet State-developed criteria under IDEA
will be eligible for services from Head Start in that State.
In order to organize activities and resources to help children with
disabilities overcome or lessen their disabilities and develop their
potential, it is essential to involve the education, health, social
services, parent involvement, mental health and nutrition components of
Head Start. Parents, staff and policy group members should discuss the
various strategies for ensuring that the disabilities service plan
integrates needs and activities which cut across the Head Start
component areas before the plan is completed.
Advance planning and scheduling of arrangements with other agencies
is a key factor in assuring timely, efficient services. Local level
interagency agreements can greatly facilitate the difficult tasks of
locating related service providers, for example, and joint community
screening programs can reduce delays and costs to each of the
participating agencies.
Guidance for Paragraph (b)
The plan and the annual updates need to be specific, but not
lengthy. As changes occur in the community, the plan needs to reflect
the changes which affect services.
Guidance for Paragraph (c)
Grantees should ensure that the practices they use to provide
special services do not result in undue attention to a child with a
disability. For example, providing names and schedules of special
services for children with disabilities in the classroom is useful for
staff or volunteers coming into that classroom but posting them would
publicize the disability of the individual children.
Guidance for Paragraph (d)
Staff should work for the children's greater independence by
encouraging them to try new things and to meet appropriate goals by
small steps. Grantees should help children with disabilities develop
initiative by including them in opportunities to explore, to create, and
to ask rather than to answer questions. The children need opportunities
to use a wide variety of materials including science tools, art media
and costumes in order to develop skills, imagination and originality.
They should be included on field trips, as their experience may have
been limited, for example, by an orthopedic impairment.
Just as a program makes available pictures and books showing
children and adults from representative cultural, ethnic and
occupational groups, it should provide pictures and books which show
children and adults with disabilities, including those in active roles.
Staff should plan to answer questions children and adults may have
about disabilities. This promotes acceptance of a child with
disabilities for him or herself and leads to treating the child more
normally. Effective curricula are available at low cost for helping
children and adults understand disabilities and for improving attitudes
and increasing knowledge about disabilities. Information on these and
other materials can be obtained from resource access projects
contractors, which offer training and technical assistance to Head Start
programs.
There are a number of useful guides for including children with
disabilities in regular group activities while providing successful
experiences for children who differ widely in
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developmental levels and skills. Some of these describe activities
around a unit theme with suggestions for activities suitable for
children with different skill levels. Staff need to help some children
with disabilities move into developmentally appropriate play with other
children.
Research has shown the effectiveness of work in small groups for
appropriately selected children with disabilities. This plan allows for
coordinating efforts to meet the needs of individual children as listed
in their IEPs and can help focus resources efficiently.
If a deaf child who uses or needs sign language or another
communication mode is enrolled, a parent, volunteer or aide who can use
that mode of communication should be provided to help the child benefit
from the program.
In order to build the language and speech capabilities of many
children with disabilities who have communication problems, it has been
found helpful to enlist aides, volunteers, cooks, bus drivers and
parents, showing them how to provide extra repetition and model
gradually more advanced language as children improve in their ability to
understand and use language. Small group activities for children with
similar language development needs should be provided regularly as well
as large group language and listening games and individual help. Helping
children with intellectual delays or emotional problems or those whose
experiences have been limited by other disabilities to express their own
ideas and to communicate during play and throughout the daily activities
is motivating and can contribute greatly to their progress.
Guidance for Paragraph (e)
The Disabilities Service Coordinator should possess a basic
understanding of the scope of the Head Start effort and skills adequate
to manage the agency to serve children with disabilities including
coordination with other program components and community agencies and
work with parents.
Guidance for Paragraph (f)
For non-verbal children, communication boards, computers and other
assistive technology devices may be helpful. Technical assistance
providers have information on the Technology Related Assistance for
Individuals with Disabilities Act of 1988, 29 U.S.C. 2201 et seq. States
are funded through this legislation to plan Statewide assistive
technology services, which should include services for young children.
Parents should be helped to understand the necessity of including
assistive technology services and devices in their child's IEP in order
to obtain them.
The plan should include any renovation of space and facilities which
may be necessary to ensure the safety of the children or promote
learning. For example, rugs or other sound-absorbing surfaces make it
easier for some children to hear stories or conversation. Different
surfaces on floors and play areas affect some children's mobility.
45 CFR Part 84, Nondiscrimination on the Basis of Handicap in
Programs and Activities Receiving or Benefiting from Federal Financial
Assistance which implements the Rehabilitation Act of 1973 and the
Americans with Disabilities Act require that all Federally assisted
programs, including Head Start, be accessible to persons with
disabilities including staff, parents and children. This does not mean
that every building or part of a building must be physically accessible,
but the program services as a whole must be accessible. Structural
changes to make the program services available are required if
alternatives such as reassignment of classes or moving to different
rooms are not possible. Information on the accessibility standards is
available from RAPs or the U.S. Department of Justice, Civil Rights
Division, Coordination and Review Section, P.O. Box 66118, Washington,
DC 20035-6115.
Staff should ensure that children with physical disabilities have
chairs and other pieces of furniture of the correct size and type for
their individual needs as they grow. Agencies such as United Cerebral
Palsy, Easter Seal Societies or SEAs can provide consultation on
adapting or purchasing the appropriate furniture. The correct
positioning of certain children is essential and requires expert advice.
As the children grow, the furniture and equipment should be checked by
an expert, such as a physical therapist, because the wrong fit can be
harmful. Efforts should be made to use furniture sized and shaped to
place children at the same level as their classmates whenever possible.
Guidance for Paragraph (h)
The plan should specify:
Overall goals of the disability effort.
Specific objectives and activities of the
disability effort.
How and when specific activities will be carried
out and goals attained.
Who will be responsible for the conduct of each
element of the plan.
How individual activities will be evaluated.
The plan should address:
Enrollment information, including numbers of
children and types of disabilities, known and estimated.
Identification and recruitment of children with
disabilities. Participation in Child Find and list of major specialized
agencies approached.
Screening.
Developmental Assessment.
Evaluation.
The multidisciplinary team and its work.
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The process for developing IEPs.
The provision of program services and related
services.
Program accessibility.
Recordkeeping and reporting.
Confidentiality of information.
Any special safety needs.
Medications.
Transportation.
The process for identifying and meeting training
and technical assistance needs.
Special parent involvement needs.
Planned actions to increase the ability of staff
to serve children with more severe disabilities and the number of
children with more severe disabilities served.
Transitioning of children in and out to the next
program.
Particular attention should be given to addressing ways to:
Involve parents throughout the disability effort,
and
Work with other agencies in serving children with
disabilities. It should be possible for a reader to visualize how and by
whom services will be delivered. Coordination with other agencies should
be described, as well as the process for developing local agreements
with other agencies. The RAPs can provide samples and models for the
process of developing agreements with LEAs.
Guidance for Paragraph (j)
Children may spend part of the program hours in Head Start for a
mainstreaming experience and part in a specialized program such as an
Easter Seal Society or a local mental health center. The amount of time
spent in either program should be flexible, according to the needs of
the individual child. All services to be provided, including those
provided by collaborating agencies, should be described in the IEP.
Staff of both programs should observe each other's work with the child
who is enrolled and maintain good communication.
Individual services such as occupational, physical or speech
therapy, staff training, transportation, services to families or
counseling may be shared by Head Start and other agencies. For example,
Head Start might provide equipment and transportation while a
development center might provide a facility and physical therapy for a
Head Start child. Some LEAs provide resource teachers while Head Start
provides a developmentally appropriate program in an integrated setting.
Hiring additional staff may be necessary to meet the needs of
children with severe disabilities. Hiring an aide may be necessary on a
full-time, part-time, temporary or as needed basis to assist with the
increased demands of a child with a severe disability. However, aides
should not be assigned the major responsibility for providing direct
services. Aides and volunteers should be guided and supervised by the
disabilities service coordinator or someone with special training. It is
desirable to have the services of a nurse, physical therapist or
licensed practical nurse available for children with severe health or
physical disabilities.
Volunteers trained by professionals to work specifically with
children with disabilities can provide valuable individualized support.
For example, a volunteer might be trained by a physical therapist to
carry out specific follow-up activities with individual children.
Guidance for Paragraph (k)
State standards for qualifications of staff to provide special
education and related services affect Head Start's acceptance as a
placement site for children who have been evaluated by an LEA. Head
Start grantees, like LEAs, are affected by shortages of staff meeting
State qualifications and are to work toward the goal of meeting the
highest State standards for personnel by developing plans to train
current staff and to hire new staff so that eventually the staff will
meet the qualifications. Grantees should discuss their needs for pre-
service and in-service training with SEAs during annual updates of
interagency agreements for use in the planning of joint State level
conferences and for use in preparation of Comprehensive State Personnel
Development plans. They should also discuss these needs with LEAs which
provide in-service training.
The program should provide training for the regular teachers on how
to modify large group, small group or individual activities to meet the
needs of children with disabilities. Specific training for staff should
be provided when Head Start enrolls a child whose disability or
condition requires a special skill or knowledge of special techniques or
equipment. Examples are structuring a language activity, performing
intermittent nonsterile catheterization, changing collection bags,
suctioning, or operating leg braces. Joint training with other agencies
is recommended to stretch resources and exchange expertise.
Staff should have access to regular ongoing training events which
keep them abreast of new materials, equipment and practices related to
serving children with disabilities and to preventing disabilities.
Ongoing training and technical assistance in support of the disabilities
effort should be planned to complement other training available to meet
staff needs. Each grantee has the responsibility to identify or arrange
the necessary support to carry out training for parents and staff.
The best use of training funds has resulted when programs carry out
a staff training needs assessment and relate current year training plans
to previous staff training with the goal of building core capability.
Staff
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who receive special training should share new knowledge with the rest of
the staff.
The core capability of the program is enhanced when speech, language
and other therapy is provided in the regular site whenever possible.
This allows for the specialist to demonstrate to regular staff and plan
for their follow through. It also reduces costs and time spent
transporting children to clinics and other settings. When university
graduate students are utilized to provide special services as part of
their training, it is helpful to arrange for their supervisors to
monitor their work. Grantees arranging for such assistance are providing
a valuable internship site and it is to the university's advantage to
have their students become familiar with programs on-site. Grantees
should negotiate when developing interagency agreements to have services
provided on-site to the greatest extent possible.
The Head Start Act, Section 648 (42 U.S.C. 9843) (a)(2), calls for
training and technical assistance to be offered to all Head Start
programs with respect to services for children with disabilities without
cost through resource access projects which serve each region of the
country. The technical assistance contractors contact each grantee for a
needs assessment and offer training. While their staffs are small and
their budgets limited, they are experienced and committed to meeting as
many needs as they can and welcome inquiries. A brochure with names and
addresses of the technical assistance providers is available from ACYF/
HS, P.O. Box 1182, Washington, DC 20013.
The SEA is responsible for developing a Comprehensive System of
Personnel Development. It is important that Head Start training needs be
conveyed to this group for planning purposes so that all available
resources can be brought to bear for staff training in Head Start.
Grantees should take advantage of free or low-cost training provided by
SEAs, LEAs, community colleges and other agencies to augment staff
training.
Many agencies offer free training for staff and parents. An example
is the Epilepsy Foundation of America with trained volunteers throughout
the country. The Lighthouse of New York City has developed a training
program on early childhood and vision which was field-tested in Head
Start and is suitable for community agencies. Head Start and the
American Optometric Association have signed a memorandum of
understanding under which member optometrists offer eye health education
and screening. State-funded adult education and training programs or
community colleges make available parenting, child development and other
courses at low or no cost. Grantees should consider the need for
training in working with parents, in developing working collaborative
relationships and in networking when planning training.
The disabilities coordinator needs to work closely with the
education and health coordinators to provide or arrange training for
staff and parents early in each program year on the prevention of
disabilities. This should include the importance of observing signs that
some children may have mild or fluctuating hearing losses due to middle
ear infections. Such losses are often undetected and can cause problems
in learning speech and language. Many children with hearing losses
benefit from amplification and auditory training in how to use their
remaining hearing most efficiently.
The disabilities coordinator should also work with the education
coordinator to provide timely staff training on recognizing signs that
some children may be at high risk for later learning problems as well as
emotional problems resulting from failure and frustration. This training
should address ways to help children develop the skills necessary for
later academic learning, such as following directions calling for more
than one action, sequencing, sustaining attention, and making auditory
and visual discriminations.
Guidance for Paragraph (l)
The RAPS can provide information on agreements which have been
developed between Head Start and SEAs and between Head Start and LEAs
and other agencies. Such agreements offer possibilities to share
training, equipment and other resources, smoothing the transition from
Head Start to public or private school for children and their parents.
Some of these agreements specify cost- and resource-sharing practices.
Tribal Government Head Start programs should maximize use of Bureau of
Indian Affairs, LEA and Head Start funds through cooperative agreements.
Indian grantees should contact ACYF for referral to technical assistance
in this regard. Grantees should bear in mind that migrant children are
served in the majority of States and include consideration of their
special needs, including the necessity for rapid provision of special
education and related services, in agreements with LEAs and other
agencies.
Guidance for Paragraph (m)
In developing the plan and the budget which is a part of the grant
application process, it is important to budget adequately for the number
of children with disabilities to be served and the types and severity of
their disabilities. The budget should reflect resources available from
other agencies as well as the special costs to be paid for from Head
Start funds. The Head Start legislation requires Head Start to access
resources to
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meet the needs of all the children enrolled, including those with
disabilities.
An effective plan calls for the careful use of funds. The
Disabilities Services Coordinator needs to keep current with the
provisions of Part B of the IDEA and the services which may be available
for three through five year-old children under this Act. Coordinators
also need to utilize the expanded services under the Early and Periodic
Screening, Diagnosis and Treatment (EPSDT) program and Supplemental
Security Income program.
To assist in the development of the plan, it may be helpful to
establish an advisory committee for the disability effort or to expand
the scope of the health advisory committee.
Guidance for Paragraph (o)
Examples of evaluation costs which can be covered include
professional assessment by the multidisciplinary evaluation team,
instruments, professional observation and professional consultation. If
consultation fees for multidisciplinary evaluation team members to
participate in IEP meetings are not available from another source, they
are allowable expenditures and need to be provided to meet the
performance standards.
Many children with disabilities enrolled in Head Start already
receive services from other agencies, and grantees should encourage
these agencies to continue to provide services. Grantees should use
other community agencies and resources to supplement services for
children with disabilities and their families.
By planning ahead, grantees can pool resources to schedule the
periodic use of experts and consultants. Grantees can time-share,
reducing travel charges and assuring the availability of scarce
expertise. Some LEAs and other agencies have enabling legislation and
funds to contract for education, health, and developmental services of
the type Head Start can provide. Grantees can also help increase the
amount of preschool funding available to their State under the
Individuals With Disabilities Education Act. The amount of the
allocation to each SEA and to the public schools is affected by the
number of three through five year old children with IEPs in place by
December 1 of each year. By establishing good working relationships with
State Public Health personnel and including them on advisory committees,
health resources can be more easily utilized.
It may be helpful to explore the possibility of a cooperative
agreement with the public school system to provide transportation. If
the lack of transportation would prevent a child with disabilities from
participating in Head Start, program funds are to be used to provide
this related service before a delay occurs which would have a negative
effect on the child's progress. The major emphasis is on providing the
needed special help so that the child can develop to the maximum during
the brief time in Head Start.
The Americans with Disabilities Act of 1990 (42 U.S.C. 12101)
requires that new buses (ordered after August 26, 1990) by public bus
systems must be accessible to individuals with disabilities. New over-
the-road buses ordered by privately operated bus and van companies (on
or after July 26, 1996 or July 26, 1997 for small companies) must be
accessible. Other new vehicles, such as vans, must be accessible, unless
the transportation company provides service to individuals with
disabilities that is equivalent to that operated for the general public.
The Justice Department enforces these requirements.
Efforts should be made to obtain expensive items such as wheelchairs
or audiometers through resources such as Title V (formerly Crippled
Children's Services). Cooperative arrangements can be made with LEAs and
other agencies to share equipment such as tympanometers. Special
equipment such as hearing aids may be obtained through EPSDT or from SSI
funds for those children who have been found eligible. Some States have
established libraries of assistive technology devices and rosters of
expert consultants.
Section 1308.5 Recruitment and Enrollment of Children With Disabilities
Guidance for Paragraph (a)
Head Start can play an important role in Child Find by helping to
locate children in need and hardest to reach, such as immigrants and
non-English speakers. In cooperation with other community groups and
agencies serving children with disabilities, Head Start programs should
incorporate in their outreach and recruitment procedures efforts to
identify and enroll children with disabilities who meet eligibility
requirements and whose parents desire the child's participation.
Integrating children with severe disabilities for whom Head Start is
an appropriate placement is a goal of ACYF. Grantees should bear in mind
that 45 CFR part 84, Nondiscrimination on the Basis of Handicap in
Programs and Activities Receiving or Benefiting from Federal Financial
Assistance or the Rehabilitation Act of 1973 (20 U.S.C. 794) states that
any program receiving Federal funds may not deny admission to a child
solely on the basis of the nature or extent of a disabling condition and
shall take into account the needs of the child in determining the aid,
benefits, or services to be provided. Many children who appear to have
serious impairments are nevertheless able to make greater gains in an
integrated setting than in a segregated classroom for children with
disabilities.
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The key factor in selecting an appropriate placement is the IEP. The
need of the individual child and the ability of the child to benefit are
determining factors. Likewise, the amount of time per day or week to be
spent in the regular setting and/or in other settings is determined by
the IEP. The IEP of a child with a severe emotional/behavioral disorder,
for example, might realistically call for less than full day attendance
or for dual placement. Another factor to consider is that according to
the PIR, the majority of children with severe impairments are provided
special services by both Head State staff and staff of other agencies,
sharing the responsibility. Many grantees have successfully served
children with moderate and severe disabilities.
The disabilities coordinator's responsibility includes providing
current names of appropriate specialized agencies serving young children
with disabilities and the names of LEA Child Find contact persons to the
director to facilitate joint identification of children with
disabilities. It also includes learning what resources other agencies
have available and the eligibility criteria for support from State
agencies, Supplemental Security Income (SSI), Title V, Maternal and
Child Health Block Grants, Title XIX (EPSDT/Medicaid), Migrant Health
Centers, Developmental Disabilities programs, Bureau of Indian Affairs,
third party payers such as insurance companies and other sources.
Grantees need to develop lists of appropriate referral sources.
These include hospital child life programs, SSI, early intervention
programs funded by Part H of the IDEA or other sources, EPSDT providers,
infant stimulation programs, Easter Seal and United Cerebral Palsy
agencies, mental health agencies, Association for Retarded Citizens
chapters, Developmental Disabilities Planning Councils, Protection and
Advocacy Systems, University Affiliated Programs, the LEA Child Find,
and the medical community.
Head Start programs are encouraged to increase the visibility of the
Head Start mainstreaming effort within the community by:
Including community child service providers on
policy council health and disability advisory boards and in other
relevant Head Start activities.
Making presentations on Head Start mainstreaming
experiences at local, State and Regional meetings and conferences, such
as the National Association for the Education of Young Children, Council
for Exceptional Children, and the Association for the Care of Children's
Health.
Participating in interagency planning activities
for preschool infant and toddler programs such as the State Interagency
Coordinating Councils supported under the IDEA.
Guidance for Paragraph (b)
Grantees should maintain records of outreach, recruitment, and
service activities for children with disabilities and their families.
Each grantee should develop a policy on what types of information
are to be included in a comprehensive file for each disabled child. The
policy should outline the locations where a copy of each record will be
sent. For example, while a comprehensive file will be maintained at the
Head Start program central office (where the disability services
coordinator and component coordinators may be based), a teacher must
have access to a child's IEP and progress notes in order to plan
effectively. Confidentiality needs to be maintained in a manner which
allows for access to information by appropriate staff while meeting
applicable Head Start and State requirements.
Guidance for Paragraph (d)
Staff should assist families who need help in obtaining
immunizations before the program year begins, bearing in mind that a
goal of parent involvement and social service activities is to encourage
independence and develop skills in meeting timelines when seeking
services for children. Care should be taken that children are not denied
enrollment, but that their families receive the necessary assistance to
meet entrance requirements. ``Healthy Young Children: A Manual for
Programs,'' (a cooperative effort of the Administration for Children,
Youth and Families, the American Academy of Pediatrics; the Division of
Maternal and Child Health, U.S. Department of Health and Human Services;
Georgetown University Child Development Center; Massachusetts Department
of Public Health, and the National Association for the Education of
Young Children, 1988, copyright, NAEYC) contains best practice guidance.
Section 1308.6 Assessment of Children
Guidance for Paragraph (b)
Early screening is essential because of the time required for the
steps necessary before special services can begin. It has been very
difficult for some grantees to complete health screenings in a timely
manner for several reasons including the lack of resources, especially
in rural areas; the need to rely on donated services from agencies whose
schedules have been especially overloaded during September and October
after the start of the Head Start program year; lack of summer staff in
most programs; and the difficulty in reaching some families. Lack of
coordination among agencies with legislative responsibility for
identifying children
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with disabilities has resulted in duplication and unacceptable delays in
providing required services for many grantees. Other grantees, however,
have demonstrated the ability to complete screenings early in the
program year without difficulty. Many programs already complete
screening by 45 days after the first day of program operation. Some
participate in spring or summer screening programs in their areas before
the fall opening. Grantees are encouraged to schedule well in advance
with clinics and with such providers as EPSDT and the Indian Health
Service for timely screening and any subsequent evaluations that may be
needed.
Recently, a number of legislative and legal requirements have
increased the resources available for the screening and evaluation of
children. Title XIX, EPDST/Medicaid, has new requirements for screening
and evaluation, as well as treatment; the Social Security Administration
has modified eligibility requirements for children with disabilities so
that more services will be available; and all States have assured that
services will be provided from at least age three under IDEA so that
LEAs in more States will be engaged in identifying and evaluating
children from birth to age six.
In response to these changes, the Department of Health and Human
Services and the Department of Education, through the Federal
Interagency Coordinating Council, have developed a cooperative agreement
for coordinated screening. Head Start is one of the participating
agencies which will work together to plan and implement community
screenings, assisting the LEAs which have the major responsibility for
identifying every child with a disability under the IDEA. In addition,
programs may elect to make some summer staff available for activities to
close out program work in the spring and prepare for the fall.
These developments make timely screening feasible. They also make it
possible to expedite immunizations. State-of-the-art coordinated
screening programs make immunizations available.
This coordination can focus staff energy on assisting families to
have their children immunized during the screening phase rather than
making repeated follow-up efforts after the program for children has
begun. Coordinated screening also provides an excellent parent education
opportunity. Information on child development, realistic expectations
for preschoolers and such services as WIC can be provided during the
screening. Some communities have combined screening with well-received
health fairs.
The staff should be involved in the planning of screening to assure
that screening requirements are selected or adapted with the specific
Head Start population and goals of the screening process in mind.
Instruments with age-appropriate norms should be used. Children should
be screened in their native language. Universities, civic organizations
or organizations to aid recent immigrants may be able to locate native
speakers to assist. The RAPs can provide information on the
characteristics of screening instruments.
Current best practice indicates that individual pure tone audiometry
be used as the first part of a screening program with children as young
as three. The purpose is to identify children with hearing impairments
that interfere with, or have the potential to interfere with
communication. The recommended procedure is audiometric screening at 20
dB HL (re ANSI-1969) at the frequencies of 1000, 2000, and 4000 Hz, (and
at 500 Hz unless acoustic immittance audiometry is included as the
second part of the screening program and if the noise level in the room
permits testing at that frequency.) Acoustic immittance audiometry (or
impedance audiometry) is recommended as the second part of the program
to identify children who have middle-ear disorders.
The audiometric screening program should be conducted or supervised
by an audiologist. Nonprofessional support staff have successfully
carried out audiometric screening with appropriate training and
supervision.
When a child fails the initial screening, an audiometric rescreening
should be administered the same day or no later than within 2 weeks. A
child who fails the rescreening should be referred for an evaluation by
an audiologist.
Current best practice calls for annual hearing tests. Frequent
rescreening is needed for children with recurrent ear infections.
Grantees who contract or arrange for hearing testing should check to
assure that the testing covers the three specified frequencies and that
other quality features are present. Speech, hearing and language
problems are the most widespread disabilities in preschool programs and
quality testing is vital for early detection and remediation.
Playing listening games prior to testing and getting use to
earphones can help children learn to respond to a tone and improve the
quality of the testing.
Some grantees have found it strengthens the skills of their staff to
have all members learn to do developmental screening. This can be a
valuable in-service activity especially for teachers. State requirements
for qualifications should be checked and non-professional screeners
should be trained.
Some programs have involved trained students from schools of
nursing, child development or special education graduate students, or
medical students who must carry out screening work as part of their
required experience.
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Guidance for Paragraph (d)
Parents should be provided assistance if necessary, so that they can
participate in the developmental assessment.
Grantees should offer parents assistance in understanding the
implications of developmental assessments as well as medical, dental or
other conditions which can affect their child's development and
learning.
Development assessment is an ongoing process and information from
observations in the Head Start center and at home should be recorded
periodically and updated in each developmental area in order to document
progress and plan activities.
Disabilities coordinators, as well as education staff, need to be
thoroughly familiar with developmental assessment activities such as
objective observation, time sampling and obtaining parent information
and the use of formal assessment instruments. Knowledge of normal child
development and understanding of the culture of the child are also
important.
Guidance for Paragraph (e)
While the LEA is responsible for assuring that each child who is
referred is evaluated in accordance with the provisions of IDEA and
usually provides the evaluation, grantees may sometimes provide for the
evaluation. In that event, grantees need to assure that evaluation
specialists in appropriate areas such as psychology, special education,
speech pathology and physical therapy coordinate their activities so
that the child's total functioning is considered and the team's findings
and recommendations are integrated.
Grantees should select members of the multidisciplinary evaluation
team who are familiar with the specific Head Start population, taking
into account the age of the children and their cultural and ethnic
background as they relate to the overall diagnostic process and the use
of specific tests.
Grantees should be certain that team members understand that Head
Start programs are funded to provide preschool developmental experiences
for all eligible children, some of whom also need special education and
related services. The intent of the evaluation procedures is to provide
information to identify children who have disabling conditions so they
can receive appropriate assistance. It is also the intent to avoid
mislabeling children for whom basic Head Start programming is designed
and who may show developmental delays which can be overcome by a regular
comprehensive program meeting the Head Start Performance Standards.
When a grantee provides for the evaluation of a child, it is
important that the Head Start eligibility criteria be explained to the
evaluation team members and that they be informed as to how the results
will be used.
Grantees should require specific findings in writing from the
evaluation team, and recommendations for intervention when the team
believes the child has a disability. The findings will be used in
developing the child's IEP to ensure that parents, teachers and others
can best work with the child. Some grantees have obtained useful
functional information by asking team members to complete a brief form
describing the child's strengths and weaknesses and the effects of the
disability along with suggestions for special equipment, treatment or
services. The evaluators should be asked in advance to provide their
findings promptly in easily understood terms. They should provide
separate findings and, when they agree, consensus professional opinions.
When planning in advance for evaluation services from other agencies,
grantees should try to obtain agreements on prompt timing for delivery
of reports which are necessary to plan services.
To assist the evaluation team, Head Start should provide the child's
screening results, pertinent observations, and the results of any
developmental assessment information which may be available.
It is important that programs ensure that no individual child or
family is labeled, mislabeled, or stigmatized with reference to a
disabling condition. Head Start must exercise care to ensure that no
child is misidentified because of economic circumstances, ethnic or
cultural factors or developmental lags not caused by a disability,
bilingual or dialectical differences, or because of being non-English
speaking.
If Head Start is arranging for the evaluation, it is important to
understand that a child whose problem has been corrected (e.g., a child
wearing glasses whose vision is corrected and who does not need special
education and related services) does not qualify as a child with a
disability. A short-term medical problem such as post-operative recovery
or a problem requiring only medical care and health monitoring when the
evaluation specialists have not stated that special education and
related services are needed does not qualify as a disability.
The evaluation team should include consideration of the way the
disability affects the child's ability to function as well as the cause
of the condition.
Some children may have a recent evaluation from a clinic, hospital
or other agency (other than the LEAs) prior to enrolling in Head Start.
If that evaluation did not include needed functional information or a
professional opinion as to whether the child meets one of the Head Start
eligibility criteria, the grantee should contact the agency to try to
obtain that information.
Some children, prior to enrolling in Head Start, already have been
diagnosed as having
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severe disabilities and a serious need for services. Some of these
children already may be receiving some special assistance from other
agencies for their disabilities but lack developmental services in a
setting with other children. Head Start programs may best meet their
needs by serving them jointly, i.e., providing developmental services
while disability services are provided from another source. It is
important in such situations that regular communication take place
between the two sites.
Beginning in 1990, State EPSDT/Medicaid programs must, by law,
evaluate and provide services for young children whose families meet
eligibility criteria at 133 percent of the poverty levels. This is a
resource for Head Start and it is important to become aware of EPSDT
provisions.
Section 1308.7 Eligibility Criteria: Health Impairment Guidance
Guidance for Paragraph (c)
Many health impairments manifest themselves in other disabling
conditions. Because of this, particular care should be taken when
classifying a health impaired child.
Guidance for Paragraph (b)
Because AIDS is a health impairment, grantees will continue to
enroll children with AIDS on an individual basis. Staff need to be
familiar with the Head Start Information Memorandum on Enrollment in
Head Start Programs of Infants and Young Children with Human
Immunodeficiency Virus (HIV), AIDS Related Complex (ARC), or Acquired
Immunodeficiency Syndrome (AIDS) dated June 22, 1988. This guidance
includes material from the Centers for Disease Control which stresses
the need for a team, including a physician, to make informed decisions
on enrollment on an individual basis. It provides guidance in the event
that a child with disabilities presents a problem involving biting or
bodily fluids. The guidance also discusses methods for control of all
infectious diseases through stringent cleanliness standards and includes
lists of Federal, State and national agencies and organizations that can
provide additional information as more is learned. Staff should be aware
that there is a high incidence of visual impairment among children with
HIV and AIDS.
Guidance for Paragraph (c)
Teachers or others in the program setting are in the best position
to note the following kinds of indications that a child may need to be
evaluated to determine whether an attention deficit disorder exists:
(1) Inability of a child who is trying to participate in classroom
activities to be able to orient attention, for example to choose an
activity for free time or to attend to simple instructions;
(2) Inability to maintain attention, as in trying to complete a
selected activity, to carry out simple requests or attend to telling of
an interesting story; or
(3) Inability to focus attention on recent activities, for example
on telling the teacher about a selected activity, inability to tell
about simple requests after carrying them out, or inability to tell
about a story after hearing it.
These indicators should only be used after the children have had
sufficient time to become familiar with preschool procedures and after
most of the children are able easily to carry out typical preschool
activities.
Culturally competent staff recognize and appreciate cultural
differences, and this awareness needs to include understanding that some
cultural groups may promote behavior that may be misinterpreted as
inattention. Care must be taken that any deviations in attention
behavior which are within the cultural norms of the child's group are
not used as indicators of possible attention deficit disorder.
A period of careful observation over three months can assure that
adequate documentation is available for the difficult task of
evaluation. It also provides opportunity to provide extra assistance to
the child, perhaps through an aide or special education student under
the teacher's direction, which might improve the child's functioning and
eliminate the behavior taken as evidence of possible attention deficit
disorder.
Attention deficit disorders are not the result of learning
disabilities, emotional/behavioral disabilities, autism or mental
retardation. A comprehensive psychological evaluation may be carried out
in some cases to rule out learning disability or mental retardation. It
is possible, however, in some instances for this disability to coexist
with another disability. Children who meet the criteria for multiple
disabilities (e.g., attention deficient disorder and learning
disability, or emotional/behavioral disorder, or mental retardation)
would be eligible for services as children with multiple disabilities or
under their primary disability.
Teacher and parent reports have been found to provide the most
useful information for assessment of children suspected of having
attention deficit disorder. They are also useful in planning and
providing special education intervention. The most successful approach
may be a positive behavior modification program in the classroom,
combined with a carryover program in the home. Prompt and clear response
should be provided consistently. Positive reinforcement for appropriate
behavior, based on rewards such as stickers or small items desired by
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the child has been found effective for children with this disorder,
along with occasional withholding of rewards or postponing of desired
activities in the face of inappropriate behavior. Effective programs
suggest that positive interactions with the child after appropriate
behavior are needed at least three times as often as any negative
response interactions after inappropriate behavior. Consultants familiar
with behavior modification should be used to assist teachers in planning
and carrying out intervention which can maintain this positive to
negative ratio while shaping behaviors. These behavior interventions can
be provided in mainstream placements with sufficient personnel.
Suggested Primary Members of A Head Start Evaluation Team for Health
Impaired Children:
Physician.
Pediatrician.
Psychologist.
Other specialists related to specific disabilities.
Possible Related Services:
(Related services are determined by individual need. These
``possible related services'' are merely examples and are not intended
to be limiting.)
Family counseling.
Genetic counseling.
Nutrition counseling.
Recreational therapy.
Supervision of physical activities.
Transportation.
Assistive technology devices or services
Section 1308.8 Eligibility Criteria: Emotional/Behavioral Disorders
Guidance for Paragraph (a)
Staff should insure that behavior which may be typical of some
cultures or ethnic groups, such as not making eye contact with teachers
or other adults or not volunteering comments or initiating conversations
are not misinterpreted.
The disability, social service and parent involvement coordinators
should consider providing extra attention to children at-risk for
emotional/behavioral disorders and their parents to help prevent a
disability. Members of the Council of One Hundred, Kiwanis, Urban
League, Jaycees, Rotary, Foster Grandparents, etc. may be able to
provide mentoring and individual attention.
Suggested Primary Members of a Head Start Evaluation Team for
Emotional/behavioral Disorders:
Psychologist, psychiatrist or other clinically trained and State
qualified mental health professionals.
Pediatrician.
Possible Related Services:
(Related services are determined by individual need. These
``possible related services'' are merely examples and are not intended
to be limiting.)
Behavior management.
Environmental adjustments.
Family counseling.
Psychotherapy.
Transportation.
Assistive technology.
Section 1308.9 Eligibility Criteria: Speech or Language Impairment
Guidance for Paragraph (a)
Staff familiar with the child should consider whether shyness, lack
of familiarity with vocabulary which might be used by testers,
unfamiliar settings, or linguistic or cultural factors are negatively
influencing screening and assessment results. Whenever possible,
consultants trained in assessing the speech and language skills of young
children should be selected. The child's ability to communicate at home,
on the playground and in the neighborhood should be determined for an
accurate assessment. Review of the developmentally appropriate age
ranges for the production of difficult speech sounds can also help
reduce over-referral for evaluation.
Suggested Primary Members of a Head Start Evaluation Team for Speech
or Language Impairment:
Speech Pathologist.
Language Pathologist.
Audiologist.
Otolaryngologist.
Psychologist.
Possible Related Services:
(Related services are determined by individual need. These
``possible related services'' are merely examples and are not intended
to be limiting.)
Environmental adjustments.
Family counseling.
Language therapy.
Speech therapy.
Transportation.
Assistive technology devices or services.
Section 1308.10 Eligibility Criteria: Mental Retardation
Guidance for Paragraph (a)
Evaluation instruments with age-appropriate norms should be used.
These should be administered and interpreted by professionals sensitive
to racial, ethnic and linguistic differences. The diagnosticians must be
aware of sensory or perceptual impairments that the child may have
(e.g., a child who is visually impaired should not be tested with
instruments that rely heavily on visual information as this could
produce a depressed score from which erroneous diagnostic conclusions
might be drawn).
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Suggested primary members of a Head Start evaluation team for mental
retardation:
Psychologist.
Pediatrician.
Possible related services:
(Related services are determined by individual need. These
``possible related services'' are merely examples and are not intended
to be limiting.)
Environmental adjustments.
Family counseling.
Genetic counseling.
Language therapy.
Recreational therapy.
Speech therapy.
Transportation.
Nutrition counseling.
Section 1308.11 Eligibility Criteria: Hearing Impairment Including
Deafness
Guidance for Paragraph (a)
An audiologist should evaluate a child who has failed rescreening or
who does not respond to more than one effort to test the child's
hearing. If the evaluation team determines that the child has a
disability, the team should make recommendations to meet the child's
needs for education and medical care or habilitation, including auditory
training to learn to use hearing more effectively.
Suggested Primary Members of a Head Start Evaluation Team for
Hearing Impairment:
Audiologist.
Otolaryngologist.
Possible Related Services:
(Related services are determined by individual need. These
``possible related services'' are merely examples and are not intended
to be limiting.)
Auditory training.
Aural habilitation.
Environmental adjustments.
Family counseling.
Genetic counseling.
Language therapy.
Medical treatment.
Speech therapy.
Total communication, speechreading or manual communication.
Transportation.
Use of amplification.
Assistive technology devices or services.
Section 1308.12 Eligibility Criteria: Orthopedic Impairment
Guidance for Paragraph (a)
Suggested Primary Members of a Head Start Evaluation Team for
Orthopedic Impairment:
Pediatrician.
Orthopedist.
Neurologist.
Occupational Therapist.
Physical Therapist.
Rehabilitation professional.
Possible Related Services:
(Related services are determined by individual need. These
``possible related services'' are merely examples and are not intended
to be limiting.)
Environmental adjustments.
Family counseling.
Language therapy.
Medical treatment.
Occupational therapy.
Physical therapy.
Assistive technology.
Recreational therapy.
Speech therapy.
Transportation.
Nutrition counseling.
Section 1308.13 Eligibility Criteria: Visual Impairment Including
Blindness
Guidance for Paragraph (a)
Primary Members of an Evaluation Team for Visual Impairment
including Blindness:
Ophthalmologist.
Optometrist.
Possible Related Services:
(Related services are determined by individual need. These
``possible related services'' are merely examples and are not intended
to be limiting.)
Environmental adjustments.
Family counseling.
Occupational therapy.
Orientation and mobility training.
Pre-Braille training.
Recreational therapy.
Sensory training.
Transportation.
Functional vision assessment and therapy.
Section 1308.14 Learning Disabilities
Guidance for Paragraph (a)
When a four or five-year-old child shows signs of possible learning
disabilities, thorough documentation should be gathered. For example,
specific anecdotal information and samples of the child's drawings, if
appropriate, should be included in the material given to the evaluation
team.
A Master's degree level professional with a background in learning
disabilities should be a member of the evaluation team.
Possible Related Services:
(Related services are determined by individual need. These
``possible related services'' are merely examples and are not intended
to be limiting.)
Vision evaluation.
Neurology.
Psychology.
Motor development.
Hearing evaluation.
Child psychiatry.
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Pediatric evaluation.
Section 1308.15 Autism
A child who manifests characteristics of the condition after age
three can still be diagnosed as having autism. Autism does not include
children with characteristics of serious emotional disturbance.
Suggested possible members of a Head Start evaluation team:
Psychologist.
Pediatrician.
Audiologist.
Psychiatrist.
Language pathologist.
Possible related services:
(Related services are determined by individual need. These
``possible related services'' are merely examples and are not intended
to be limiting.)
Family support services.
Language therapy.
Transportation.
Section 1308.16 Traumatic Brain Injury
Traumatic brain injury does not include congenital brain injury.
Suggested possible members of an evaluation team included:
Psychologist.
Physical therapist.
Speech or language pathologist.
Possible related services:
(Related services are determined by individual need. These
``possible related services'' are merely examples and are not intended
to be limiting.)
Rehabilitation professional.
Occupational therapy.
Speech or language therapy.
Assistive technology.
Section 1308.17 Other Impairments
This category was included to ensure that any Head Start child who
meets the State eligibility criteria as developmentally delayed or
State-specific criteria for services to preschool children with
disabilities is eligible for needed special services either within Head
Start or the State program.
Suggested primary members of an evaluation team for other
impairments meeting State eligibility criteria for services to preschool
children with disabilities.
Pediatrician.
Psychologist.
Other specialists with expertise in the appropriate area(s).
Possible Related Services:
(Related services are determined by individual need. These
``possible related services'' are merely examples and are not intended
to be limiting.)
Occupational therapy.
Speech or language therapy.
Family Counseling.
Transportation.
Deaf-blindness
Information on assistance or joint services for deaf-blind children
can be obtained through SEAs.
Multiple Disabilities
A child who is deaf and has speech and language impairments would
not be considered to have multiple disabilities, as it could be expected
that these impairments were caused by the hearing loss.
Suggested primary members of a Head Start evaluation team:
Audiologists.
Special educators.
Speech, language or physical therapists.
Psychologists or psychiatrists.
Rehabilitation professional.
Possible related services:
(Related services are determined by individual need. These
``possible related services'' are merely examples and are not intended
to be limiting.)
Speech, language, occupational or physical therapists as needed.
Assistive technology devices or services.
Mental health services.
Transportation.
Section 1308.18 Disabilities/Health Services Coordination
Guidance for Paragraph (a)
It is important for staff to maintain close communication concerning
children with health impairments. Health and disability services
coordinators need to schedule frequent re-tests of children with
recurrent middle ear infections and to ensure that they receive ongoing
medical treatment to prevent speech and language delay. They should
ensure that audiometers are calibrated annually for accurate testing of
hearing. Speech and hearing centers, the manufacturer, or public school
education services districts should be able to perform this service. In
addition, a daily check when an audiometer is in use and a check of the
acoustics in the testing site are needed for accurate testing.
Approximately 17 percent of Down Syndrome children have a condition
of the spine (atlanto-axial instability) and should not engage in
somersaults, trampoline exercises, or other activities which could lead
to spinal injury without first having a cervical spine x-ray.
Guidance for Paragraph (b)
The disabilities services coordinator needs to assure that best use
is made of mental health consultants when a child appears to have a
problem which may be symptomatic of a disability in the social/emotional
area. Teachers, aides and volunteers should keep
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anecdotal records of the child's activities, tantrums, the events which
appear to precipitate the tantrums, language use, etc. These can provide
valuable information to a mental health consultant, who should be used
primarily to make specific recommendations and assist the staff rather
than to document the problem.
The mental health coordinator can cooperate in setting up group
meetings for parents of children with disabilities which provide needed
support and a forum for talking over mutual concerns. Parents needing
community mental health services may need direct assistance in accessing
services, especially at first.
The disability services coordinator needs to work closely with staff
across components to help parents of children who do not have
disabilities become more understanding and knowledgeable about
disabilities and ways to lessen their effects. This can help reduce the
isolation which some families with children with disabilities
experience.
Guidance for Paragraphs (c) and (d)
Arrangements should be made with the family and the physician to
schedule the administration of medication during times when the child is
most likely to be under parental supervision.
Awareness of possible side effects is of particular importance when
treatment for a disability requires administration of potentially
harmful drugs (e.g., anti-convulsants, amphetamines).
Section 1308.19 Developing Individual Education Programs (IEPs)
Guidance for Paragraph (a)
The IEP determines the type of placement and the specific
programming which are appropriate for a child. The least restrictive
environment must be provided and staff need to understand that this
means the most appropriate placement in a regular program to the maximum
extent possible based on the IEP. Because it is individually determined,
the least restrictive environment varies for different children.
Likewise, the least restrictive environment for a given child can vary
over time as the disability is remediated or worsens. A mainstreamed
placement, in a regular program with services delivered by regular or
special staff, is one type of integrated placement on the continuum of
possible options. It represents the least restrictive environment for
many children.
Following screening, evaluation and the determination that a child
meets the eligibility criteria and has a disability, a plan to meet the
child's individual needs for special education and related services is
developed. In order to facilitate communication with other agencies
which may cooperate in providing services and especially with LEAs or
private schools which the children will eventually enter, it is
recommended that programs become familiar with the format of the IEP
used by the LEAs and use that format to foster coordination. However,
the format of the IEP to be developed for children in Head Start can
vary according to local option. It should be developed to serve as a
working document for teachers and others providing services for a child.
It is recommended that the staff review the IEP of each child with a
disability more frequently than the minimum once a year to keep the
objectives and activities current.
It is ideal if a child can be mainstreamed in the full program with
modifications of some of the small group, large group or individual
program activities to meet his or her special needs and this should be
the first option considered. However, this is not possible or realistic
in some cases on a full-time basis. The IEP team needs to consider the
findings and recommendations of the multi-disciplinary evaluation team,
observation and developmental assessment information from the Head Start
staff and parents, parental information and desires, and the IEP to plan
for the best situation for each child. Periodic reviews can change the
degree to which a child can be mainstreamed during the program year. For
example, a child with autism whose IEP called for part-time services in
Head Start in the fall might improve so that by spring the hours could
be extended.
If Head Start is not an appropriate placement to meet the child's
needs according to the IEP, referral should be made to another agency.
Helpful specific information based on experience in Head Start is
provided in manuals and resource materials on serving children with
disabilities developed by ACYF and by technical assistance providers.
They cover such aspects of developing and implementing the IEP as:
Gathering data needed to develop the IEP;
Preparing parents for the IEP conference;
Writing IEPs useful to teachers; and
Developing appropriate curriculum activities and
home follow-up activities.
Guidance for Paragraph (j)
Programs are encouraged to offer parents assistance in noting how
their child functions at home and in the neighborhood. Parents should be
encouraged to contribute this valuable information to the staff for use
in ongoing planning. Care should be taken to put parents at ease and to
eliminate or explain specialized terminology. Comfortable settings,
familiar meeting rooms and ample preparation can help lessen anxiety.
The main purpose is to involve parents actively, not just to obtain
their signature on the IEP.
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It is important to involve the parents of children with disabilities
in activities related to their child's unique needs, including the
procurement and coordination of specialized services and follow-through
on the child's treatment plan, to the extent possible. It is especially
helpful for Head Start to assist parents in developing confidence,
strategies and techniques to become effective advocates for their
children and to negotiate complicated systems. Under IDEA, a federally-
funded Parent Training and Information Program exists whereby parent
training centers in each State provide information, support and
assistance to parents enabling them to advocate for their child.
Information regarding these centers should be given to parents of a
child determined to have a disability. Because some parents will need to
advocate for their children over a number of years, they need to gain
the confidence and skills to access resources and negotiate systems with
increasing independence.
Some parents of children with disabilities are also disabled. Staff
may need to adjust procedures for assisting parents who have
disabilities to participate in their children's programs. Materials to
assist in this effort are available from technical assistance providers.
Section 1308.20 Nutrition Services
Guidance for Paragraph (a)
Vocabulary and concept building, counting, learning place settings,
social skills such as conversation and acceptable manners can be
naturally developed at meal or snack time, thus enhancing children's
skills. Children with disabilities often need planned attention to these
areas.
The staff person who is responsible for nutrition and the
disabilities services coordinator should work with the social services
coordinator to help families access nutrition resources and services for
children who are not able to learn or develop normally because of
malnutrition.
The staff person who is responsible for nutrition and the
disabilities services coordinator should alert staff to watch for
practices leading to baby bottle caries. This is severe tooth decay
caused by putting a baby or toddler to bed with a nursing bottle
containing milk, juice or sugar water or letting the child carry around
a bottle for long periods of time. The serious dental and speech
problems this can cause are completely preventable.
In cases of severe allergies, staff should work closely with the
child's physician or a medical consultant.
Section 1308.21 Parent Participation and Transition of Children From
Head Start to Public School
Guidance for Paragraph (a)
Grantees should help parents understand the value of special early
assistance for a child with a disability and reassure those parents who
may fear that if their child receives special education services the
child may always need them. This is not the experience in Head Start and
most other preschool programs where the majority of children no longer
receive special education after the preschool years. The disabilities
coordinator needs to help parents understand that their active
participation is of great importance in helping their children overcome
or lessen the effects of disabilities and develop to their full
potential.
The disabilities coordinator should help program staff deal
realistically with parents of children who have unfamiliar disabilities
by providing the needed information, training and contact with
consultants or specialized agencies. The coordinator should ensure that
staff carrying out family needs assessment or home visits do not
overlook possible disabilities among younger siblings who should be
referred for early evaluation and preventive actions.
Guidance for Paragraphs (b) and (c)
As most Head Start children will move into the public school system,
disabilities coordinators need to work with the Head Start staff for
early and ongoing activities designed to minimize discontinuity and
stress for children and families as they move into a different system.
As the ongoing advocates, parents will need to be informed and confident
in communicating with school personnel and staff of social service and
medical agencies. Disabilities coordinators need to ensure that the Head
Start program:
Provides information on services available for
LEAs and other sources of services parents will have to access on their
own, such as dental treatment;
Informs parents of the differences between the
two systems in role, staffing patterns, schedules, and focus;
Provides opportunities for mutual visits by staff
to one another's facilities to help plan appropriate placement;
Familiarizes parents and staff of the receiving
program's characteristics and expections;
Provides early and mutually planned transfer of
records with parent consent at times convenient for both systems;
Provides information on services available under
the Individuals With Disabilities Education Act, the federally-funded
parent training centers and provisions for parent involvement and due
process; and
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Provides opportunities for parents to confer with
staff to express their ideas and needs so they have experience in
participating in IEP and other conferences in an active, confident
manner. Role playing has been found helpful.
It is strongly recommended that programs develop activities for
smooth transition into Head Start from Part H infant/toddler programs
funded under IDEA and from Head Start to kindergarten or other
placement. In order to be effective, such plans must be developed
jointly. They are advantageous for the children, parents, Part H
programs, Head Start and LEAs. ACYF has developed materials useful for
transition. American Indian programs whose children move into several
systems, such as Bureau of Indian Affairs schools and public schools,
need to prepare children and families in advance for the new situation.
Plans should be used as working documents and reviewed for annual
update, so that the foundation laid in Head Start is maintained and
strengthened.