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
- 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 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.
- 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 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 met 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.
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 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.
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 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 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).
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.
- 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 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.
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
- 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.