DEL Releases Plan to Improve Services for Infants, Toddlers

The 2016 Legislature passed (SB) 5879 which required the Department of Early Learning (DEL) to develop and submit a plan to the Washington Legislature on comprehensive and coordinated services for all children eligible for the early support for infants and toddlers (ESIT) program in accordance with part C of the Individuals with Disabilities Act (IDEA). If implemented, this plan would create efficiency that will direct more resources to infants and toddlers with special needs and their families.

This plan:

• Improves financial oversight and transparency within early intervention programs,
• Simplifies administrative processes and provides greater technical support to early intervention providers, and
• Ensures the State is maximizing resources for infants and toddlers by significantly increasing usage of both Medicaid and private insurance funding.

DEL received significant feedback from stakeholders during the development of the plan and made substantial changes to the final version in response.

We recognize that some of the administrative costs described in this report are being used by school districts for necessary special education services for preschool (age 3-4) and school age children. Immediate change would be disruptive and we recommend that changes to the program only become effective upon passage of the state’s plan to fund public education (in response to McCleary v. State of Washington Supreme Court Case Number 84362-7) and no earlier than July 1, 2018.

In addition, there is currently a proposal from a Governor-appointed commission to revise how Washington serves children and families. The proposal suggests restructuring existing services to create the Washington State Department of Children, Youth, and Families. If this proposal is implemented by the Legislature, then this early intervention plan should be implemented in a coordinated way on July 1, 2018. DEL is committed to maintaining an effective system that serves all Washington children and families in need of these essential services and working with our partners to do so.

For the last ten months, DEL staff members have engaged more than 1,000 stakeholders across 46 separate events as well as responded to more than 50 pieces of written feedback in order to meet their legislative charge (see appendix A in the report linked below). DEL leadership and ESIT staff have been gathering stakeholder feedback through surveys and facilitated discussions with local lead agency (LLA) staff,
school district contacts, the State Interagency Coordinating Council (SICC), stakeholders from the Office of Superintendent of Public Instruction (OSPI), as well as receiving support from national technical assistance providers and Part C leadership in other states.

To read the entire plan, click here: 2016 ESIT Plan.

Meet Colton: Early Intervention Success

The following is a guest blog post authored by a Pierce County mom:

Colton was the kid everyone looked at in public. At 24 months, he still couldn't speak. Colton would yell, scream, hit, kick, and bite his message across. He hated the smell of strong foods – they made him gag or vomit. He hated anything on his hands and would scream until we wiped them, but he hated the wet wipes as well and would scream even more. Good luck getting anything off his face without a wrestling match! His face was off limits: no wiping, no touching, not even a kiss goodnight.

Colton was constantly on the move. Jumping here and there, crashing into things. We had him evaluated for Autism Spectrum Disorder, but that was ruled out. 

We knew he had a speech delay and a sensory processing disorder. I was an exhausted mom. I was a frustrated mom. It's hard to admit, but I was also a mom who was embarrassed by his behavior. 

One of the biggest blessings of Children's Therapy Center Early Intervention program was having someone explain why our son was acting like this and giving us the encouragement and knowledge to support him. 

Picture Exchange Communication example.

I was surprised when his first therapist was a special education teacher, considering he had been referred for speech. But Stephanie was exactly what Colton needed. He couldn't practice speech until we helped him regulate himself. She taught us how to parent him with love and logic. She taught him sign language (“more,” “all done,” “help,” and “please”) so that he could request his needs. She gave us PECS (Picture Exchange Communication System) so that meals, snacks, and activities were no longer a guessing game ending in fights and tears. She saw his body and knew a SPIO® would help him gain control. She was right! He was like a different kid with it on. Stephanie saw that music helped him learn and calm himself, and she utilized it. She led a play group where he flourished and was motivated by his peers. Within 6 months, Colton went from speaking four to 60 words. He began tolerating wiping. 

The first person my son ever blew a kiss to was Stephanie. I think that's a bold expression of the amazing staff that CTC employs. 

The amazing, Colton!

Colton’s speech therapist, Alyssa, had participated in his playgroup and I think this familiarity made a huge difference. Her enthusiasm really drew Colton in. Alyssa was great at taking Stephanie's observations and utilizing games and songs to get him to enunciate. She showed us how to break words apart, target sounds, and practice repetition in positive ways. 

Colton also received occupational therapy with Marge. Marge really took the time to understand Colton. She observed his reactions and the environmental input and explained all of this to me in a way I could understand. She helped us see how his lack of speech was causing his aggressive behavior. Marge helped us make daily struggles (teeth brushing, hair washing, eating, bedtime) into tolerable and fun routines. She also noticed his weak muscles (hypotonia) and how they negatively impacted the simplest tasks. She taught us how to help him gain strength utilizing household items and games.

I was extremely nervous knowing that Colton would be leaving Early Intervention. All of his therapists and teachers were unconditionally supportive. They worked with me to review notes, prep for the evaluations, and calm any fears I had. With their help, we were able to get Colton the support he needs for the future via developmental preschool. 

Colton doesn't need to yell, scream, hit, kick, or bite to get his messages across anymore. He can use one of the 120 words he now has in his vocabulary. Colton can play with clay or paint with his sisters and wipe his hands calmly. Colton is still on the move but he is not crashing into things. He has much better control over his body and his emotions. 

Every night now, I can tuck him in and give him a kiss – something that would never have been possible without Early Intervention and his teacher and therapists at CTC. 

For more information about Early Support for Infants and Toddlers in Washington State, go to www.del.wa.gov/ESIT. 

Feedback Needed: Early Support for Infants and Toddlers

Prior to the 2016 Legislative session, oversight for the Early Support for Infants and Toddlers program was distributed across multiple agencies. This situation caused confusion and uncertainty for families and providers.

As a result, the Legislature passed a law (SB 5879) that required the following:

• The Legislature established DEL as the agency of record and gave it full program oversight responsibility. DEL now has the authority to adopt rules related to Part C programs.
• The Legislature voiced their frustrations with the accounting practices of the program and asked for a full accounting of ESIT expenditures at DEL and OSPI.
• The Legislature asked DEL to propose a plan for program design and oversight that is due in December. 

Please find the most current version of the Department of Early Learning’s response to SB 5879 below. This document has been revised for clarity based on feedback provide at the October 19, 2016 State Interagency Coordinating Council (SICC) meeting and the October 21, 2016 webinar during which the same information was presented.

• Response Plan Draft (Response to SB5879): Draft ESIT Paper 10 31.pdf

We have also included a link to the map of the proposed local lead agency (LLA) regions.

• Map of Proposed Regions: Proposed_regions_2.pdf

Additional elements of the plan that are yet to be incorporated into the document include:

• proposed timelines,
• updated cost study information and other fiscal components of the plan
• logic model and
• clarification of feedback from stakeholders (included in tables in the plan).

The next steps and timelines for our response to the legislation are listed below:

• ESIT’s proposed rules were published in the State Register on Nov. 2 and are posted on DEL’s rulemaking web page. These rules are draft and indicate a direction but would benefit greatly from your input.
• Creating an easily audited and transparent financial model for the ESIT program is essential to securing future investment and maximizing the amount of services we can deliver with the resources available. 
• We will submit our draft plan to the Legislature in December. The Legislature will then respond to our plan. If they want changes, more information, etc., they will ask in the 2017 session which begins January 9, 2017.
• There will be hearings on the proposed plan where testimony is welcome.

Legislative response on our plan and the budget decisions made in the 2017 session will have a profound impact on the direction of the program.

If you have any questions, please contact laurie.thomas@del.wa.gov.

The most current version of the Department of Early Learning’s response to SB 5879 is now available on the DEL website.

You can also find the recording of the stakeholder feedback webinar from 10/21/16 posted with the draft plan on the DEL website. This webinar was an opportunity for feedback, questions and answers.

We will be accepting feedback on the plan until November 10, 2016.  Please send any written feedback to Laurie Thomas at laurie.thomas@del.wa.gov

Meet the Lymans: Early Intervention Services in Washington State

Meet the Lymans!

The Lymans are a Washington family that benefits from Early Intervention Services for their daughter, Phoebe. Hear their story and find out about the kind of high-quality early learning the Lymans experience. Early Support for Infants and Toddlers (ESIT) is a Washington State program that serves thousands of children each year.

Early intervention services during the first three years can make a big difference in a child’s life. According to the Lymans, their daughter Pheobe has had consistent support and has made developmental progress since her birth!

The Department of Early Learning's (DEL) Early Support for Infants and Toddlers (ESIT) program provides services to children birth to age 3 who have disabilities or developmental delays. Eligible infants and toddlers and their families are entitled to individualized, quality early intervention services in accordance with the federal Individuals with Disabilities Education Act (IDEA), Part C.

Early intervention services are designed to enable young children to be active, independent and successful participants in a variety of settings—in their homes*, in child care, in preschool programs and in their communities--*you can see this in Phoebe's play time with her parents and with her dog, Pepper :). 

Fast Facts about ESIT:

• 6,529 infants/toddlers and their families served at any one time 
• 13,686 eligible infants/toddlers and their families received services 
• 29% of toddlers exiting early intervention did not qualify for special education at age 3 
• 94% of infants/toddlers and families received services in the natural environment 
• 82% of families surveyed reported knowing their rights to the program 
• 89% of families surveyed reported early intervention helped them effectively communicate their child’s needs 
• 86% of families surveyed reported early intervention helped them to help their child develop and learn

Statistics based on early intervention service delivery in Washington, July 1, 2014 through June 30, 2015.

For more information about Early Intervention in Washington State, go here: http://www.del.wa.gov/development/esit/Default.aspx.

Special thanks to the Lymans for letting DEL share your inspirational story and optimism!

Director Visits Children's Therapy Center

Last week, DEL Director Ross Hunter took a tour of Children’s Therapy Center in Burien. He got an opportunity to see first-hand some of the therapies for children with disabilities, and hear about the extensive home-based early intervention services they provide. CTC serves about 3,400 children each year, providing everything from speech-language, physical, and occupational therapies to parent education and community playgroups. Many of these services are provided through DEL’s Early Support for Infants and Toddlers program (ESIT).

At a glance: Washington families served by CTC.

We know that children with disabilities or developmental delays can have a wildly improved quality of life with early intervention services. About 85 percent of a person’s brain development happens in the first three years of life – children in this stage are forming more than 700 new neural connections every second. The services delivered through ESIT are designed to enable young children to be active, independent and successful participants in a variety of settings—in their homes, in preschool programs, and in their communities.

DEL Director Ross Hunter with CTC CEO Jon Botten (left) and staff in front of a river-themed mural at CTC’s Burien center.

While the evidence is clear on what works for children who need early interventions, the system in Washington State needs to become more sophisticated and be more coordinated with the other birth to age three services available. Luckily, the Legislature passed a law this year, Senate Bill 5879, which will help DEL do just that. It gives DEL the opportunity to take a critical look at the current service delivery process and to create a more efficient and expanded system. In the end, we want to get more money going directly to services that support our state’s children.

Look out for more information on this system plan design process throughout 2016 from our ESIT team. We continue to be inspired by the work of incredible partners like Children’s Therapy Center, and we look forward to a day when every child in our state gets the high-quality care they need to live full, rich lives.

National Better Speech & Hearing Month: Early Intervention

Early intervention services during the first three years can make a big difference in a child’s life. In honor of National Better Speech and Hearing Month (May), DEL would like to highlight the various programs and resources Washington has for families with young children in need of speech and hearing assistance.

DEL supports early intervention services as they are designed to enable young children to be active and successful participants during the early childhood years and in the future in a variety of settings:

• in their homes,
• in child care,
• in preschool or school programs,
• and in their communities.

DEL’s Early Support for Infants and Toddlers (ESIT) program supports families with information and skills to ensure they are supported as the most critical influence on their child’s early learning and development.

Early intervention services may include but are not limited to:

·         specialized instruction,

·         speech therapy,

·         occupational therapy,

·         or physical therapy.

If babies have hearing loss, it is important to find out as soon as possible so that they can receive the proper developmental and communications support.

According to the Washington Department of Health, undetected hearing loss can lead to delays in speech and language development, social development and difficulties learning. The Early Hearing-loss Detection, Diagnosis and Intervention (EHDDI) Program follows the 1-3-6 goals, to ensure that infants in Washington are:

1 – Screened for hearing loss before hospital discharge or by one month of age

3 – Have a diagnostic hearing evaluation by an audiologist by three months of age (if the infant did not pass two screens)

6 – Enrolled in early intervention by six months of age (if a hearing loss was found)

For more information about early hearing loss from the Washington State Department of Health, click here.

The Family Health Hotline is a good place to start to find out whether your child is eligible for early intervention services. Call 1.800.322.2588 (TTY 1.800.833.6384) to be connected with a family resources coordinator in your area. The FRC will help you access early intervention services your child may need. For more information about who is eligible for services in Washington, click here.

You can also reference the following web resources if information is needed or when there are concerns a about a child’s hearing, speech/language, or overall development:

·         ESIT Family Resources Coordination Contact Directory

·         Washington State Hands & Voices