KANSAS INFANT-TODDLER SERVICES
TECHNICAL ASSISTANCE BULLETIN

TAB #6 January, 2000

GUIDELINES FOR IMPLEMENTATION OF EARLY INTERVENTION SERVICES IN NATURAL ENVIRONMENTS

FEDERAL REGULATIONS

The 1997 re-authorization of the Individuals with Disabilities Education Act (P.L. 105-17) strengthened the requirements for the provision of early intervention services in "natural environments". The current statute states "(a) to the maximum extent appropriate, early intervention services are provided in natural environments; and (b) the provision of early intervention services for any infant or toddler occurs in a setting other than a natural environment only when early intervention cannot be achieved satisfactorily for the infant or toddler in a natural environment." [Section 635(a)(16) of P.L. 105-17]

P.L. 105-17 also requires that "the IFSP contain a statement of the natural environments in which early intervention services will be provided, and a justification of the extent, if any, to which the services will not be provided in a natural environment". [CFR 303.344 (d)(ii)]

BACKGROUND

Kansas Infant-Toddler Services has, from its inception, required that services be provided in natural environments. During 1997-98, 65% of early intervention services were delivered in the home and 7% were delivered in child care settings in Kansas.

DEFINITIONS

Natural Environments: Settings that are natural or normal for the child's age peers who have no disabilities. [CFR 303.18]

"To the maximum extent appropriate to the needs of the child, early intervention services must be provided in natural environments, including the home and community settings in which children without disabilities participate". [CFR 303.12 (b)]

REQUIRED ACTION

Justify other than natural environments on the IFSP.

In those instances when an IFSP team decides that a natural environment is not the best location to provide a service, it must be justified on the IFSP. P.L. 105-17 requires that "the IFSP contain a statement of the natural environments in which early intervention services will be provided, and a justification of the extent, if any, to which the services will not be provided in a natural environment". [CFR 303.344(d)(ii)] Networks must revise IFSP forms if there is currently no area to reflect this information.

Justification for placement in a not natural environment must be appropriate to the child and family. What family or child's need supports this placement? The environment in which a child receives intervention services is based on the family's needs, concerns and priorities as they relate to the child's abilities. If the family's needs initially support providing these services in an environment that is not "natural" as defined in [CFR 303.18], then:

• assessment, by a professional, must support this placement;
• data should support this placement;
• the IFSP goal should be to move this child from this not natural environment to a natural environment; and
• this movement from not natural to natural environment would be expected to take no longer than six months to a year.

Document the process that was used to reach the decision about the location of the services. This documentation can be included in the family's concerns, priorities and resource section of the IFSP document, in the section for the statement of the natural environments in which services shall be provided, or in another area of the child's permanent record.

Demonstrate that an "individualized" decision was made for each child regarding his or her natural environment, and that decisions were not made based on established program models and availability of providers. Your network's IFSP forms may need to be revised to encourage a broad array of paid and unpaid supports and services.

RECOMMENDED ACTIONS

1. Identify the family's natural environments

The basis for all services and supports to children and families participating in Infant-Toddler Services is the development of the Individualized Family Service Plan (IFSP). Outcomes are developed based on the needs identified during the evaluation process including assessments of the child's and family's strengths, concerns and resources. IFSP development includes determination of the environments in which the child is involved during his or her daily routines, and an exploration of the environments the family would access if their child did not have a disability. Services are then identified and delivered within the context of the family's life and community.

The focus of early intervention services is to increase the family's competence and capacity to meet the needs of their child. Outcomes are designed from the family's perspective: what is important to them and what happens in their daily routines. The IFSP team should follow the family through their day, and develop an IFSP which supports the child's developmental activities across environments. Early intervention services are most effective when routines, materials, and people common to the family and child are used. The location selected to provide these services should be one that maximizes the child's and family's opportunity to learn.

2. Provide information supporting the provision of services in natural environments

During the initial evaluation and on-going assessments, it is important to discuss the reasons for providing services in a natural environment with the family. Examples of reasons include:

• All children can learn from one another.
• Familiar environments allow children to focus on targeted learning.
• Interactions with children without disabilities are linked to the child's ability to interact in adulthood with other adults.
• All children need to develop a sense of belonging.
• Children with disabilities have a right to access the same environments as other children

The family service coordinator also can provide information to the family about community resources and services.

3. Local Interagency Coordinating Councils: Address the challenges to meet the natural environment requirement.

There may be many challenges within communities to meet the natural environment requirement. Parents, physicians and other early intervention professionals may believe that a clinical model is most effective. Services may not be available or accessible in communities. This challenge provides Local Interagency Coordinating Council's (LICC's) with unique opportunities for community education and collaboration. Some examples of LICC activities could include the following:

• Provide information to referral sources and those who make first contact with families and professionals about the benefits of services in natural environments.
• Provide training opportunities to the broader early childhood community on how to support children with disabilities in community settings.
• Carry out planning activities that address how to meet the needs of all children in the community, not just those of children with disabilities.

LICC's can provide support and guidance to the local early intervention service delivery system as it moves toward all services being provided in natural environments. Actions that may be considered:

• Provide incentives that can be offered to professionals to provide services in natural environments rather than in clinical or office settings.
• Use telecommunication technology to increase efficiency.
• Deliver services through a consultative model.
• Hire and train para-professionals.
• Focus personnel recruitment and training on designing and implementing outcomes in natural environments.
• Families and family service coordinators can continually provide information to the medical community regarding progress and successes of individual children and families.
• Encourage families who have been successful in natural environments to share their experiences with families entering the system.
• Discuss the IFSP process with families, rather than the program site or type of "therapy" or service.

LICC's are encouraged to continue their planning and advisory activities around this issue to work toward a service delivery system that provides services in places where there are children without disabilities, that are part of the community, and that are part of the family's daily life.

(Some information adapted from "Service Guideline 2: Natural Environments. Intervention Guidelines for Service Providers and Families" from the Connecticut Birth to Three System.)