Referral Process Children age 0-3

Transcription

1 Referral Process Children age 0-3 Score on a developmental screen falls below the tool's empirical cutoff in one or more of the five domains,or there is an established condition, or parent concern. Children's Developmental Services Agency (CDSA) Entry Evaluation Completed Eligible for Services if: 1- Developmental Delay in one or more of the five developmental domains (delay determined by type of test adminstered, i.e. either % delay or standard deviations below mean of composite score) 2-Established Condition which has a high probability of resulting in a delay (see legend below for established conditions list) YES NO Infant Toddler/Early Intervention Program includes Case Management/Direct Services such as OT, PT, and S&L IFSP Developed with Family Child Service Coordination, or other appropriate community service (If Renewed Concern) Transition To: 3-5 Yr Old Program with DPI Discharge by: Age 3 LEGEND: ESTABLISHED CONDITIONS A-Congenital Anomaly /Genetic Disorders/Inborn Errors of Metabolism (e.g. Down Syndrome, Fragile X, fetal alcohol syndrome, familial retardation) B-Congenital Infection (e.g. toxoplasmosis, rubella, cytomegalovirus, HIV) C-Autism D-Attachment Disorder(Per DC-03-Reactive Attachment Deprivation/Maltreatment Disorder of Infancy) E-Hearing Loss or Visual Impairment F-Neurologic Disease/Central Nervous System ( e.g. Cerebral Palsy, Spina Bifida, Epilepsy & Microcephaly) G-Neonatal Conditions & Associated Complications (e.g. Gestational age less than 27 weeks or birth weight less than 1000 grams, neonatal seizures, stroke, meningitis, encephalitis, etc.) DEFINITIONS IFSP-Individual Family Service Plan; PT- Physical Therapist; OT - Occupational Therapist ; S&L -Speech and Language Therapist DPI -Department of Public Instruction

2 Primary Care Autism Screening Referral Process for Infants and Toddlers MCHAT is Positive (+) OR Autism Surveillance yields 2 or more + risk factors If Global Developmental Delay, Intellectual Disability is present, or Genetic or Neurologic disorder is suspected Consider referral to D & B Pediatrician Geneticist Neurologist CDSA Eligibility evaluation If developmental delay or established condition found IFSP No ASD or Developmental Delay found Audiology Evaluation Further Autism-specific evaluation as needed Continued Case Management, IFSP Continued Direct Services as indicated Primary Care Physician (PCP) is notified ASAP about the evaluation result and service plans in order to have a follow-up with the family. PCP shares results of Audiological Evaluation and other referrals (if any) with the CDSA as soon as results are reported. Notes: CSC or other community services (if renewed concern rerefer) Autism specific evaluations and/or confirmation of an autism diagnosis are influenced by the age of the child and findings; younger children and those with less significant symptoms are more difficult to diagnose.

3 Referral Flow Chart Legend & Notes Questions of autism for a specific infant or toddler: The AAP recommends simultaneous referral for ASD evaluation, EI services, and Audiology evaluation. leads to a referral to your Children s Developmental Services Agency (CDSA) leads to a referral for an audiology evaluation may lead to a referral to a D&B pediatrician, geneticist, or neurologist for assistance with an etiologic workup and/or a search for coexisting conditions if indicated. When referring, include: Diagnosis of autism if you have made it Copies of child s MCHAT Additional information as appropriate Copies of family s release of information for communication from and to pediatrician/cdsa ACTION STEPS As Primary Care Practices begin screening for autism per AAP recommendations: PCP s: Discuss CDSA resources with CDSA staff Discuss other community resources with community partners, including CDSA Facilitate communication between primary practice, other diagnostic referrals, and CDSA - CDSAs: Discuss CDSA resources with community PCP s (e.g., possibility of audiological evaluation) Assure feedback to referring PCP s regarding eligibility of child. (Complete ROI if it has not been obtained at the primary care practice.) Continue communication regarding additional assessment as needed CCNC

4 (Insert Letterhead Identification Here) Referral Form Developmental Screening & Surveillance Name of Child: Date of Birth: / / Age Sex Address: Medicaid#: Insurance Social Security Parent/ Guardian Name: Home Phone: Work Phone: Race: Primary Language: Concerns: Developmental/Interdisciplinary Referral: Screening Tool: ASQ PEDs MCHAT ASQ-SE Other (Please Name) The ASQ or PEDS and/or MCHAT scoresheet is attached, if completed. I have discussed this referral with parent(s) Referred By: PCP Office: Phone: Fax: CCNC

5 North Carolina Physician to Preschool Exceptional Children Program Notification Process Chart For Children 3 to Pre-Kindergarten 5 Years of Age e.g., Developmental Delays, MCHAT is Positive (+) OR Autism Surveillance yields 2 or more + risk factors; ASQ or PEDs scores are raised Physician informs family of LEA services Child Find information, from Physician provides family with school system Physician sends notification and parental release of information form Contact information Signed release of information Health screening; including vision and hearing Developmental screening Behavioral health screening Evaluation(s) in process Referral for child service coordination via health department (if appropriate) YES Direct contact made between school system & family Interview parents about child development concerns School system obtains existing screenings, observations, etc. Suggested Interventions offered to family School system or parent may initiate a referral NO School system or parent initiates referral If school system rejects referral, parent may make a written request Parent signs informed consent to evaluate 90 day timeline begins Process stopped- NO EVALUATION Parent denies consent to make written referral School system may utilize procedural safeguards to pursue evaluation. No educational concerns identified School system conducts assessment or proceeds to eligibility determination Eligibility determination & IEP developed, if eligible parental consent for services obtained, if eligible Services begin Process stopped Parent denies consent for services Assessments reveal no educational concerns Not eligible for special education School system sends followup information to physician With consent for release of confidential information