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Addressing the Needs of Young Children in Child Welfare: Part C -- Early Intervention Services
Bulletin for Professionals

Author(s):  Child Welfare Information Gateway

Year Published:  2007

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You are in section: Table of Contents 1. Child Welfare and Early Intervention 2. Promising Strategies 3. Funding Strategies Resources References

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1. Child Welfare and Early Intervention

Despite some implementation challenges, the Part C referral provisions promise unique benefits for child welfare agencies and the children in their care.

Special Needs of Children in Child Welfare

Research shows that children who are abused or neglected often experience physical, developmental, and emotional problems, including attachment disorders, social and emotional disturbances, cognitive deficits, neurobiological changes in the brain, and failure to thrive (Jaudes & Shapiro, 1999). This risk is greatest for the very young. In 2005, children ages birth to 3 had the highest rates of victimization, at 16.5 per 1,000 children of the same age group. More than three-quarters (76.6%) of the estimated 1,460 children who died as a result of child abuse or neglect that year were younger than 4 years of age (U.S. Department of Health and Human Services, 2007).

Many young children under the age of 3 who experience abuse and neglect are placed in foster care. Studies reveal one-quarter of these young children have significant delays in motor development, and almost one-half have significant delays in communication and cognitive development (Jaudes & Shapiro, 1999; Spiker & Silver, 1999; U.S. GAO, 1995; Blatt, Saletsky, & Meguid, 1997; Hochstadt, Jaudes, Zimo, & Schachter, 1987).

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Part C Referral Provisions and Early Intervention Programs

In recognition of these risks, Congress's reauthorization of CAPTA'with the enactment of the Keeping Children and Families Safe Act of 2003 (P.L. 108-36)'required States to develop "provisions and procedures for referral of a child under age 3 who is involved in a substantiated case of child abuse or neglect to early intervention services funded under Part C of the Individuals with Disabilities Education Improvement Act" (§ 106(b)(2)(A)(xxi)). The 2004 reauthorization of the IDEA contains language parallel to CAPTA.¹

The IDEA also details specific requirements for State early intervention programs (EIPs) that include services for children in foster care. EIPs are administered by lead agencies in each State (including departments of health, developmental disability, social services, children and families, or education). Among the Part C application requirements are the following:

• Each lead agency must implement a comprehensive child find system to identify, locate, and evaluate children needing early intervention services—particularly young children in foster care.
• When a child is identified as being potentially eligible for Part C, a formal referral must be made to Part C within 2 working days of identification.
• EIPs must ensure timely, comprehensive, multidisciplinary evaluations to determine initial and continuing eligibility.
• For those children determined eligible, an Individual Family Services Plan (IFSP) must be developed within 45 days of referral.
• EIPs must ensure that "appropriate early intervention services are available to all infants and toddlers with disabilities in the State and their families, including... infants and toddlers who are wards of the state" (§ 634).

The 2004 IDEA also requires the establishment of a State Interagency Coordinating Council that includes representatives from the State child welfare agency responsible for foster care.

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Benefits of Part C for Child Welfare

Research confirms that the early years present an unparalleled window of opportunity to support the positive development of children (Shonkoff & Phillips, 2000). Child welfare workers can help ensure that the developmental needs of children who are abused and neglected are addressed by attending trainings on child development, referring children to the EIP, and working closely with EIP staff. An EIP service coordinator can then help families (and child welfare professionals) navigate the eligibility process, design an IFSP, and ensure needed services are provided.

The IDEA encourages service providers to collaborate with families to be sure the IFSP or Individualized Education Program (for school-aged children) reflects the family's vision for the child. The IFSP can include any of the following:

• Occupational, physical, speech, and language therapies
• Assessment and treatment of hearing and vision problems
• Psychological services, assessment, and counseling
• Social work
• Nursing services
• Special instruction
• Assistive devices such as hearing aids and wheelchairs
• Nutrition counseling
• Transportation

The EIP also permits caregivers to consent to and participate in services that can help them enhance their child's development.² The stress of caring for a child with a disability or delay can strain family resources and threaten family stability. Child welfare professionals can refer caregivers to EIP services such as parent counseling and training, home visitation, and respite care that may help them manage the stress of parenting their children, encourage the recruitment and retention of foster and adoptive families, stabilize placements, and support reunification.

Referrals to the EIP support a State's capacity to enhance the safety, permanency, and well-being of children and their families in the following ways:

• Referral to the EIP enhances service availability and accessibility, enabling children to receive appropriate services to meet their educational, mental health, and physical needs and supporting families' enhanced capacity to provide for those needs.
• By providing parent training and respite services to eligible children and their caregivers, referrals to the EIP enhance a State's capacity to provide family-centered services that safely maintain children in their own homes, prevent removals, promote reunification, and stabilize placements.
• CAPTA's referral provisions help State child welfare administrators comply with Federal child welfare regulations to ensure that "families have enhanced capacity to provide for their children's needs ' children receive appropriate services to meet their educational needs and children receive adequate services to meet their physical and mental health needs" 45 CFR 1355.34(b)(1)(iii).

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Implementation Challenges

Despite their documented need and eligibility for EIP services, many children who have experienced abuse or neglect do not receive them. States nationwide report underidentification and underenrollment of children involved with child welfare in early intervention services (Robinson & Rosenberg, 2004). Some of the challenges include:

• Many of these children do not have a consistent caregiver in their lives who can observe their development over time.
• It is difficult to understand the complexity of the early intervention system, Federal laws, and State policies and effectively navigate the system on a child's behalf.
• While pediatricians and primary care physicians are often referral agents for the EIP, Federal Child and Family Services Review (CFSR) data suggest that a lack of access to primary health care and limited contact with health-care professionals in general are problems for many children in the child welfare system.³
• Child welfare professionals, foster parents, and court personnel who are responsible for the well-being of these children are not always trained to identify developmental needs of children in foster care and may have limited knowledge about Part C services. One study found that children had more problems than were identified by caseworkers and foster parents. Only one-third of the problems later identified by EIP professionals in this study were initially reported by caseworkers and foster parents (Halfon, Mendonca, & Berkowitz, 1995).
• At every stage of the EIP beyond referral, Federal legislation under the IDEA requires parental consent and participation. Yet, the parents of children who have substantiated reports of abuse and neglect are sometimes unknown or cannot be found to provide consent for services.
• EIP professionals may be unfamiliar with child welfare policies and procedures, with strategies for engaging families who are involuntarily involved in a referral to child welfare services, or both.

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¹ The IDEA requires States seeking grants to include in their applications "a description of the State policies and procedures that require the referral for early intervention services … of a child under the age of 3 who -- (A) is involved in a substantiated case of child abuse or neglect; or (B) is identified as affected by illegal substance abuse, or withdrawal symptoms resulting from prenatal drug exposure." CAPTA section 106 [42 U.S.C. 5106a], subsection (b)(2)(A)(xxi) discusses specific elements that must be included in a State's plan, including "provisions and procedures for referral of a child under the age of 3 who is involved in a substantiated case of child abuse or neglect to early intervention services funded under part C of the Individuals with Disabilities Education Act." Subsection (b)(2)(A)(iii) requires "the development of a plan of safe care for the infant born and identified as being affected by illegal substance abuse or withdrawal symptoms." back

² Foster parents can be considered parents or serve as surrogate parents under the EIP, and many States include foster parents under the parent definition of the 2004 IDEA 20 U.S.C. 1401(23). back

³ Common challenges States cited in meeting the well-being indicator related to physical health include finding doctors willing to accept Medicaid, providing timely health assessments, and providing adequate preventive health care. For more information, see www.acf.hhs.gov/programs/cb/cwmonitoring/results/genfindings04/ch1.htm back

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Updated on February 7, 2008