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DFS New Worker Training

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					DFS New Worker Training
Child Development Watch (New Castle County) 2055 Limestone Road, Suite 201 Wilmington, DE 19808 302-995-8617 Child Development Watch (Kent & Sussex County) 18 N. Walnut Street Milford, DE 19963 302-424-7300

What is Child Development Watch?

 IDEA Part C (Individuals with Disabilities Education Act)-- Birth to Three Early Intervention System Delaware’s Birth to Three early intervention services are operated by Child Development Watch in the Division of Public Health, and administered by the Birth to Three Early Intervention System, Delaware Health and Social Services, in collaboration with the U.S. Department of Education.

Child Development Watch is…
…the statewide early intervention program for children ages birth to 3. The program's mission is to enhance the development of infants and toddlers with disabilities or developmental delays and to enhance the capacity of their families to meet the needs of their young children. …comprised of staff from several state agencies, the duPont Hospital for Children and Christiana Care. These professionals work together to provide multidisciplinary assessments, service coordination, plan development and service delivery to eligible children from birth up to age three and their families.

The Referral Process
 A referral is made by calling CDW and letting the receptionist know that you would like to make a referral. They will connect you to someone to take the necessary identifying information and will ask what the developmental concern is for the child The case is assigned to a Family Service Coordinator or a nurse at Triage Contact is attempted with the family within 2 business days of case assignment and the developmental assessment is scheduled  At the assessment, the child’s development is assessed by a team of professionals consisting of developmental nurses, child development specialists, a pediatrician and other professionals If the child has no delays, the CDW case will be closed as the child would be ineligible for services If the child has delays or there is an established condition, the Family Service Coordinator or nurse develops an IFSP with the family and refers the child for services

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Developmental Domains
 Motor  Fine Motor- pre-writing skills, using pincer grasp, picking up small toys Gross Motor- sitting up, crawling, walking, running, jumping

 Cognitive- ability to solve problems, memory skills  Self-Help/ Adaptive- expressing or meeting one’s needscrying when hungry, holding own bottle, feeding self, showing interest in toilet training  Social/ Emotional- ability to relate to others  Communication  Expressive- how the child vocalizes, uses words or gestures to make needs known Receptive- ability of the child to understand what is said to him/ her

What qualifies as a developmental delay?
 If the child is found to more than 25% delayed in cognitive, social/ emotional, motor, adaptive or more than 30% delayed in his/her communication skills, the child qualifies for Child Development Watch services.

Why might a child have a developmental delay?
 prenatal environment (exposure to illegal drugs and other substances, lack of prenatal care)  environmental conditions (lacking appropriate stimulation in their environment)  medical issues (pre-maturity, genetic issues, other medical conditions)  other reasons

What are DFS responsibilities as a team member?
 Screen all children that DFS comes into contact with from the ages of 0-3  Talk to the family about any concerns  Talk to the Primary Care Physician of the child about any concerns  Make a referral when there are concerns  Keep lines of communication open  Obtain an educational surrogate parent when needed

Protocol for Referrals to CDW
 DFS worker will utilize the variety of developmental checklists and charts provided as a tool to identify children with suspected developmental delays  DFS will contact the parent of a potentially eligible child and discuss the concerns with the parent. DFS will encourage the parent to make the referral to CDW for their child.  In situations in which it is not likely that the parent will make the referral, the DFS worker will make the referral to CDW  In NCC call 995-8616 In Kent & Sussex call 424-7300  DFS worker will be asked to provide child’s name, DOB, MCI #, address, phone number, gender, insurance information, PCP, mother’s name, her DOB, address, phone number, father’s name, DOB, address, phone number, pertinent history, and reason for referral

Protocol for Referrals to CDW
 DFS will document referral to CDW in notes section of FACTS  CDW will obtain consent to share information with DFS and information will be shared as necessary for case planning purposes  DFS will be made aware of the status of the referral, the assessment, and be invited to the IFSP planning meeting if the child is found eligible

What are the services provided by Part C?
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Assistive Technology - equipment and technology used to assist the child's development Audiology - hearing services Family Training and Counseling Health Services - special health services provided in cooperation with your child's primary doctor Nutrition Plans Nursing Services Occupational Therapy - program to teach self-help, playing and eating skills Physical Therapy - program involving motor skills and various movements Psychological Services - counseling on behavior management, learning, and mental health Social Work - family and child counseling and help with coordination of services Special Instruction - services related to the child's skill development Speech-Language Therapy - services related to the child's language development Transportation - assistance to and from appointments Visual Services - services related to improving the child's visual development

The Educational Surrogate Parent (ESP)
 The educational surrogate parent program is an independent state agency mandated under federal law to protect educational rights of children and young adults with disabilities as defined under IDEA. Federal law demands that each state provide a system whereby children who are in state custody will be provided an independent voice to advocate for their educational needs. Delaware created the Educational Surrogate Parent program to provide this service to children and young adults who have been placed in state custody and whose parents are no longer able to advocate for their needs.

ESP (con’t)
 The ESP program has one full time coordinator who recruits, trains and matches volunteers with children who are in need of advocacy and meet criteria to the program  Darlene Lantz, ESP Coordinator 900 King Street, Suite 230 Wilmington, DE 19081 2551740 phone 577-2008 fax

When might you (as DFS worker) be asked to assist with obtaining an ESP for a child?     Parental rights are terminated Parent can not be identified Parents whereabouts are unknown Parents voluntary consent to appointment of ESP *complete referral form and include appropriate documentation and fax or send to Darlene Lantz

Who can sign CDW Consents and the IFSP?
    Child’s parent Child’s legal guardian Educational Surrogate Parent Relative with whom child resides

**Foster parents can not sign unless they are appointed as the ESP for the child.

(DFS can sign for releases of information if they hold custody)

Definitions of Eligible Infants and Toddlers under Part C of IDEA
 If the child has an established condition chromosomal (Down’s Syndrome, Trisomy 18, Trisomy 13, Klinefelter, et);  genetic disorders (muscular dystrophy, Tay Sachs, et);  severe infections diseases (HIV, toxoplasmosis, rebella, syphilis, variecella, meningitis, encephalitis);  neurologic disorders (neonatal seizures, mutliple apnea episodes, cerebral palsy, seizure disorder, birth injury, degenerative disorder, et)

Definitions of Eligible Infants and Toddlers under Part C of IDEA (con’t)
 established condition- (con’t)  Congenital anomalies (spina bifida, hydrocephalus, cleft palate, limb deficiences)  Sensory disorders (moderate to severe visual and/ or hearing impairment)  Severe adjustment, socio-affective and other atypical disorders (autism, atypical child (nervous, withdrawn, anxious behavior), PDD, ODD, Shyness Disorder of Childhood  Severe Toxic Exposure- effect on child from prenatal exposure to alcohol, cocaine, phenytoin or coumadin, other illegal substances and postnatal lead poisoning. For illegal substances child must be suffering from withdrawal symptoms- excessive crying, jittery, difficult to soothe, or when placed on opium to ease withdrawal symptoms

Prenatal Exposure to Toxic Substances
-a child or mother that tests positive for cocaine, marijuana,
alcohol, opiates, barbiturates, heroin, et al, at birth does not in and of itself warrant a referral to Child Development Watch. Only children who tested positive at birth and suffer effects from that exposure are appropriate to be referred to CDW
-for children who test positive to illegal toxic substance but do not have effects or for children whose mother tested positive to illegal toxic substance but the baby themselves did not test positive, it would be appropriate to refer these children for a Public Health Nurse to monitor the child and family. The Public Health nurse in turn would refer to CDW if concerns arose regarding the child’s development. A referral for a Public Health Nurse can be made by the same phone numbers as referring for CDW which are the central intake phone numbers. The DFS Worker is to specify referring for Public Health Nurse and will be asked to provide other appropriate identifying information as necessary

Definitions of Eligible Infants and Toddlers under Part C of IDEA (con’t)
 established condition- (con’t)
 Medically fragile  Chronic medical illness  Low birth weight/ small for gestational age birth weight less than 1250 grams for gestational age and birth weight less than 2000 grams at term  Growth deficiency- failure to thrive “inorganic” or “organic”

Role of the DFS Liaison
 Primary case manager for majority of DFS cases referred to CDW  Trains all new DFS employees on CDW  Trains all CDW employees on DFS related issues  Ensures that children DFS marks as appropriate for referral to CDW are referred to CDW

 Annual statistic count showing DFS children active with CDW, DFS foster children active with CDW, and DFS children of substantiated DFS cases active with CDW
 Answers questions by CDW/ DFS staff as they arise  Has access to FACTS and can let CDW staff know name of DFS worker or if case is presently active with DFS  Other duties as required……..

Your DFS Liaisons
 New Castle County Sarah MacDonald Child Development Watch 2055 Limestone Road, Suite 201 Wilmington, DE 19808 302-995-8617 Kent/Sussex County JoEllen Kimmey Child Development Watch 18 N. Church Street Milford, DE 19963 302-424-7335 Direct supervision of DFS Liaison is by the local CDW Clinic Manager. Liaisons are also supervised by Gail Womble DSCYF Program Administrator 1825 Faulkland Road Wilmington, DE 19805 302-892-6438

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