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

   Child Development Watch (Kent & Sussex County)
                               18 N. Walnut Street
                                Milford, DE 19963
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
The Referral Process
   A referral is made by calling      At the assessment, the
    CDW and letting the                 child’s development is
    receptionist know that you          assessed by a team of
    would like to make a                professionals consisting of
    referral. They will connect         developmental nurses, child
    you to someone to take the          development specialists, a
    necessary identifying               pediatrician and other
    information and will ask            professionals
    what the developmental             If the child has no delays,
    concern is for the child            the CDW case will be closed
   The case is assigned to a           as the child would be
    Family Service Coordinator          ineligible for services
    or a nurse at Triage               If the child has delays or
   Contact is attempted with           there is an established
    the family within 2 business        condition, the Family
    days of case assignment             Service Coordinator or
    and the developmental               nurse develops an IFSP with
    assessment is scheduled             the family and refers the
                                        child for services
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 needs-
  crying 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
 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
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
 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
 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?
   Assistive Technology - equipment and technology used to assist the child's
   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
   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
 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,
   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
   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
-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

   Kent/Sussex County
    JoEllen Kimmey
    Child Development Watch
    18 N. Church Street
    Milford, DE 19963

   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