using informed clinical opinion during eligibility determination
DESCRIPTION
This webinar will explore the key components of informed clinical opinion and describe its uses during the eligibility determination process. Information will include definitions and descriptions of informed clinical opinion, provider skills necessary for using informed clinical opinion, and the importance of the intake process in ensuring informed clinical opinion can be used effectively and appropriately for eligibility determination. Participants will have the opportunity to practice using informed clinical opinion with 3 different eligibility scenarios. This webinar will feature Beverly Crouse and Kyla Patterson, Part C Technical Assistance Consultants.TRANSCRIPT
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KylaDeana Bev
WELCOME
This presentation has been modified for use on slideshare.
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Purpose2
Define informed clinical opinion
Explain its use in eligibility determination
Provide a chance to practice with some examples
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Part C Regulations3
303.322(c)(2
Evaluation (for eligibility determination) & assessment must be based on informed clinical opinion.
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Definition - Practice Manual
Informed clinical opinion: The
outcome of using information
gathered through eligibility
determination and/or assessment for
service planning methods combined
with professional expertise and
experience to determine the child’s
developmental status and eligibility
under Part C.
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Page 189 of Practice Manual
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Informed clinical opinion is the
result of synthesizing medical and
developmental information (based
on a tool, observation, parent
report, medical records, etc.) with
professional expertise and
experience to make a
determination regarding a child’s
developmental status and/or
eligibility.
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Description - Practice Manual
Page 29 of the Practice Manual
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“Informed clinical opinion makes use of qualitative and quantitative
information to assist in forming a determination regarding difficult-
to-measure aspects of current developmental status and the
potential need for early intervention services.”
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Definition – NECTAC Notes 2002
Informed Clinical Opinion, Jo ShackelfordNECTAC Notes, Issue No. 10May 2002
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Key Components
Multiple sources of information
Expertise and experience
Synthesizing
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A 2-year-old child is referred by his child care
center because he is “not talking as much as the
other kids and doesn’t really interact with others.”
A provider goes to the family’s house for intake.
After 5 minutes of watching the child and trying to
talk to him and without getting information from
the mom about the family’s observations and
concerns about the child, the provider tells the
mom that her son is on the autism spectrum.
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Check Your Understanding
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What It Isn’t!
Informed clinical opinion is not “eyeballing” a child for a
few minutes and deciding whether or not he/she is eligible.
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The ability to use informed clinical opinion requires:
Appropriate training; Previous experience; Cultural sensitivity; and Ability to gather and use family perceptions
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Provider Skills Needed
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Given those necessary skills, how would you rate your own
ability to effectively and appropriately use informed clinical
opinion?
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Consider This…
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Individual - Develops an informed
opinion about child’s development
and need for EI services
Team – Synthesizes info from all
members to determine eligibility
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Individual and Team Level
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To Determine Status in Each Area
Across settings
On the border
Instrument does not fully cover
Difficult to measure
Observations don’t match measurement
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Determine Eligibility
Team process
Consensus decision-making
Documenting decision
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Use of Existing Information
• Parent observation and report
• Information from referral source
• Medical and health information
• Screening results
• Provider observation
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Informed clinical
opinion may be used
by qualified personnel
to establish a child’s
eligibility even when
other instruments do
not establish eligibility.
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Atypical Development
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Have you participated in an eligibility determination meeting where
the child was found eligible based only on atypical development (e.g.,
no developmental delay or diagnosed condition)?
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Poll
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Training
Practice Manual
Screening tool
Gathering information from families Consistency of process, practices
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Importance of Intake
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Documentation
• On the screening tool
• Contact notes Communication with eligibility determination team
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Importance of Intake
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Practice Sessions
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Drake is an 8-month-old who was referred to the local system
by his pediatrician because Drake is not yet rolling over. During
the intake visit, Drake’s mom confirms that he has not rolled
over yet from back to front or front to back, and she comments
that he often feels kind of floppy when she holds him. The
hearing and vision screenings completed during intake indicate
no reason for further hearing or vision evaluation. The service
coordinator completes the ASQ for gross motor development
and finds that Drake is not yet doing any of the skills on the 8-
month questionnaire for gross motor development.
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Scenario 1
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Based on the Scenario #1 summary, would you find Drake???
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Poll
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Sarah is 10 months, 10 days old. She was referred to the local system by the
local Department of Social Services which is involved with Sarah’s family
because of concerns about neglect During the intake visit, all areas of the
ASQ-III were administered using the 10-month questionnaire. Hearing and
vision screenings were also completed. Sarah’s scores on the ASQ were as
follows: Communication = 30 (in the grey/monitor column); Personal-Social =
35 (grey/monitor), Gross Motor = 60 (white/above cut score column), Fine
Motor = 50 (white/above cut score), Problem-Solving = 50 (white/above cut
score). The hearing and vision screenings indicated no reason for further
hearing or vision evaluation. During intake, the service coordinator observed
that Sarah still drinks from a bottle and makes few playful sounds. The
referring DSS worker had also noted that Sarah rarely uses sounds, but Sarah’s
mom reports that she does make more sounds when it’s just the two of them.
No physician report is available.
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Scenario 2
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Based on the Scenario #2 summary, would you find Sarah???
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Poll
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What might have been done differently at referral and/or intake to
provide the eligibility determination team with enough information?
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Could You Have Had Enough Info?
Use Chat to Respond
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Betsy is a 20-month-old who was referred to the local system by her mother
because she is concerned that Betsy is not talking nearly as much as her
older brother did at the same age. Medical records indicate no health
concerns. The hearing and vision screenings indicate no reason for further
hearing or vision evaluation. The ASQ indicates that Betsy is at or above age
level in all areas of development. The service coordinator observes that the
words Betsy uses are fairly easy to understand, that Betsy follows directions
well and that she tried to imitate 2 new words during the Intake visit.
Although Betsy’s mom reports that Betsy uses fewer words than her brother
did at that age, she states that Betsy is adding more words and, even in
situations where Betsy doesn’t use her words, she is very good at
communicating her needs and wants through gestures and sounds. Betsy is
engaged and routinely interacts with her family during the day and with
other children at the Church day care center on Sundays.
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Scenario 3
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Based on the summary, would you find Betsy???
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Poll
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Questions?
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www.eipd.vcu.edu
THANK YOU
Virginia Early Intervention Professional Development
Center
a recording will be available on our website in approximately 10 days