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Please feel free to share the following responses to questions which relate to infants and toddlers with visual and/or auditory impairments. These responses were reviewed by both Sha Cowan in the Division of Deaf Education, and Stephanie Herrmann at the Interagency Council on Early Childhood Intervention.

1. Is it true that deaf and/or vision teachers are not required at six-month reviews? 

According to the Memorandum of Understanding (MOU) between the Interagency Council on Early Childhood Intervention (ECI) and the Texas Education Agency (TEA), the deaf and/or vision teacher must attend each Individual Family Service Plan (IFSP) meeting. The six-month review is not an IFSP meeting.

The purpose of the six-month review is to address: a) the degree to which progress toward achieving the outcomes in the IFSP has been made, b) whether or not additional needs have been identified based on ongoing observation procedures, and c) whether modifications or revisions of the outcomes or services are necessary.

All members of the interdisciplinary team, including the teacher of the deaf and/or vision teacher, must be invited to attend the meeting; however, not all members must attend. At a minimum, the meeting must include the parent and the service coordinator.

However, changes to the IFSP may not be made during the six-month review. Changes in the child's outcomes and/or services can be made only by the IFSP team at an IFSP meeting, which does require the attendance of the deaf and/or vision teacher. So, if during the six-month review it becomes apparent that modifications or revisions of the outcomes or services are necessary, those changes cannot be made at an IFSP meeting immediately following the review if the required members (including the deaf and/or vision teacher) are not present. An IFSP meeting would have to be scheduled for a later time when the required team members can be present.

Obviously, if it is anticipated that the review will result in a need for IFSP changes, it would be more efficient if the deaf and/or vision teacher and other required members were present at the review and then, with the parents' permission, an IFSP meeting could immediately follow.

2. Who should make the referral for an orientation and mobility (O&M) evaluation? Can it come directly from one team member or should the referral be an IFSP team decision? 

Services to children in an ECI program are provided as a result of decisions by the IFSP team. Assessment is a service and therefore the need for the assessment should be determined by the team. If the parent or the vision teacher, or anyone else on the team believes there is a need for the evaluation, then that should be discussed by IFSP team in an IFSP meeting to determines if there is a need, who will do it, who pays, when, etc. If the team determines there is a need, then ECI provides the notice to the parents and obtains parent permission according to IDEA-Part C requirements. Once the decision to have an O&M evaluation is made, ECI should follow the logistical procedures to provide to the district appropriate paperwork, such as the consent, that were previously worked out with the district.

According to the MOU, O&M is a service provided by the district . If the district relies on O&M evaluation/instruction provided by an education service center (ESC), the district should forward appropriate referral information to the ESC, according to procedures set forth by the ESC.

3. Sometimes physicians are hesitant to estimate visual acuities for very young children. How should this be documented on the Texas Eye Examination Report? 

For most infants, a competent eye doctor will be able to get a general idea of acuity from direct ophthalmoscopy. Reluctance to give an estimate may be due to not knowing specifically how the information will be used possibly resulting in fear of litigation. Sometimes this can be addressed by providing technical assistance to the doctor. If the doctor has had little experience with young children, especially those who are very difficult to assess, there is an excellent video by Dr. Debra Chen that can be given to the doctor to demonstrate effective diagnostic techniques to use with babies. This may be available from your education service center. If not, it is available from TSBVI Outreach at 512 206-9242.

4. Sometimes we wait several weeks or even longer to obtain documentation from eye doctors. How should we document this and do you have any suggestions? 

TEA cannot address this question for ECI programs which are responsible for obtaining the eye doctor report for children under three years of age. We can only address it in relation to students three and older who need the evaluation under IDEA-Part B.

For students who are 3 years or older who need eye reports as part of their special education evaluation, the district can use logs, contact reports, etc., to document attempts to get copies of the reports. However, this does not eliminate the district's responsibility to adhere to required timelines.

Since the district requires the report and is paying for it as a part of FAPE, it does have the option of choosing who will provide the evaluation and report. If specific doctors do not respond to reasonable timelines, do not provide the information the district requires, and do not respond to efforts by the district to explain the critical need for timely and quality information, the district should identify doctors who will do these things, and refer students to them. The district may establish a contract with a specific doctor in order to meet its responsibilities under IDEA.

This may be an issue the regional stakeholders can effectively address through the Regional Plan for Students with Visual Impairments, since the planning groups include the agencies for which this is a problem (ECI, TCB, LEAs). Some strategies that have been suggested include visiting with the doctors to share information; inviting doctors to a luncheon meeting; developing informational brochures/packets for the doctors; developing a cover letter to accompany the form explaining the critical need for timely, and complete information; etc.

If you need additional information, please feel free to contact me.

Marty Murrell 
Division of Special Education Texas Education Agency