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2016-2021 Answers to Questions About EA Procedures

Bohring-Opitz Syndrome

Andrea Stanley



I have a child that is diagnosed with Bohring-Opitz syndrome.  Children with this diagnosis have severe intellectual delay and often times will never talk. It is currently not listed in the EA Diagnosis conditions because it is so rare. Would this child be automatically eligible?


Tonya Krueger



 This diagnosis has been reviewed by CHSC medical staff and it is automatically eligible for Early ACCESS.  Iowa's Early ACCESS Diagnosed Conditions Eligibility List has been updated to include Bohring-Opitz syndrome.


Dextrocardia and Hetrotaxia

Jen Mars



Have a child with Dextrocardia and Hetrotaxia - can't find either on the list.


Tonya Krueger



These conditions have been reviewed by CHSC medical staff.  Dextrocardia is not a diagnosed condition that is automatically eligible for Early ACCESS.  Hetrotaxia is not a diagnosed condition that is automatically eligible for Early ACCESS.


Both of these diagnosed conditions have been added to the Iowa Early ACCESS Diagnosed Conditions Eligibility List.



Jen Mars



Have a child with Rhabdomyosarcoma. Currently getting chemo and radiation treatments. Would this be automatic eligibility?


Tonya Krueger



CHSC medical staff reviewed this and rhabdomyosarcoma is not a diagnosed condition that is automatically eligible for Early ACCESS. It will be added to our list.

There are some genetic syndromes that may be related to/cause rhabdomyosarcoma that are automatically eligible for Early ACCESS:

  • Costello Syndrome, Noonan Syndrome, Neurofibromatosis 1

Meghan Miller12/10/2020A child with a diagnosis of chromosome 6q duplication is automatically eligible for Early ACCESS based on this known condition.

Chromosome 6q Duplication

Jen Mars



Is a child with a diagnosis of chromosome 6q duplication automatically eligible?


Meghan Miller



A child with a diagnosis of chromosome 6q duplication is automatically eligible for Early ACCESS based on this known condition.


Early Access Diagnosis


Cindy Weigel


The diagnosis of 16P11.2 deletion syndrome qualifies a child for Early ACCESS.  


Meghan Miller



A child who has been referred to Early ACCESS as a diagnosis of 16P11.2 deletion syndrome. Does this diagnosis qualify the child for Early ACCESS?


Foreign Language Access

Cindy Weigel


You can access the manual in different languages through TransAct.  If that is the link that doesn't work, please let me know.  The version on Transact is not the most current.  There were some slight changes made last year and that version has not been translated yet.  The changes are minor and you are OK to use the versions in other languages.


Gale Randall



Looking for the Early ACCESS parental rights in Spanish...the link in resources does not work.


Information to Include on Prior Written Notice at Exit

Cindy Weigel


A brief statement regarding result of the evaluation is included on the Prior Written Notice form.  The full evaluation information is recorded either in the IFSP evaluation section or uploaded as an associated file. 


An example of wording shared by a service coordinator is: Johnny entered Early ACCESS at 6 months old due to a delay in motor skills. He is now 2 years old. You and your IFSP team members have no concerns about his development. According to current evaluation results, he is demonstrating overall developmental skills that are age appropriate. Johnny will be exited from Early ACCESS at this time. We have provided you with resources on milestones and you are encouraged to contact the team if you have concerns in the future.


Gale Randall



What evaluation information needs to be included on a prior written notice when a child either ends a service at a meeting or exits Early ACCESS?


Exit From Services

Meghan Miller


Evaluation results that are not part of an initial, periodic or annual IFSP meeting can be uploaded as an associated file to the child's IFSP.


A guiding document titled Final Exit: Program Completion Prior to Age 3 (PMA) was posted in July 2019, this document addresses your question of where to store the results of an evaluation when not part of meeting.  


Exit code PMA would not be an appropriate code to use for a child age 2 years 9 months and older because of the transition activities or services that are required at least 3 months prior to the child's third birthday.


Gale Randall



During a home visit a parent feels their child is doing well and no longer needs services. A meeting is not open....evaluations are done in all areas...where are the results of these evaluations documented?


Completing Early Childhood Outcomes Form due to Death of Child

Meghan Miller


Early ACCESS providers should make every effort to collect early childhood outcome data on all children who have received at least 6 months of services. For children who leave the program unexpectedly, including because of death, ideally the IFSP team would meet to determine ratings using the best information they have available about the child’s functioning. If the deceased code is used at final exit, the web IFSP system will not require a final ECO form. If the IFSP team feels confident that the information they have paints an accurate picture of the child’s functioning at the time of his/her death, they can complete the final ECO form.


In order to complete the final ECO form, fill the form out prior to checking the box "Is the reason for exit due to death (DEC)?" on the Final Exit tab. If you check the box before filling out the final ECO form, the IFSP system will not let you go to the form. If you uncheck the box, the form will become available.


Meghan Wolfe



For a child who has been in Early ACCESS for than 6 months and the child is now deceased, are we required to complete the Early Childhood Outcomes Form?


Interauterine Growth Restriction

Meghan Miller


When looking at the Colorado Established Condition Database IUGR (intrauterine growth restriction) is a condition that qualifies a child for early intervention.  The Colorado Established Condition Database is not exhaustive.  If you have a condition that is not listed, we can ask a physician to make the determination if it is a diagnosis that puts the child at high risk for future developmental delays.  We encourage you to get medical records and/or have a nurse or other medical provider interpret what is in the records and use Informed Clinical Opinion if evaluators are concerned.


Iowa uses Colorado's Database, as both states have the same eligibility criteria.  However there are few differences in Colorado's list vs, the Early ACCESS Eligibility Guiding Document Iowa released in 2016.  The differences are: children born 32 weeks gestation, children with a very low birth weight of 1500 grams (3 pounds 5 ounces), children with a diagnosed blood lead level of 20 ug/ml, and children diagnosed with any degree of hearing loss qualify for Early ACCESS.  


For more information on eligibility, we also have a presentation posted on the Iowa Family Support Network that can be viewed. 


Patti Burma



Is interauterine growth restriction a known condition qualifying a child for services?



Periodic Evaluation No Longer Shows a 25% Delay

Linda Boshart 10/3/2018 If the team decides at a periodic that the child is no longer showing a 25% delay and is no longer in need of EA services, do they need to go ahead and evaluate all areas of development (in other words, follow the procedure that they would at an annual, even though it is a periodic)? Can the team determine the child is not eligible at a periodic? Is eligibility only determined annually, and not at a periodic?
Cindy Weigel 10/4/2018 There are no procedure changes for exiting a child at a periodic meeting with a family.  Do not follow the procedures for re-determining eligibility at an annual IFSP review.  Eligibility is only determined annually and should not impact what you do at periodic meetings held between the initial and/or annual meetings.


Providers Evaluating Annual Forms

Maureen Lonsdale


It is required at initial evaluations to include 2 providers with the evaluation. Is it required to have two providers evaluate at annuals? Can it be the SC evaluating the health information (nutrition, vision, and hearing) and another provider evaluating the other areas?


Annual Review with an Early Childhood Specialist

Beth Torneton


When completing an initial valuation I know that there needs to be two providers for a multidisciplinary assessment. Is that the requirement as well for an annual review when an early childhood specialist is involved as we are generalist and can evaluate all areas? I know a speech person usually involves an ECS at an annual review to look at the other areas if we have not been on the plan in the past.


Procedural Safeguard Language Preferences

Dianne Brenneman


I understand the Procedural Safeguards are available in a variety of languages. Where can I access those? Also, are other EA forms available in other languages?

Kate Small 1/5/2017

At this time, the Department of Education has not translated additional forms.  However, individual AEAs may have had other IFSP forms translated. We recommend you ask your Early ACCESS Regional Liaison if they are aware of any agency that has had other forms translated.


Move-in from Another State

Maureen Lonsdale


When you have a child who moves to Iowa from another state on an IFSP, do providers complete a full evaluation as a new referral and determine eligibility in Iowa OR just update skills since the child was on an IFSP in another state?

Cindy Weigel 08/31/16

States have differing eligibility so you need to determine if the child is eligible in our state.  You can determine eligibility using review of records where an established 25% delay in any one area might be found.  You also review to see if there is a documented physical or mental condition that might make them eligible.  This would include a review of the IFSP from another state and their accompanying documentation.  If you find the child is eligible via record review, you then move on to completing the child assessment to get information to build the Iowa IFSP.  If the records do not indicate that the child is eligible, you need to do an initial evaluation to determine eligibility for Iowa EA services and follow the established processes.

120.321(3) General procedures.

       a.    A child's medical and other records may be used to establish eligibility (without conducting an evaluation of the child) under this chapter if those records indicate that the child's level of functioning in one or more of the developmental areas identified in subrule 120.21(1) constitutes a developmental delay or that the child otherwise meets the criteria for an infant or toddler with a disability under rule 281-120.21(34CFR303). If the child's Part C eligibility is established under this paragraph, the public agency or EIS provider must conduct assessments of the child and family in accordance with subrule 120.321(5).


IFSP Forms in Spanish

Michele Harrison


Where do I find Spanish IFSP forms?

Cindy Weigel 07/18/16

The IFSP forms are not available in Spanish.

The only document that the Dept. of Education has translated is the Early ACCESS Procedural Safeguards for Parents Manual.  This was translated in 11 languages. You can find the translated manuals here: /vnews/display.v/ART/53f35fe53f190

Individual AEAs may have had other IFSP forms translated into Spanish, we recommend you ask your Early ACCESS Regional Liaison if they are aware of any agency that has had other forms translated.


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