19.28 Children 1st and Babies Can’t Wait

Georgia State Seal

Georgia Division of Family and Children Services
Child Welfare Policy Manual

Chapter:

(19) Case Management

Policy Title:

Children 1st and Babies Can’t Wait

Policy Number:

19.28

Previous Policy Number(s):

N/A

Effective Date:

May 2019

Manual Transmittal:

2019-04

Codes/References

O.C.G.A. § 15-11-70
O.C.G.A. § 15-11-181
O.C.G.A. § 15-11-212
Child Abuse Prevention and Treatment Act (CAPTA), Section 2, Assurances and Requirements, Referrals to Individuals with Disabilities Education Act (IDEA, Part C, Section (a) (6) (A&B)

Requirements

The Division of Family and Children Services (DFCS) will:

  1. Refer children to Babies Can’t Wait (BCW) via Children 1st for a developmental screening, assessment if they meet the following criteria:

    1. Any child under the age of three involved in a substantiated Investigation, prior to the conclusion of the Investigation;

    2. Any child under the age of three with a suspected or diagnosed developmental delay, physical impairment, or disability, prior to the conclusion of the Investigation or Family Support Services.

    3. An infant prenatally exposed to substances, to support the development of the Plan of Safe Care (see policy 19.27 Case Management: Plan of Safe Care for Infants Prenatally Exposed to Substances or a Fetal Alcohol Spectrum Disorder).

    4. All children in foster care under five years of age, as part of the Health Check, within 10 calendar days of entering foster care.

      Under five years old means the child has not reached their 5th birthday.
      A new referral is not needed if the child was referred during the Investigation, however, follow up with Children 1st is needed to determine the results of the screening.

  2. Reassess child development on an ongoing basis and re-refer children under the age of three for BCW services who were initially determined ineligible for BCW services when there’s a suspected or diagnosed developmental delay, disability or physical impairment after the initial ineligibility. Refer to Forms and Tools: Developmental Milestones for Children age 0-5.

  3. Obtain and review the developmental screening and assessment and incorporate the recommendations into the case plan, if appropriate.

  4. Discuss the screening/assessment and any recommendations with the caregiver, including their ability to meet the needs of the child and any identified barriers. Ensure the following occurs:

    1. Provide a copy of the recommendations to the caregivers of children in the custody of DFCS.

    2. Assist the caregiver with developing a plan to overcome any barriers.

    3. Assess the plan each month to determine progress towards goals.

  5. Invite the BCW/Children 1st representative to any relevant meetings involving the child receiving BCW services, including but not limited to the Multidisciplinary Team Meetings (MDT), POSC meeting, Family Team Meeting (FTM), placement change meeting(s).

  6. Monitor the provision of BCW services by maintaining monthly contact with the service coordinator/developmental specialist or BCW/Children 1st representative.

  7. Upload all assessments and other documentation to Georgia SHINES within 72 hours of receipt.

Procedures

Investigation or Family Support Services Social Services Case Manager

  1. Determine whether a child meets the criteria for a BCW referral as outlined in the above Requirements and in conjunction with the Social Services Supervisor (SSS).

  2. Discuss the following with the caregiver:

    1. The child meets the eligibility criteria for a referral to BCW;

    2. DFCS is required to refer the child to BCW when they meet the criteria;

    3. The criteria for referral and eligibility;

    4. BCW services are voluntary;

    5. The benefits of BCW services for the child and family;

    6. The referral process;

    7. The screening and evaluation process;

    8. The services provided through BCW;

    9. The importance of the caregiver’s participation in the development of the Individualized Family Service Plan (IFSP), the six-month review, and the annual evaluation of the IFSP to ensure timely and appropriate developmental services.

  3. Complete the Children 1st Screening and Referral Form in Georgia SHINES:

    1. Complete the application in its entirety to facilitate the screening and evaluation process;

    2. Engage the caregiver to assist in responding to specific questions regarding the child and reconcile any inconsistencies in information.

    3. Ask the caregiver to sign the Authorization for Release of Information Form-BCW Specific (ROI-BCW) and the Family Educational Rights and Privacy Act (FERPA) Consent Form to allow DFCS to assist in monitoring the provision of services offered through Children 1st or BCW;

      The SSCM cannot sign the ROI-BCW or the FERPA form when a child is in foster care. The release must be signed by the surrogate (foster parent or other approved placement resource).

    4. If a case is being transferred to Family Preservation Services (FPS) or Foster Care, include the name of the assigned FPS or Foster Care SSCM on the Children 1st Screening and Referral Form.

    5. Review the Children 1st Screening and Referral Form to verify all pertinent sections of the form are completed.

  4. Submit the Children 1st Screening and Referral Form, ROI-BCW, and the FERPA forms to the Children 1st District Coordinator as outlined in the protocol between DFCS and the local county health department in the county where the child resides.

    Submit the referral to Children 1st regardless of the caregiver’s willingness to participate in the program or his/her cooperation in completing the form.

  5. Contact Children 1st to confirm receipt of the Children 1st Screening and Referral Form.

  6. Obtain the Status of Eligibility letter from Children 1st. If the letter is received by the referring SSCM after the case has been transferred to another program area, forward to the letter to the assigned primary SSCM.

    Children 1st will provide DFCS a copy of the IFSP and Status of Eligibility (SOE) within 60 days of the date of the referral to Children 1st.

  7. Review the Status of Eligibility letter to determine the recommendations from Children 1st. The letter will provide one of the following recommendations:

    1. The child is eligible to receive BCW services, and the child has been referred to BCW.

      BCW will provide DFCS with an Acknowledgement Letter within three days of the referral, if Children 1st refers the child to BCW and the ROI-BCW of information and FERPA are approved and signed by the caregiver or surrogate.

    2. The child is not eligible for BCW services; however, the child is eligible to enroll in Children 1st.

      Children 1st will request the consent of the caregiver or surrogate to conduct the Maternal and Child Health (MCH) Assessment and enroll the child in Children 1st as needed.

    3. The child is not eligible for BCW services and no further services are needed

  8. Document the following in Georgia SHINES:

    1. Whether the child meets the criteria for referral to BCW via Children 1st, as outlined in the requirements above. Be specific in documenting if the referral is based on suspected or diagnosed developmental delays, disability or physical impairment; prenatal exposure to substances or an FASD; and/or involves a substantiated investigation; or whether the child is in foster care and under the age of 5;

    2. The discussion with the caregiver regarding the Children 1st referral and screening results;

    3. The date the Children 1st Screening and Referral Form was faxed or mailed to Children 1st.

    4. Upload a copy of the Status of Eligibility form, the assessment from Children 1st and BCW, and the IFSP in External Documentation.

Foster Care or Family Preservation Services Social Services Case Manager

  1. Contact the Children 1st representative within 72 hours of the case transfer to verify that the Children 1st Screening and Referral Form was received.

    1. If the referral was not received by Children 1st:

      1. Complete another referral in Georgia SHINES and fax to Children 1st. Ensure that the caregiver information such as name, address and phone number is included on the referral form; and

      2. Attach a copy of the order granting DFCS custody (if applicable) and the ROI-BCW form (signed by the caregiver or surrogate).

    2. If the referral was received by Children 1st:

      1. Obtain the status of the referral and meeting schedules;

      2. Provide the Children 1st representative with updated caregiver contact information (name, address, telephone);

      3. Fax or mail Children 1st a copy of the order granting DFCS custody (if applicable); and

      4. Fax or mail the ROI-BCW form signed by the caregiver or surrogate.

  2. Notify the Care Coordination Team (CCT) of the referral to BCW via the Amerigroup Notification Form (E-form).

  3. Inform and encourage caregiver participation in the development of the IFSP, the six-month review, and the annual evaluation of the IFSP to ensure the timely and appropriate provision of developmental services for the child. Collaborate with caregivers to address issues that may impede their ability to attend IFSP meetings, such as arranging transportation, if this is an issue.

  4. Obtain the schedule and participate in all IFSP meetings.

  5. Obtain copies of evaluations/reports and the IFSP from BCW.

  6. Ensure that the caregiver has signed the ROI-BCW and FERPA forms to facilitate information sharing.

  7. Encourage and monitor the caregiver’s adherence with all IFSP recommendations.

  8. Ensure recommended services are in place, including any recommendations for agency or caregiver follow up.

  9. Invite the BCW/Children 1st representative to case planning, FTMs, MDTs and placement change meetings, relevant case conferences/staffings, etc.

  10. Notify BCW/Children 1st, Care Coordination Team (CCT) and the Revenue Maximization Specialist (RMS) within 24 hours of placement changes involving a child receiving BCW services:

    1. When a family meeting occurs prior to the placement move, invite the BCW/Children 1st representative to the meeting;

    2. Whenever there are placement changes, a new ROI-BCW and FERPA must be completed and signed by the new caregiver/surrogate and submitted to the Children 1st or BCW program; and

    3. When the SSCM changes, or transfers to other program areas, and at case closure.

  11. Modify the case plan/action plan based on the following:

    1. Identified needs/services from the BCW evaluation;

    2. Progress made related to BCW service goals; and

    3. Any other identified needs and services if the child was not eligible for BCW services.

  12. Monitor service provision/progress by maintaining monthly contact with the Children 1st or BCW representative working with the child/family.

  13. Reassess child development on an ongoing basis to determine if any indicators of developmental delays or physical impairment were manifested later in the life of the case. See Forms and Tools: Developmental Milestones for Children 0-5.

    For many children who enter foster care, indicators of developmental delays or other manifestations of trauma may not emerge for six months or more after the initial placement.

    1. Make another referral to Children 1st via the Children 1st Screening and Referral Form, by completing the form in Georgia SHINES and faxing/mailing to Children 1st when developmental delays are suspected or identified:

      1. Clearly document on the referral form that the case is being re-referred;

      2. Specify the reason for re-referral, including the developmental delays suspected or identified since initial referral; and

      3. For children in foster care include the name, address and contact information for the new caregiver/surrogate and attach a copy of the court order, ROI-BCW, and FERPA forms signed by the new caregiver/surrogate.

  14. Document the following information in Georgia SHINES:

    1. Referral dates and child’s Status of Eligibility (SOE) for BCW services;

    2. Children 1st/BCW recommendations and referrals for services to address identified needs;

    3. Other identified needs and referrals for services to address these needs if the child is not eligible for BCW services;

    4. Participation in relevant meetings, ongoing follow-up, and monitoring of services; and

    5. Upload copies of BCW evaluations/reports and IFSPs to External Documentation.

Social Services Supervisor

  1. Ensure that all children who meet the eligibility criteria are referred to Babies Can’t Wait.

  2. Ensure the Children 1st Screening and Referral Form is completed in Georgia SHINES and review it for accuracy and completeness prior to submission.

  3. Ensure that the child’s caregiver signed the Authorization for Release of Information Form-BCW Specific (ROI-BCW) and the Family Educational Rights and Privacy Act (FERPA) Consent Form before the provision of services.

  4. Ensure the Children 1st Referral Form, ROI-BCW, and the FERPA forms are submitted to the Children 1st District Coordinator based on the protocol between DFCS and the local county health department in the county where the child resides.

  5. Verify the following:

    1. The date the Children 1st Screening and Referral Form was faxed or mailed to Children 1st.

    2. The SSCM contacted the Children 1st District Coordinator to confirm receipt of the referral form.

    3. DFCS received a copy of the IFSP and Status of Eligibility (SOE) within 60 days of the date of the referral to Children 1st.

    4. DFCS received an Acknowledgement Letter within three days of the referral, if Children 1st referred the child to BCW.

    5. The completion of the Maternal and Child Health (MCH) Assessment by the caregiver, if the child is ineligible for BCW, but eligible to enroll in Children 1st and enroll the child in Children 1st.

    6. The Status of Eligibility letter was forwarded to the primary SSCM, if the case was transferred to another program or SSCM.

  6. Ensure the documentation identifies the specific reason for the referral to BCW (i.e. observed and/or reported developmental delays, a diagnosed disability, physical impairment, prenatal exposure to substances or an FASD, and/or involves a substantiated investigation).

  7. Ensure the SSCM is assessing child development on an ongoing basis to determine if any indicators of developmental delays or physical impairment were manifested later in the life of the case.

  8. Ensure a new referral to BCW is made when concerns are identified related to the developmental milestones for children 0-5.

  9. Ensure all documents are uploaded to Georgia SHINES within 72 hours of receipt.

Practice Guidance

Notifications of Children’s 1st Referrals and Updates to Amerigroup, Rev Max, and DCH for Children in the Custody of DHS

Amerigroup Notification Form (E-Form)

DFCS communicates with Amerigroup, Rev Max, and DCH utilizing an electronic notification form (E-Form). It is the primary means for communicating information about a member enrolled in Georgia Families 360˚. The E-Form must be completed and sent to Amerigroup, Rev Max, and DCH within 24 hours of a youth entering foster care. It should be completed thoroughly to include demographic information, medical information, placement information, the identified CCFA provider and other referrals (e.g., Babies Can’t Wait). The E-Form is also used to report updates such as placement changes, a youth exiting care, etc. If there is information not available at the time of the initial referral to Amerigroup, submit an E-Form (update) as soon as the information is obtained. Accurate and timely communication with Amerigroup is vital to the Medicaid eligibility determination and the assignment of a CCT and service providers. Important decisions regarding the assignment of primary care providers and referrals are made based on the information submitted on the E-Form.

Babies Can’t Wait

Babies Can’t Wait (BCW) is Georgia’s statewide interagency service delivery system for infants and toddlers with developmental delays or disabilities and their families. The Georgia Department of Public Health (DPH) is the lead agency administering the Babies Can’t Wait (BCW) Program in Georgia. DPH ensures:

  1. Services are provided in accordance with federal guidelines.

  2. Families have access to the services that are needed to enhance their child’s development.

  3. Training is available to ensure that professionals who work with children and families have up to date information.

BCW serves Georgia children from birth up to their third birthday, regardless of income, who meet one of the following criteria:

  1. Have a diagnosed physical or mental condition which is known to result in a developmental delay, such as blindness, Down syndrome, or Spina Bifida; or

  2. Have a diagnosed developmental delay confirmed by a qualified team of professionals.

For children in foster care referred to BCW, the BCW Service Coordinator will contact the foster/surrogate parent for consent and conduct an assessment. The BCW Service Coordinator will also develop a primary service provider (PSP) team that includes the SSCM and the CCT. The PSP team will:

  1. Have the licensed provider on the primary service provider team submit the prior authorization request to the CMO to conduct a full developmental evaluation.

  2. Develop the IFSP to identify services.

  3. Send SOE letter to DFCS within 60 days of the BCW referral notifying DFCS that services will be provided.

  4. Send IFSP evaluation report to DFCS.

BCW will notify DFCS in writing if a caregiver of a child declines participation with the BCW process and procedures and will provide the reason given by the caregiver for refusal of services.

Children 1st

Children 1st is a Georgia Department of Public Health program which promotes the healthy development of young children [birth to five years old] and assures that they arrive at school healthy and ready for success.

Children 1st is the single point of entry to a statewide collaborative system of Public Health and other prevention-based programs and services. This system helps caregivers provide their young children with a healthy start in life. It allows at-risk children to be identified early and gives them a chance to grow up healthy and ready for school. Children 1st collaborates with local hospitals, pediatricians and other health care providers, schools, community-based organizations and other agencies to ensure the healthy development of newborns and young children.

Children 1st completes developmental screenings and refers families to other public health programs, including Babies Can’t Wait (BCW). If a child is found ineligible for BCW, DFCS refers the child back to Children 1st for appropriate monitoring and follow-up. Informed written consent from the parent or legal guardian is required.

What Happens After DFCS Makes a Referral to Children 1st

Category 1 Referral

  1. When Children 1st receives a referral from DFCS, they request a faxed copy of the most current standardized developmental screening results (if DFCS has one on file) within 24 hours of receipt of the referral.

  2. The Children 1st referral completed by DFCS is sent to BCW within two business days of when criteria are met.

  3. The referral is sent to the next staffing of the Birth to Five Review Team (BCW, Children 1st, 1st Care, Children’s Medical Services (CMS), and Universal Newborn 1st Care (formerly known as High-Risk Infant Follow-Up). This is a nurse case management service provided through Children 1st that is designed to provide services to infants who are very low birth weight or are low birth weight and have medical/health conditions.

Hearing Screening and Intervention Coordinator (UNHSI) to Determine the Most Appropriate Public Health Program Referral(s)

Category 2 Referral

  1. The Developmental Specialist or other trained DPH staff will initiate contact with the family within three business days.

  2. Once contact has been made with the family, a home visit will be scheduled to gain consent to screen the child’s development using the appropriate Ages and Stages Questionnaire (ASQ-3)[1] or the Ages and Stages Questionnaire Social and Emotional (ASQ-SE)[2].

  3. If the screening indicates possible developmental delays, then Children 1st will send the referral along with the ASQ-E or ASQ-SE to BCW within two business days.

  4. If the screening indicates that the child is age appropriate or in the monitoring zone, the Children 1st Developmental Specialist or Registered Nurse will offer to enroll the child in Children 1st and complete the Maternal Child Health Integrated Assessment.

Developmental Delay

Developmental Delay is a chronological delay in the appearance of normal developmental milestones achieved during infancy and early childhood, adjusted for prematurity in one or more of the following areas: cognitive, physical (including vision and hearing), communication, social/emotional and adaptive.

Developmental delays may be caused by organic, psychological or environmental factors. For example, if most children crawl by eight months of age and walk by the middle of the second year, then a child five or six months behind schedule in reaching these milestones may be classified as developmentally delayed regarding mobility.

Disability

A disability means a child has a diagnosed physical or mental condition that has a high probability of resulting in a developmental delay (e.g., Down syndrome, autism, cerebral palsy).

Early Intervention Services

Early intervention services are interventions designed to meet the developmental needs of children age birth to three who have or are at risk of developmental delays. Developmental services are provided in several areas, including physical, cognitive, communication, social-emotional and adaptive functioning. Caregivers of children receiving early intervention services receive education and support to assist them in understanding and enhancing their child’s development.

Individualized Family Service Plan (IFSP)

The IFSP is a written plan for providing early intervention supports and services to eligible children/families. It is developed jointly by the family, service coordinator and other appropriate, qualified personnel providing early intervention services. The IFSP is based on a multi-disciplinary evaluation and assessment of the child and the strengths and needs of the child’s family. The IFSP includes developmental outcomes, strategies, activities and services necessary to meet the IFSP outcomes, to enhance the development of the child, and to meet the special needs of the child.

Individuals with Disabilities Education Act (IDEA)

IDEA includes specific provisions to ensure that all children with disabilities have a “parent” to act on their behalf. Per Section 602(23) of the IDEA of 2004, a parent is:

  1. A natural, adoptive or foster parent of a child (unless a foster parent is prohibited by state law from serving as a parent).

  2. A guardian (but not the state if the child is a ward of the state).

  3. An individual acting in the place of a natural or adoptive parent, including a grandparent, stepparent or another relative with whom the child lives or a person who is legally responsible for the child’s welfare.

  4. An individual assigned to be a surrogate parent, in accordance with Babies Can’t Wait Standards.

Physical Impairment

A physical impairment is defined as a dysfunction of the musculoskeletal and/or neurological body systems, which affects the ability of an individual to move or coordinate movement. This includes one or more of the following body systems: neurological, musculoskeletal, sensory organs, respiratory (including speech organs), cardiovascular, reproductive, digestive, genital, urinary, hemic and lymphatic, skin and endocrine. A physical impairment on its own does not make a child eligible for BCW, but if there is a significant developmental delay due to the physical impairment then the child may be eligible.

Plan of Safe Care and Prenatal Exposure to Substances

The Child Abuse Prevention and Treatment Act (CAPTA) requires that healthcare providers identify and make appropriate referrals to DFCS of infants affected by prenatal drug exposure or a Fetal Alcohol Spectrum Disorder; and that “plans for safe care” (safety, family and case plans that promote health and well-being) be developed for infants and families.). This identification of affected may occur during any stage of DFCS involvement, including at birth, or later during the infant’s development and/or as symptoms manifest. The Plan of Safe Care that is created will address actions and services to address the infant’s and family’s needs, and these needs must be incorporated into the case plan/action plan when developed. The developmental screening by Children 1st is an important component of the assessment of needs for infants and determining services needed as part of the development and implementation of the plan of safe care.

See policy 19.27 Case Management: Plan of Safe Care for Infants Prenatally Exposed to Substances or a Fetal Alcohol Spectrum Disorder [FASD].

Surrogate Parent

A surrogate parent is an individual who has been appointed to represent a child in all matters related to BCW early intervention services. A surrogate parent’s responsibility is to ensure that the child is provided with appropriate early intervention services under Part C of IDEA. The surrogate parent has the right to make decisions relating to the development and implementation of the child’s IFSP, including evaluation, assessment, ongoing provision of services, annual evaluations and periodic reviews and any other rights established under Part C regulations. Appointment as a surrogate parent does not mean the surrogate parent has authority over care and maintenance, financial support of the child, custody of the child, foster home placement or any other matters that are not directly related to BCW early intervention services.

The surrogate parent must always act in a manner that he/she believes is in the best interest of the child. A surrogate parent is not liable to the child for damages that result from any act or omission in representing the child in decisions relating to participation in early intervention. The surrogate parent would be liable for gross or willful acts of negligence or misconduct.

A surrogate parent shall not be an employee of the state lead agency or other state agency and shall not be any person or any employee of a person providing early intervention services.

A surrogate parent must:

  1. Be a citizen of the United States, a resident of the state of Georgia and above the age of 18.

  2. Have no interest that conflicts with the interests of the child represented.

  3. Have sufficient knowledge and skill to ensure adequate representation of the child.

  4. Have time and desire to become involved in the early intervention process.

  5. Possess an understanding of the cultural and linguistic background of the child he/she represents.

Activities performed by a surrogate parent include:

  1. Visiting the child and observing the child’s development and environment, as appropriate.

  2. Attending the child’s evaluations and assessments as appropriate.

  3. Participating in the development of the child’s IFSP.

  4. Participating in the development of the annual IFSPs and reviews.

  5. Reviewing the child’s BCW record to become familiar with the child and as needed.

  6. Exercising independent judgment in pursuing the child’s interests within early interventions.

  7. Representing the child within the BCW Early Intervention System.

A surrogate must be appointed to ensure that the rights of eligible children are protected if:

  1. No parent can be identified in accordance with Section 602(23);

  2. After reasonable efforts, the whereabouts of the parent cannot be discovered; or

  3. The child is a ward of the state pursuant to Georgia state law.

A surrogate parent can be assigned to a child in foster care once that child is in DFCS custody and before the court has terminated parental rights. In Georgia, a foster parent may be appointed as a child’s surrogate parent since there is no conflict of interest between the foster parent and child since the foster parent has the requisite knowledge and skills to adequately represent the child. Foster parents are not deemed employees of DFCS, but rather DFCS agents.

If a foster parent meets the criteria, he or she may be considered the parent and there is no need for the appointment of a surrogate parent. When there is a foster parent, the BCW Coordinator is still responsible for ensuring that a copy of the court order stating that DFCS has legal custody of the child is maintained in the BCW record. The DFCS SSCM is responsible for providing a copy of the juvenile court order appointing DFCS as temporary legal custodian of a child to BCW each time a child is referred to BCW.

When a foster parent serves as the parent, the foster parent has the authority to sign the IFSP and all related documents, forms and releases. The DFCS SSCM should sign the IFSP document as a participating team member (not the parent) and should participate in the development and implementation of the IFSP. If a foster parent is unwilling to serve as the parent, a surrogate parent must be appointed. When the surrogate and foster parent are different, the ultimate decision related to the provision of BCW early intervention services is determined by the surrogate parent.

A person acting in the place of a parent, such as a grandparent or a stepparent with whom the child lives or a person who is legally responsible for the child’s welfare, may be considered the child’s parent under IDEA. Before assuming a grandparent or relative is the “parent” under IDEA, the BCW Coordinator must interview the person and document that the child lives with the individual and that this person is responsible for the child’s day-to-day care. It is understood that any time there is someone acting in the place of the parent and if the parent returns, all rights immediately revert to the parent (as long as the parental rights have not been terminated through the court system). A person whose role is a caregiver and whose contact is only incidental (e.g., babysitter, childcare worker) cannot assume the responsibility of a parent.

Significant Developmental Delay

A significant delay is identified through the informed clinical opinion of the Multi-Disciplinary Team (MDT). A delay is considered significant when it interferes with the child’s ability to achieve expected developmental milestones of cognitive, communication, adaptive, physical, social, or emotional development. These delays are so significant that ongoing development for the child is compromised. Secondary delays relative to the initial delay are also likely to occur (e.g., because of significant delays in expressive communication, social skills with peers are jeopardized). Criteria include identification of deficits in skills that are prerequisite to or instrumental in accomplishing later developing skills or functional tasks that would be expected of peers who are developing typically. If the use of standardized diagnostic measures is deemed appropriate, a score of two standard deviations below the mean in one of the five developmental domains or at least 1.5 standard deviations below the mean in two or more of the five developmental domains constitutes a significant delay through the informed clinical opinion of the MDT.

Forms and Tools

Authorization for Release of Information - Babies Can’t Wait Specific
Authorization for Release of Information - Babies Can’t Wait Specific (Spanish)
Developmental Milestones for Children 0-5
Family Educational Rights and Privacy Act (FERPA) Consent Form
Family Educational Rights and Privacy Act (FERPA) Consent Form (Spanish)

1. ASQ-3 is used to monitor and identify issues in general infant development in the communication, gross motor, fine motor, problem-solving, and personal-social domains. It can be used on children one month through 66 months of age.
2. The ASQ-SE focuses deeply and exclusively on children’s social and emotional behavior. It helps the 1st Care nurse determine if a child would benefit from an in-depth evaluation in social-emotional development. It can be used on children six months through 60 months of age.