Special Services

Special Services Page

Section I - *Introduction*	Section II - Identification of Needs and/or Assessment
Section III - *Referrals*	Section IV - Provision of Services
Section V - *Training*	Section VI - *Community Partnership*
Section VII - *Job Description*	Section VIII - *Miscellaneous*
Section IX - Staff

Section I

Introduction

PROCEDURES FOR THE DELIVERY OF SERVICES TO CHILDREN WITH SPECIAL NEEDS

I. INTRODUCTION

Head Start of Greater Dallas provides special services and mental wellness services in the areas of identification, preventive and remedial treatment to children and families in accordance with CFR 1304 and 45-CFR 1308. The Mental Health content area focuses mainly on prevention of problems related to mental wellness for all Head Start children and their families.

Mental wellness is included in Head Start classroom curriculum, by teachers introducing children to mental health related topics daily. The Mental Health Professional ensures proper implementation of mental wellness curriculum, by monitoring lesson plans weekly. On-going classroom observation is provided by the Mental Health Professional to ensure a healthy environment for children. Additionally, the Mental Health Professional provides Head Start parents with relevant training that will enable entire families to be mentally healthy. As part of intervention, children diagnosed with behavioral or severe emotional problems are enrolled for special services in an educational setting. Parents in crisis receive appropriate services from a Mental Health Professional.

The Special Services Specialist, Special Education Coordinator and Mental Health Professional are responsible for enrollment of children with special needs at their centers. These staff members refer children suspected of having developmental disabilities to appropriate diagnosticians. Children that are suspected of having speech and language impairments are referred to a Speech Pathologist for in-depth evaluation. The Psychologist and Mental Health Professional evaluate children having difficulties in cognitive, motor and emotional/behavioral areas. Enrollment of children for special services is based on diagnostic test results and observation.

The Special Services and Mental Health staff use Control sheets to track all activities of children with special needs. This is done by documenting identification, diagnosis and treatment activities. Specific goals of the special services and mental wellness are outlined in the Special services (Disabilities) and Mental Health Plans, which are updated annually. Appropriate diagnosticians reevaluate eligible school age children before transition into public schools for special services placements.

At the centers, delivery of special services and mental wellness are directly carried out by the following staff: Special Services Specialists, Mental Health Professionals, Special Education Coordinators, Speech Pathologists, and Psychologist. The Special Services/Mental Health Director is responsible for execution of the Disabilities and Mental Health content areas of Head Start of Greater Dallas, Inc. The responsibility includes direct supervision of professional staff, monitoring of guidelines, training activities for parents and staff. The director also ensures partnership with the school districts/outside agencies for delivery of services, and serves on boards whose mission is to work with special needs children. As the Agency’s operations and policy manager for these content areas, any questions or concerns on services delivery should be directed to the Special Services/Mental Health Director at the Central Office.

Section II

Identification of Needs and/or Assessment

A. IDENTIFICATION OF SPECIAL SERVICES NEEDS

There is a four-level approach to service delivery: (1) identification of children with special needs by screening, (2) diagnosis, (3) treatments, and (4) transition. The Special Services Specialist confers and plans with other Staff, including Special Education Coordinator, Education, Health, Family Advocate, and Nutrition in an effort to provide the full range of services needed for children with special needs that are available to all Head Start children.

1. DISABILITIES

SELECTION AND ENROLLMENT

The Special Services Specialist maintains procedures established for selection and enrollment of children with disabilities in accordance with. Also, throughout the year, collaborative plans are made with the Family Advocate to locate, recruit and enroll children with special needs under the following conditions: when parents request to enroll the child; child meets Head Start requirements; and the Program has vacancy even if the ten-percent enrollment is already met. In this case, children with special needs and children without special needs would compete for available slots. Eligible children from Early Childhood Intervention (EIC) programs are also referred to Head Start for placement, six months before their third birthday.

Procedure:

The following nondiscriminatory written procedures are used for the enrollment of children for special services.

a.	The Family Advocate will place applicants on waiting lists according to screening priority scores for enrollment, when there are no vacancies. When openings become available, enrollment of children with special needs takes priority over non-special need children.
b.	By observing State laws regarding immunization in enrolling Head Start children, the Family Advocate staff coordinates with the Health, Special Services, Education and Administration staff in validating shots. The Family Advocate staff will assist parents with transportation and referrals when they have transportation problems. The Special Services Specialist notes children who are unable to take immunizations due to disability or condition.
c.	HS Special services and Mental Health staff will ensure enrollment of children into Head Start is not denied due to severity or type of disabilities, staff attitudes or lack of knowledge, facility inaccessibility or need for personalized services or specialized equipment.
d.	They also provide variety of placement options for children with special needs, such as dual enrollment, half-day, and home-based placements.
e.	At the center, the Family Advocate will work collaboratively with the Special Services Specialist to make slots available to meet ten percent enrollment of eligible children with special needs.
f.	The Special services staff will establish collaborative agreements with the agencies serving children with special needs, by referring children and sharing facilities and services when needed. Family Partnership is completed on all families to identify their concerns and needs.

ASSESSMENT (SCREENING & EVALUATION)

Procedure:

In accordance with the Head Start performance standards, children must be screened for sensory, speech/language, developmental, motor skills, and health within 45 calendar days of entry into Head Start.

1.	Each child is screened for developmental skills in the areas of speech-language and cognition by the screening team, Education and Special services staff or designees upon entry.
2.	The Health Specialist takes a thorough health history of each child and arranges vision/hearing and physical examinations when needed.
3.	The Special Services Specialists at each Center participate in an enrollment folder review when scheduled. At folder review meeting, the Special Services Specialist notes any health, education, social, or parent concerns found in the child's records. Concerns requiring documentation will include, but are not limited to, low birth weight, severe health conditions (e.g., sickle cell anemia, asthma etc.), low screening scores, and emotional or behavioral concerns. Appropriate Professionals also review folders of children referred for in-depth evaluations. *Note: Folder review is ongoing for all special services and mental health staff, (specialists, speech pathologists, special education coordinators, and psychologist). Hence, review of folders must be done as often as possible, using Folder Review form* to document it.
4.	The Special Services staff and Mental Health Professional review all screening results, to ensure any speech or developmental and social/behavior deficits are addressed as soon as possible.
5.	Upon review, the Special Services Specialist and Mental Health Professional, screen children with developmental screening scores with the Early Screening Profiles by Kaufman, et al., and Social Skills by AGS respectively. Children from Early Head Start program are screened using appropriate age eligible screening instrument. They are used to determine eligibility for cognitive, speech-language, gross/fine motor, and self-help/social needs. Note: Enrolled children that fail initial screening and non English speaking children are usually allowed to become familiar with the classroom environment for two to three weeks before they are re-screened by Special Services Specialist. Screening must be done in the child’s primary language. However, since the screening tool is in English, translators may be used when needed. To determine eligibility for speech referral, administration and scoring procedures of the test must be followed. The Special Services Specialist will refer eligible children to appropriate school districts and professionals for in-depth evaluation. A signed parent permission form must accompany all referral forms. (parent concern for child's deficits: speech/developmental deficits or low screening scores).
e.	Appropriate in-house professionals, such as the Speech Pathologist, Mental Health Professional and Psychologist will evaluate children referred to the school districts for services. This helps to determine eligibility for services upon referral by the Special Specialist. Children with low scores in the area of cognition must be referred to their school districts for a complete developmental evaluation. The Special Services Coordinator must refer children from Early Head Start program within two days to appropriate agency for evaluation. Referral of Head Start children to the Public Schools must be documented on *Head* *Start Referrals to Public Schools* forms. Note: Children with current Medicaid receive services from designated Medicaid Contractors. However, eligible children must first be pre-qualified by the Head Start Speech Pathologist before referral is made to a Medicaid Provider. When a non English speaking child is no longer eligible for Medicaid; and child's school district is unable to provide services, services will continue to be provided by authorized Medicaid Provider at the expense of Head Start of Greater Dallas, Inc.
f.	In-depth evaluation will be completed by a Certified or Licensed Professional within 30 days of the referral date by the Special Services Specialist. Evaluation of children referred for behavioral/emotional disturbances may last more than 30 days, depending on severity. Observation of such children may be extensive before the Diagnostician can provide valid diagnostic reports. In accordance with the Texas Education Agency (TEA), the school districts are required to complete evaluation within 60 schools days after the referral is received. Individualized Educational Plan (I.E.P.), if needed is in place after staffing or IEP meeting (in-house), or ARD (school districts). Some school districts may not be able to complete evaluation within stipulated time. The Special Services Specialist must ensure child’s physical examination is current. In other words, vision and hearing screenings must have been completed before child is referred for evaluation. Note: In order to ensure services are provided on time, the Special Services Specialist must follow-up, if the status of their referrals to the school districts is not known after 20 days of referral.
g.	The Special Services Specialist will formally refer children who have serious observable social, emotional or behavioral problems to the Mental Health Professional for in-depth evaluation. The parent before referral must have signed parent Permission Form. Also, before formal referral is made, helpful data and information record collected must be shared with the parent, Special Education Coordinator and Mental Health Professional. Note: All of the child's screening record sheets must be kept in the child's file. The Special Services Specialist, or Mental Health Professional or Diagnostician, if any, must record administration of screening or assessment.

2. MENTAL HEALTH SERVICES

The primary focus of the Mental Health content area of the Dallas Head Start program is to provide preventive mental health services. The Mental Health Professional addresses this area initially, by evaluating each Head Start Center to ensure that the environment is stress free. Also, to ensure those children's activities are age appropriate, and have good relationship with caregivers and peers.

Procedure

a.	The Mental Health Professional will formally conduct general classroom observation of all Head Start children, at least twice a year (fall and late spring) and documented. Observation reports are used to assist staff in planning mental health activities in the classrooms. Also, intervention recommendations for individual children with special needs or challenged behaviors are provided after in-depth evaluations have been completed. Recommendations will be based on classroom/home observation and test scores reports. Dallas Head Start staff is expected to be trained to be involved in the assessment of mental health needs, Mental Health staff, when needed. The Special Education Coordinator is involved in assessment process of children referred for evaluation, by helping with completion of questionnaires BASC & Conners (teacher and parent).
b.	The Mental Health Professional will provide information that will help staff members better understand normal development and common problems in children, by conducting workshops. The workshops may include: Classroom Management, Effective Conferences with Parents, Child Development from a Multicultural Perspective, Communication Skills, Dealing with Difficult People and Difficult Situations, Handling Burnout and Stress, Activities to Enhance Self-Concepts, and Understanding Parenting.
c.	The second level of intervention is focused on children exhibiting severe inappropriate emotions and behaviors. The classroom staff refers children with challenged behaviors to the Special Services Specialist.
d.	The Special Services Specialist will submit the referral, and all required records/information (physical examination report, observations, educational evaluation, and parent permission form) to the Mental Health Professional for evaluation.
e.	When children are referred, the Education Specialist or Special Services, Special Education Coordinator and Mental Health Professional will observe and offer suggestions on how inappropriate behaviors can be remedied. While that is going on, the Mental Health Professional must screen the child using Social Skills Profiles, AGS to determine the child’s developmental level in the area of social/self help skills. Evidence of screening must be available by filing screening records in child’s file (education section), and documented on contact/log of child’s family services section. (Social Skills Screening completed on -- by--).
f.	If the behavior persists or child scores low, then Mental Health Professionals must proceed to the next level, by doing in-depth evaluation and intervention. In order to avoid erroneous diagnosis, the Mental Health Professional must observe the child properly in his/her normal environment (classroom and home, if possible) at least twice; and use unbiased multiple diagnostic instruments. Determination for categorical diagnosis of children referred for social/behavior deficits must be based on results/data collected from the following instruments: Social Skills Profiles, BASC, and Connors along with DSM-IV.
g.	The Mental Health Professional will provide ongoing professional training and assistance to Center staff in accordance with job duties. These require devising a process for screening and observing children; and how to use behavior checklists and other screening instruments.
h.	The Mental Health Professional will give evaluation reports and/or recommendations to the Special Services Specialist when evaluation is completed. An assessment of the child's medical and family history is made to determine if the child and family need additional assistance. For follow-through services, the Special Services Specialist or Mental Health Professional arranges a home visit with the other support staff and a practicable plan is developed.
i.	The Special Services Specialist convenes a meeting/conference to inform other Head Start staff and parents of the diagnosis and treatment of the intervention plan (IEP). Only children diagnosed with severe emotional disturbances and behavioral problems will be enrolled for special services. The Mental Health Professional must attend the meeting. Conferences are held periodically with the Education Specialist, teaching staff and parents to provide an educational program keyed to the individual needs of children with special needs. The Mental Health Professional must be at such meetings. Parents are encouraged to participate fully in planning to meet the individual educational and mental health needs of their children.
j.	Implementation of I.E.P. is carried out by class teachers after it is developed by the Mental Health Professional with input from the Special Services Specialist, Special Education Coordinator, Education Specialist, teacher and parents. Only signed I.E.P. by parent(s) will be implemented.
k.	The Special Services Specialist monitors the implementation for progress, problems or concerns on a weekly basis. If there are problems or concerns, the Special Services Specialist or Mental Professional, Psychologist and Special Education Coordinator will show the teacher how to implement specific activities as recommended. * The Mental Health Professional conducts evaluation of children needing further assessments in the following areas: Physical Coordination and Development, Intellectual Development, Sensory Development, Emotional Development, and Social Development. * Practicable suggestions will be given to teaching staff on how to provide special services for children with challenged behaviors or development, including speech and language problems by the following staff. (Mental Health Professionals, Speech Pathologists, Special Education Coordinator and Health staff). This is given on how to increase verbal skills, and how to work with the shy child and aggressive child with incidents of impulsive behavior(s). The Special Education Coordinators provide professional instructions needed to effectively serve children with special needs in the classrooms.

Section III

Referrals

REFERRAL PROCESS FOR IN-DEPTH EVALUATION

All Head Start children are screened for developmental skills upon entry into the program. Before a child is referred for in-depth evaluation, parental rights must be explained to the parents. By law, children are required to receive services from their school districts. Hence, Special Services Specialists must ensure that procedures for referral of children are adhered to.

SPEECH/LANGUAGE & COGNITIVE	SEVERE EMOTIONAL/BEHAVIORAL DISORDERS
HEALTH IMPAIRMENT	DIAGNOSTIC EVALUATION

A. SPEECH/LANGUAGE & COGNITIVE

Procedures

1.	Re-screening: Children with low developmental screening scores such as Learning Accomplishment Profile (LAP-D) will be screened by the Special Services Specialist using Early Screening Profiles, by Kaufman, etc. (AGS) as follows.
	a.	Using LAPD, if a child’s score falls within Secondary Cut-Off Score, the child will not be referred right away for in-depth evaluation. Instead, child will be monitored for 6 weeks from the date of screening by Special Services Specialist or, and Special Education Coordinator. Use of the Early Screening Profiles to re-screen child will be based on child’s six weeks progress.
	b.	If a child does not seem to be making satisfactory progress in LAPD ongoing assessment, the Early Screening Profiles must be used to re-screen the child within 15 days.
	c.	Upon re-screening, if a child scores below Index 2 Cut-Off Score of Early Screening Profiles in either language or cognitive sub-tests referral must be made to appropriate professional (school district Head Start professional, or contractor) for in-depth evaluation.
	d.	If a child scores Index 2 Cut-Off Score of Early Screening Profiles in either language cognitive sub-tests and parent or staff has a concern for the child’s performances in either of those areas, referral must be made to the appropriate professional for in-depth evaluation. (School districts and Head Start professionals or contractors).
2.	Children whose screening scores fall within Tertiary Cut-Off Score of LAP-D must be referred immediately to appropriate professional for in-depth evaluation in the area of need. (Referral to child’s school district or and appropriate Head Start Professional/Contractor. Children in this category do not need re-screening.

School District’s Referral

Children must be referred to the school districts for special services/education services in accordance with the Performance Standards and Individual Disability Education Act (IDEA). Children with low scores must be referred for in-depth evaluation in the area of deficits. The following procedure must be followed for all children.

Procedures

1.	Discuss with parent(s) child’s screening scores and next level of action, in-depth evaluation for categorical diagnosis by appropriate diagnostician.
2.	Obtain parent’s permission by asking for a signed *Parent Permission for Services* form and *Consent to Release Records* form.
3.	Fill out *Child Find* form and *Referra*l form. All relevant information, such as screening results, child’s health information that will help the diagnostician/psychologist/speech pathologist must be filled out.
4.	Send everything directly to appropriate school district as packet. Copies of records or forms sent to the school districts must be kept. If evaluation is completed by a Head Start professional or provider, copies of reports must be sent along with child find form. This may help the school district officials to provide treatment services as soon as possible.
5.	The Head Start special services specialist and parents will be notified of referrals. (DISD call to schedule appointments with the special services specialist).
6.	If after 20 days of referral nothing is received from the Child Find, follow-up should be made on status of referrals. Note, that school districts have 60 working days to take care of referrals. However, do not wait for sixty days before you follow up.

B. SEVERE EMOTIONAL/BEHAVIORAL DISORDERS

Procedure

1.	If a child scores below average on social/self help skills of developmental screenings, or staff has concerns for behavior, the child’s behavior will be carefully monitored in the classroom by Education, Special Services and Mental Health Professional. Efforts to rule out poor class management will be made by providing behavior guidelines or tips to be used in the classroom by the class teacher. *Such informal service is not an I.E.P. if there is no formal categorical diagnosis and enrollment for special services*.
2.	The Mental Health Professional will first screen children referred for social skills/behavior concerns with the *Behavior/Social Checklist AGS, before using BASC and Conners* for categorical diagnosis.
3.	If a child is categorically diagnosed with emotional or behavioral disturbances, child will be enrolled for special services with treatment plans (I.E.P.).

REFERRAL PROCESS FOR IN-DEPTH EVALUATION

C. HEALTH IMPAIRMENT

Procedure

1.	Only children diagnosed with severe health conditions, and functional limitation reports from appropriate Medical or Health Practitioner will be enrolled for special services. Children must not be enrolled for special services without diagnosis. Children reported as asthmatic, epileptic, or other health conditions in the Health folders will not be automatically counted a special need, without diagnostic reports from authorized professionals. Enrollment of children with asthma or any health conditions will be in accordance with the Head Start Performance Standards (1308).
2.	To secure diagnostic reports for Health impairments, child will be referred to the Health Specialist assigned to the Center. If you are unable to get the required reports, notify your supervisor.
3.	In accordance with the Head Start Performance Standards, all children must be screened for developmental, speech/language, social/self-help skills. The Health Specialist is responsible for health related wellness, including vision and hearing. Children with hearing impairments are referred for audiological services. Completion of hearing examination is very important for speech/language and developmental or psychological evaluations. The Head Start Speech Pathologist ensures completion of ear examination for children with low scores in speech/language screenings before referral to UTD-Callier or Children’s Medical Center for ENT examination. (Please follow procedures for referring children for audiological services). Impedance is checked by the Speech Pathologist using Audiometer.

D. DIAGNOSTIC EVALUATION

In order for a child to be evaluated by authorized professional, the following must be followed.

1.	Child must have low developmental test scores or staff/parent have concerns.
2.	The Special Services Specialist will have a signed *Parent Permission* form. Additionally, when parents have concerns about their child’s health or any other potential impairments, a signed *Release of Records to Head Start* form must be used when it is documented that child was, or being treated by a professional. *Statement of Functional Limitations* form is sent along to secure necessary information useful to a child in the program. This helps to determine the child's eligibility for special services based on the guidelines of 45-CFR 1308. Note: The Special Services Specialist and Mental Health Professional rely on teachers and other support staff members to refer children who may be qualified for special services, and who could not be identified at enrollment. Therefore, teachers are encouraged by the Special Services staff to refer any observable developmental problems for immediate attention.
3.	Before a child is referred for diagnostic evaluation, the Special Services Specialist must ensure that current information on child’s hearing and vision screening is available to the diagnostician. This is very important for school districts’ and psychological/developmental referrals. Hence all pertinent information must be completed on the *Referral forms*.
4.	Teachers must use *Referral Form* to refer children to the Special Services Specialist for any observable developmental problems any concerns.
5.	Before a child is referred for evaluation, the Education Specialist, Special Services Specialist, and Special Education Coordinator and Mental Health Professional must observe the child in class setting, to rule out poor class management, if referral is for inappropriate behaviors. Emotional or behavior concerns, for example, usually require more than two observations, because sufficient data for behavioral problems must be collected if **Guidelines on Behavior Management appear not to be working for the child. Any "insolvable" behavioral problems must be referred to the Diagnostician or Mental Health Professional assigned to the Center with a signed Parent Permission Form and Diagnostic Evaluation Referral** form attached with all data collected. All diagnoses must be completed within 30 days from the day of referral. Evidence of screening or assessments should be documented on the child's record by staff.

Section IV

Provision of Services

A. THE GOALS OF SPECIAL SERVICES, MENTAL HEALTH AND SPEECH PLANS

1. DISABILITIES

To enroll and maintain at least ten percent of Head Start enrollment as children with special needs in the following categories, as required by 45-CFR 1308

1308.7 Health Impairment,

1308.8 Emotional/Behavioral Disorders,

1308.9 Speech or Language Disorders,

1308.10 Mental Retardation,

1308.11 Hearing Impairment, Including Deafness,

1308.12 Orthopedic Impairment,

1308.13 Visual Impairment, Including Blindness,

1308.14 Learning Disabilities,

1308.15 Autism,

1308.16 Traumatic Brain Injury,

1308.17 Other Impairments.

2. MENTAL HEALTH

The Mental Health Delivery plan provides services in accordance with the Performance Standards 45-CFR 1304.24, by focusing on prevention of mental health problems for all children enrolled in Head Start and their families. There is a three-level approach to the service delivery: (1) preventative mental wellness services; (2) intervention services to children with emotional and/or behavioral problems; and (3) services to children with other special needs.

a.	Assist all children participating in the Program with emotional, cognitive and social development toward the overall goal of social competence, in coordination with the Education Program and other related activities.
b.	Provide staff and parents with an understanding of child growth and emotional/social development, appreciation for individual differences in a supportive environment.
c.	Work toward prevention of, and early intervention, when a child exhibits emotional/behavioral challenges, which interfere with the child’s social development; and develop a positive attitude toward mental health services.
d.	Utilize community resources to the greatest extent possible to serve children with problems that prevent them from coping with their environment.
e.	Ensure that children enrolled in the Early Head Start, Home Base receive the age appropriate services as all other children enrolled in Head Start.
f.	Provide children with special needs necessary mental health services, which will ensure that they are offered an opportunity for all available benefits with their families through participation in the Program.
g.	Provide ongoing training to Education, Teacher and Special Services staff to improve prevention and intervention skills for children with special needs and their families.

3. SPEECH SERVICES

Licensed Speech-Language Pathologist will provide speech services in accordance with the Performance Standards, the ASHA rules and regulations, and State law as the following goals are implemented.

a.	To assess children who failed speech-language screening when referred.
b.	To aid staff and parents in understanding child growth and development, and in appreciating the individual differences of children by providing a supportive environment for speech impaired children.
c.	To develop strategies for transition from infant/toddler programs, as well as from Head Start to the next placement.
d.	To utilize available resources to the fullest capacity by collaboration in using practicum, or/and intern students in the Centers.
e.	To ensure age appropriate language developments for all Head Start children, by including language enrichments as part of education curriculum.

B. DIAGNOSTIC CRITERIA FOR REPORTING CHILDREN WITH DISABILITIES

Before a child is formally enrolled for special services, Special Services Specialist ensures appropriate certified or licensed professional who works with children with these conditions must have diagnosed all children reported in the following categories. The professional must consider the cultural and/or ethnic characteristics of the Head Start children.

In order to be counted as disabled in Head Start, children must meet two criteria. They must have one of the following disabling conditions (by professional diagnosis) and, by reason thereof, require special require special education and related services:

BLINDNESS AND VISUAL IMPAIRMENTS

A child shall be reported as blind when any of the following exists:

The child is sightless or has such limited vision that he/she must rely on hearing and touch as his/her main means of learning.

A determination of legal blindness in the State of residence has been made.

Central acuity does not exceed 20/200 in the better eye, with correcting lenses, or whose visual acuity is greater than 20/200, but is accompanied by a limitation in the field of vision such that the widest diameter of the visual field subtends an angle of no greater than 20 degrees.

A child who is not blind shall be reported as visually impaired:

* Central acuity with corrective lenses does not exceed 20/70 in either eye.

*
Visual acuity is greater than 20/70, but accompanied by a limitation in the field of vision such that the widest diameter of visual field subtends an angle of no greater than 140 degrees; or he/she suffers any other loss of visual function that will restrict learning processes, e.g., faulty muscular action.

The following includes a sample of behaviors that may indicate visual impairments, and may need further evaluation. However, when using informal observation as a screening for referral to a diagnostician, keep detailed records of the behavior, including frequency, intensity and duration.

- squints, tilts or turns head to look at angles

- closes one eye

- often bumps into things or falls on the playground

- frequently rubs eyes or complains that eyes hurt

- sometimes or always crosses one or both eyes

- frequently holds book or other object too close to eyes

NOTE: Persons whose vision with eyeglasses is normal or nearly so are not to be include in this category.

DEAFNESS AND HEARING IMPAIRMENTS

A child shall be reported as deaf when any one of the following exists:

His/her hearing is extremely defective so as to be essentially nonfunctional for the ordinary purposes of life.

Hearing loss is greater than 92 decibels in the better ear.

Legal determination of deafness has been made in the State of residence.

A child shall be reported as hearing impaired when any one of the following exists:

The child has slightly to severely defective hearing, as determined by his/her ability to use residual hearing in daily life, sometimes with the use of hearing aid.

The child has hearing loss from 26-92 decibels in the better ear.

The following includes a sample of behaviors that may indicate hearing impairment or deafness, and may need further evaluation. Adequate record or showing intensity, 0duration and frequency must be kept when staff observes any of the following.

*	does not turn towards you when you softly call child's name
*	reaction upon a sudden noise
*	attention during music or story time is less than five minutes
*	use of gestures rather than words to communicate
*	frequent earaches or running ears
*	talks in a very loud or very soft voice
*	turns the same ear towards a sound she/he wishes to hear
*	does not respond when you call from another room

	ORTHOPEDIC IMPAIRMENT A child shall be reported as orthopedically impaired when a condition prohibits or impedes normal development of gross or fine motor abilities. Such functioning is impaired as a result of conditions associated with congenital anomalies, accidents or diseases. These conditions include, spina bifida, loss of or deformed limbs, burns that cause contractures, and cerebral palsy. Observable characteristics of motor impairments are:
	a.	unable to balance on one foot for a short time by age four
	b.	unable to throw a ball overhand and catch a large ball bounced to him/her by age five
	c.	one side of body is more coordinated when walking or running
	d.	hands are shaky or clumsy when doing fine motor tasks
	e.	unable to cut with scissors by age four

4.	COMMUNICATION DISORDERS (SPEECH AND LANGUAGE) A child shall be reported as speech or language impaired with such identifiable disorders as receptive and/or expressive language impairment, stuttering, chronic voice disorders, and serious articulation problems affecting social, emotional and/or educational achievements. Or speech and language disorders accompanying conditions of hearing loss, cleft palate, cerebral palsy, mental retardation, emotional disturbance, multiple disabling conditions, and other sensory and health impairments. This category excludes transitional condition consequent to the early developmental processes of the child. Characteristics of communication impairments are:
	a.	unable to repeat common rhymes or television jingles by age three
	b.	is not talking in short sentences by age four
	c.	hard to understand by people outside the family by age five
	d.	does not follow simple verbal directions
	e.	is not talking at all by age two

5.	HEALTH IMPAIRMENT The impairments refer to chronic illness or with prolonged convalescence, including but not limited to epilepsy, severe asthma, severe cardiac conditions, severe allergies, blood disorders (such as sickle cell, hemophilia or leukemia), diabetes or neurological disorders.

MENTAL RETARDATION

A child shall be considered mentally retarded who, during the early developmental period, exhibits significant sub average intellectual functioning accompanied by impairment in adaptive behavior. In using standardized tests to determine intellectual functioning, adequate consideration should be given to cultural influences as well as age and developmental level.

7. SERIOUS EMOTIONAL/BEHAVIORAL DISTURBANCES
A child shall be considered seriously emotionally disturbed based on evaluation report by an authorized professional. Definition includes conditions that indicate child's dangerous aggression towards others, self-destructiveness, severely withdrawal, and non-communicative, hyperactivity if it affects adaptive behavior.

The following are some observable characteristics of serious emotional/behavioral disturbances:

a. interaction with others with adults: resists separation from parents, shies away from adults, excessive number of attention-getting behaviors with peers. Such behaviors may be solitary or parallel play, avoiding certain children or latches onto one particular child, disrupting other children's play, over-reacting to unexpected stimuli.

b. does not like to share and take turns by age five

c. does not like to play in group games (such as hide-and-seek) with other children by age 4

d. self-abusive behavior

e. repetitive behavior

8. LEARNING DISABILITIES/COGNITIVE IMPAIRMENTS
These disabilities refer to a disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, which may manifest itself in imperfect ability to listen, speak, read, write, spell or do mathematical calculations. Such disorders include such conditions as perceptual disabilities, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia.
Learning problems that are primarily the result of visual, hearing or motor disabilities of mental retardation, emotional disturbance and environmental/economical disadvantage are not included. For preschool children, precursor functions to understanding and using language, spoken or written, and computational or reasoning abilities are included.
The following are some characteristics of learning impairments:

a. cannot answer simple questions about a story by age three

b. does not give reasonable answers to such questions as "What do you do when you are hungry?" by age five

c. does not seem to understand the meaning of the words "today, tomorrow, yesterday” by age five

d. does not demonstrate simple problem solving skills, such as completing puzzles following pattern for bead stringing by age five

e. does not demonstrate memory skills, such as repeating short sequence of numbers or telling what’s by age five

C. IMPLEMENTATION OF SPECIAL SERVICES & MENTAL HEALTH PROGRAM

Mental Health services are provided to children with special needs diagnosed with developmental delays, physical problems, mental or emotional disturbances.

The Special Services Specialist ensures that the purpose of all special services proposed is explained to the parents. Written parental consent must be obtained for all special services provided to the Head Start child. The form will include child's name, name of service provider, description of services to be provided, signature of parent(s), and date signed.

Confidentiality is essential per Title 92 of the Texas Mental Health Code. Notes and reports should be written on observations and interventions undertaken with individual children, teachers, and on the overall classroom environment. Confidentiality of these records must be maintained in a locked file cabinet. The key is available only to authorized persons. (See general SOP for procedures).

All Head Start parents are expected to be oriented by the Special Services Specialist and Mental Health Professional to the services provided by the Dallas Head Start Program before and during enrollment. As needs arise during the school year, the Special Services Specialist and Family Advocate will continue to promote these services. Workshops available to parents may include:

* Understanding My Four-Year Old,

            * Behavior Management and Discipline,

            * Improving Your Mental Health and Feelings About Yourself,

            * Activities to Improve Your Life with Your Child, and

          * Parenting Skills.

The observation and assessment process must be ongoing. However, observation of Head Start children in the classrooms must be formally conducted twice every school year, (beginning of the school year and at the end of the school year by the Mental Health Professional(s). This requires proper documentation and written reports showing recommendations, if any
Long-range and short-range goals are prepared and reviewed periodically by the staffing team.

The Site Managers and teaching staff are responsible for the daily educational program. Head Start of Greater Dallas, Inc. provides mental health services to all Head Start children and families. A holistic approach is used to provide mental wellness by emphasizing physical, emotional/social, and cognitive developments. The holistic approach is implemented by providing identification, treatment/intervention and preventive services to all Head Start children.

1. MENTAL WELLNESS METHODS FOR CHILDREN

The following methods are used to provide mental wellness to all Head Start children.

IDENTIFICATION

The Mental Health Professional observes and screens all Head Start children for social/emotional deficits, when enrolled. Children with social/self-help skill deficits will be evaluated promptly.

TREATMENT OR INTERVENTION

Children with low developmental screening scores in social/emotional skills domain are referred immediately to the Mental Health Professional for re-screening, using AGS Social/Behavior Checklist. In-depth evaluation is next using BASC and Conners, when children score below required standard. Diagnostic reports will reflect all data collected, Social/Behavior Checklists, BASC and Conners scores.

Children whose parents or teachers have concerns for their inappropriate behaviors will be referred to the Special Services Specialist. The Special Services and Education Specialists assigned to the center(s) to rule out poor class management and suggest behavior guidelines to the teacher(s), will observe such children in classrooms. The Special Education or Education Coordinator’s professional attention and recommendations may be needed. When child’s inappropriate behavior is very destructive or harmful to others, the Mental Health Professional should be contacted immediately by giving him/her referral form(s).

The Special Services Specialist and Education Specialist will refer children to the Mental Health Professional, after efforts to remediate problem(s) or Special Education Coordinator seem not to be working.

The Mental Health Professional uses AGS Behavior/Social Skills Checklists, BASC, Conners and DSM-IV to evaluate Head Start children referred for observable behavior/emotional problems. The Special Education Coordinator is also included in this process to gather data that will help the Mental Health Professional complete evaluations. As part of documentation, the following must be completed: observation of the child in a class setting, data collection, and consistent provision of tips/guidelines to the teacher with progress monitoring up to 2-4 weeks, to rule out poor classroom management. Children receiving mental wellness or any other remedial services at this level cannot be counted for disability or special services, if they do not meet enrollment requirements for special services (45 CFR 1308.8).

The Special Services Specialist will formally enroll children diagnosed with severe emotional/behavioral disorders for special services in accordance with 45 CFR 1308. Formal I.E.P. meeting must be conducted to discuss child’s evaluation reports and intervention/treatment plans. Children in this category will be included on the Special Services Control Sheets as special needs. Such children must have individualized education plans (IEP). The I.E.Ps are expected to be implemented consistently in the classrooms by teachers, and by the Mental Health

C. IMPLEMENTATION OF SPECIAL SERVICES & MENTAL HEALTH PROGRAM (CONTINUED)

Professional in the form of play therapy. The Mental Health Professional, for filing must give individual progress reports of children officially enrolled for special services to the Special Services Specialist.

PREVENTATIVE SERVICES

Preventative mental wellness is inclusion of mental health in the regular classroom curriculum. It is implemented as follows.

1.	Teachers use “Mental Health Curriculum” to integrate related topics in their lesson plans. The Education Specialist and Mental Health Professional work collaboratively to ensure implementation by checking lesson plans regularly.
2.	The Mental Health Professional observes classrooms sporadically and provides technical assistance to class teachers on how to implement the topic.
3.	The Mental Health Professional ensures provision of seminars or training for the teachers during staff development days. Outside professionals may be invited to provide training to staff on Mental Health topics.

2. MENTAL WELLNESS FOR PARENTS

IDENTIFICATION

At enrollments, the Mental Health Professional orients parents with the types of mental health services available in Head Start by completing Family Support Questionnaires. These questionnaires are used to identify potential mental health problems in the families and prioritized if needed.

TREATMENT OR INTERVENTION SERVICE

Basic counseling service is provided to the parents referred for counseling on time. Parents in crisis are referred to the Mental Health Professional immediately for appropriate services. The Special Services Specialist must document names of referred parents/families on Page 2 of the Special Services Control Form. This information will be needed to complete Program Information Report (PIR) at the end of the program year.

When families need further mental health services beyond what is provided by an in-house Mental Health Professional, further referral must be made to appropriate provider(s) in the community with proper documentation.

The Mental Health Professional must document mental health services provided to all Head Start children and families on the Mental Health Control or Tracking sheets. Control sheets should be updated monthly.

Parent Training/Focus Group meetings will be conducted at least four times yearly, by grouping Centers (2 or 3 or 4 Centers depending on size,). Centers may be grouped for this purpose when they are in the same area. There must be proper documentation of training/focus group activities by filing training notices/fliers and handouts, if any. Transportation arrangement must be made with the Transportation department for parents who do not have means of transport.

D. RECORDS

Throughout the school year, the Special Services Specialist, Mental Health Professional, Speech Pathologist and Psychologist must keep records of evaluations, assessments, referrals, follow-up reports, contracts, training agendas and sign in sheets, including mental health records, in locked file cabinets at the Centers. The use of locked file cabinets is to ensure that confidentiality of records of Center based children, Home Base children, and dual enrollment option children are maintained.

The Special Services Specialist and the Mental Health Professional use the Special Services cabinets to store all special services/mental health folders/records. The top drawer of the file cabinet contains special services folders for children with special needs; and the bottom drawer for mental health records. Hauling of confidential records is forbidden. Hence, Special Services and Mental Health Professionals must ensure that records are kept locked in the designated file cabinets at the Centers. For example, individual special services and mental health records of children at East Dallas Center should be kept there and not transported elsewhere.

E. CONFERENCES: PRE-STAFFING, IEP & ADMISSION, REVIEW & DISMISSAL (A.R.D.)

Pre-staffing, IEP or Admission, Review and Dismissal (A.R.D.) meetings are arranged by the Special Services Specialist for all children diagnosed to discuss child's admission, program review and dismissal from special services. Staffing/IEP meetings will be conducted for eligible children receiving special services directly from Head Start staff or and providers. A.R.D. meetings are required to be conducted for children receiving services directly from the school districts. When services are recommended to be provided by Head Start staff or contractors, I.E.P. meetings are expected to be conducted at least twice a year by the Special Services Specialist for the following reasons. A representative from the child’s school, district must be invited.

* To discuss the child's specific assessment results, strengths, and weaknesses to officially enroll the child into the special services program.

* To dismiss the child from the special services program.

* To discuss and write an appropriate I.E.P. that attempts to remediate the child's problems based on the diagnosis.

Note: Public School districts conduct A.R.D. meetings for children diagnosed by the district at least once a year (Anniversary day) to review plans. Otherwise, A.R.D must be conducted for each child at least twice a year, (first one at the beginning of the school year and second at the end of the school year). Head Start staff must be present when ARD is scheduled.

I.E.P. meetings comprise of the following staff: Site Manager, Diagnostician, Health, Nutrition, Education

Specialist, Family Advocate, Special Education Coordinator, and the Special Services Specialist, the Chairperson. The meetings are scheduled by the Special Services Specialist to meet parents' schedules. A copy of the “Summary of Parents' Rights and Responsibilities” and “Records Policy” (see copy) must be given to the parents when they are notified for conference. If this cannot be done, the Special Services Specialist must give a copy to the parent(s) at the meeting with proper explanation.

For record purposes, the parents must sign the form to show that they have been informed and are aware of their rights and responsibilities. At least a week notice of the meeting, using Parent Conference form should be given to parents, support staff and consultants whose attendance will be expected. The child’s school district must also be notified/invited in writing. A confidential list of the children to be talked about should be given to the support staff members to enable them to be fully prepared.

Pre-Staffing/Meeting is also conducted for ECI children transitioning from their programs for placements, and pre-diagnosed children coming into Head Start. This meeting is required to discuss how to meet their needs, but it is not as formalized as IEP meeting or ARD. However, there must be documentation of the meeting. In documenting the meeting, Special Services Specialist will use the IEP Meeting Summary/Sign-In sheet. But Pre-Staffing must be written on the form. The Head Start I.E.P. meeting committee is made up of the parent(s)/guardian(s), Site Managers, and support staff.

Procedure for Head Start I.E.P. Meeting

1.	Support staff, comprising Special Services Specialist, Special Education Coordinator, Teachers, Education Coordinator, Teachers, Education Specialist, and Site Manager must meet prior to the day or time of the I.E.P. meeting. The purpose of the meting is to discuss all evaluation reports, concerns and recommendations in order to reach a consensus before the I.E.P. meeting.
2.	The Special Specialist facilitates the meeting and fills out all required Staffing/I.E.P. forms and any other vital records.
3.	At the I.E.P. meeting, Committee Members introduce themselves and sign in to document their attendance document their attendance and participation in the meeting.
4.	At the meeting, the Special Services Specialist states the functional level of the child in the areas of gross/fine motor, self-help, speech-language, and social/emotional. This Committee must be reminded of the purpose of the meeting.
5.	The class teacher states the teacher's concern for the child.
6.	The parent then states his/her concern(s) for the child.
7.	The diagnostician explains the evaluation results to the parent and the entire Committee.
8.	Committee Members state their concerns for the child in their areas of specialization.
9.	The entire Committee participates and agrees on any I.E.P. that will be written by the diagnostician(s) and proposals for the children.
10.	The parent(s) and all Committee members do signing of all required Staffing/I.E.P. forms.

NOTE: The Special Services Specialist should remember that signing of forms should be the last item on the I.E.P. meeting agenda.

INDIVIDUALIZED EDUCATION PLAN (I.E.P.)

The person(s) responsible for implementing the I.E.P. may vary for each child, depending on diagnosis. However, it is anticipated that there will be at least one goal to be implemented by the teacher. The Special Services Specialist will ensure that the teacher integrates I.E.P s developed for children with special needs with the regular plans. The Special Services Specialist or Mental Health Professional or Special Education Coordinator demonstrates, from time to time, the required methods the teacher needs to implement the plan, by participating in the Special Needs Sessions.

Each time the teacher or staff works with the child using the I.E.P., it should be recorded on the Special Sessions Recording Sheet and kept in the child's classroom coded folder. The Specialist monitors and updates the implementation of the various portions of the Individualized Education Plan as needed, and ensures that the SNS forms are recorded and updated. The Special Education Coordinator provides ongoing instructions, and how to serve children with disabilities in a regular setting to teachers. The Special Education Coordinator and Psychologist should help the Special Services Specialists develop age appropriate I.E.P. if weaknesses are found in some areas such as cognition, self-help, and fine motor.

The Individualized Education Plan must include the following:

1.	Present Level of Functioning: The Evaluator's report of the level in which the child is functioning.
2.	Person Responsible: The professional or staff member(s) that will implement the program.
3.	Duration: Recommended amount of time that services or plan will be implemented.
4.	Long-Term Goals: The general goal expected to be mastered by the child within a certain time, usually annually. An example is "John Doe will be able to increase his vocabulary by 500 words by June 2003."
5.	Short-Term Objectives: Suggested teaching steps for a recommended topic to be mastered.
6.	Review Date: Date objective(s) will be reviewed or revised to determine if the child is making expected progress as recommended by the Diagnostician.
7.	Begin Date: Date goals and objectives are supposed to begin. This is encouraged to be immediately.
8.	Evaluation Criterion: This is method of measurement for goal/objective attainment. For example, 4/5x for 5 days; teacher made tests; posttests; etc.
9.	Signatures of I.E.P. Committee
10.	Prioritized Goals: Child's regular goals recommended in different subject areas. (Check with the support staff for expected prioritized goals.)
11.	Recommended Programs: Types of programs recommended at the I.E.P. meeting for child's special services and duration. An example is Home Base or Center Base.
12.	Parent's/Guardian's Signature: Parent must sign the I.E.P. (either agree or disagree with the plan).

No I.E.P. shall be implemented without parent/guardian signature and date. If the parent disagrees with the plan or refuses enrollment of the child into the special services program; do not implement the plan. Give the parent the Refusal of Service Form to sign and date in front of the Site Manager who signs as a witness. Then staple the form to the I.E.P. Summary/Sign-In Sheet.

The Agency’s policies on Procedures for Emotional/Behavioral Intervention must be followed and enforced when a parent refuses intervention services recommended based on child’s categorical diagnosis and recommendations by authorized or licensed professionals. (See “Procedures for Emotional/Behavioral Intervention”). Staff is required to read and follow this document.

SPECIAL EDUCATION-PARENT AND STUDENT RIGHTS IN PUBLIC SCHOOLS ADMISSION, REVIEW AND DISMISSAL (A.R.D.) COMMITTEE

The A.R.D. Committee decides the educational program and setting of a student referred for special education or currently receiving special education services (19 TAC 89.221(a); 34 CFR 300.343). As an A.R.D. Committee Member, you are an active partner with school personnel in planning your child's educational program

The A.R.D. Committee consists of the following voting members:

*	You, the adult designated representative of the handicapped student, or the student, when appropriate.
*	At least one representative from special education, school administration representative, a representative from instruction,
*	a representative from special education assessment when needed (usually at the time of initial placement or three-year reevaluation), and other professionals named in the State Board of Education Rules for Handicapped Students if your child is visually handicapped, hearing impaired, limited English proficient, or being considered for vocational education (19 TAC 89.221(h)).

The A.R.D. Committee's first task is to review the assessment and all other information collected to decide if the student is disabled according to specified eligibility criteria. The second task of the A.R.D. Committee is to decide if the student needs special education instruction and related services. This decision must be made within 30 calendar days after the assessment report is completed for students referred for the first time. If the 30th day falls in the summer, the A.R.D. Committee has until the first day of classes in the fall to make the placement and Individualized Education Plan decisions (19 TAC 89.221(d)).

If your child needs special education, the A.R.D. Committee develops an Individualized Education Plan (I.E.P.). The parent must be involved in the development. A.R.D. Committee meetings are scheduled by the school at least once a year to review your child's progress. However, you may request an A.R.D. Committee meeting at any time to discuss educational concerns, such as placement, I.E.P goals, and extent of services provided. You are encouraged to confer informally with the school's special education personnel about problems or questions before asking for an A.R.D. Committee meeting. However, the A.R.D. Committee must make any change in placement.

In the Admission, Review and Dismissal Committee process, you have a right to:

*	Receive written notice of scheduled A.R.D. Committee meetings. This notice must be given at least five school days before the meeting, unless you agree otherwise (34 CFR 300.34 (a); 19 TAC 89.229(b)).
*	Receive written notice of what the school is proposing to do with your child as a result of the meeting
*	Have the A.R.D. Committee meeting held at a time and place that is convenient for both you and the school. However, if you or the other parent cannot attend, the school will use other methods telephone, letter, or personal conferences - to ensure your participation before or during the meeting (34 CFR 300.345(d)). If neither parent can attend, the school may conduct the meeting without you (34 CFR 300.345(c)(d)).

7.	SERIOUS EMOTIONAL/BEHAVIORAL DISTURBANCES A child shall be considered seriously emotionally disturbed based on evaluation report by an authorized professional. Definition includes conditions that indicate child's dangerous aggression towards others, self-destructiveness, severely withdrawal, and non-communicative, hyperactivity if it affects adaptive behavior. The following are some observable characteristics of serious emotional/behavioral disturbances:
	a.	interaction with others with adults: resists separation from parents, shies away from adults, excessive number of attention-getting behaviors with peers. Such behaviors may be solitary or parallel play, avoiding certain children or latches onto one particular child, disrupting other children's play, over-reacting to unexpected stimuli.
	b.	does not like to share and take turns by age five
	c.	does not like to play in group games (such as hide-and-seek) with other children by age 4
	d.	self-abusive behavior
	e.	repetitive behavior

8.	LEARNING DISABILITIES/COGNITIVE IMPAIRMENTS These disabilities refer to a disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, which may manifest itself in imperfect ability to listen, speak, read, write, spell or do mathematical calculations. Such disorders include such conditions as perceptual disabilities, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia. Learning problems that are primarily the result of visual, hearing or motor disabilities of mental retardation, emotional disturbance and environmental/economical disadvantage are not included. For preschool children, precursor functions to understanding and using language, spoken or written, and computational or reasoning abilities are included. The following are some characteristics of learning impairments:
	a.	cannot answer simple questions about a story by age three
	b.	does not give reasonable answers to such questions as "What do you do when you are hungry?" by age five
	c.	does not seem to understand the meaning of the words "today, tomorrow, yesterday” by age five
	d.	does not demonstrate simple problem solving skills, such as completing puzzles following pattern for bead stringing by age five
	e.	does not demonstrate memory skills, such as repeating short sequence of numbers or telling what’s by age five

	Mental Health services are provided to children with special needs diagnosed with developmental delays, physical problems, mental or emotional disturbances.
	The Special Services Specialist ensures that the purpose of all special services proposed is explained to the parents. Written parental consent must be obtained for all special services provided to the Head Start child. The form will include child's name, name of service provider, description of services to be provided, signature of parent(s), and date signed.
	Confidentiality is essential per Title 92 of the Texas Mental Health Code. Notes and reports should be written on observations and interventions undertaken with individual children, teachers, and on the overall classroom environment. Confidentiality of these records must be maintained in a locked file cabinet. The key is available only to authorized persons. (See general SOP for procedures).
	All Head Start parents are expected to be oriented by the Special Services Specialist and Mental Health Professional to the services provided by the Dallas Head Start Program before and during enrollment. As needs arise during the school year, the Special Services Specialist and Family Advocate will continue to promote these services. Workshops available to parents may include: * Understanding My Four-Year Old, * Behavior Management and Discipline, * Improving Your Mental Health and Feelings About Yourself, * Activities to Improve Your Life with Your Child, and * Parenting Skills.
	The observation and assessment process must be ongoing. However, observation of Head Start children in the classrooms must be formally conducted *twice* every school year, (beginning of the school year and at the end of the school year by the Mental Health Professional(s). This requires proper documentation and written reports showing recommendations, if any
	Long-range and short-range goals are prepared and reviewed periodically by the staffing team.
	The Site Managers and teaching staff are responsible for the daily educational program. Head Start of Greater Dallas, Inc. provides mental health services to all Head Start children and families. A holistic approach is used to provide mental wellness by emphasizing physical, emotional/social, and cognitive developments. The holistic approach is implemented by providing identification, treatment/intervention and preventive services to all Head Start children.