Guidelines for Best Practices in Determining Eligibility Based on Children’s Physical Development

The goal of the Guidelines for Best Practices in Determining Eligibility Based on Children’s Physical Development is to offer support to the evaluation team support in their decision-making regarding a child’s need for early intervention services based on physical development. In Wisconsin, physical development is defined as follows:
Physical development, including hearing and vision, as evidenced by gross motor and fine motor coordination, tactility, health and growth. [HFS 90.08 (7)(c)2.]

In the first three years of life a typical infant learns to move purposefully, to sit, crawl, stand, walk, run and jump. Movement of a typically developing child is smooth, easy, coordinated, purposeful and graded. Typical motor control is characterized by variability and adaptability.

Multiple factors influence the progression of the ability to move. A child’s health situation can greatly impact motor development. This is particularly true in the first few months of life when the infant needs energy to move. Poor health, low birth weight, ineffective feeding, and birth complications all have a tremendous impact on early movement patterns.

Motor skills support other domains, such as an infant’s cognitive need to explore and to manipulate objects and a toddler’s social-emotional need to safely keep up with peers and to gain independence with self-help tasks. Children develop concepts about objects through manipulation and learn about their world by moving through the space around them.

Physical Development

Fine Motor and Vision

COMPONENTS TO EVALUATE:

Vision Components

Sensory Responsiveness

Fine Motor Control Components

Acceptable Evaluation Approaches

  1. Standardized or norm referenced evaluation tools
  2. Naturalistic assessment
  3. Ecological assessment
  4. Parent/caregiver developmental history report

Selecting Appropriate Evaluation Tools

Based on your data from record review and caregiver concerns, select an evaluation tool to tailor your evaluation:

Fine Motor or Quality of Movement Concerns Vision Concerns Self Help Concerns Behavioral, motor planning Adaptive, social, emotional
Infant Toddler Development Assessment Vision Skills Development Guidelines Pediatric Evaluation of Disability Inventory DeGangi Infant Toddler Symptom Checklist
Peabody Developmental Motor Scales _ _ Dunn Infant Toddler Sensory Profile
Toddler Infant Motor Evaluation _ _ Sensory Motor History
Alberta Infant Motor Scales _ _ Hanschu Sensory Profile
Bayley Scales of Development _ _ Wisconsin Behavior Rating Scale
Clinical Observations _ _ Test of Sensory Function in Infants

If there is global concern for overall developmental delay, a combination of above tests may be appropriate or a combination of a sensory integration test with a more generalized test from the following list:

Interpreting Results

Appendix 1

Acceptable Standardized or Norm Referenced Evaluation and Assessment Tools
(This list is not exhaustive.)

Tool Authors Population/Type Publisher
Alberta Infant Motor Scales (AIMS) Piper & Darrah (1994) Birth to 18 months; observation W.B. Saunders Company
Bayley Scales of Infant and Toddler Development III – Bayley (2005) 1 to 42 months; norm referenced Harcourt Assessment, Inc.
Early Intervention Developmental Profile (EIDP) D’Eugenio &.Moersch (1994) Birth to 36 months; criterion referenced University of Michigan Press,
Hawaii Early Learning Profile (HELP) Furuno et al (1994) Birth to 36 months; curriculum based VORT Corporation
Infant Toddler Development Assessment (IDA) Provence, Erikson, Vater, & Palmeri (1995) 1 to 36 months; Standardized; criterion referenced; yields a performance age range; percentage delay can be computed Riverside Publishing
Infant/Toddler Sensory Profile Dunn (2002) Birth to 36 months; norm referenced Harcourt Assessment, Inc.
Infant Toddler Symptom Checklist DeGangi, Poisson, Sickel, & Santman Wiener (1995) 7-30 months; parent report or interview; criterion referenced Therapy Skill Builders, Psychological Corporation
Peabody Developmental Motor Scales-2 Folio & Fewell (2000) Birth to 60 months; norm referenced PRO-ED, Inc.
Pediatric Evaluation of Disability Inventory (PEDI) Haley et al (1992). 6 months - seven year; Functional skills; standardized; normed; parent interview; Boston University, Health and Disability Research Institute
Test of Infant Motor Performance (TIMP) Campbell et al (1993) From 34 weeks gestational age to 4 months post-term; developmental age standards for performance Infant Motor Performance Scales, LLC
1301 W. Madison St. #526
Chicago, IL 60607-1953
Test of Sensory Function in Infants (TSFI) DeGangi, and Greenspan 4 to 18 months Western Psychological Services
Toddler Infant Motor Evaluation (TIME) Miller and Roid (1994) Birth to 3 1/2 years. Standard scaled scores Harcourt Assessment, Inc.
Wisconsin Behavior Rating Scale Song, et al Adaptive behavior scale for persons functioning below the developmental level of 3 years Central Wisconsin Center for the Developmentally Disabled, Madison

Appendix 2

Normal Development

Vision Development

AGE SKILL
Newborn Focuses 8-15 inches away.
Has 20/400 acuity
Eye movements are not coordinated
1-3 Months Eyes begin to track together
Follows moving object by 5 weeks
Sustains eye contact by 3 months
4-6 Months Binocular vision established
Looks at hands and feet
Has 20/100 acuity at 5 months
8-12 Months Looks at object to grasp it with accuracy
12-24 Months Visually interested in simple pictures
25-36 Months Visually explores entire environment
Identifies pictures in book
Visually watches and imitates others

Fine Motor Development

0-1 Month Fisting
2-3 Months Holds rattle briefly
4-5 Months Brings hands together for play above chest
6-7 Months Uses palmer hand grasp
Transfers objects from one hand to the other
8-9 Months Uses an inferior Pincer grasp
Claps hands together
10-11 Months Uses superior pincer grasp
12-14 Months Turns pages in a cardboard book
15-17 Months Begins to place pegs in a pegboard
Builds a tower of 3 1-inch cubes
18-23 Months Separates pop beads
Imitates a circular scribble stroke
24-29 Months Completes a simple 3 piece form board
Imitates a vertical and horizontal stroke
Builds a tower of 4-5 1-inch cubes
30-36 Months Copies a circular stroke
Builds a tower of 6 1-inch cubes

REFERENCES FOR NORMAL DEVELOPMENT

  1. Early Intervention Developmental Profile
  2. Pediatric Evaluation of Disability Inventory
  3. Peabody Developmental Motor Scales
  4. University of Connecticut Cooperative Extension of Education
  5. www.med.utah.edu/healthinfo/pediatric/Growth/infhab.htm