Services for Infants and Toddlers with Disabilities: IDEA, Part H

Article excerpt

Social workers in health care settings whose primary responsibility is infants and toddlers with disabilities have a new ally in the Individuals with Disabilities Education Act (IDEA). Social workers may know this legislation better as P.L. 99-457, the Education of the Handicapped Act Amendments of 1986. IDEA includes two programs - Part H and Part B - that are designed to increase services to young children with special needs and their families: Part H is the Infants and Toddlers with Disabilities Program, and Part B, Section 619, is the Preschool Grants Program. This article addresses the facets of IDEA, Part H, that social workers in health care settings need to know to better serve infants and toddlers with special health care and educational needs.

It is estimated that 750,000 neonates each year may have or be at risk for developmental disabilities (Haber, 1989). After a brief historical introduction to IDEA, this article defines the valuable role that social workers can play in the identification, referral, and coordination of services for disabled, Part H-eligible children from birth up to age 3.


IDEA is an evolutionary piece of federal legislation. Its roots are P.L. 91-230, the Education of the Handicapped Act (EHA), which was passed nearly 25 years ago on April 13, 1970. It was not until 1986, however, that amendments were made to the EHA to guarantee that infants and toddlers with special needs and their families in participating states would receive the services they needed to maximize the children's development. These amendments to the EHA became P.L. 99-457, which passed both houses of Congress unopposed and was signed into law on October 8, 1986. This act was again amended in 1988, 1990, and 1991. In 1990, the original title of the act (EHA) was changed to the Individuals with Disabilities Education Act. Although Part H became Subchapter VIII in the revised legislation, it has retained its more easily recognized designation.

The Part H program mandates a statewide, comprehensive, multidisciplinary service system to address the needs of infants and toddlers who are experiencing developmental delays or a diagnosed physical or mental condition with a high probability of an associated developmental disability in one or more of the following areas: cognitive development, physical development, language and speech development, psychosocial development, and self-help skills. In addition, states may opt to define and serve at-risk children. Commonly cited factors that may put an infant or toddler at risk of developmental delay include low birthweight, respiratory distress as a newborn, lack of oxygen, brain hemorrhage, infection, and prenatal exposure to toxins through maternal substance abuse.

Part H is nearing full implementation in many states. The original legislation provided a five-year phase-in period for states to develop their comprehensive system of service for the affected population. Although IDEA does not mandate states' participation in Part H, powerful financial incentives from the federal government have kept every state in the planning process to date. States have been provided extensions of the five-year period as they struggle with the logistic, interagency, and financial demands of developing a statewide system. To ensure a coordinated approach to service delivery and financing of services, federal regulations of Part H require that states develop interagency agreements that define the financial responsibility of each agency and impanel a state interagency coordinating council to assist the lead agency in implementing the statewide system. Regulations also prohibit the substitution of funds and reduction of benefits once the plan is implemented in each state (U.S. Department of Education, 1993).

As states and federal territories (for example, Guam, Puerto Rico, the Virgin Islands) began to plan for implementation of P.L. 99-457 and later IDEA, their first obligation was to designate an agency that would provide leadership in the planning and administration of the state's comprehensive system. …