Table 1 Count of Infant and Toddlers Served

Page 5 of 5

TABLE 1

REPORT OF CHILDREN RECEIVING

EARLY INTERVENTION SERVICES IN ACCORDANCE WITH PART C

Specific State-Designated Date Between October 1 and December 1 of 2006

Paperwork Burden Statement

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 1820-0557. The time required to complete this information collection is estimated to average 28 hours per State response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Education, Washington, D.C. 20202. If you have comments or concerns regarding the status of your individual submission of this form, write directly to: Office of Special Education Programs, U.S. Department of Education, 400 Maryland Avenue, SW, Washington, D.C. 20202.

Instructions

Authorization: P.L. 108-446, Section 618 (a)(1)(B), Section 618(a)(2), and Section 618(a)(3)

Due Date: February 1, 2007

Sampling Allowed: Section A1 – Yes

Section A2 – No

Section B1 – Yes

Section B2 – No

Section C - Yes

Section D - Yes

Send Form to: Alexa Posny, Director

Office of Special Education Programs

Part B Data Reports

Program Support Services Group

Mail stop 2600

550 12th Street, S.W.

Washington, D.C. 20202

Attn: Cheryl Broady

General Instructions

1. Report the number of children receiving early intervention services according to an individualized family service plan (IFSP) in place on the count date. This must be an unduplicated count; each child is counted once and only once.

2. All reported totals must equal the sum of the subsequent rows or columns. Report zeroes (0) where there are no children to report in a data cell.

3. The count date is a state-designated date between October 1, 2006 and December 1, 2006 (inclusive). States must use the same count date each year.

4. Include children in your State who are:

1. under age 3 or, if your state offers parents the choice of continuing in Part C until the child is eligible to enter kindergarten, age 3 and older, and

2. experiencing developmental delays or have a diagnosed physical or mental condition which has a high probability of resulting in developmental delay, and

3. receiving early intervention services regardless of whether Part C monies are used to provide these services. Early intervention services are developmental services which:

1. are provided in conformity with an IFSP;

2. are provided under public supervision (i.e., Federal, State, or local funds are used in connection with the provision of services). This includes children receiving services through a program funded by public monies as well as children receiving services from a private provider, but whose services are supervised or paid for by a public agency;

3. are provided at no cost except where Federal or State law provides for a system of payments by families, including a schedule of sliding fees;

4. are designed to meet the developmental needs of infants or toddlers and older children with disabilities and the needs of the family;

5. meet the standards of the State; and

6. are provided, to the maximum extent appropriate, in natural environments.

More detailed information about the definition of early intervention services can be found in 20 U.S.C. 1432 (4) and in 34 CFR §303.12 and 303.13.

5. If your State serves children who are at risk of having substantial delays if early intervention services are not provided, include these children in Sections A, B and C.

6. Do NOT include children age 3 or older unless your state offers parents the choice of continuing in Part C until the child is eligible to enter kindergarten.

7. STATES SHOULD NOT PROVIDE PERCENTAGES IN SECTIONS A OR B, AS THEY WILL BE CALCULATED AFTER THE COUNTS ARE SUBMITTED.

Instructions for Section A: Age and Race/Ethnicity

1. Enter the count date (a date between October 1, 2006 and December 1, 2006, inclusive).

2. Report the (unduplicated) number of children with an active IFSP in place on the count date, according to the child’s age and race/ethnicity. This count should include:

   1. In Section A.1, all infants and toddlers, ages birth through 2; and

   2. In Section A.2, any children, ages 3 or older, with disabilities continuing in early intervention services until they are eligible to enter kindergarten. If your state does not offer parents the choice of continuing Part C services until the child is eligible to enter kindergarten, leave this section blank.

3. Report children according to their age on the count date. See instructions below for reporting race/ethnicity.

4. Report children less than 1 year of age in the “birth to 1” cell.

5. States must provide data for each discrete age and age grouping (birth through 2 and, if appropriate, 3 or older).

6. States that have discrete age data available must base this report on these actual data. States that do not have data for each discrete age are required to report actual data for the age groupings birth through 2 and, if appropriate, 3 or older. See sampling guidelines below.

Instructions for Section B: Gender

1. Report the (unduplicated) number of children with an active IFSP in place on the count date, according to the child’s gender. This count should include:

   1. In Section B.1, all infants and toddlers, ages birth through 2; and

   2. In Section B.2, any children, ages 3 or older, with disabilities continuing in early intervention services until they are eligible to enter kindergarten. If your state does not offer parents the choice of continuing Part C services until the child is eligible to enter kindergarten, leave this section blank.

2. The total number of children reported in Section B.1 should equal the total number of children reported in Section A.1. The total number of children reported in Section B.2 should equal the total number of children reported in Section A.2.

Instructions for Section C: At Risk

(TO BE COMPLETED ONLY BY STATES THAT SERVE AT-RISK INFANTS AND TODDLERS)

1. Report the (unduplicated) number of infants and toddlers, ages birth through 2, who were determined to be at risk of experiencing substantial developmental delays if early intervention services were not provided and who have an active IFSP in place on the count date. These infants and toddlers should also be reported in Sections A.1 and B.1.

2. Report at-risk children according to their age on the count date. See instructions below for reporting race/ethnicity.

Race/Ethnicity Instructions (Sections A and C)

Children should be reported in ONLY one race/ethnicity category.

STATES MUST REPORT THE RACE/ETHNICITY OF THE CHILD, NOT THE FAMILY. FOR EACH OF THE RACE/ETHNICITY CATEGORIES, REPORT AN UNDUPLICATED COUNT OF ALL CHILDREN SERVED UNDER IDEA, PART C.

In October 1997, OMB issued standards for the collection and aggregration of data on race and ethinicity (see “Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity”).  In that announcement, OMB identified a minimum of five racial categories -- American Indian or Alaska Native, Asian, Black or African American, Native Hawaiian or Other Pacific Islander, and White -- and one ethnic category -- Hispanic or Latino.  Additionally, OMB announced that individuals should be allowed to select as many race/ethnicity categories as were applicable.  This data collection allows for the reporting of only one race or ethnicity category per individual and is therefore not in compliance with these standards. OSEPand the Department of Education (ED) are considering changes to the categories used for reporting aggregate data to bring this collection into compliance with OMB’s standards. For the time being, data should be reported using the five racial categories described below. 

The race/ethnicity categories are defined as follows:

American Indian or Alaska Native	A person having origins in any of the original peoples of North and South America (including Central America) and who maintains tribal affiliation or community attachment.
Asian or Other Pacific Islander	A person having origins in any of the original peoples of the Far East, Southeast Asia, the Indian subcontinent, or the Pacific Islands. This includes, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, Vietnam, Hawaii, Guam, and Samoa.
Black (not Hispanic)	A person having origins in any of the Black racial groups of Africa.
Hispanic	A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.
White (not Hispanic)	A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.
Total	The unduplicated total across the race/ethnicity designations.

Instructions for Section D: Cumulative Count

1. This section is OPTIONAL.

2. Report the cumulative number of infants and toddlers, ages birth through 2, who received early intervention services (as defined above) during the most recent 12-month period for which data are available. For example, if data on the total number of infants and toddlers served during the period from January 1, 2006, through December 31, 2006, are available, report this count and the corresponding dates in Section D.

3. Report the start and end dates of the 12-month period for which data are reported.

4. Do NOT include children ages 3 or older in this count.

Sampling Guidelines

States may use sampling to obtain data from State and local service agencies on the counts of infants and toddlers, ages birth through 2, served by discrete age and by race/ethnicity. States may NOT sample to obtain the count of the total infants and toddlers, ages birth through 2, receiving services. States may NOT sample to obtain any counts of children ages 3 or older. When sampling is used, a description of the sampling methodology outlining how the design will yield valid and reliable estimates must be submitted to OSEP for approval. The level of precision of the estimates to be obtained must be specified in this description. States must submit sampling plans to OSEP for approval by September 1 of the reporting year.

OSEP will evaluate the validity of the sampling plan using the following guidelines:

1. The sampling framework may include all programs or service units or a sample of those programs or units. If a State chooses to sample, programs or service units for the most populous areas in the State must be included.

2. States that serve at-risk infants and toddlers must sample data separately for eligible infants and toddlers and at-risk infants and toddlers.

States that use sampling will provide OSEP with weighted rather than unweighted data. A description of the final sample sizes and the weights used must be provided at the time the data are submitted.

U.S. DEPARTMENT OF EDUCATION	TABLE 1	PAGE 1 OF 4
OFFICE OF SPECIAL EDUCATION
AND REHABILITATIVE SERVICES	REPORT OF CHILDREN RECEIVING	OMB NO.: 1820-0557
OFFICE OF SPECIAL EDUCATION
PROGRAMS	EARLY INTERVENTION SERVICES IN ACCORDANCE WITH PART C	FORM EXPIRES: XX/XX/XXXX
		STATE:____________________________
	CHILD COUNT DATE FOR 2006

SECTION A

COUNT DATE:

MONTH

DAY

YEAR

A.1. AGE AND RACE/ETHNICITY OF INFANTS AND TODDLERS, AGES BIRTH THROUGH 2
	Total	birth to 1 (0 to <12 months)	1 to 2 (>12 and < 24 months)	2 to 3 (>24 and <36 months)	Percent*
TOTAL (ROWS 1-5)					100%
1. AMERICAN INDIAN OR ALASKA NATIVE
2. ASIAN OR OTHER PACIFIC ISLANDER
3. BLACK (NOT HISPANIC)
4. HISPANIC
5. WHITE (NOT HISPANIC)

A.2. AGE AND RACE/ETHNICITY OF CHILDREN, AGES 3 OR OLDER
	Total	3 to 4 (>36 and <48 months)	4 to 5 (>48 and <60 months)	5 or older (> 60 months)	Percent*
TOTAL (ROWS 1-5)					100%
1. AMERICAN INDIAN OR ALASKA NATIVE
2. ASIAN OR OTHER PACIFIC ISLANDER
3. BLACK (NOT HISPANIC)
4. HISPANIC
5. WHITE (NOT HISPANIC)

* STATES SHOULD NOT PROVIDE PERCENTAGES IN THIS SECTION. THESE WILL BE CALCULATED BY OSEP’S DATA TRANSMISSION SYSTEM.

U.S. DEPARTMENT OF EDUCATION	TABLE 1 (CONTINUED)	PAGE 2 OF 4
OFFICE OF SPECIAL EDUCATION
AND REHABILITATIVE SERVICES	REPORT OF CHILDREN RECEIVING	OMB NO.: 1820-0557
OFFICE OF SPECIAL EDUCATION
PROGRAMS	EARLY INTERVENTION SERVICES IN ACCORDANCE WITH PART C	FORM EXPIRES: XX/XX/XXXX
	CHILD COUNT DATE FOR 2006	STATE:____________________________

SECTION B

B.1. GENDER OF INFANTS AND TODDLERS, AGES BIRTH THROUGH 2, RECEIVING EARLY INTERVENTION SERVICES
	Total	Percent*
TOTAL BIRTH THROUGH 2		100%
1. MALE
2. FEMALE

B.2. GENDER OF CHILDREN, AGES 3 OR OLDER, RECEIVING EARLY INTERVENTION SERVICES
	Total	Percent*
TOTAL 3 OR OLDER		100%
1. MALE
2. FEMALE

* STATES SHOULD NOT PROVIDE PERCENTAGES IN THIS SECTION. THESE WILL BE CALCULATED BY

OSEP’S DATA TRANSMISSION SYSTEM.

U.S. DEPARTMENT OF EDUCATION	TABLE 1 (CONTINUED)	PAGE 3 OF 4
OFFICE OF SPECIAL EDUCATION
AND REHABILITATIVE SERVICES	REPORT OF CHILDREN RECEIVING	OMB NO.: 1820-0557
OFFICE OF SPECIAL EDUCATION
PROGRAMS	EARLY INTERVENTION SERVICES IN ACCORDANCE WITH PART C	FORM EXPIRES: XX/XX/XXXX
	CHILD COUNT DATE FOR 2006	STATE:____________________________

SECTION C

(TO BE COMPLETED ONLY BY STATES THAT SERVE AT-RISK INFANTS AND TODDLERS)

AT-RISK INFANTS AND TODDLERS, AGES BIRTH THROUGH 2 (THESE INFANTS AND TODDLERS SHOULD BE INCLUDED IN COUNTS FOR SECTIONS A.1 AND B.1)
		AGE AS OF CHILD COUNT DATE
	Total	birth to 1 (0 to <12 months)	1 to 2 (>12 and < 24 months)	2 to 3 (>24 and <36 months)
TOTAL (ROWS 1-5)
1. AMERICAN INDIAN OR ALASKA NATIVE
2. ASIAN OR OTHER PACIFIC ISLANDER
3. BLACK (NOT HISPANIC)
4. HISPANIC
5. WHITE (NOT HISPANIC)

U.S. DEPARTMENT OF EDUCATION	TABLE 1 (CONTINUED)	PAGE 4 OF 4
OFFICE OF SPECIAL EDUCATION
AND REHABILITATIVE SERVICES	REPORT OF CHILDREN RECEIVING	OMB NO.: 1820-0557
OFFICE OF SPECIAL EDUCATION
PROGRAMS	EARLY INTERVENTION SERVICES IN ACCORDANCE WITH PART C	FORM EXPIRES: XX/XX/XXXX
	CHILD COUNT DATE FOR 2006	STATE:____________________________

SECTION D

(OPTIONAL)

CUMULATIVE NUMBER OF INFANTS AND TODDLERS WHO RECEIVED EARLY INTERVENTION SERVICES FROM _____/_____/_____ TO _____/_____/_____ (SPECIFY EXACT DATES)
	AGE: Birth through 2 ONLY
NUMBER OF INFANTS AND TODDLERS