Background:Early intervention (EI) services are designed to promote the development of skills and enhance the quality of life of infants and toddlers who have been identified as having a disability or developmental delay, enhance capacity of families to care for their child with special needs, reduce future educational costs, and promote independent living (NECTAC, 2011). EI services are regulated by Part C of the Individuals with Disabilities Education Improvement Act (IDEA); however, personnel shortages, particularly in rural areas, limit access for children who qualify. Telehealth is an emerging delivery model demonstrating potential to deliver EI services effectively and efficiently, thereby improving access and ameliorating the impact of provider shortages in underserved areas. The use of a telehealth delivery model facilitates inter-disciplinary collaboration, coordinated care, and consultation with specialists not available within a local community.Method:A survey sent by the National Early Childhood Technical Assistance Center (NECTAC) to IDEA Part C coordinators assessed their utilization of telehealth within states’ IDEA Part C programs. Reimbursement for provider type and services and barriers to implement a telehealth service delivery model were identified.Results:Representatives from 26 states and one jurisdiction responded to the NECTAC telehealth survey. Of these, 30% (n=9) indicated that they are either currently using telehealth as an adjunct service delivery model (n=6) or plan to incorporate telehealth within the next 1–2 years (n=3). Identified telehealth providers included developmental specialists, teachers of the Deaf/Hard of Hearing (DHH), speech-language pathologists, occupational therapists, physical therapists, behavior specialists, audiologists, and interpreters. Reimbursement was variable and included use of IDEA Part C funding, Medicaid, and private insurance. Expressed barriers and concerns for the implementation of telehealth as a delivery model within Part C programming included security issues (40%; n=11); privacy issues (44%; n=12); concerns about quality of services delivered via telehealth (40%; n=11); and lack of evidence to support the effectiveness of a telehealth service delivery model within IDEA Part C programming (3%; n=1). Reimbursement policy and billing processes and technology infrastructure were also identified as barriers impacting the implementation of telehealth programming.Conclusions:Provider shortages impact the quantity and quality of services available for children with disabilities and developmental delay, particularly in rural areas. While many states are incorporating telehealth within their Early Intervention (IDEA Part C) services in order to improve access and overcome personnel shortages, barriers persist. Policy development, education of stakeholders, research, utilization of secure and private delivery platforms, and advocacy may facilitate more widespread adoption of telehealth within IDEA Part C programs across the country.

The use of telehealth has been discussed nationally as an option to address provider shortages for children, birth through two, enrolled in Part C of the Individuals with Disabilities Education Act (IDEA) Early Intervention (EI) programs. Telehealth is an evidence-based service delivery model which can be used to remove barriers in providing EI services to children and their families. In 2016, Colorado’s Part C Early Intervention (EI) program began allowing the use of telehealth as an option for providers to conduct sessions with children and their caregivers. This article outlines the process taken to develop the necessary requirements and supports for telehealth to be incorporated into EI current practice.

Since the 2004 reauthorization of the Individuals With Disabilities Education Act (IDEA), there has been a growing focus on improving the quality of programs for children with disabilities and measuring the results/outcomes of those programs. Across the country, IDEA Part C Programs for Infants and Toddlers and IDEA Part B, Section 619 Preschool Programs have been developing, implementing, and improving their accountability systems, and in spite of significant fiscal limitations, the states have produced meaningful data demonstrating both program improvement and positive outcomes for the children and families being served. This article uses trend data reported by the states over the past 4 years to provide a national picture of the progress they have made, the challenges they have faced, and the improvement strategies they have undertaken. The lessons they have learned are relevant to the broader early childhood community. A discussion about implications for the future is included.

Objectives-All US states and territories have an Early Hearing Detection and Intervention (EHDI) program to facilitate early hearing evaluation and intervention for infants who are deaf or hard of hearing. To ensure efficient coordination of care, the state EHDI programs rely heavily on audiologists' prompt reporting of a newborn's hearing status. Several states have regulations requiring mandatory reporting of a newborn's hearing status. This is an important public health responsibility of pediatric audiologists. Reasons for failing to report vary. Design-TheEarly Hearing Detection and Intervention-Pediatric Audiology Links to Services (EHDI) facility survey was used to inform reporting compliance of audiology facilities throughout the United States. The survey was disseminated via articles, newsletters, and call-to-action notices to audiologists.Results-Among 1024 facilities surveyed, 88 (8.6%) reported that they did not report newborn's hearing findings to their state EHDI program. Not knowing how to report to the state EHDI program was the most frequently chosen reason (60%). However, among the 936 facilities that were compliant with the reporting requirements, 51 estimated that they reported less than twothird of all hearing evaluation results (5.4%). Some facilities did not report a normal-hearing result and some failed to report because they assumed another facility would report the hearing results.Conclusions-Survey results indicated that audiologists were compliant reporting hearing results to the state EHDI programs. However, there is room for improvement. Regular provider

The National Early Childhood Technical Assistance Center was charged by the U.S. Department of Education's Office of Special Education Programs from October 2001 through September 2006 to develop, implement, and evaluate an approach to technical assistance (TA) that would result in sustainable systems change in state early intervention and preschool special education programs served under the early childhood provisions of Individuals with Disabilities Education Act. Both process and summative evaluations were conducted over the 5-year contract period. The TA Model for Long-Term Systems Change was found to result in improvements in state and local infrastructures, personnel development systems, practices, and outcomes for children and families. The resulting model is a legacy that Pat Trohanis leaves to the field of technical assistance.