### 1 of 5 TABLE 2 REPORT OF PROGRAM SETTINGS WHERE EARLY INTERVENTION

SERVICES ARE PROVIDED TO CHILDREN WITH DISABILITIES AND THEIR FAMILIES IN ACCORDANCE WITH PART C Child Count Date for **2014** Paperwork Burden Statement According to the Paperwork Reductio n Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. Public reporting burden for this collection of information is estimated to average 23.9 hours per State response, i ncluding time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. The obligation to respond to this collection is required to obtain or retain a benefit (P.L. 108.446 Section 618). Send comments regarding the burden estimate or any

other aspect of this collection of information, including suggestions for reducing this burden, to the U.S. Department of Education, 400 Maryland Ave., SW, Washington, DC 20202
- 4536 or email ICDocketMgr@ed.gov and reference the OMB Control Number 1820

- 0557. Note: Please do not return the completed Report of Program Settings Where Early Intervention Services are Provided to Childr en with Disabilities and their Families in Accordance with Part C form to this address. **All States must submit these data via the IDEA Part C Child Count and Setting survey**  **in the EDFacts online survey tool, EMAPS.**  Instructions Authorization: 20 U.S.C
. 14 18 (a)(3) Due Date: **April 1, 2015**  Sampling Allowed: No
General Instructions 1. Report the primary early intervention service setting for all children reported on Table 1, Report of Children Receiving Early Intervention Services in Accordance with Par t C for **2014** . These are the children receiving early intervention services according to an active individualized family

service plan (IFSP) in place on the date of the Child Count. 2. States must use the same date for reporting settings data that is used in reporting the Child Count for that year. Note further that the total count and crosstabulations under this table by age and race must match those provided in the Child Count (Table 1). 3. Your count should include infants and toddlers with disabilities (as defined in 20 U.S.C. 1432(5)(A) and (B)(i)) who are under age three , and also children with disab ilities age three and older , if your state has elected under 20 U.S.C. 1432(5)(B)(ii) and 1435(c) to

### 2 of 5 provide parents the choice of, and the child’s parent has consented to their child, continuing to receive Part C services (in lieu of FAPE) under 20 U.S.C. 1435(c)
. 4. Do NOT include children age three or older (for example, who are receiving FAPE using Part C funds under 20 U.S.C. 1438(3) ) unless your state has elected under 20 U.S.C. 1432(5)(B)(ii) and 1435(c) to provide parents the choice of, and the child’s parent has consented to their child, continuing to receive Part C services under 20 U.S.C. 1435(c)
. 5. All totals must represent the sum of the success ive rows or columns. 6. In providing data for this collection, the State is to submit complete and unsuppressed data. Specific Row (Setting) Instructions For each early

intervention service setting, report the number of children whose IFSP indicates this i s the primary

early intervention setting. This is an unduplicated count; within each section, each child is counted once and only

once. Report children and families in one of the following setting categories: Home. Unduplicated count of children whos e early intervention services are provided primarily in the residence of the child’s family or caregivers. Community

-based Setting. Unduplicated count of children whose early intervention services are provided primarily

in a setting where children witho ut disabilities ty pically are found. These settings include but are not limited to child care centers (including family day care), preschools, regular nursery

schools, early

childhood center, libraries, grocery stores, parks, restaurants, and community

centers (e.g., YMCA, Boy s and Girls Clubs). Other Setting. Unduplicated count of children whose early intervention services are provided primarily in a setting that is not home or community

-based . These settings include, but are not limited to, services pro vided in a hospital, residential facility , clinic, and EI center/class for children with disabilities. Primary setting is the service setting in which the child receives the largest number of hours of Part C early intervention service s . Determination of primary setting should be based on the information included on the IFSP in place on the Child Count date.

 If, according to the IFSP, the only early intervention s ervices that are provided are service coordination services or services provided to a fami ly member, such as counseling , family training, and home visits , report for this child the setting where most of these services are provided. If this information is not specified in the IFSP, report the child in the other setting category
.

 If, accord ing to the IFSP, all of the early intervention services for a child were delivered in the same setting then that setting is the primary setting. For example, if the IFSP states that the child receive s 1 hour of phy sical therapy services in his or her home each week, and that is the only early intervention service the child receives (in addition to service coordination services) according

### 3 of 5

to the IFSP in place on the Child Count date, then the home is the primary setting for that child
.

 If, according to the IFSP **,** a child was to receive services in more than one setting, report the child in the setting in which he or she was to receive the largest number of hours of early intervention service. For example, a toddler who receives 1 hour of service a month in the home and 4 hours of service a month in a preschool that serves children without disabilities in addition to children with disabilities , should be reported in the category “ community

-based setting.”

 If, according to the IFSP, there is tie for primary setting (the child was to receive an equal number of hours of service in two or more settings and the child does not receive a higher number of hours of early intervention service in a different setting), report primary setting based on the following deci sion rules: 1. If the child receives an equal number of hours of service in the home and one or both of the other settings, report the child in the home setting. 2. If the child receives an equal number of hours of service in a community

-based setting and othe r settings, report the child in the community

-based setting. Specific Column (Age) Instructions for Section A 1. Report the (unduplicated) number of children with an active IFSP in place on the Child Count date, according to the child’s age and primary setting. This count should include: a. In Section A.1, all infants and toddlers, ages birth through 2; and b. In Section A.2, any

children, ages 3 or older, with disabilities continuing in early intervention services under 20 U.S.C. 1432(5)(B)(ii) and 1435(c ) . I f your state does not offer parents the choice of continuing Part C services under 20 U.S.C. 1432(5)(B)(ii) and 1435(c) , leave this section blank. 2. Report children according to their age on the date of the Child Count. 3. For each column, the total number of infants and toddlers reported for that age in Section A.1 should equal the number of infants and toddlers reported for that age in Section A.1 of Table 1, Report of Children Receiving Early Intervention Services in Accordance with Part C. 4. For each co lumn, the total number of children reported for that age column in Section A.2 should equal the number of children reported for that age in Section A.2 of Table 1, Report of Children Receiving Early

Intervention Services in Accordance with Part C. Specifi c Column (Race/Ethnicity ) Instructions for Section B 1. Report the (unduplicated) number of children with an active IFSP in place on the Child Count date, according to the child’s race/ethnicity and primary

setting. This count should include: a. In Section B.1, all infants and toddlers, ages birth through 2; and b. In Section B.2, any

children, ages 3 or older, with disabilities continuing in early intervention services under 20 U.S.C. 1432(5)(B)(ii) and 1435(c)
. If your state does

### 4 of 5 not offer parents the choic e of continuing Part C services under 20 U.S.C. 1432(5)(B)(ii) and 1435(c) , leave this section blank. 2. For each row (setting), the total number of children reported for that setting in Section B.1 should equal the total number of children reported for that setting in Section A.1. 3. For each row (setting), the total number of children reported for that setting in Section B.2 should equal the total number of children reported for that setting in Section A.2. 4. For each column (race/ethnicity ), the total number of infants and toddlers reported for that race/ethnicity

category in Section B.1 should equal the number of infants and toddlers reported for that race/ethnicity

category in Section A.1 of Table 1, Report of Children Receiving Early Intervention Services in Accordance with Part C. 5. For each column (race/ethnicity ), the total number of children reported for that race/ethnicity category in Section B.2 should equal the number of children reported for that race/ethnicity category in Section A.2 of Table 1, Rep ort of Children Receiving Early Intervention Services in Accordance with Part C. 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 2007, the Department of Education published its Final Guidance on Maintaining, Collecting and Reporting Racial and Ethnic Data to the U.S. Department of Education in the Federal Register (Vol. 72, No. 202, available at http://www.gpoaccess.gov/nara/index.html ), referred to in these instructions as the new guidance . The procedures for collecting, aggregating, and reporting race and ethnicity , as described in the new guidance , mu st be implemented for the report of the **2014** Settings data. States should report all children with disabilities according to the seven categories listed below. The following definitions of the seven categories for aggregate report of race/ethnicity hav e been adapted from definitions appearing in the new guidance
.

### 5 of 5

Hispanic/Latino A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race. Refers to Hispanic and/or Latino. 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. ( Does not include persons of Hispanic/Latino ethnicity .) Asian A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent. This includes, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam. ( Does not include persons of Hispanic/Latino ethnicity .) Black or African American A person having origins in any of the Black racial groups of Africa. ( Does not include persons of Hispanic/Latino ethnicity .) Native Hawaiian or Other Pacific Islander A perso n having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands. ( Does not include persons of Hispanic/Latino ethnicity .) White A person having origins in any of the original peoples of Europe, the Middle East, or North A frica. ( Does not include persons of Hispanic/Latino ethnicity .) Two or more races A person having origins in two or more of the five race categories listed immediately

above. ( Does not include persons of Hispanic/Latino ethnicity .) Total The unduplicated total across the seven (7) race/ethnicity designations. Note that each child should be reported in only one of the race/ethnicity categories, above.U.S. DEPARTMENT OF EDUCATION TABLE 2 PAGE 1 OF 2 OFFICE OF SPECIAL EDUCATION AND REHABILI TATIVE SERVICES REPORT OF PROGRAM SETTING W HERE EARLY INTERVENTION SERVICES OMB NO.: 1820
- 0557 OFFICE OF SPECIAL EDUCATION ARE PROVIDED TO CHILDREN W ITH DISABILITIES PROGRAMS AND THEIR FAMILIES IN ACCORDANCE W ITH PART C FORM EXPIRES: xx /xx /xxxx C HILD COUNT DATE FOR **2014** STATE:____________________________

SECTION A

A.1. AGE GROUP AND SETTING OF INFANTS AND TODDLERS, AGES BIRTH THROUGH 2

Total birth to 1 1 to 2 2 to 3 TOTAL (ROW S 1
- 3) 1. HOME 2. COMMUNITY
- BASED SETT ING 3. OTHER SETTING

A.2. AGE GROUP AND SETTING OF CHILDREN, AGES 3 OR OLDER
Total 3 to 4 4 to 5 5 to 6 TOTAL (ROW S 1
- 3) 1. HOME 2. COMMUNITY
- BASED SETTING 3. OTHER SETTINGU.S. DEPARTMENT OF EDUCATIO N TABLE 2 (CONTINUED) PAGE 2 OF 2 OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES REPORT OF PROGRAM SETTING W HERE EARLY INTERVENTION SERVICES OMB NO.: 1820
- 0557 OFFICE OF SPECIAL EDUCATION ARE PROVIDED TO CHILDREN W ITH DISABILITIES PROGRAMS AND THEIR FAMILIES IN ACCORDANCE W ITH PART C FORM EXPIRES: xx /xx /xxxx CHILD COUNT DATE FOR **2014** STATE:____________________________

SECTION B
B.1. RACE/ETHNICITY AND SETTING OF INFANTS AND TODDLERS, AGES BIRTH THROUGH 2

PROGRAM SETTING TO TAL HISPANIC/ LATINO AMERICAN

INDIAN OR ALASKA NATIVE ASIAN BLACK OR AFRICAN AMERICAN NATIVE

HAW AIIAN OR OTHER PACIFIC ISLANDER WH ITE TW O OR MORE RACES
TOTAL (ROW S 1
- 3) 1. HOME 2. COMMUNITY
- BASED SETTING 3. OTHER SETTING

B.2. RACE/ETHNICITY AND SETTING OF CHILDREN , AGES 3 AND OLDER

PROGRAM SETTING TOTAL HISPANIC/ LATINO AMERICAN

INDIAN OR ALASKA NATIVE ASIAN BLACK OR AFRICAN AMERICAN NATIVE

HAW AIIAN OR OTHER PACIFIC ISLANDER WH ITE TW O OR MORE RACES
TOTAL (ROW S 1
- 3) 1. HOME 2. COMMUNITY
- BASED SETTING 3. OTHER SETTING