First Steps Eligibility

As outlined in the Missouri State Plan for Part C – First Steps (34 CFR 303.21), children who are eligible for early intervention services are children between the ages of birth and 36 months who have been determined to have a diagnosed physical or mental condition associated with developmental disabilities, or a high probability of resulting in a developmental delay or disability, or children who have a developmental delay. (Printable Copy)

State Definition of Diagnosed Conditions
  1. Newborn Condition, for a child referred prior to 36 months of age with a birth weight of 1,500 grams (3.31 pounds or 3 pounds 4.9 ounces) or less with one or more of the following conditions diagnosed at birth or within 30 days post birth:
    • APGAR of 6 or less at 5 minutes
    • Intraventricular hemorrhage (IVH) (Grade II, III, or IV)
    • Any Positive Pressure Ventilation greater than 48 hours, including continuous positive airway pressure (CPAP), ventilator, or oscillator
    • Resuscitation/code-event requiring chest compressions
  2. Diagnosed Conditions, for a child referred prior to 36 months of age include, but are not limited to, the following:
    • Autism Spectrum Disorders Autism, Pervasive Development Disorder-Not Otherwise Specified
    • Chromosomal Trisomy Down syndrome, Edwards Syndrome, Patau Syndrome
    • Craniofacial Anomalies Cleft lip, Cleft Palate, Cleft Lip/Palate
    • Disorders of the Nervous System Erb’s Palsy, Beckwith-Wiedemann Syndrome, Cerebral Palsy, Encephalopathy (all types), Epilepsy, Hydrocephalus, Infantile Spasms, Macro/Microcephalus, Periventricular Leukomalacia, Seizure Disorder, Shaken Baby Syndrome, Spina Bifida, Stroke, Traumatic Brain Injury
    • Disorders Related to Exposure to Toxic Substances Fetal Alcohol Syndrome, Lead Poisoning Level >10mcg/dL
    • Infections/Viruses/Bacteria Acquired Immune Deficiency Syndrome, Cytomegalovirus, Herpes, Rubella, Syphilis, Toxoplasmosis
    • Other Chromosomal Abnormalities Angelman Syndrome, Cri-du-Chat Syndrome, DiGeorge Syndrome, Fragile X Syndrome, Klinefelter’s Syndrome, Triple X Syndrome, Williams Syndrome
    • Other Genetic/Congenital/Metabolic Conditions Cyanotic Congenital Heart Disease, Hypoplastic Left Heart Syndrome, Leukodystrophy, Muscular Dystrophy – Duchenne Type, Noonan Syndrome, Phenylketonuria (PKU), Pierre Robin, Pompe Disease, Prader Willi, Rett Syndrome, Tetralogy of Fallot
    • Sensory Impairments Blind, Deaf, Hard of Hearing, Visually Impaired
    • Severe Attachment Disorders
  3. Other Diagnosed Conditions, for a child referred prior to 36 months of age, include conditions known to be associated with a high probability of developmental delay or developmental disabilities. In order for other diagnosed conditions to be considered for eligibility, there must be an informed clinical opinion provided by Board certificated neonatologists, pediatricians, geneticists, pediatric neurologists, licensed assistant physicians, advance practice registered nurses, and/or other pediatric specialists. These physicians may refer a child by indicating the specific condition and documenting the potential impact of the condition in any of the five developmental areas.
State Definition of Developmental Delay (34 CFR 303.111)

A developmental delay, as measured by appropriate diagnostic measures and procedures emphasizing the use of informed clinical opinion, is defined as a child who is functioning at half the developmental level that would be expected for a child developing within normal limits and of equal age. In the case of infants born prematurely, the adjusted chronological age, which is calculated by deducting one-half of the prematurity from the child’s chronological age, should be assigned for a period of up to 12 months or longer if recommended by the child’s physician. The delay must be identified in one or more of the following areas:

  • cognitive development
  • communication development
  • adaptive development
  • physical development, including vision and hearing
  • social or emotional development
Services to At-Risk Children

It is the policy of the State of Missouri to not include children considered to be “at-risk” of having substantial developmental delays for eligibility in the Part C program.

Residency Requirements

A child must be a resident of the State of Missouri to receive Part C services from the Part C program. This means:

  • a child living with a parent as defined in Part C of IDEA in the State of Missouri is considered a resident, and
  • a child living in Missouri solely for the purpose of receiving Part C services is not considered a resident.

Citizenship or immigrant status is not a requirement of residency and cannot be used to deny Part C services to an eligible child and family.