Early Start Program (ESP)

A Pathway for Healthcare Professionals to Access Regional Center and/or Local Education Agency (LEA)

1. Any child less than 3 years old

2. Perform Developmental Surveillance And Developmental Screening

3. Developmental Surveillance and Screening Results?

Developmental Surveillance:

• History (Hx) including milestones and functioning
• Family History (FH)
• Social History (SH)
• Physical and neurological exam (PE)

Developmental Screening Test:

• Such as ASQ, PEDS, Denver II, BINS; at least at ages 9,18, 24 and 30 months

Child has no conditions, risk factors, and passes screen

• Monitor closely AND follow AAP screening recommendations

Child has CP, neuromuscular condition, or chronic musculoskeletal disease or deformity

• Consider interdisciplinary developmental evaluation
• Refer to ESP AND CCS MTP (Algorithm link below)
• Link to CCS MTP algorithm – http://dbpeds.stanford.edu/resources.html

Child only has a “solely low incidence condition”

“Solely low Incidence Conditions”:

• Hearing impairment
• Vision impairment
• Severe orthopedic impairment

Refer to County Office of Education for ESP

Child has 2 biomedical risk factors

Biomedical High Risk:

• < GA 32 weeks OR 1500 grams -Ventilation >= 48 h
• SGA
• Asphyxia neonatorum
• Persistent metabolic abnormality
• Neonatal or nonfebrile seizures
• CNS lesion/infection
• Multiple anomalies
• Prenatal exposure to teratogens or drugs
• FTT
• Hypo- or hypertonia
• Biomedical insults which may seriously affect developmental outcome

Refer to local Regional Center for ESP

Child has at least 1 condition known to compromise development

Examples of established risk conditions known to compromise development:

• Disorder secondary to exposure to toxic substances, including fetal alcohol syndrome
• Genetic or congenital disorder
• Inborn errors of metabolism
• Infection or disease of the central nervous system
• Neurological trauma

Refer to local Regional Center for ESP

≥ 33% delay in 1 or more domains

Domains:

• cognitive
• communication
• social or emotional
• adaptive
• physical development

Refer to local Regional Center for ESP AND health insurance plan for therapy (PT, OT, ST)

Child fails developmental screening test

Consider interdisciplinary developmental evaluation and/or refer to Regional Center for ESP

Contact GGRC at:

• Intake: (888) 339-3305
• Intake Fax: (888) 339-3306
• Email: intake@ggrc.org
• San Francisco (Main Phone #): (415) 546-9222
• San Mateo: (650) 574-9232
• Marin: (415) 446-3000
• Website Link to Referrals: http://www.ggrc.org/services/applying-for-services

(Intake processing may take 1 to 4 weeks)