This packet must be completed by event coordinators working for Early Intervention units to be credited to participants. The Mississippi State Department of Health Infant and Toddler Early Intervention Program, First Steps, requires training for early intervention providers in the State of Mississippi.
This application is for person(s) who will be sponsoring or conducting training/workshops for early intervention providers. Currently there is no fee for the endorsement. Upon completion and acceptance of this application, you will receive an approval letter with the EIU sign-in sheets and a master copy certificate attached. The attendees will be eligible to receive required Early Intervention Units for participating in your training/workshop. EI Units will be necessary for endorsement through the Mississippi State Department of Health in order to contract or be an employee working in an official capacity with the First Steps Early Intervention Program.
Providers are required to obtain 30 EI Units every two years. Approved events and a record of accumulated EIU’s will be maintained by the Department of Health.
INSTRUCTIONS FOR COMPLETION OF TRAINER PACKET:
Appendix A: Application for Early Intervention Units
Complete Page 1. NOTE: CEUs are encouraged but not required. You will be responsible for CEU approval for your training. IF you have completed this, please provide a copy of the Approval Letters.
If you are not offering CEUs, please note under #10. No CEUs offered.
Page 2 provides a blank Early Intervention Continuing Education Timed Agenda form for you to complete and return with your application. (A sample is included)
Appendix B: Early Intervention Application Checklist
Competencies have been developed for Mississippi’s early intervention personnel. The competency statements delineate the core knowledge and skills (competencies) that are expectancies for all early intervention personnel who provide services for infants and toddlers with disabilities and their families.
The competencies are categorized into the following seven competency core areas:
Law and Policy
Services and Resources
Infant/Toddler Growth and Development
Family Systems and Theory
Professional Collaboration and Teaming
VII. Assessment and Evaluation
Please circle the ONE competency (Between I and VII listed above), which best describes your training/workshop and check appropriate statements under that competency (Appendix B). There is a space provided on the last page of Appendix B for your name, title and date, and submission date.
You may submit one application for a workshop offered on multiple dates. A new vita may be requested yearly if the workshop is repeated.
Appendix C: This checklist is for the agency or person completing this form. Do not return the checklist to the Health Department. Return completed A & B appendixes to:
First Steps Early Intervention
P.O. Box 1700, Jackson, MS 39215
If you have any questions call 1-800-451-3903.
FOR EARLY INTERVENTION UNITS Official CEUs for professional licensure for one or more disciplines requires a separate process and it is strongly recommended they be applied for in addition to this application. 1INSTRUCTIONS
All items must be completed for review of application.
Information must be typed or printed legibly.
Incomplete applications will be returned.
Application must be received 30 calendar days prior to date of program.
A copy of the proposed program to include goals, objectives and time frames (form is attached), vita and biographical information on presenters and the evaluation tool must accompany the application. Only goals and objectives that correspond with early intervention professional competencies will be considered for early intervention units.
Following completion of the training, a copy of the sign-in sheet and the evaluation summary must be submitted to the early intervention unit review committee within two weeks. (address given on page 1)
1. TITLE OF EVENT: 2. DATE(S): 3. LOCATION(S):
4. NUMBER OF HOURS OF TRAINING/WORKSHOP (1 direct instruction hour = 1 EI Unit): 5. NAME OF SPONSORING ORGANIZATION: 7. ADDRESS: CITY/STATE/ZIP CODE: 8. PHONE: FAX: 9. EMAIL: 10. PLEASE ATTACH CEU APPROVAL LETTER(S) FOR PROFESSIONAL
DISCIPLINE(S) (IF APPLICABLE).
Early Intervention Continuing Education Timed Agenda
Play Based Assessment Workshop
Date: Title of Workshop: Play Based Assessment Workshop
Early Intervention Competencies
8:30 - 9:45 am
Overview of play-based assessment methods - Sally Jones
Identify tools and methods appropriate for a transdisciplinary team to use in a play-based assessment
VII. 6. Assessment and Evaluation
10:00 - 11:45
Play-based assessment demonstration - Happy Times Assessment Team - Sally Jones, Jane Smith, Lucy Clay, Tom Fair
Observe and identify play facilitation strategies within TPBA
VII. 6 Assessment and Evaluation
1:00 - 3:00
Overview of Integrated Report Writing -
Jane Smith and Tom Fair
Identify the differences in interdisciplinary versus transdisciplinary report writing
VII. 6., 7., 8 Assessment and Evaluation
Early Intervention Continuing Education Agenda
Date: Title of Workshop:
Early Intervention Competencies
1EARLY INTERVENTION APPLICATION CHECKLIST EARLY INTERVENTION SERVICE PROVIDER COMPETENCIES FOR MISSISSIPPI’S COMPREHENSIVE SYSTEM OF PERSONNEL DEVELOPMENT Instructions: Circle (1)ONE competency (Between I and VII listed), which best describes your training/workshop. Below the circled competency, check appropriate statements which best target your objectives.
Law and Policy
1. Assisting families to understand relevant laws and their rights with regard to federal,
state, and program procedural safeguards (e.g., IDEA, ADA)
2. Using and applying procedural safeguards and family rights (e.g., getting
consent/informed consent, not violating rights, confidentiality, appropriate written
3. Complying with the professional ethics and standards in accordance with the Code of
Ethical Conduct for the profession
II. Services and Resources
1. Developing IFSP outcomes that support positive growth for child and family
2. Identifying resources and options for service delivery and transition
3. Synthesizing information, recommendations, and strategies from the family and multiple
disciplines in the design of intervention strategies
4. Designing intervention plans that incorporate the use of technology, including switches
and adaptive toys and feeding equipment
5. Identifying learning opportunities, designing intervention strategies, and
integrating instructional objectives within the context of the family’s self-defined routines
a. including siblings and extended family members in service delivery
b. using a variety of techniques to support infant and toddler learning (e.g.,
incidental teaching, prompting, elaborating, following the child’s leads, teaching
through play, and facilitating self-directed learning)
c. formulating strategies using a transdisciplinary approach to promote child growth
in multiple developmental domains (see appendix for specific competency levels
in various domains by discipline)
d. designing developmentally and individually appropriate environments
6. Applying data collection methods, such as evaluating the progress of IFSP and
modifying intervention strategies
7. Preparing and maintaining accurate and current child and family records that comply with
federal, state, and program standards
III. Infant/Toddler Growth and Development
1. Typical infant/toddler development to include benchmarks of development in order to
make appropriate referrals
2. Atypical development: common genetic and medical conditions and their impact
3. The effects of stress, trauma, neglect, and abuse on development
8. Writing reports that are clear, informative, sensitive and useful
_________________________________: Event title and date
_________________________________: Submission date
A copy of speaker’s resume/vita
Page 1, 2 - Appendix A – Completed
All 3 pages of Appendix B – Completed and
CEU approval letters (if appropriate)
Please make a copy of all forms for your records. You will not receive any forms back.
Thank you for submitting your application. If you do not receive confirmation within two weeks, please feel free to call