Page posted: 6/15/15
Page reviewed: 6/7/18
Page updated: 6/7/18
A person is eligible to receive Early Intensive Developmental and Behavioral Intervention (EIDBI) services if he or she meets all of the following criteria:
An MHCP-enrolled CMDE provider determines a person meets these eligibility criteria during the CMDE process.
Autism spectrum disorder (ASD)
Core symptoms of ASD include when the person has:
1. Persistent challenges in social communication and social interaction across multiple contexts, demonstrated by challenges in all of the following:
2. Restricted, repetitive patterns of behavior, interests or activities, demonstrated by at least two of the following:
A person’s symptoms can range in severity. Severity is based on social communication impairments and restricted, repetitive patterns of behavior.
Additional diagnostic criteria include the following:
For a full definition of ASD, see the current version of the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM).
A related condition is a condition that is closely related to ASD and:
1. Is severe and chronic
5. May also include delays or a high level of support in one or more of the following related domains:
A diagnosis of ASD or a related condition must:
The diagnosing provider must use the current version of the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) to diagnosis the person.
The diagnosing provider may choose not to use the current DSM criteria only if the person is younger than age 5 and has risk factors for ASD, such as:
In this case, the provider must use the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Childhood (DC: 0-3R or DC: 0-5R).
To determine a diagnosis, the provider may consider additional assessment information, including:
DHS encourages providers to use standardized assessment tools to diagnose ASD or related conditions and evaluate cognitive/intellectual, adaptive and sensory regulatory abilities. However, DHS does not require specific assessment tools.
A comprehensive multi-disciplinary evaluation (CMDE) is a covered EIDBI service delivered by a qualified provider(s) to determine if a person has a medical need for EIDBI services. For more information about the CMDE and medical necessity determination process, see: