Minnesota Minnesota

Early Intensive Development and Behavioral Intervention Manual

Early Intensive Development and Behavioral Intervention Manual

Glossary

A | B | C | D | E | F | G | H | I | L | M | O | P | Q | R | S | T

Note: The Minnesota Autism Resource Portal includes a variety of resources about terms included on this page.

A

Adaptive behavior treatment: See intervention.

Adaptive behavior treatment with protocol modification: See observation and direction.

Applied Behavior Analysis (ABA): A treatment modality with a set of data-driven practices grounded in behavioral science. This approach can be applied to people of all ages. ABA focuses on increasing positive and appropriate behaviors through reinforcement while decreasing interfering/unwanted behaviors or behaviors that interfere with learning. Under ABA, the provider systematically analyzes factors in the person’s environment that interfere with their success and teaches new and more appropriate ways of responding. For more information, see EIDBI – Treatment modalities – ABA.

Autism-Focused Intervention Resources and Modules (AFIRM): Resources designed to help explain a step-by-step process to plan for, use and monitor an evidence-based practice with people who have ASD, from birth to age 22.

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:

  • · Social-emotional reciprocity (e.g., person has atypical social approach; reduced sharing of interests, emotions or affect; lack of starting or responding to social interactions including, but not limited to, conversations and play)
  • · Nonverbal communicative behaviors (e.g., person has atypical body language or gestures, poor eye contact)
  • · Developing, maintaining and understanding relationships (e.g., person has difficulty making friends, having interest in peers, sharing, imaginative play)
  • 2. Restricted, repetitive patterns of behavior, interests or activities, demonstrated by at least two of the following:

  • · Stereotyped or repetitive motor movements, use of objects or speech (e.g., person lines up toys, has echolalia)
  • · Ritualized patterns or routines (e.g., person demonstrates interfering behaviors when asked to transition from a preferred activity, insists on eating the same way or taking the same route every day)
  • · Highly restricted or fixated interests
  • · Hyper- or hypo-reactivity to sensory input or atypical interest in sensory aspects of the environment (e.g., person has adverse reaction to specific sounds, textures, smells or fascination with lights or movement).
  • ASD Strategies in Action: An online, video-based learning series that covers the characteristics of ASD and evidence-based strategies to support people with ASD in homes, schools and community settings. For more information, see EIDBI – Individual provider trainings.

    Back to top

    B

    Behavior identification assessment: See comprehensive multi-disciplinary evaluation (CMDE).

    Back to top

    C

    Case notes: A documentation requirement. Each time an EIDBI provider delivers an EIDBI service to a person or their legal representative, the provider must create a case note to document the service delivery. For more information, see EIDBI – Health service records – Case notes.

    Center: A setting where a person receives EIDBI services that:

  • · Is not a private residence, clinic or hospital
  • · Follows basic best practice for business health and safety standards.
  • For more information, see EIDBI – Settings.

    Clinic: A setting where a person receives diagnostic, outpatient and/or EIDBI services that:

  • · Is not a private residence
  • · Follows basic best practice for business health and safety standards.
  • For more information, see EIDBI – Settings.

    Clinical supervision: The act of a qualified EIDBI provider supervising service delivery and accepting full professional responsibility to ensure all EIDBI services provided are medically necessary, clinically appropriate and individualized to the unique needs of each person and their family. For more information, see EIDBI – Clinical supervision.

    Comprehensive multi-disciplinary evaluation (CMDE) (also known as behavior identification assessment): An EIDBI service that covers the required comprehensive evaluation of the person. The CMDE is a behavior identification assessment. The information gathered in the CMDE is used to:

  • · Determine the person’s eligibility and medical need for EIDBI services
  • · Develop the person’s individual treatment plan (ITP), including treatment type and intensity.
  • For more information, see EIDBI – CMDE.

    Comprehensive multidisciplinary evaluation (CMDE) provider: See EIDBI – CMDE provider qualifications, roles and responsibilities.

    Coordinated care conference (also known as a medical team conference): An EIDBI service that covers a voluntary meeting between the person, their family, EIDBI provider(s), other service professionals and/or other individuals the person/family requests to:

  • · Review the comprehensive multi-disciplinary evaluation (CMDE) or individualized treatment plan (ITP)
  • · Integrate and coordinate services across providers and service-delivery systems to develop the ITP.
  • For more information, see EIDBI – Coordinated care conference.

    Cultural Responsiveness in ASD Services: An online training module that helps providers increase their understanding of culturally responsive practices when providing services to people with ASD or related conditions. For more information, see EIDBI – Individual provider trainings.

    Back to top

    D

    Department: The Minnesota Department of Human Services (DHS), unless otherwise specified.

    Developmental, Individual Difference, Relationship-Based (DIR)/Floortime Model: A treatment modality that provides a framework for a provider to conduct a comprehensive assessment of the person and develop a program tailored to their unique needs and strengths. This approach can be applied to people of all ages. DIR/Floortime creates opportunities for learning through spontaneous exchanges. These exchanges help the person build critical developmental abilities, including the ability to:

  • · Attend to environments and people in the environments
  • · Engage and relate to others
  • · Initiate and respond to communication
  • · Participate in shared, social problem-solving
  • · Think and play creatively and flexibly.
  • For more information, see EIDBI – Treatment modalities – DIR/Floortime.

    Back to top

    E

    Early Intensive Developmental and Behavioral Intervention (EIDBI) benefit: A Minnesota Health Care Program (MHCP) for people who:

  • · Are younger than age 21
  • · Are on Medical Assistance (MA), MinnesotaCare, Minnesota Tax Equity and Fiscal Responsibility Act (TEFRA) or other qualifying health plans
  • · Have autism spectrum disorder (ASD) or a related condition.
  • The purpose of the EIDBI benefit is to provide medically necessary, early and intensive intervention for people with ASD and related conditions. The benefit also is intended to:

  • · Educate, train and support parents and families
  • · Promote people’s independence and participation in family, school and community life
  • · Improve long-term outcomes and the quality of life for people and their families.
  • For more information, see EIDBI – Overview of the benefit.

    Early Social Interaction (ESI): A treatment modality with the following important elements:

  • · Routine-based intervention in natural environments, (e.g., home, preschool or child care setting)
  • · Individualized curriculum developed around the child’s unique needs and abilities
  • · Parent-implemented strategies in which providers train families to create learning opportunities and use specific intervention strategies to encourage practice of the child's goals during daily activities and routines.
  • Early Start Denver Model (ESDM): A treatment modality that integrates a relationship-focused, developmental model with Applied Behavior Analysis (ABA) teaching practices. The program typically serves children ages 12 to 48 months. The program:

  • · Focuses on the powerful pairing of interpersonal exchange and positive affect to promote shared engagement and teach social language and communication skills, play skills, cognitive and motor skills and personal independence
  • · Supports parents’ involvement
  • · Is designed to be implemented in natural settings
  • · Uses behavioral and developmental strategies and increases opportunities to promote typical development.
  • For more information, see EIDBI – Treatment modalities – ESDM.

    EIDBI 101: An online training that informs providers of the various requirements of providing EIDBI services. For more information, see EIDBI – Individual provider trainings.

    Back to top

    F

    Family adaptive behavior treatment guidance: See family/caregiver training and counseling.

    Family/caregiver training and counseling (also known as family adaptive behavior treatment guidance): An EIDBI service that covers specialized training, education and support for a person’s family/caregiver. For more information, see EIDBI – Family/caregiver training and counseling.

    Back to top

    G

    Generalizable goals: Results or gains observed during a variety of activities over time with different people (e.g., providers, family members, other adults) and in different environments including, but not limited to, clinics, homes, schools and the community.

    Group intervention session: A defined period of time when a qualified EIDBI provider delivers intervention to at least two, but no more than eight, people who receive EIDBI services. For more information, see EIDBI – Intervention.

    Back to top

    H

    Health service records: To receive payment for providing EIDBI services, the EIDBI provider agency and its staff must:

  • · Maintain a health service record for every person it serves
  • · Document in the record every EIDBI service delivered to the person and their family.
  • For more information, see EIDBI – Health service records.

    Home: The primary residence of a person who receives EIDBI services. For more information, see EIDBI – Settings.

    Back to top

    I

    Incident: Any of the following situations:

  • · Illness, accident, or injury that requires first aid treatment
  • · Bump or blow to the head
  • · Unusual or unexpected event that jeopardizes the safety of a person or staff, including a person leaving the agency unattended.
  • Individual EIDBI provider: A person who works for or is affiliated with an EIDBI provider agency and meets the qualifications to be an enrolled EIDBI service provider. Individual EIDBI providers include the following:

  • · Comprehensive multi-disciplinary evaluation (CMDE) provider
  • · Qualified supervising professional (QSP)
  • · Level I provider
  • · Level II provider
  • · Level III provider.
  • Individual intervention session: A defined period of time when a qualified EIDBI provider delivers intervention to one person. For more information, see EIDBI – Intervention.

    Individual treatment plan (ITP) development and progress monitoring: An EIDBI service that covers the development of the person’s initial ITP and ongoing monitoring of their progress. The ITP is a person-centered plan of care that:

  • · Is created from the information gathered in the person’s comprehensive multi-disciplinary evaluation (CMDE)
  • · Specifies the type and amount of medically necessary services the person will receive.
  • For more information, see EIDBI – ITP development and progress monitoring.

    Intervention (also known as adaptive treatment): An EIDBI service that covers the medically necessary, intensive and individually designed direct treatment. The treatment is designed specifically to address the person’s core developmental skill deficits identified in their comprehensive multi-disciplinary evaluation (CMDE) and goals/objectives specified in their individual treatment plan (ITP). For more information, see EIDBI – Intervention.

    Back to top

    L

    Legal representative: The parent of a child younger than age 18, a court-appointed guardian or other representative with legal authority to make decisions about services for a person.

    Level I provider: See EIDBI – Level I provider qualifications, roles and responsibilities.

    Level II provider: See EIDBI – Level II provider qualifications, roles and responsibilities.

    Level III provider: See EIDBI – Level III provider qualifications, roles and responsibilities.

    Back to top

    M

    Managed care organization (MCO): An organization certified by the Minnesota Department of Health to provide all defined health care benefits to people enrolled in a Minnesota Health Care Program (MHCP) in return for a capitated payment. MCOs also are referred to as health plans or prepaid health plans (PPHP).

    Medical necessity determination: A decision made by a qualified professional about whether a person with autism spectrum disorder (ASD) or a related condition has a medical need for and, therefore, is eligible to receive EIDBI services. For more information, see EIDBI – Medical necessity criteria.

    Medical team conference: See coordinated care conference.

    Mental health professional: A person who meets criteria in Minn. Stat. § 245.4871, subd. 27, 1-6.

    Minnesota Health Care Programs (MHCP): Any of the following programs:

  • · Medical Assistance (MA)
  • · MinnesotaCare
  • · Minnesota Family Planning Program
  • · Home and community-based waiver programs
  • · Medicare Savings Programs.
  • These programs might help pay for all or part of a person’s health care costs if they:

  • · Do not have insurance
  • · Cannot get affordable health insurance through a job
  • · Have a disability or chronic condition and need help paying for care and services to stay in their home
  • · Need help paying for care in a nursing home, hospital or other medical facility
  • · Have other insurance or Medicare but needs help paying the premiums, deductibles and copays or need services not covered.
  • Back to top

    O

    Observation and direction: An EIDBI service that covers the clinical direction and oversight given by a qualified EIDBI provider to a lower-level EIDBI provider who is delivering individual intervention services. For more information, see EIDBI – Observation and direction.

    Office: A setting where administrative tasks are performed and/or a person receives diagnostic services. An office:

  • · Is not a private residence, clinic or hospital
  • · Follows basic best practice for business health and safety standards.
  • For more information, see EIDBI – Settings.

    Back to top

    P

    Play and Language for Autistic Youngsters (PLAY) Project: A treatment modality that is an evidence-based, parent-implemented, early intervention program. PLAY Project-trained PLAY consultants coach parents in the natural environment and provide feedback about how to support their child’s language, social interaction and overall development. The parent is taught to be the primary provider of the intervention. For more information, see EIDBI – Treatment modalities – PLAY Project.

    Person: A person age 21 or younger (specific to references in this manual only).

    Person-centered services: Services that:

  • · Respond to the identified needs, interests, values, preferences and desired outcomes of the person or their legal representative
  • · Respect the person’s history, dignity and cultural background
  • · Allow for inclusion and participation in the person’s community.
  • Positive Supports Rule: A rule governing positive support strategies and restrictive interventions. The purpose of the rule is to improve the quality of life for people, including children. It requires service providers to use person-centered principles and positive support strategies for people to whom the rule applies.

    Prepaid Medical Assistance Program (PMAP): A mandatory managed care program for Medicaid-eligible adults, families and children in Minnesota.

    Progress monitoring: A required ITP update the qualified supervising professional (QSP) must submit after each six months of treatment, or more frequently as determined by the comprehensive multidisciplinary evaluation (CMDE) provider or QSP. This is to determine if the person is making progress toward targeted functional and generalizable goals specified in the ITP. For more information, see EIDBI – ITP development and progress monitoring.

    Provider agency: The legal entity enrolled with Minnesota Health Care Programs (MHCP) as a Medical Assistance (MA) provider to provide EIDBI services. The agency has the legal responsibility to ensure its employees or contractors carry out the responsibilities defined in the EIDBI Policy Manual. “Agency” includes a licensed, individual professional.

    Back to top

    Q

    Qualified supervising professional (QSP): See EIDBI – QSP qualifications, roles and responsibilities.

    Back to top

    R

    Related condition: A condition that is closely related to autism spectrum disorder (ASD) and:
    1. Is severe and chronic
    2. Results in impairment of a person’s adaptive behavior and function similar to that of a person with ASD
    3. Requires treatment or services similar to those required for a person with ASD
    4. Results in challenges in the following symptom areas (similar to the symptoms of ASD):

  • · Social interaction and communication
  • · Restrictive, repetitive behaviors or hyper- or hypo-reactivity to sensory input.
  • Relationship Development Intervention (RDI): A treatment modality that is a family-based, behavioral treatment that builds on the theory that “dynamic intelligence” is key to improving quality of life for people with ASD and related conditions. This approach can be applied to people of all ages. Dynamic intelligence is the ability to think flexibly and includes:

  • · Appreciating different perspectives
  • · Coping with change
  • · Integrating information from multiple sources (e.g., sights and sounds).
  • For more information, see EIDBI – Treatment modalities – RDI.

    Back to top

    S

    Service authorization (SA): A requirement for some EIDBI services that safeguards against inappropriate and unnecessary use of health care services under state and federal law. The SA allows qualified providers to bill and receive payment from Minnesota Health Care Programs (MHCP) after providing EIDBI services. However, having an approved SA does not guarantee MHCP payment. The provider must meet all other MHCP requirements to receive payment. For more information, see MHCP Provider Manual – EIDBI service authorization.

    Session: A period of time in which a qualified provider delivers an EIDBI service to a person. Each provider agency may further define a session, but all EIDBI intervention sessions must:

  • · Have a predetermined start and end time
  • · Only include covered EIDBI services
  • · Follow the person’s ITP
  • · Meet DHS billing requirements.
  • For more information, see EIDBI – Intervention.

    Setting: The location in which a person receives EIDBI services. A person may receive EIDBI services in:

  • · Center
  • · Clinic
  • · Community environment (billed from the originating location, e.g., home or center)
  • · Their home
  • · Office.
  • For more information, see EIDBI – Settings.

    Supervisee: An individual EIDBI provider who is receiving documented clinical supervision while delivering EIDBI services. They may be working toward licensure or certification. For more information, see EIDBI – Clinical supervision.

    Back to top

    T

    Tax Equity and Fiscal Responsibility Act (TEFRA): An option that allows Medical Assistance eligibility for children with disabilities in families with incomes too high to qualify for Medical Assistance.

    Telehealth: The delivery of health care services or consultations while the patient is at an originating site and the health care provider is at a distant site. For more information, see EIDBI – Telehealth services.

    Travel time: An EIDBI service that covers the time it takes for a qualified EIDBI provider to travel to and from a location other than their typical place of service to provide EIDBI services. For more information, see EIDBI – Travel time.

    Treatment modalities: A person may receive treatment intervention according to one of the DHS-recognized treatment modalities. DHS recognizes the following treatment modalities:

  • · Applied Behavior Analysis (ABA)
  • · Developmental, Individual Difference, Relationship-based (DIR)/Floortime model
  • · Early Start Denver Model (ESDM)
  • · PLAY Project
  • · Relationship Development Intervention (RDI)
  • · Other specific modality certifications; for more information, see EIDBI – Treatment modalities.
  • Back to top

    Report this page