Early Intervention Medical Conditions Resulting in a High Probability of Developmental Delay & Related Eligible Conditions for Division of Specialized Care for Children - 04/2022

MEDICAL DIAGNOSES

(Not an exclusive list)

NOTE: this is not an exclusive List

Eligible EI Diagnoses

Children with medical conditions which are not listed may be determined eligible for EI services by a qualified family physician, pediatrician or pediatric subspecialist (pediatric neurologist, geneticist, pediatric orthopedic surgeon, pediatrician with special interest in disabilities, Licensed Clinical Social Worker , Licensed Clinical Professional Counselor, PsyD, PhD with expertise in diagnostics) who provides written verification that the child's medical condition is associated with a high probability of developmental delay as listed in eligibility criteria.

The following is not an exclusive or exhaustive list. When determining eligibility, consider the multiple factors that may impact a child's development, such as Global Developmental Delay (GDD) and Failure to Thrive.

GDD may occur alone, but more often, in combination with other disorders. It is diagnosed when infants/young children have significantly below average functioning across developmental domains, including verbal and nonverbal reasoning, problem solving, language development, social development, fine and gross motor skills, and adaptive behaviors. GDD is diagnosed instead of intellectual disability in infancy and early childhood to reflect greater plasticity of early development and the possibility of cognitive and adaptive growth.

Eligible DSCC Diagnoses

The DSCC Eligible criteria is listed as "Potentially" when a diagnosis does meet the criteria but there are other indicators within DSCC that must also be met. The family/child should be referred to DSCC for additional eligibility discussions.

One of the criteria for DSCC medical eligibility is the diagnosis must fall into one of the following categories:

• blood disorders
• orthopedic impairment
• nervous system impairment
• cardiovascular impairment
• craniofacial or external body anomalies
• hearing impairment
• eye impairment
• inborn errors of metabolism leading to severe neurological mental and/or physical deterioration
• urogenital impairments
• pulmonary impairments
• gastrointestinal impairments

ANOMALIES OF CENTRAL NERVOUS SYSTEM

Diagnosis	DSCC Eligible or Description of DSCC Diagnoses
Spina Bifida/Myelomeningocele	Potentially
Spina Bifida with Hydrocephaly	Potentially
Encephalocele	Potentially
Hydroencephalapathy	Potentially
Microencephaly	No
Congenital Hydrocephalus	Potentially
Reduction deformities of brain, including: Absence Holoprosencephaly Agenesis Hypoplasia Agyria Lissencephaly Aplasia Microgyria Arhinecephaly	No, none of these would be DSCC eligible on their own; treatable motor/orthopedic impairments or seizures could be DSCC eligible for these deformities
Schizencephaly	No, only treatable motor/orthopedic impairments are DSCC eligible
Anomalies of the Spinal Cord	Potentially
Birth weight: less than 1000 grams	No, not by itself

CHROMOSOMAL DISORDERS

(Most Common, List Not Exclusive)

Note: Syndromes are not DSCC eligible by themselves but may include DSCC eligible conditions. Chromosome Disorders or Syndromes are not
eligible for DSCC. Diagnoses that frequently present with disorder or syndrome may be eligible potentially.

Diagnosis	DSCC Eligible or Description of DSCC Diagnoses
Trisomy 21 (Down Syndrome)	No, but typically cover cardiac and hearing impairments
Trisomy 13	No, but craniofacial, limb deformities, and cardiac impairments are typically DSCC eligible
Trisomy 18	No, but cardiac impairments are DSCC eligible
Autosomal Deletion Syndromes	Typically, No, unless it causes cardiac, hypospadias or other DSCC eligible conditions
Fragile X Syndrome	No
Williams Syndrome	No
Angelman Syndrome	Typically, No, unless is causes cardiac impairments or strabismus.

CONGENITAL INFECTIONS

Diagnosis	DSCC Eligible or Description of DSCC Diagnoses
Toxoplasmosis Rubella Cytomegalovirus Herpes Simplex with CNS involvement	No, long-term side effects meeting categorically eligibility are potentially eligible.
Neonatal Meningitis	No, long-term side effects such as chronic motor/orthopedic, hearing loss and eye impairments (defects of eyeball or eye muscle) are potentially DSCC eligible.

DISORDERS OF THE SENSE ORGANS

Diagnosis	DSCC Eligible or Description of DSCC Diagnoses
Hearing loss of 30dB or greater at any 2 of the following frequencies: 500, 1000, 2000, 4000 and 8000 Hz; or hearing loss of 35 dB or greater at any one of the frequencies 500, 1000 and 2000 Hz; involving one or both ears.	Potentially
Visual Impairment	Potentially
Bilateral Amblyopia	Unilateral or bilateral are potentially eligible
Severe Retinopathy of Prematurity ROP 3+	Potentially
Bilateral Cataracts	Potentially
Myopia of 3 diopters or more	No
Albinism	No

DISORDERS OF THE CENTRAL NERVOUS SYSTEM

Diagnosis	DSCC Eligible or Description of DSCC Diagnoses
Hypsarrhythmia	No
Acquired Hydrocephalus	Potentially
Stroke	Potentially DSCC eligible could cause DSCC eligible motor, speech or orthopedic conditions
Traumatic Brain Injury Intraventricular Hemorrhage - Grade III, IV	Potentially DSCC eligible but could cause DSCC eligible motor, speech or orthopedic conditions
Cerebral Palsy	Potentially orthopedic and/or neurological
Hypoxic Ischemic Encephalopathy	Not DSCC eligible by itself but seizures, renal impairments, cardiac impairments are DSCC eligible
Spinal Cord Injury	No, only if treatable motor/orthopedic impairments are DSCC eligible
Neonatal Seizures	Acute seizures are not DSCC eligible
Central Nervous System Cysts	Potentially, if not cancerous
Central Nervous System Tumors	Potentially, if not cancerous
Periventricular Leukomalacia	No, not by itself, but if causing cerebral palsy, potentially

INBORN ERRORS OF METABOLISM

Diagnosis	DSCC Eligible or Description of DSCC Diagnoses
Inborn Errors of Metabolism	Potentially eligible if causes severe neurological, mental and/or physical deterioration

NEUROMUSCULAR DISORDERS

Diagnosis	DSCC Eligible or Description of DSCC Diagnoses
Congenital Muscular Dystrophy Myotonic Dystrophy Werdnig-Hoffman (Spinal Muscular Atrophy) Congenital Myopathy Duchenne	Potentially, Motor and orthopedic conditions are eligible for these conditions

SYNDROMES

Diagnosis	DSCC Eligible or Description of DSCC Diagnoses
Cornelia de Lange	No, not by itself, but orthopedic and craniofacial impairments are DSCC eligible
Lowe's	No, but cataracts and kidney problems are potentially eligible.
Rett	No
Rubenstein-Taybi	No, unless it causes DSCC eligible hip dislocation and joint problems.
CHARGE (Multiple anomalies)	Can cause eye, kidney, cardiac, nervous, hearing and external body impairments
VATER	Can cause urinary, cleft palate and esophageal atresia
Fetal Alcohol Syndrome	Can cause some types of motor/orthopedic impairments that are DSCC eligible

CONGENITAL ANOMALIES

Diagnosis	DSCC Eligible or Description of DSCC Diagnoses
Craniofacial Anomalies (Major)	Potentially
Cleft Palate	Potentially see instructions on referring to DSCC, listed at bottom of page

ORTHOPEDIC ABNORMALITIES

Diagnosis	DSCC Eligible or Description of DSCC Diagnoses
Brachioplexus at birth Caudal Regression Proximal Focal Femoral Deformities Partial Amputations	Potentially
Holt-Oram Acquired Amputations Arthrogryposis Multiplex Congenita Osteogenesis Imperfecta	Potentially

TECHNOLOGY DEPENDENT

Diagnosis	DSCC Eligible or Description of DSCC Diagnoses
Tracheostomy	Potentially
Ventilator Dependent	Potentially, DSCC eligible for Core, IDHFS/DSCC Home Care Program (waiver)

NEURODEVELOPMENTAL DISORDERS

A group of disorders with varied manifestations, but they share several common features: an onset in early childhood, a delay or abnormality in functions strongly related to biological maturation of the central nervous system, and a generally steady course that does not involve remissions and relapses that are more typical of other mental disorders. They are believed to be treatable, but not often curable. Early and intensive interventions are recommended for this age group. Although these disorders have been linked to brain dysfunction, there is ample evidence that many conditions are improved by psychosocial interventions. Because of the complexity of neurodevelopmental disorder, it is important that multiple disciplines work collaboratively on both assessment and intervention.

Diagnosis	DSCC Eligible or Description of DSCC Diagnoses
Autism Spectrum Disorder Early Atypical Autism Spectrum Disorder Attention Deficit Hyperactivity Disorder Overactivity Disorder of Toddlerhood Other Neurodevelopmental Disorder of Infancy/Early Childhood	No

SOCIAL and EMOTIONAL DISORDERS

Sensory Processing Disorders

Diagnosed when the infant/young child demonstrates behaviors that are believed to reflect abnormalities in regulating sensory input.

Diagnosis	DSCC Eligible or Description of DSCC Diagnoses
Sensory Over-Responsivity Disorder Sensory Under-Responsivity Disorder Other Sensory Processing Disorder	No

Anxiety Disorders

Until recently, distressing anxiety in infants/young children was regarded either as a normative phase of development or a temperament style imparting risk for anxiety disorders, depression, and other mental health disorders later in life. It is now clear that early childhood anxiety and associated symptoms can reach clinically significant levels, cause significant impairment, and increase risk for anxiety and depression later in life. Older children and adults are better able than infants/young children to verbally describe their internal experiences and emotions, including fear, anxiety, and worry. Thus, assessment of anxiety in early childhood depends on descriptions of the infant's/young child's emotional state that are 1.) based on their behaviors and manifest distress and 2.) are primarily based on adult report. Young children who are 3 years old and older may verbalize their anxieties and fears and represent these internal experiences within their play.

Separation Anxiety Disorders

Diagnosis	DSCC Eligible or Description of DSCC Diagnoses
Social Anxiety Disorder (Social Phobia) Generalized Anxiety Disorder Inhibition to Novelty Disorder Other Anxiety Disorder of Infancy/Early Childhood	No

Mood Disorders

Developing the capacities to regulate emotions, especially negative emotions, is a primary task in the first few years of life for all infants/young children. In early infancy, regulation is a dyadic process, with the infants' primary caregivers playing a primary role in helping the infant regulate and manage negative feeling states. Through repeated experiences of being comforted, infants learn that distress can be expressed to a caregiver and relieved, and gradually over the first few years of life, young children learn to manage distress more independently as their cognitive and language skills develop. There is ample evidence that negative emotions are more closely linked to psychopathology than positive emotions. In addition, physical expression of intense emotions is linked to reduced competence in relating to others. When depression and irritability are not just transient feeling states but instead are severe, poorly regulated, and prolonged, they may reflect established mood disorders. How to best conceptualize angry and aggressive outbursts has been a longstanding controversy for both older and younger children.

Diagnosis	DSCC Eligible or Description of DSCC Diagnoses
Depressive Disorder of Early Childhood When sadness and irritability predominate in young children, especially when accompanied by vegetative symptoms (i.e., insomnia, reduced appetite, reduced activity level).	No
Disorder of Dysregulated Anger and Aggression of Early Childhood When irritability is chronic and associated with angry and aggressive behavioral outbursts. It represents a profound disturbance in emotional and behavioral regulation.	No
Other Mood Disorder of Early Childhood	No

Obsessive Compulsive and Related Disorders

Each of these disorders is better studied and more prevalent in older children and adults, but clear evidence exists that they may present in early childhood (in some cases infancy) and be associated with impaired functioning and distress. The clinical picture in this group is perhaps more similar to the clinical picture in older children than some other groups of disorders. At least some of the disorders are genetically linked, and they also tend to cluster with anxiety disorders in some individuals. In infants/young children, the major challenge in this category is to distinguish between individual differences within the normative range and impairing symptomatic behavior.

Diagnosis	DSCC Eligible or Description of DSCC Diagnoses
Obsessive Compulsive Disorder Trichotillomania Skin Picking Disorders of Early Childhood Other Obsessive Compulsive and Related Disorder	No
Tourette's Disorder	Yes

Eating Disorders of Infancy/Early Childhood

Eating disorders in infants/young children are among the most common behavioral disturbances that lead parents to seek treatment in primary care settings. The various eating disorders are defined descriptively by observable symptomatic behaviors that manifest cross-contextually rather than by inferred etiologies. Contributors to the behavioral patterns may be made to direct appropriate treatment, but the extant evidence does not permit linking eating patterns with specific etiologies in most cases. Sensory aversion, regulation problems, and fearful behaviors from exposure to traumatic medical procedures to the mouth and throat have all been implicated in eating problems and can be noted as associated features that are important for treatment planning. In addition, caregivers' interactions during feeding may be responsive, controlling, indulgent, or neglectful. An infant's/young child's interactions may be cooperative, resistant, or conflicted.

Diagnosis	DSCC Eligible or Description of DSCC Diagnoses
Overeating Disorder Undereating Disorder Atypical Eating Disorder (Hoarding) Atypical Eating Disorder (Pica) Atypical Eating Disorder (Rumination) Other Eating Disorder of Infancy/Early Childhood	No

Crying Disorders of Infancy/Early Childhood

Crying is an innate vocal signal of distress - physical or emotional - essential for survival, especially in the preverbal period of life. Therefore, in isolation, crying is not a disorder. It becomes a symptom and a reason for referral when the infant/young child goes on crying after his or her needs for food, physical closeness, safety, and regulation have been met by caregivers.

Diagnosis	DSCC Eligible or Description of DSCC Diagnoses
Excessive Crying Disorder Other Excessive Crying Disorder of Infancy/Early Childhood	No

Trauma, Stress, and Deprivation Disorders

Many of the symptomatic behaviors displayed in these disorders are nonspecific (i.e., aggression, irritability, reduced positive expression of emotions); therefore, linking the behaviors to an etiology of loss, stress, trauma, or deprivation is essential for proper diagnosis. Consequently, it is important to assess for losses, stressors, and traumas in relation to the clinical symptom picture. However, not all infants/young children exposed to stressors, traumas, or deprivation will develop these or any other symptoms. Therefore, in infants/young children who have had such exposures, it is also important to inquire about the specific symptoms that are causing difficulties rather than assuming that exposure equals disorder.

Diagnosis	DSCC Eligible or Description of DSCC Diagnoses
Posttraumatic Stress Disorder A specific constellation of symptomatic responses to traumatic exposure. In infants/young children, it always requires exposure to a frightening/terrifying event or series of events. The infant/young child may experience the event directly witness it as it occurred to others or learn that the event occurred to a significant person in the infant's/young child's life. The defining feature is a characteristic set of signs that appear following the exposure.	No
Adjustment Disorder A condition in which the infant/young child develops symptoms in response to one or more stressors, which may be acute, chronic, or enduring circumstances, and the symptomatic picture is less than 3 months.	No
Complicated Grief Disorder of Infancy/Early Childhood The death or permanent loss of an attachment figure represents a severe emotional stressor for an infant/ young child. Infants/young children have not yet developed an understanding of the permanence of death and the involuntary nature of most deaths, and their effort to give meaning to the absence of the loved one reflects the cognitive capacities and limitations of their developmental stage. This diagnosis is designed for those infants/young children who show a significant and pervasive impairment of function following a death that lasts for at least 30 days and interferes with normative developmental activities.	No
Reactive Attachment Disorder A condition in an infant/young child who lacks an attachment figure, despite being developmentally capable of forming an attachment. Manifestations of the disorder include both lack of expected attachment behaviors and aberrant social and emotional responsiveness.	No
Disinhibited Social Engagement Disorder A pattern of socially aberrant behavior with unfamiliar adults in an infant/young child who has experienced serious social neglect. It is characterized by reduced or absent reticence about approaching and engaging with unfamiliar adults. There is no or almost no stranger wariness; in fact, there is an active seeking of contact and interaction with unfamiliar adults.	No
Other Trauma, Stress, and Deprivation Disorder of Infancy/ Early Childhood	No

Relationship Disorders

Historically, psychiatry and medicine have defined disorders as existing within individuals. Implicit in this tradition is the expectation that they symptomatic behavior will be expressed cross-contextually and in all relationships. Although there may be some variation in the intensity of symptom expression, the disorder is carried by that individual, and therefore, the symptoms are specific to the individual and expressed similarly across contexts and relationships. Research on relationships between infants/young children and their caregivers, however, has demonstrated that behaviors of infants/young children may differ systematically with different caregivers.

Relationship Specific Disorder of Infancy/Early Childhood

Symptomatic behavior in the infant/young child that is limited to one caregiving relationship. There is no specification for the behaviors that the infant/young child displays but only that these behaviors are evident in one but not in other relationships and that the behaviors impair the infant's/young child's functioning. If the behaviors are evident in more than one context, the disorder cannot be diagnosed. No

Diagnosis

DSCC Eligible or Description of DSCC Diagnoses

Relationship Specific Disorder of Infancy/Early Childhood Symptomatic behavior in the infant/young child that is limited to one caregiving relationship. There is no specification for the behaviors that the infant/young child displays but only that these behaviors are evident in one but not in other relationships and that the behaviors impair the infant's/ young child's functioning. If the behaviors are evident in more than one context, the disorder cannot be diagnosed.

No

OTHER CONDITIONS

Diagnosis	DSCC Eligible or Description of DSCC Diagnoses
Lead Poisoning Elevated Blood Lead Level of 5 micrograms per deciliter (µg/dL) of whole blood confirmed by a venous blood test	No

Children with undiagnosed medical conditions or who may require further medical evaluation may be referred for a medical diagnostic evaluation. If you have any questions regarding these eligible medical conditions or medical diagnostic services, please contact your developmental pediatrician consultation contractor.

*If a condition is potentially eligible for DSCC, please contact your local regional office to discuss additional eligibility criteria.