MEDICAL DIAGNOSES
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) who provides written verification that the child's medical condition is associated with a high probability of developmental delay as listed in eligibility criteria.
Eligible DSCC Diagnoses
Any specific diagnosis alone (except cystic fibrosis and hemophilia) is not eligible for DSCC unless there are associated impairments in the following categories:
- orthopedic
- nervous system
- cardiovascular
- external body
- hearing
- organic speech disorders
- inborn errors of metabolism leading to severe neurological
- mental and physical deterioration
- eye and urinary system
ANOMALIES OF CENTRAL NERVOUS SYSTEM
| Diagnosis |
EI Eligible |
DSCC Eligible or Description of DSCC Diagnoses |
| Spina Bifida/Myelomeningocele |
Yes |
Yes |
| Spina Bifida with Hydrocephaly |
Yes |
Yes |
| Encephalocele |
Yes |
Yes |
| Hydroencephalapathy |
Yes |
Yes |
| Microencephaly |
Yes |
No |
| Congenital Hydrocephalus |
Yes |
Yes |
|
Reduction deformities of brain, including:
Absence Holoprosencephaly
Agenesis Hypoplasia
Agyria Lissencephaly
Aplasia Microgyria
Arhinecephaly
|
Yes |
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 |
Yes |
No, Only treatable motor/orthopedic impairments
are potentially DSCC eligible. |
| Anomalies of the Spinal Cord |
Yes |
Yes |
| Birth weight: less than 1000 grams |
Yes |
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.
| Diagnosis |
EI Eligible |
DSCC Eligible or Description of DSCC Diagnoses |
| Trisomy 21 (Down Syndrome) |
Yes |
No, but typically cover cardiac and hearing
impairments. |
| Trisomy 13 |
Yes |
No, but craniofacial, limb deformities, and
cardiac impairments are typically DSCC eligible. |
| Trisomy 18 |
Yes |
No, but cardiac impairments are DSCC eligible. |
| Autosomal Deletion Syndromes |
Yes |
Typically, No, unless it casues cardiac, hypospadias or other DSCC eligible conditions. |
| Fragile X Syndrome |
Yes |
No |
| Williams Syndrome |
Yes |
No |
| Angelmann's Syndrome |
Yes |
Typically, No, unless is causes cardiac impairments
or strabismus. |
CONGENITAL INFECTIONS
| Diagnosis |
EI Eligible |
DSCC Eligible or Description of DSCC Diagnoses |
|
Toxoplasmosis
Rubella
Cytomegalovirus
Herpes Simplex with CNS involvement
|
Yes |
No, unless treatable or chronic |
| Neonatal Meningitis |
Yes |
No, only treatable chronic motor/orthopedic, hearing
loss and eye impairments (defects of eyeball or eye muscle)
are DSCC eligible for these congenital infections. |
| Cerebral Palsy |
Yes |
Yes, motor and neuro impairments |
| Craniofacial Anomalies (Major) |
Yes |
Yes |
| Cleft Palate |
Yes |
Yes, **see instructions on referring to DSCC, listed at bottom of page |
DISORDERS OF THE SENSE ORGANS
| Diagnosis |
EI Eligible |
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. |
Yes |
Yes, if 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 sides. |
| Visual Impairment |
Yes |
Potentially DSCC eligible (blindness not DSCC eligible) eye muscle
imbalance - DSCC eligible. |
| Bilateral Amblyopia |
Yes |
Yes, if eye muscle imbalance, (blindness not DSCC eligible) |
| Severe Retinopathy of Prematurity ROP 3+ |
Yes |
Yes |
| Bilateral Cataracts |
Yes |
Yes |
| Myopia of 3 diopters or more |
Yes |
No |
| Albinism |
Yes |
No |
DISORDERS OF THE CENTRAL NERVOUS SYSTEM
| Diagnosis |
EI Eligible |
DSCC Eligible or Description of DSCC Diagnoses |
| Hypsarrhythmia |
Yes |
No |
| Acquired Hydrocephalus |
Yes |
Yes |
| Stroke |
Yes |
No, unless motor and speech problems |
|
Traumatic Brain Injury
Intraventricular Hemorrhage - Grade III, IV
|
Yes |
Neither are automatically DSCC eligible but either could cause
DSCC eligible motor, speech or orthopedic conditions. |
|
Yes |
Not DSCC eligible by itself but seizures, renal impairments,
cardiac impairments are DSCC eligible. |
Hypoxic Ischemic Encephalopathy
(with organ failure, seizures, renal failure, cardiac failure) |
Yes |
|
| Spinal Cord Injury |
Yes |
No, only if treatable motor/orthopedic impairments are DSCC eligible |
| Neonatal Seizures (secondary to asphyxia or hypoglycemia) |
Yes |
Acute seizures are not DSCC eligible. |
| Central Nervous System Cysts |
Yes |
Potentially Yes, if not cancerous. |
| Central Nervous System Tumors |
Yes |
Potentially Yes, if not cancerous. |
| Periventricular Leukomalacia |
Yes |
No, not by itself, but if causing cerebral palsy, Yes |
INBORN ERRORS OF METABOLISM
| Diagnosis |
EI Eligible |
DSCC Eligible or Description of DSCC Diagnoses |
| Inborn errors of metabolism |
Yes |
No, unless causing physical and neurological impairment and
mental retardation, if left untreated |
NEUROMUSCULAR DISORDERS
| Diagnosis |
EI Eligible |
DSCC Eligible or Description of DSCC Diagnoses |
|
Congenital Muscular Dystrophy
Myotonic Dystrophy
Werdnig-Hoffman (Spinal Muscular Atrophy)
Congenital Myopathy
Duchenne
|
Yes |
Potentially, Motor and orthopedic conditions are eligible
for these conditions. |
PERVASIVE DEVELOPMENTAL DISORDER/AUTISTIC SPECTRUM
| Diagnosis |
EI Eligible |
DSCC Eligible or Description of DSCC Diagnoses |
Pervasive Developmental Disorder
Autistic Spectrum Disorder |
Yes |
No |
SYNDROMES
| Diagnosis |
EI Eligible |
DSCC Eligible or Description of DSCC Diagnoses |
| Cornelia de Lange |
Yes |
No, not by itself, but orthopedic and craniofacial
impairments are DSCC eligible. |
| Lowe's |
Yes |
No, but cataracts and kidney problems are |
| Rett |
Yes |
No |
| Rubenstein-Taybi |
Yes |
No, unless it causes DSCC eligible hip dislocation
and joint problems. |
| CHARGE (Multiple anomalies) |
Yes |
Yes, eye, kidney, cardiac, nervous, hearing and
external body impairments |
| VATER |
Yes |
Yes, urinary, cleft palate and esophageal atresia |
|
Fetal Alcohol Syndrome
(Not just exposure to alcohol in utero or
fetal alcohol effects, but a
diagnosis of the syndrome)
|
Yes |
No, but could cause some types of motor/orthopedic
impairments that are DSCC eligible |
ORTHOPEDIC ABNORMALITIES
| Diagnosis |
EI Eligible |
DSCC Eligible or Description of DSCC Diagnoses |
| Brachioplexus at birth |
Yes |
Potentially |
| Caudal Regression |
Yes |
No |
| Proximal Focal Femoral Deformities |
Yes |
Potentially |
| Partial Amputations |
Yes |
Yes |
| Holt-Oram |
Yes |
Potentially |
| Acquired Amputations |
Yes |
Yes |
| Arthrogryposis Multiplex Congenita |
Yes |
Yes |
| Osteogenesis Imperfecta |
Yes |
Yes |
TECHNOLOGY DEPENDENT
| Diagnosis |
EI Eligible |
DSCC Eligible or Description of DSCC Diagnoses |
| Tracheostomy |
Yes |
Potentially DSCC eligible if secondary to structural defect of upper airway and not chronic lung disease. |
| Ventilator Dependent |
Yes |
Potentially DSCC eligible for IDHFS/DSCC Home Care Program (waiver). |
SOCIAL EMOTIONAL DISORDERS
| Diagnosis |
EI Eligible |
DSCC Eligible or Description of DSCC Diagnoses |
| Attachment or Relationship Disorder |
Yes |
No, not by itself |
OTHER
| Diagnosis |
EI Eligible |
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 |
Yes |
Not DSCC eligible by itself |
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.
**Referring to DSCC - Children with cleft palate, orthopedic abnormalities, or other potential DSCC eligible diagnoses associated with physical disabilities are to be referred with written consent to the Division of Specialized Care for Children (DSCC) prior to IFSP development. DSCC may provide medical diagnostic support at no cost to the family. Simultaneously Child and Family Connections should complete the intake process as usual. DSCC will determine the type of ongoing assistance they can provide.
Revised 08/2020
