Child Development Web

After conception, the fertilized egg divides repeatedly into a mass of cells. The germinal period is the period of prenatal development that takes place in the first 2 weeks after conception. By 1 week after conception, the fertilized egg is composed of 100 to 150 cells. These cells have differentiated into 2 layers, an inner and outer layer. The blastocystis the inner layer of these cells that develop during this period and later develop into the embryo. The outer layer is the trophoblast which also develops during this period and later provides nutrition and support for the embryo. About 10 days after conception, the fertilized egg or now called a zygote, attaches to the inner wall of the uterus.

2 To 8 Weeks: Embryonic Period

The embryonic period occurs 2 to 8 weeks after conception. During this period the rate of cell differentiation intensifies, with support systems and organs beginning to form. The zygote now forms another 2 layers of cells and is then called an embryo. The embryo’s new inner layer of cells, the endoderm, later develops into the digestive and respiratory systems. The outer layer is then further divided into 2: the ectoderm and the mesoderm. The ectoderm later becomes the nervous system and sensory receptors (ears, nose, and eyes, for example) and skin parts (hair and nails, for example). The mesoderm later becomes the circulatory system, bones, muscles, excretory system, and reproductive system. Every body part eventually develops from these 3 layers.

As the 3 layers form, the embryo’s life support systems begin to mature and develop rapidly. These life support systems include the placenta, the umbilical cord, and the amnion.
placenta – consists of tissues where blood vessels between the mother and baby intertwine.
umbilical cord – contains 2 arteries and a vein, connects the baby to the placenta. Nutrients from the mother’s blood and digestive wastes from the baby’s blood can now pass back and forth between mom and baby.
amnion – a pouch containing a clear fluid that envelopes and protect the developing embryo.
GROWTH: At the third week the neural tube that becomes the spinal cord begins to form. At 21 days, eyes begin to appear and at 24 days, cells for the heart begin to differentiate. During the fourth week, arm and leg buds emerge. When organs are being formed, they are vulnerable to environmental changes.

2 To 9 Months: Fetal Period

Growth and development continue dramatically during the fetal period. Three months after conception, the fetus is about 3 inches long and weighs about 1 ounce. It has become very active, moving its arms and legs, opening and closing its mouth, and moving its head. The face, forehead, eyelids, nose, chin, arms, hands, and lower limbs are now distinguishable, and the genitals can be identified as male or female. By the end of the fourth month, the fetus is about 6 inches in length and weighs 4 to 7 ounces. By the end of the 5th month, the fetus then grows to 12 inches long and weighs close to a pound. Its toenails and fingernails have begun to form and is more active, showing a preference for a particular position in the womb. By the end of the 6th month, a thin layer of hair has formed and irregular breathing occurs. By the end of the 7th month, the fetus is now about 16 inches long and weighs about 3 pounds. During the 8th and 9th months, the fetus rapidly gains another 4 pounds. At birth, the average American baby weighs 7 pounds and is about 20 inches long.

Fetal Growth Chart by Trimester:

First Trimester (first 3 months)

Conception to 4 weeks

• Less than 1/10 inches long
• Spinal cord, nervous system, gastrointestinal system, heart and lungs begin to develop
• Amniotic sac envelopes the body

8 weeks

• Less than 1 inch long
• Face is forming with rudimentary eyes, ears, mouth and teeth
• Arms and legs are moving
• Brain is forming
• Fetal heartbeat is detectable with ultrasound

12 weeks

• About 3 inches long, weighs 1 ounce
• Can move arms, fingers and toes
• Fingerprints are present
• Can smile. frown, suck and swallow
• Sex is distinguishable

Second Trimester (middle 3 months)

16 weeks

• About 5 1/2 inches long and weighs 4 ounces
• Strong heartbeat
• Thin, transparent skin formed
• Downy hair (lanugo) covers body
• Fingernails and toenails are forming
• Coordinated movements; is able to roll over in amniotic fluid

20 weeks

• 10 to 12 inches long and weighs 1/2 to 1 pound
• Heartbeat is audible with stethoscope
• Sucks thumb
• Hiccups
• Hair, eyelashes, and eyebrows have formed

24 weeks

• 11 to 14 inches long and weighs 1 to 1 1/2 pounds
• Skin is wrinkled are covered with protective coating
• Eyes are open
• Has strong grip

Third Trimester (last 3 1/2 months)

28 weeks

• 14 to 17 inches long and weighs 2 1/2 to 3 pounds
• Adding body fat
• Very active
• Rudimentary breathing present

32 weeks

• 16 1/2 to 18 inches long and weighs 4 to 5 pound
• Periods of sleep and wakefulness
• Responds to sounds
• May assume birth position
• Bones of head are soft and flexible
• Iron is being stored in liver

36 to 38 weeks

• 19 inches long and weighs 6 pounds
• Skin is less wrinkled
• Less active
• Gaining immunities from mother

State Services

A L A B A M A
Early Intervention-800/543-3098 Director of Special Education Alabama Department of Education Division of Special Education P.O. Box 302101 Montgomery, AL 36130-2101	Program Director Alabama Disabilities Advocacy Program P.O. Drawer 870395 Tuscaloosa, AL 35487-0395 205/348-4928 800/826-1675	Director Rehabilitation and Crippled Children Service 2129 E. South Blvd. P.O. Box 11586 Montgomery, AL 36116 205/281-8780
A L A S K A
Early Intervention-800/478-2221 Director of Special Education Office of Special Services Alaska Department of Education Office of Special and Supplemental Services 801 West 10th Street, Suite 200 Juneau, AK 99301-1894 907/465-2971	Director Disability Law Center of Alaska 615 E. 82nd Avenue, Suite 101 Anchorage, AK 99518 907/344-1002 800/478-1234	Director ASIST 2900 Boniface Parkway, #100 Anchorage, AK 99504-3195 907/333-2211
A M E R I C A N S A M O A
Early Intervention-800/633-4929 Director of Special Education Special Education Department of Education Pago Pago, American Samoa 96799 684/633-1323		P&A and CAP Client Assistance Program P.O. Box 3937 Pago Pago, American Samoa 96799 684/633-2441
A R I Z O N A
Early Intervention-800/232-1676 Director of Special Education Special Education Section Department of Education 1535 W. Jefferson Phoenix, AZ 85007-3280 602/542-3084		P&A and CAP Arizona Center for Law in the Public Interest 3724 N. 3rd Street, Suite 300 Phoenix, AZ 85012 602/274-6287
A R K A N S A S
Early Intervention-800/752-2160 Director of Special Education Special Education Section Arkansas Department of Education Education Bldg., Room 105-C #4 State Capitol Mall Little Rock, AR 72201-1071 501/682-4221		P&A and CAP Executive Director Advocacy Services, Inc. 1100 N. University Suite 201, Evergreen Place Little Rock, AR 72207 501/324-9215 800/482-1174
C A L I F O R N I A
Early Intervention-800/515-2229 Director of Special Education California Department of Education 515 L Street, Suite 270 Sacramento, CA 95814 916/445-4602	Executive Director Protection & Advocacy, Inc. 100 Howe Avenue, Suite 185N Sacramento, CA 95825 916/488-9950 800/952-5746	Client Assistance Program 830 K St. Mall Sacramento, CA 95814 916/322-5066
C O L O R A D O
Early Intervention-800/288-3444 Director of Special Education Special Education Services Unit Colorado Department of Education 201 E. Colfax Denver, CO 80203 303/866-6695		P&A and CAP Executive Director The Legal Center 455 Sherman Street, Suite 130 Denver, CO 80203 303/722-0300
C O N N E C T I C U T
Early Intervention-800/505-7000 Bureau of Special Education and Pupil Personnel Services Connecticut Department of Education 25 Industrial Park Rd. Middletown, CT 06457 860/638-4265		Executive Director Office of Protection & Advocacy for Persons with Disabilities 60 Weston Street Hartford, CT 06120-1551 203/297-4300 800/842-7303
D E L A W A R E
Early Intervention-302/577-4643 Director of Special Education Exceptional Children/Special Programs Division Department of Public Instruction P.O. Box 1402 Dover, DE 19903-1402 302/739-5471	Administrator Disabilities Law Program 144 E. Market Street Georgetown, DE 19947 302/856-0038	Director Client Assistance Program United Cerebral Palsy, Inc. 254 Camden-Wyoming Ave. Camden, DE 19934 302/698-9336
Department of Defense/Dependents Services Department of Defense Office of Dependents’ Education 4040 Fairfax Drive Arlington, VA 22203 703/696-4493
D i s t r i c t o f C o l u m b i a
Early Intervention-202/727-8300 Director of Special Education Goding School 10th and F St. NE Washington, DC 20002 202/724-4800	Executive Director Information, Protection, and Advocacy Center for Handicapped Individuals , Inc. 4455 Connecticut Ave., NW, Suite B-100 Washington, DC 20008 202/966-8081	Administrator Client Assistance Program D.C. Rehabilitation Services Administration Commission on Social Services Department of Human Services 605 G St, NW, Room 1101 Washington, DC 20001 202/727-0977
F L O R I D A
Early Intervention-800/654-4440 Director of Special Education Bureau of Student Services/Exceptional Education Florida Education Center 325 Gaines Street, Suite 614 Tallahassee, FL 32399-0400 904/488-1570		P&A and CAP Executive Director Advocacy Center for Persons with Disabilities, Inc. 2671 Executive Center, Circle West Webster Bldg., Suite 100 Tallahassee, FL 32301-5024 904/488-9070 800/342-0823
G E O R G I A
Early Intervention-800/229-2038 Director of Special Education Division for Exceptional Children Georgia Department of Education 1952 Twin Towers East 205 Butler Street Atlanta, GA 30334-5040 404/656-3963	Executive Director Georgia Advocacy Office, Inc. 999 Peachtree Street NW, Suite 870 Atlanta, GA 30309 404/885-1234 800/282-4538	Director Division of Rehabilitation Services 2 Peachtree St., NW, 23rd floor Atlanta, GA 30303 404/657-3009
G U A M
Early Intervention-671/475-0549 Director of Special Education Department of Education P.O. Box DE Agana, Guam 96910 671/647-4400	Administrator The Advocacy Office Micronesia Mall, Office A West Marine Drive Dededo, Guam 96912	Director Client Assistance Program Parent Agencies Network P.O. Box 23474 GMF, Guam 96921 671/649-1948
H A W A I I
Early Intervention-800/235-5477 808/955-7273(Oahu only);Director of Special Education Special Needs Branch Hawaii Department of Education Special Education Section 3430 Leahi Avenue Honolulu, HI 96815 808/733-4990		P&A and CAP Executive Director Protection and Advocacy Agency of Hawaii 1580 Makaloa St., Suite 1060 Honolulu, HI 96814 808/949-2922
I D A H O
Early Intervention-800/962-2588 Supervisor Special Education Section Idaho Department of Education P.O. Box 83720 Boise, ID 83720-0027 208/334-3940		Idaho’s Coalition of Advocates for the Disabled, Inc. 447 Emerald, Suite B100 Boise, ID 83706 208/336-5353
I L L I N O I S
Early Intervention-800/323-4679 Director of Special Education Center of Policy, Planning, Resource Illinois State Board of Education Mail Code E-216 100 North First Street Springfield, IL 62777-0001 217/782-6601	Director Equip for Quality, Inc. 11 E. Adams, Suite 1200 Chicago, IL 60603 312/341-0022	Director Illinois Client Assistance Program 100 N. First Street, 1st Floor W Springfield, IL 62702 217/782-5374
I N D I A N A
Early Intervention-800/964-4746 Director of Special Education Division of Special Education Indiana Department of Education 229 State House Indianapolis, IN 46204-2798 317/232-0570		P&A and CAP Indiana Advocacy Services 850 North Meridian, Suite 2-C Indianapolis, IN 46204 317/232-1150 800/622-4845
I O W A
Early Intervention-800/779-2001 Chief Bureau of Special Education Iowa Department of Public Instruction Grimes State Office Building Des Moines, IA 50319-0146 515/281-3176	Director Iowa Protection & Advocacy Services, Inc. 3015 Merle Hay Rd., Suite 6 Des Moines, IA 50310 515/278-2502 800/779-2502	Administrator Client Assistance Program Lucas State Office Bldg. Des Moines, IA 50319 515/281-3957
K A N S A S
Early Intervention-800/332-6262 Director of Special Education Student Support Services Kansas Department of Education 120 S.E. Tenth Street Topeka, KS 66612-1182 913/296-0946	Executive Director Kansas Advocacy & Protection Services 2601 Anderson Avenue, Suite 200 Manhattan, KS 66502 913/776-1541 800/432-8276	Client Assistance Program Biddle Bldg., 2nd Floor 2700 West 6th Street Topeka, KS 66606 913/296-1491
K E N T U C K Y
Early Intervention-800/442-0087 Director of Special Education Kentucky Department of Education Division of Exceptional Children’s Services 500 Mero Street Room 805 Frankfort, KY 40601 502/564-4970	Director Office for Public Advocacy Division for Protection and Advocacy 100 Fair Oaks Lane, 3rd Floor Frankfort, KY 40601 502/564-2967 800/372-2988	Administrator Client Assistance Program Capitol Plaza Tower Frankfort, KY 40601 502/564-8035
L O U I S I A N A
Early Intervention-800/922-3425 Director of Special Education Louisiana Department of Education Special Education Services P.O. Box 94064, 9th Floor Baton Rouge, LA 70804-9064 504/342-3633		P&A and CAP Executive Director Advocate Center for the Elderly & Disabled 210 O’Keefe, Suite 700 New Orleans, LA 70112 504/522-2337 800/662-7705
M A I N E
Early Intervention-207/278-3272 Director of Special Education Division of Special Services Maine Department of Educational and Cultural Services 23 State House Station Augusta, ME 04333 207/287-5950	Director Maine Advocacy Services 32 Winthrop Street P.O. Box 2007 Augusta, ME 04338-2007 207/626-2774 800/452-1948	CARES, Inc. 4-C Winter Street Augusta, ME 04330 207/622-7055
M A R Y L A N D
Early Intervention-800/535-0182 Director of Special Education Division of Special Education Maryland State Department of Education 200 W. Baltimore Street Baltimore, MD 21201-2595 410/767-0238	Director Maryland Disability Law Center 2510 St. Paul St. Baltimore, MD 21218 410/235-4700 800/33-7201	Client Assistance Program Division of Vocational Rehabilitation 2301 Argonne Drive Baltimore, MD 21218-1696 410/554-3224
M A S S A C H U S E T T S
Early Intervention-800/462-5015 Administrator Program Quality Assurance Massachusetts Department of Education 350 Main Street Malden, MA 02148-5023 617/388-3300	Executive Director Disability Law Center of Massachusetts 11 Beacon Street, Suite 925 Boston, MA 02108 617/723-8455	MA Office of Disability Client Assistance Program One Ashburton Place, Room 1305 Boston, MA 02108 617/7440
M I C H I G A N
Early Intervention-800/327-5966 Director of Special Education Special Education Services Michigan Department of Education P.O. Box 30008 Lansing, MI 48909-7508 517/373-9433	Executive Director Michigan Protection & Advocacy Service, Inc. 106 W. Allegan, Suite 210 Lansing, MI 48933 517/487-1755	State Director Client Assistance Program P.O. Box 30018 Lansing, MI 48909 517/373-8193
M I N N E S O T A
Early Intervention-800/728-5420 Director of Special Education Department of Children, Families, and Learning 811 Capitol Square Bldg. 550 Cedar Street St. Paul, MN 55101-2233 612/296-1793		Protection and Advocacy and CAP Minnesota Disability Law Center 430 First Avenue N, Suite 300 Minneapolis, MN 55401-1780 612/334-5785
M I S S I S S I P P I
Early Intervention-800/451-3903 Director of Special Education Office of Education State Department of Education P.O. Box 771 Jackson, MS 39205-0771 601/359-3498	Executive Director Mississippi Protection & Advocacy System for DD, Inc. 5330 Executive Place, Suite A Jackson, MS 39206 601/981-8207	Client Assistance Program Easter Seal Society 3226 N. State Street Jackson, MS 39216 601/362-2585 601/982-7051
M I S S O U R I
Early Intervention-800/863-6623 Director of Special Education Special Education Programs Department of Elementary and Secondary Education P.O. Box 480 Jefferson City, MO 65102-0480 314/751-2965		Protection and Advocacy and CAP Missouri Protection & Advocacy Services 925 S. Country Club Drive, Unit B-1 Jefferson City, MO 65109 314/893-3333
M O N T A N A
Early Intervention-800/222-7585 Director Office of Public Instruction Division of Special Education P.O. Box 202501 State Capitol Helena, MT 59620-2501 406/444-4429		Protection and Advocacy and CAP Executive Director Montana Advocacy Program 316 N. Park, Room 211 P.O. Box 1680 Helena, MT 59623 406/444-3889 800/245-4743
Native American Indian Affairs
Early Intervention-202/208-6675 Branch of Exceptional Education/BIA Mail Stop #3530 1951 Constitution Ave., NW Washington, DC 20245 202/208-6675		Protection and Advocacy DNA People’s Legal Service, Inc. P.O. Box 306 Window Rock, AZ 86515 602/871-4151
N E B R A S K A
Early Intervention-800/742-7594 Director of Special Education Nebraska Advocacy Services, Inc. 522 Lincoln Center Bldg. 215 Centennial Mall South Lincoln, NE 68508 402/474-3183		Client Assistance Program Division of Rehabilitative Services State Department of Education 301 Centennial Mall South, 6th Floor Lincoln, NE 68509 402/471-3656
N E V A D A
Early Intervention-800/522-0066 Director of Special Education Special Education Branch Nevada Department of Education 400 W. King Street Capitol Complex Carson City, NV 89710-0004 702/687-3140	Director Office of Protection & Advocacy, Inc. Financial Plaza 1135 Terminal Way, Suite 105 Reno, NV 89502 702/688-1233 800/922-5715	Client Assistance Program 1755 East Plumb Lane, #128 Reno, NV 89502 702/688-1440 800/633-9879
N E W H A M P S H I R E
Early Intervention-800/298-4321 Director of Special Education Special Education Bureau New Hampshire Department of Education 101 Pleasant Street Concord, NH 03301-3860 603/271-6693	Executive Director Disabilities Rights Center, Inc. P.O. Box 3660 18 Low Avenue Concord, NH 03302-3660 603/228-0432	Director Client Assistance Program Governors Commission of the Handicapped 57 Regional Drive Concord, NH 03301-0686 603/271-2773
N E W J E R S E Y
Early Intervention-800/792-8858 Director of Special Education Office of Special Education New Jersey Department of Education P.O. Box CN 500 225 W. State St. Trenton, NJ 08625-0050 609/633-6833		Protection and Advocacy and CAP NJ Department of Protection and Advocate 210 S. Broad, 3rd Floor Trenton, NJ 08608 609/292-9742 800/792-8600
N E W M E X I C O
Early Intervention-800/522-8195 Director of Special Education State Department of Education 300 Don Gasper Ave. Santa Fe, NM 87501-2786 505/827-6541		Protection and Advocacy and CAP Protection and Advocacy System 1720 Louisiana Blvd. NE, Suite 204 Albuquerque, NM 87110 505/256-3100 800/432-4682
N E W Y O R K
Early Intervention-800/522-4369 Assistant Commissioner Office for Special Education New York State Education Department 1 Commerce Plaza, Room 1624 Albany, NY 12234-0001 518/474-5548		Protection and Advocacy and CAP Commissioner New York Commission on Quality of Care for the Mentally Disabled 99 Washington Ave., Suite 1002 Albany, NY 12210 518/473-7378
N O R T H C A R O L I N A
Early Intervention-800/852-0042 Director of Special Education Division of Exceptional Children’s Services North Carolina Department of Public Instruction 301 N. Wilmington Street Raleigh, NC 27601-2825 919/715-1565	Director Governor’s Advocacy Council for Persons with Disabilities 2113 Cameron Street, Suite 218 Raleigh, NC 27605-1344 919/733-9250 800/821-6922	Director Client Assistance Program Division of Vocational Rehabilitation Services P.O. Box 26053 Raleigh, NC 27611 919/733-3364
N O R T H D A K O T A
Early Intervention-800/472-8529 Director of Special Education Special Education Department of Public Instruction 600 E Blvd. Bismark, ND 58505-0440 701/328-2277	Director Protection & Advocacy 400 E. Broadway, Suite 616 Bismark, ND 58501-4038 800/472-2670	Associate Director Client Assistance Program 400 E. Broadway, Suite 303 Bismark, ND 58501-4038 701/328-3970
NORTH MARIANA ISLANDS
Director Special Education Programs CNMI Public School System P.O. Box 1370 Saipan, MP 96950 670/322-9956		Protection and Advocacy and CAP Karidat P.O. Box 745 Saipan, MP 96950 670/234-6981
O H I O
Early Intervention-800/374-2806 Director of Special Education Ohio Department State of Education Division of Special Education 933 High Street Worthington, OH 43085-4087 614/466-4859	Executive Director Ohio Legal Rights Service 8 E. Long St., 6th Floor Columbus, OH 43215 614/466-7264 800/282-9181	Client Assistance Program Governor’s Office of Advocacy for People with Disabilities 30 E. Broad Street, Suite 1201 Columbus, OH 43215 614/466-9956
O K L A H O M A
Early Intervention-800/426-2747 Executive Director Special Education Section State Department of Education 2500 N. Lincoln Blvd., Suite 411 Oklahoma City, OK 73105-4599 405/521-4859	Director Oklahoma Disability Law Center, Inc. 4150 S. 100 East Avenue 210 Cherokee Bldg., Tulsa, OK 74146-3661 918/664-5883	Client Assistance Program Oklahoma Office of Hndcp. Concerns 4300 N. Lincoln Blvd., Suite 200 Oklahoma City, OK 73105 405/521-3756
O R E G O N
Early Intervention-800/322-2588 Director of Special Education Special Education and Student Services Division Oregon Department of Education 700 Pringle Pkwy. SE Salem, OR 97310-0290 503/378-3598	Executive Director Oregon Advocacy Center 620 S.W. 5th Avenue, 5th Floor Portland, OR 97204 503/243-2081	Oregon Advocacy Center 1257 Ferry Street S.E. Salem, OR 97310 503/378-3142
P A L A U
Early Intervention-670/664-3754 Special Education Coordinator P.O. Box 278 Koror Palau, 96940 680/488-2568
P E N N S Y L V A N I A
Early Intervention-800/692-7288 Director of Special Education Bureau of Special Education Pennsylvania Department of Education 333 Market Street Harrisburg, PA 17126-0333 717/783-6913	Pennsylvania Protection & Advocacy, Inc. 116 Pine St. Harrisburg, PA 17101 717/236-8110 800/692-7443	Client Assistance Program (SEPLS) 1617 JFK Blvd., Suite 800 Philadelphia, PA 19103 215/557-7112
Client Assistance Program (Western PA) 211 N. Whitfield Street, Suite 215 Pittsburgh, PA 15206 412/363-7223
P U E R T O R I C O
Early Intervention-800/981-8492 Assistant Secretary of Special Education Department of Education P.O. Box 190759 San Juan, PR 00919-0759 809/759-2000	Director Planning Research and Special Projects Ombudsman for the Disabled Governor’s Office P.O. Box 5163 Hato Rey, PR 00936 809/766-2338	Assistant Secretary for Vocational Rehabilitation Department of Social Services P.O. Box 118 Hato Rey, PR 00919 809/725-1792
R H O D E I S L A N D
Early Intervention-800/464-3399 Director of Special Education Roger Williams Bldg. Room 209 22 Hayes Street Providence, RI 02908-5025 401/277-3505		Protection and Advocacy and CAP Executive Director Rhode Island Protection & Advocacy System 151 Broadway, 3rd Floor Providence, RI 02903 401/831-3150
S O U T H C A R O L I N A
Early Intervention-800/922-1107 Director Office of Programs for Exceptional Children State Department of Education Room 808 Rutledge Bldg. 1429 Senate Columbia, SC 29201 803/739-8806	Executive Director South Carolina Protection & Advocacy System for the Handicapped, Inc. 3710 Landmark Drive, Suite 208 Columbia, SC 29204 803/782-0639 803/922-5225	Office of the Governor Division of Ombudsman and Citizen Services P.O. Box 11369 Columbia, SC 29211 803/734-0457
S O U T H D A K O T A
Early Intervention-800/529-5000 Director Office of Special Education Department of Education and Cultural Affairs 700 Governors Drive Pierre, SD 57501-2291 605/224-8294 800/742-8108
T E N N E S S E E
Early Intervention-800/582-7157 Assistant Commissioner Division of Special Education Tennessee Department of Education Gateway Plaza, 8th Floor 710 James Robertson Pkwy. Nashville, TN 37243-0380 615/741-2851		Protection and Advocacy and CAP Director Tennessee Protection and Advocacy, Inc. P.O. Box 121257 Nashville, TN 37212 615/298-1080 800/342-1660
T E X A S
Early Intervention-512/502-4920 Director of Special Education Special Education Unit Texas Education Agency WB Travis Bldg. Room 5-120 1701 N. Congress Ave. Austin, TX 78701-2486 512/463-9414		Protection and Advocacy and CAP Executive Director Advocacy, Inc. 7800 Shoal Creek Blvd., Suite 171-E Austin, TX 7857 512/454-4816 800/463-9414
U T A H
Early Intervention-800/333-8824 Director Special Education Services Unit Utah State Office of Education 250 E 500 South Salt Lake City, UT 84111-3204 801/538-7587		Protection and Advocacy and CAP Executive Director Legal Center for People with Disabilities 455 East 400 South, Suite 201 Salt Lake City, Utah 84111 801/363-1347 800/662-9080
V E R M O N T
Early Intervention-800/727-3686 Director Division of Special Education Vermont Department of Education State Office Bldg. 120 State Street Montpelier, VT 05602-3403 802/828-3141	Director Vermont DD Law Project 264 Winoosk Avenue P.O. Box 1367 Burlington, VT 05401 802/863-2881	Client Assistance Program Ladd Hall 103 South Main Street Waterbury, VT 05676
V I R G I N I S L A N D S
Early Intervention-809/773-8804 Director of Special Education Department of Special Education State Office of Special Education P.O. Box 6640 Charlotte Amalie, St. Thomas Virgin Islands, 00801 809/776-5802		Protection and Advocacy and CAP Director Virgin Islands Advocacy Agency 7A Whim Street, Suite 2 Frederiksted, VI 00840 809/772-1200
V I R G I N I A
Early Intervention-800/234-1448 Director of Special Education Virginia Department of Education P.O. Box 2120 Richmond, VA 23216-2120 804/225-2402		Protection and Advocacy and CAP Director Department of Rights of Virginians with Disabilities James Monroe Bldg. 101 N. 14th St., 17th Floor Richmond, VA 23219 804/225-2042 800/552-3962
W A S H I N G T O N
Early Intervention-800/322-2588 Director of Special Education Special Education Section Superintendent of Public Instruction Old Capital Bldg. Olympia, WA 98502-0001 206/753-6733	Washington Protection & Advocacy System 1401 E. Jefferson Street, Suite 506 Seattle, WA 98122 206/753-1521	Client Assistance Program P.O. Box 22510 Seattle, WA 98122 206/721-4049
W E S T V I R G I N I A
Early Intervention-800/734-2319 Director Office of Special Education West Virginia Department of Education Bldg. #6, Room B-304 1800 Kanawha Blvd. Charleston, WV 25305 304/558-2696		West Virginia Advocates, Inc. Litton Building, 4th Floor 1207 Quarrier St. Charleston, WV 25301 304/346-0847 800/950-5250
W I S C O N S O N
Early Intervention-800/642-7837 Assistant Superintendent Division of Learning Support: Equity and Advocacy Department of Public Instruction 125 S. Webster P.O. Box 7841 Madison, WI 53707-7841 608/266-1649	Executive Director Wisconsin Coalition for Advocacy, Inc. 16 N. Carroll Street, Suite 400 Madison, WI 53703 608/267-0214	Governors Commission for People with Disabilities 1 W. Wilson Street, Room 558 P.O. Box 7852 608/267-7422 800/362-1290
W Y O M I N G
Early Intervention-800/438-5791 Federal Programs Unit State Department of Education Hathaway Bldg. 2300 Capitol Avenue Cheyenne, WY 82002-0050 307/777-7417		Executive Director Protection & Advocacy System, Inc. 2424 Pioneer Ave., No. 101 Cheyenne, WY 82001 307/638-7668 307/624-7648

Early Intervention Programs

City and State Programs

City and State programs provide free services to families based on a child’s age and needs. Services accessed for children ages birth to 3 years are typically provided by city programs regulated and funded through the State’s Department of Health. These programs are called Early Intervention Programs. Services accessed for children ages 3 years and up are usually regulated through the State’s Board of Education Program. These programs are called,”Committee on PreSchool Special Education Programs (CPSE). All programs though regulated from separate sources, are aimed at assisting children in achieving their developmental goals in becoming school ready. Services may be obtained for free based on separate eligibility requirements for each of the 2 program types, and have the following purposes:
– to assist children with developmental delays in becoming school ready so they do not fall behind in the school system
– to identify early, any conditions or disorders associated with learning

Early Intervention

As mentioned above, Early Intervention Programs are city and state programs regulated and funded by each state’s Department of Health. Every state has an Early Intervention Program available to provide eligible children with services to help children ‘catch up’ in their development. Early Intervention Programs are not typically advertised and are usually referral based with most referrals coming from Pediatricians and other parents. Early Intervention Programs within each State do not necessarily provide the actual services, they only fund and approve them. Early Intervention “Providers” are private or non-profit businesses that actually provide the services and then bill the State or City’s Early Intervention Program. To obtain services for your child you must first contact your State’s Early Intervention Office, to find out which providers are nearest you, and then choose an Early Intervention Provider that best suites your child’s needs. Many EI Providers have their own specialties, for example ‘United Cerebral Palsy, (UCP)”, provides EI services to all children eligible and of course may have many more resources to services for children with Cerebral Palsy. You may call EI Providers and arrange to have a tour of their facilities to check them out before hand before choosing one. If you do so however, you must try not to waste too much time; the enrollment process can take long enough. It is not impossible for a child to go through a long evaluation process just in time to transfer out of the Early Intervention Program. I heard from a parent once that while choosing an Early Intervention Provider and touring their facilities, what helped her make her decision was the greetings she received from the staff. On one of her tours she was greeted by everyone passing by while in the waiting area, even the janitor had stopped to say hello to both her and her two sons. She claimed that this impressed her and that to see a facility where all the staff are both happy to work there and friendly, she knew she had made the right choice.

What types of services can I receive for my child through an Early Intervention Program?

The answer is: as many services that your child is eligible for that are out there. Typically you must have your child tested for eligibility first. Testing would determine your child’s estimated, developmental age for each of the 6 areas of development. From there your child could be eligible to receive services at home, in a classroom or even both, depending on your child’s age and needs. If your child tested as delayed in speech, then your child would be eligible to receive Speech Therapy either at home, one on one with a Speech Therapist, or at a center. A child could be eligible to receive services such as: Speech Therapy, Physical Therapy, Occupational Therapy, Special Instruction, Vision Therapy, Respite (home care), Daycare, medical, Parent Training, Family counseling, Psychological Play Therapy, and many more of course depending on your child’s and family’s needs.

THE EI Process:

1)You must first choose an Early Intervention Provider. Remember to not waste too much time in doing so; children grow fast and everyday counts.
2)Contact the provider to arrange testing. The provider you chose would first take your information and forward it to the Early Intervention Office in notification. EI will assign an ID number to your child and alert the provider to proceed with testing. This takes approximately 2-3 days.
3)A ‘Service Coordinator’ will be assigned to your child. This person may or may not be from the provider you chose though is there to advocate on your child’s behalf regardless. Your SC will explain to you your rights: that all information you provide is confidential, that these services are voluntary and that you may terminate services at any time, and that you have the right to choose any provider of services that best suites your child’s needs. The SC will wish to meet with you to obtain your signature for some consents and obtain your insurance information. EI plans on billing your insurance company for the services it will approve though you may refuse to provide this info – it is your right to refuse. You may only have to put your refusal in writing if you choose to do so. Typically you will not be billed by your insurance company and if you give this information, it will not affect your deductible. EI would be responsible for any bills you might receive by your insurance since they state that their services are at no cost to families.
4) Choose the place to have testing conducted. Most places allow you to choose to have testing conducted either at your home or at the center. Just know that testing will be conducted with your child by a stranger and if at a center, in an unfamiliar place. Testers understand this and know that your child may not perform typically which is why much of the testing is based on parent input. The tester will basically ask you the parent if your child has certain skills. To get a sample of the skills an evaluator will look to observe based on your child’s age, go to the “Milestones” page of this web site.
5) Test #1: The Developmental Test. The first test should be conducted by a Special Educator and will be a ‘general’ test. In other words, the test will not be specific to the individual areas of development. It will score estimated results of developmental ages in each of the developmental areas. For example, a 2 year old child may only score as a 1 year old in speech, and a 3 year old in physical development – thus having 1 year as the developmental age for speech and being 1 year delayed. Based on the results of this test, eligibility would be determined first to see if your child should need any specific tests. In the previous example, a year delay in speech would then merit the need for a more specific evaluation for your child’s speech. The person that conducts this first test would have at least a Master’s Degree in Special Education. The reason why a general, developmental test to look at all areas is performed first despite possibly that your concern may only be in your child’s speech for example, is that EI wants to be sure that if they are to provide a service, they must first learn that this service is the only service your child needs.
6)Other specific tests would then be conducted depending on the results of the developmental test. These might be a Speech evaluation, a Physical Therapy evaluation, etc. or multiple tests.
7)Eligibility is then determined from the results of testing. Typically your child must have a 33% delay in an area in order to receive services for that area. If your child is 33% delayed in one area already, then your child need only be 25% delayed in another area in order to receive services for that area. The Service Coordinator would be responsible for explaining the results of testing to you and also explain your rights as to what you can now do regarding these results. If you are not happy with the results or disagree, you may request a new test or discuss it at the meeting coming up.
8)Meeting with EI scheduled. Once eligibility has been determined, a meeting will then be scheduled by your Service Coordinator with Early Intervention. This meeting should include an EI Official Designee, at least one member of the evaluation team, your Service Coordinator, and anybody that you feel should be present.
9)The EI Meeting. At this meeting you will discuss what services you would like to receive for your child. An Individualized Family Service Plan will be formed based on the goals you wish your child to receive from Early Intervention Services. At this meeting you may voice your opinion regarding testing results and try to obtain approval for additional services available such as Parent Training, Respite (home or emergency care), or Family Counseling if needed and for example. Your Service Coordinator should be able to prepare you before hand as to what to expect of this meeting and what services you should be eligible to receive. You will determine the type of services that are best for your child – whether you wish to receive services at home or at an EI Center. A frequency of services will be recommended based on the evaluation results and based on the recommendations of the evaluators. A typical frequency for a service such as Speech Therapy for example, would be 30 minutes, 2 or 3 days a week. All services approved at this meeting will be approved in 1 year intervals up until your child turns 3 years of age. Every 6 months your Service Coordinator will wish to meet with at least one of the therapists assigned to your child and review the the goals outlined in the IFSP and your child’s progress. Based on your child’s progress or lack of progress, every 6 months in this review, you may opt to change your service plan to include additional services, additional days, less days, longer sessions, etc. Your Service Coordinator would be responsible for assisting you with any of the changes you would like to make.
10) Services. You may interview and screen the therapists who get assigned to work with your child. If for any reason you feel that a particular therapist is not doing well with your child, you may opt to have a new therapist. Consider however, that therapist’s availability may be limited and there may be a wait for an available therapist. It is also your right to be present during or at least observe all the therapy sessions. Just keep in mind that being present during the sessions may distract your child and render the sessions
useless. Therapists are required to go over the session with you so make sure you learn what it is they are doing in the sessions. It is important that you learn these things and help carry them over after the therapy sessions so your child benefits most from therapies.

Areas of Development

Cognitive Development:
This area defines a child’s ability to think, process information, learn and solve problems. There are several theories that describe the skills and processes associated with infant learning and taught in schools today. Such skills and information processing and are: object permanence (ability to understand that objects and events continue to exist even though the infant is no longer in contact with them), attention, symbolic play, imitation,conceptual ability, habituation (the repeated presentation of the same stimulus causing reduced attention over time), and memory. Several developmental tests are used today and were developed based on these theories. Some of the more common tests used are The Bayley Scales of Infant Development and The H.E.L.P. Checklist. Such tests evaluate an infant’s auditory and visual attention, manipulation of objects and toys, interaction with examiner and imitation, memory involved with object permanence (like finding hidden toy), goal-directed behavior involving persistence (like peg board, shape sorter), ability to follow directions, knowledge of object names and understanding concepts (such as concept of ‘one’).
Milestones associated with this area are: identifies self in mirror(15-16 months), identifies 6 body parts(22-24 months) and completes 3-4 piece puzzle (30-36 months).Children who are tested and found delayed in this area would be recommended to receive “Special Instruction” services either at home, in a classroom setting or both, depending on the child’s needs and age. A Special Education Teacher would be serviced to assist a child’s development in this area. Special Instruction in a classroom setting also overlaps with learning skills in each of the other areas as well due to many of the classroom activities.

Communication Development:
Language: In an infant’s first few months, sharp noises can show a startle response. At 3 to 6 months, infants can begin to show an interest in sounds, play with saliva, and respond to voices. In the next 3 to 6 months, babbling can begin and is determined mainly by biological maturation, not so much reinforcement, hearing, or care-giver-infant interaction. It has been found that deaf babies can begin to babble at this time. The purpose of a baby’s earliest communication is to attract attention from parents and others in the environment. This is usually accomplished by a baby making and breaking eye contact, by vocalizing sounds, or by performing manual actions such as pointing. All of these behaviors involve the aspect of language called pragmatics.
The environment can play a significant role in communication development. It is encouraged for babies to be bathed in language very early by speaking to them extensively, especially about what the baby is attending to at the moment.

Communication is divided further into 3 areas when assessed:

Receptive Speech: This area is defined as a child’s ability to understand words as they are spoken to them. It involves understanding directions in steps, answering questions or responding appropriately when spoken to.

Expressive Speech: This area defines a child’s ability to produce sounds in expression of wants and needs; the child’s ability to appropriately speak. It involves vocalizing all needs, vocabulary building and identifying by name.

Oro-Motor: This is the physical aspect responsible for speech; it involves the oral mechanics behind sound production. Since this area of speech focuses on muscles of the mouth, movement of the tongue, reflexes and coordination, both Speech Therapists and Occupational Therapists work with children for this area.

Some of the milestones in infant communication are: babbling(3-6 months), first words understood(6-9 months), growth of receptive vocabulary(reaches 300 words or more by age 2), first instructions understood (9 months to 1 year), first word spoken(10-15 months), and the growth of spoken vocabulary(reaches 200-275 words by age 2).

Concepts expected with two-word statements by ages 18 to 24 months are:identification(‘see book’), location(‘toy there’), repetition(‘more’), nonexistence(‘all gone’), negation(‘not dog’), possession(‘my toy’), attribution(‘big car’), agent-action(‘mom move’), action-direct object(‘hit you’), action-indirect object(‘give dadda’), action-tool(‘cut knife’), and question(‘where ball?’).

Speech Therapists typically work with children delayed in this area either one to one at home, at a center, in a speech group, or in a classroom. Occupational Therapists overlap with respect to oro-motor, and Special Education Teachers overlap in this area with respect to working with a child’s speech in the classroom.

Physical Development (gross motor):
This area involves the development and coordination of large muscle groups. At birth, an infant does not have significant coordination of chest and arms, yet in the first month an infant should lift its head from a prone position. At about 3 months, an infant should hold its chest up and use its arms for support after being in a prone position. At 3 to 4 months, infants should roll over, and at 4 to 5 months, they should support some weight on their legs. Other skills associated with this area are rolling over, holding head up, walking, balance and ascending/descending stairs. The actual month at which the milestones occur varies by as much as 2 to 4 months, especially among older infants. What remains fairly uniform however, is the sequence of accomplishments. As each skill is learned, so does the level of independence as well.

Physical Therapists are serviced to work with children delayed in this area, typically on a one to one basis. A common condition that occurs in children who were breached or born of multiple births and in need of physical therapy, is torticollis. If a child is in a constraining position while in the womb, muscles can become tightened and in the case of torticollis, the neck muscle is tightened. In this case a child would be born with his/her head tilted to one side. Physical therapy for a few months, 2 or 3 times a week and some parental carry-over exercises could relieve this condition.

Hand/Eye Coordination (fine motor):
This area involves the delicate coordination of smaller muscles and muscle groups such as hands, fingers, mouth and eyes. Infants have hardly any control over fine motor skills at birth, although they have many components of what later become finely coordinated arm, hand, mouth and finger movements. Skills associated with this area involve reaching and grasping, manipulating objects, coloring with a crayon, grasping objects appropriately, following objects with eyes, and later, feeding oneself and being toilet trained. This area can also include two other areas of development:

Feeding: This area is focused on oro-motor development. By stimulating certain areas of the mouth with foods and therapeutic devices, a child may learn to coordinate the mouth muscles necessary for speech and eating various textured foods. Occupational and Speech Therapists work with children in this area.
Sensory Development: This area of development involves sensory integration; it involves how a child tolerates touching all textures like sand or water, tolerates loud noises, tolerates being touched, and tolerates being picked up off the ground. Occupational Therapists work with children in this area. Occupational Therapy focuses on these areas and may at times involve other therapies such as Speech and Physical Therapy. A child with delays in motor planning/coordination may need Physical, Occupational and Speech Therapies, for example.

Social/Emotional Development:

This area involves a child’s ability to display and identify emotions such as fear and anger, for example. It is also the area that involves attachment, temperament, how a child acts in social situations such as greeting people hello or goodbye, sharing attention with another, and looking at another for approval. Emotions are the first language that parents and infants communicate with before the infant acquires language. various emotions occur at different ages – for example, a social smile (4-6 weeks), surprise (3-4 months), and shame (6-8 months).

Attachment to a caregiver intensifies at about 6 to 7 months of age, and can be classified by three areas: secure – assumed optimal for development, avoidant, or resistant. An infant’s temperament (such as easy, difficult, or slow to warm up) is strongly influenced by biological factors but becomes more malleable with experience. Psychologists, Social Workers and classroom settings all play key roles in working with children delayed in this area.

Adaptive/Self Help Development:

This area involves a child’s independence, ability to do things for one’s self, and a child’s ability to adapt to the environment. As children progress in physical and coordination development, they have more opportunities to explore their environment and gain independence. Skills associated with this area are feeding oneself, opening door independently, unzips/zips zipper and going in potty independently, for examples. Occupational Therapists and Special Instruction Teachers typically work with delayed children in this area.

Access to US Services

TOLL FREE HOTLINES

•American Association on Mental Retardation
(800)424-3688
•AMC Cancer Information Center
(800)525-3777
•American Cleft Palate Education Foundation
(800)242-5338
•American Diabetes Association
(800)232-3472
•American Foundation for the Blind
(800)232-5463
•American Kidney Fund
(800)638-8299
•American Liver Foundation
(800)223-0179
•American Paralysis Association
(800)225-0292
•Amputee Coalition of America
National Limb Loss Information Center
(888)267-5669
•Cancer Information Service National Line
(800)4-CANCER
•Captioned Films for the Deaf
(800)237-6213
•Chrysler Corporation Assistance Line for
the Disabled Driver
(800)255-9877
•Cornelia de Lange Syndrome Foundation
(800)223-8355
•International Shriners Headquarters
(800)237-5055 •Job Accommodation Network (JAN)
(800)JAN-PCEH

•Job Opportunities for the Blind
(800)638-7516
•Lung Disease
(800)22-LUNG
•Medicaid Hotline
(800)638-6833
•National Adoption Center
(800)862-3678
•National Association for Hearing and Speech Action
(800)638-8255
•National Association for Parents of the Visually Impaired
(800)562-6265
•National Center for Stuttering
(800)221-2483
•National Child Abuse Hotline
(800)4-A-CHILD
•National Crisis Center for the Deaf
(800)446-9876 [TDD only]
•National Hearing Aid Society
(800)521-5247
•National Information Center for Developmental Disabilities
(800)922-9234
•National Multiple Sclerosis Society
(800)344-4867
•National Spinal Cord Injury Hotline
(800)526-3456
•National Tuberous Sclerosis Association
(800)225-NTSA
•Retinitis Pigmentosa Association
(800)344-4877
•Sickle Cell Disease Association of America
(800)421-8453

Warning Signs and Behaviors of Childhood Disorders Articles

Warning Signs and Behaviors of Childhood Disorders, Part VII: Eating & Feeding Disorders (Pica, Rumination, Feeding)

How could I know the difference between a warning sign and an appropriate behavior?
answer: Know the warning signs.
These disorders of Infancy and Early Childhood are characterized by persistent disturbances in feeding and eating (DSM-IV).

Pica
Pica is significant for the persistent eating of nonnutritive substances which may vary with age. Infants and younger children are typically found to eat string, hair, plaster, paint, or cloth. Older children may tend to eat animal droppings, sand, insects, leaves, or pebbles. Adolescents may eat soil or clay. These eating behaviors would be developmentaly inappropriate and typically associated with other mental disorders. Specific symptons significant of this disorder are:
• Persistent eating of nonnutritive substances
for at least 1 month
• The eating of nonnutritive substances is
inappropriate to developmental level
• The eating behavior is not part of a culturally
sanctioned practice
• It is sufficiently severe to warrant independent
clinical attention

Rumination Disorder
Rumination Disorder is known for the repeated regurgitation and rechewing of food that develops in infants or children after a period of normal functioning. Partially digested food is brought back up to the mouth without apparent nausea, retching, disgust or associated gastrointestinal disorder. The food is either ejected or more frequently, chewed and reswallowed. These symptoms would not be due to another medical condition. (DSM IV). Infants and children are typically irritable and hungry between episodes of regurgitation having this disorder. Specific symptons significant of this disorder are:
• Repeated regurgitation and rechewing of food for
at least 1 month following a period of normal functioning
• These behaviors are not due to an associated
gastrointestinal or other medical condition
• Symptoms are sufficiently severe to warrant
independent clinical attention

Feeding Disorder
Feeding Disorder is significant for its persistent failure to eat adequately, as reflected in significant failure to gain weight or significant weight loss over at least 1 month. Infants with feeding disorder are often irritable, difficult to console during feeding, may appear apathetic and withdrawn, and may also exhibit developmental delays. (DSM IV). Other factors that may contribute to this disorder include parental psychopathology and child abuse or neglect. Specific symptons significant of this disorder are:
• Feeding disturbance manifested by persistent failure to
adequately eat with significant failure to
gain weight or significant loss of weight
over at least 1 month
• Feeding disturbance is not due to an associated
gastrointestinal or other medical condition
• often actively defies or refuses to comply with
adults’ requests or rules
• Disturbance is not better accounted for by another
mental disorder or lack of available food
• The onset is before age 6

Note: The above lists are not intended for the use of diagnosing disorders. Disorders are diagnosed by the severity, frequency and a combination of many factors. Please seek professional advice should any of the above listed criteria cause any concern.

Warning Signs and Behaviors of Childhood Disorders, Part VI: Oppositional Defiant Disorder

How could I know the difference between a warning sign and an appropriate behavior?
answer: Know the warning signs.
Warning Signs and Behaviors:
Oppositional Defiant Disorder
Oppositional Defiant Disorder is significant for a recurrent pattern of negative, defiant, disobedient, and hostile behaviors toward authoritative figures. These behaviors consist of losing temper, arguing with adults, deliberately doing things to annoy others, actively defying or refusing to comply with rules or requests, blaming others for his/her own mistakes or misbehavior, being touchy or is easily or easily annoyed by others, being angry and resentful, or being spiteful and vindictive (DSM IV). Behaviors would lead to significant impairment in social, academic, or occupational functioning. Some of the symptoms significant of this disorder are:
Pattern of negativistic, hostile, and defiant behavior lasting at least 6 months:
• often loses temper
• often argues with adults
• often actively defies or refuses to comply with
adults’ requests or rules
• often deliberately annoys people
• often blames others for his/her mistakes or
misbehavior
• is often touchy or easily annoyed by others
• is often angry and resentful
• is often spiteful and vindictive

Warning Signs and Behaviors of Childhood Disorders, Part V: Conduct Disorder

How could I know the difference between a warning sign and an appropriate behavior?
answer: Know the warning signs.
Warning Signs and Behaviors:
Conduct Disorder
Conduct Disorder is significant for a repitive and persistent pattern of behavior where the basic rights of others, age-appropriate norms or rules are violated. These behaviors consist of aggressive conduct that causes/threatens physical harm, non-aggressive conduct causing property loss or damage, theft or deceiptfulness, and serious violations of rules (DSM IV). Severity of this disorder varies from mild, moderate and severe. Some of the symptons significant of this disorder are:
Aggression to people & animals:
• often bullies, threatens, or intimidates others
• often initiates physical fights
• has used a weapon that can cause serious physical
harm to others (e.g., knife, gun, broken bottle, a bat)
• has been physically cruel to people
• has been physically cruel to animals
• has stolen while confronting a victim (e.g., mugging,
purse snatching, armed robbery, extortion)
• has forced someone into sexual activity
Destruction of property:
• has deliberately engaged in fire setting with
the intention of causing serious damage
• has deliberately destroyed other people’s property
(other than by fire)
Deceiptfulness or theft:
• has broken into someone else’s home, building, or car
• often lies to obtain goods or favors
or to avoid obligations (e.g., ‘cons’ others)
• has stolen items of nontrivial value without
confronting a victim (e.g., shoplifting- without
breaking and entering, forgery)
Serious violations of rules:
• often stays out at night despite parental
prohibitions, before age 13 years
• has run away from home overnight at least
while living in parents/surrogate’s home
• is often truant from school, beginning
before age 13 years

Child Development Information

Prenatal Development