Developmental Services - Case Management Manual

Evaluations and Consultations

Any number of variables will enter into making a request for an evaluation or consultation, including sound judgment and common sense. Age, history, current programming and other evaluations should all be taken into consideration. The interdisciplinary team must be a pat of the referral process so that team members can offer information and receive feedback from the evaluation. Such an approach strengthens the cooperative effort and helps the team to function with other consumers, as well as the person being referred.

Frequency of evaluations should be determined by the needs of the consumer and the evaluator.

Evaluations for youngsters are frequently repeated every six months or yearly because of the child's rapid growth. Adults may need to be seen again every year or even every three years. The degree of intervention programmed by the specialist will also determine frequency of evaluation. Consultation should be done on an as needed basis with a note indicating the consultation has taken place. More frequent evaluations may be required for consumers in the waiver program and those subject to behavioral procedures.

The "why" of referral, evaluation and consultation seems obvious, but is often overlooked. The referring party should assist in not only gathering information for the specialist to use in the evaluation, but also to have in mind what is expected from the final report. A list of specific questions regarding the consumer would give the specialist or therapist a good starting point. The Case Manager might note that a certain problem showed up on a screening and ask why. Another problem might be evident, but strategy is the help being sought.

One important result of any evaluation is the final written report. This document should be received in a timely manner, and, if it isn't, then the referring person should work to expedite its release.

The four primary disciplines generally associated with services for the persons eligible for Developmental Services  are occupational therapy, communication therapy, physical therapy and psychology. There in increasing recognition of other types of intervention however for purposes of this section, the focus will be on the use of the four primary disciplines: These disciplines provide consumers with evaluations and therapy and deliver consultations, program design and a wide variety of general and specific in-service training to district staff and providers. Other disciplines are briefly noted.

It is important for Case Managers to have a clear understanding of what types of intervention each discipline can provide. Understanding how each therapy can assist the person in his/her development will help the Case Manager make good judgments about when to refer and what questions to present to the therapist.

Support services staff is a valuable resource to the Case Manager and they should be consulted whenever there is a question about a consumer's progress or development. for example, changes in a consumer's behavior may signal a need for a psychological evaluation or minor modifications in a person's person centered plan. Consultation with the psychologist can help determine the appropriate course of action. Also, the role of the occupational therapist with adult consumers can not be understated. Many adults with intellectual disabilities have sensory problems that contribute to difficulty functioning in other areas. Consultation with the occupational therapist can help to identify and resolve these difficulties through appropriate person centered planning. Frequent consultation with support services staff will insure timely and appropriate intervention in a consumer's program.

Tips on Making Referrals

  • Provide the therapist with relevant background information about the consumer, i.e., history, previous evaluations from within that discipline or from a related discipline.
  • Ask specific referral questions, preferably in writing, when requesting the evaluation or consult.
  • Assure that necessary release forms are signed.
  • Make the referral one to three months prior to the date report is needed, and make sure evaluator is aware of relevant timelines, i.e., date of person centered plan.
  • If the evaluator requests that referral form is completed, assure that this is done.
  • Attempt to assure that a person who is knowledgeable about the consumer is available to the therapist or clinician at the time of the evaluation/consult. 
  • Request a qualified interpreter (if needed) immediately after the appointment is scheduled. Assist the therapist in locating interpreters who work well with the consumer.