65G-4.017. Establishing Eligibility

(1) Establishing Eligibility – Autism. A diagnosis of autism, as defined by Rule 65G-4.014, F.A.C., may only be made by one or more of the following who has specific training and experience in making such diagnosis:

(a) A Florida-licensed psychiatrist;

(b) A Florida-licensed psychologist;

(c) A board-certified pediatric neurologist who is qualified by training and experience to make a diagnosis of autism;

(d) A board-certified developmental pediatrician, or

(e) Collateral information received from another state may be accepted if the evaluator is licensed through the same credentials required for licensure in Florida for the professions listed in paragraph (1)(a), above.

(2) Establishing Eligibility – Cerebral Palsy. Diagnosis is confirmed by written documentation from one or more of the following:

(a) A medical doctor;

(b) A doctor of osteopathy, or

(c) Medical records documenting a diagnosis of cerebral palsy before the age of 18.

(3) Establishing Eligibility – Mental Retardation or Intellectual Disability. To establish that an individual has mental retardation the following criteria shall be applied:

(a) A single test or subtest should not be used alone to determine eligibility. If a person has significantly different (statistically defined) scores on different scales of a test or tests, or a great deal of variability on subtest scores of an IQ test, the full-scale score may not indicate mental retardation and should not be relied on as a valid score. In that instance, closer scrutiny is required to make an appropriate differential diagnosis. This may include review of school records, school placement, achievement scores, medical records, medication history, behavior during testing and the psychosocial situation at the time of testing. Closer scrutiny must also be required when there is a great deal of variability between IQ scores on different IQ tests or different administrations of the same IQ test. Nothing here is intended to preclude clinical judgment from appropriately determining that a single full-scale IQ score of 70 or below, or two or more standard deviations below the mean, on an individually administered intelligence test is sufficient to establish eligibility.

(b) The performance measures for this category of adaptive functioning deficits must be validated by the professional judgment of a psychologist who is experienced in working with people who have retardation, who has specific training and validation in the assessment instrument that is used, and who is one of the following:

1. A Florida-licensed psychologist,

2. A Florida-licensed school psychologist,

3. A certified school psychologist.

(c) Any standardized test may be submitted as proof. However, the applicant must demonstrate that any test not presumptively accepted by the agency is valid. The following are presumptively accepted standardized tests of intelligence to establish eligibility for mental retardation:

1. Stanford-Binet Intelligence Test (all ages),

2. Wechsler Preschool and Primary Scale of Intelligence (under six years of age),

3. Differential Ability Scales – Preschool Edition (under six years of age),

4. Wechsler Intelligence Scale for Children (WISC) (children up to 15 years, 11 months),

5. Differential Ability Scales (children up to 15 years, 11 months),

6. Wechsler Adult Intelligence Scale (WAIS),

7. Test of Nonverbal Intelligence-3 (TONI-3),

8. Comprehensive Test of Nonverbal Intelligence-2 (C-TONI 2),

9. Universal Nonverbal Intelligence Test (UNIT),

10. Leiter International Performance Scale-Revised (Leiter-R).

(d) The following tests of adaptive functioning are presumptively accepted in the determination:

1. Vineland Adaptive Behavior Scales,

2. AAMR Adaptive Behavior Scale,

3. Adaptive Behavior Assessment System (ABAS),

4. Adaptive Behavior Evaluation Scale (ABES).

5. Scales of Independent Behavior-Revised

(e) In all cases, assessments or evaluations for eligibility should be obtained from appropriately licensed professionals with experience and training in the instruments and population for whom eligibility is to be determined.

(4) Establishing Eligibility – Prader-Willi Syndrome. Diagnosis is confirmed by written documentation from one or more of the following:

(a) A medical doctor;

(b) A doctor of osteopathy, or

(c) Medical records that document a diagnosis of Prader-Willi syndrome before the age of 18.

(5) Establishing Eligibility – Spina Bifida. Diagnosis is confirmed by written documentation from one or more of the following:

(a) A medical doctor;

(b) A doctor of osteopathy, or

(c) Medical records that document a diagnosis of spina bifida cystica or myelomeningocele before the age of 18.

(6) Establishing Eligibility – Down Syndrome. Evidence under this category requires medical records documenting a chromosome analysis (also referred to as a karyotype) finding the individual has an extra genetic material on their number 21 chromosome.

(7) Establishing Eligibility – Phelan-McDermid Syndrome. The diagnosis of Phelan-McDermid Syndrome must be confirmed utilizing genetic testing, with written documentation from a:

(a) Medical doctor, or

(b) Doctor of osteopathy.

(8) Establishing Eligibility – High-Risk Children, 3 to 5 years of age. Evidence under this category requires a determination by an APD area office that a medical diagnosis of developmental delay evidenced by the child indicates a high probability that the child is likely to have an eventual diagnosis of a qualifying condition under rule 65G-4.014, F.A.C., if early intervention services are not provided, or the child has one or more physical or genetic anomalies associated with a developmental disability, such as:

(a) Genetic or chromosomal disorders (such as Down syndrome or Rett syndrome);

(b) Metabolic disorders (such as phenylketonuria);

(c) Congenital malformations (such as microcephaly or hydrocephaly);

(d) Neurological abnormalities and insults;

(e) Congenital and acquired infectious diseases;

(f) Chronic or catastrophic illnesses or injuries;

(g) A parent or guardian with developmental disabilities who requires assistance in meeting the child’s developmental needs, or

(h) Other conditions or genetic disorders generally associated with developmental disabilities, such as tuberous sclerosis, congenital syphilis, fetal alcohol syndrome, or maternal rubella, as documented by a physician.

(i) If a child between three and five years of age already has been determined to have a developmental disability in one of the five categories identified in chapter 393, F.S., that child shall be eligible for services from the agency under the appropriate diagnosis and shall be added to the waiting list.

(j) If a child served under the category of high risk does not have a confirmed diagnosis by his or her fifth birthday, they shall be given a notice of case closure and the case will be closed at the agency. The agency shall make the child’s parent or guardian aware of appropriate agencies, programs or school programs which the agency is aware of which might be able to assist the child.

(9) This rule shall be reviewed, and if necessary, renewed through the rulemaking process five years from the effective date.

Rulemaking Authority 393.065(10), 393.066(8), 393.501 FS. Law Implemented 393.065, 393.066 FS. History–New 5-16-12, Amended 6-3-20.