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Note:  This document has been delivered to the Office of the Federal Register but has not yet been scheduled for publication.  The official version of this document is the document that is published in the Federal Register.

service provider’s office may be considered the natural

environment in cases when specialized instrumentation or equipment that cannot be transported to the home is needed. Natural environments mean settings that are natural or typical for an infant or toddler without a disability.

Section 635(a)(16) of the Act and §303.126 require services

be provided, to the maximum extent appropriate, to infants and toddlers with disabilities in natural environments

(including the home and community settings). We do not

believe that a clinic, hospital or service provider’s

office is a natural environment for an infant or toddler without a disability; therefore, such a setting would not be natural for an infant or toddler with a disability.

However, §303.344(d)(1) requires that the identification of

the early intervention service needed, as well as the appropriate setting for providing each service to an infant or toddler with a disability, be individualized decisions

made by the IFSP Team based on that child’s unique needs,

family routines, and developmental outcomes. If a determination is made by the IFSP Team that, based on a review of all relevant information regarding the unique needs of the child, the child cannot satisfactorily achieve the identified early intervention outcomes in natural environments, then services could be provided in another