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exposure to lead paint, alcohol abuse, fetal alcohol syndrome, abandonment, post-natal drug exposure, homelessness, and family violence. One commenter suggested

the list of factors be preceded by the phrase “including,

but not limited to.”

Discussion: The list of factors that may contribute to an infant or toddler being considered at-risk for a

developmental delay included in §303.5 is not meant to be

exhaustive. We have not expanded this list further because

§303.5 provides a sufficient number and range of factors

that a State may include in its definition of at-risk infant or toddler for each State to understand the scope of

the regulation. Further, §303.5 provides discretion and

flexibility for each State to define at-risk infant or toddler and determine the factors that may contribute to an infant or toddler being considered at-risk for a developmental delay in light of the unique needs of the

State’s at-risk population. Therefore, revising the

definition of at-risk infant or toddler to expand the list

of factors included in the definition is not necessary.

For clarity, we have replaced the phrase “such as,”

which precedes the list of factors, with the word

“including.” We note that the definitions of include and

including in §303.18 clarify that the items named in a