Broadly speaking, early intervention services are specialized health, educational, and therapeutic services designed to meet the needs of infants and toddlers (from birth through age two, who have a developmental delay or disability) and their families. At the discretion of each State, services can also be provided to children who are considered to be at-risk of developing substantial delays if services are not provided.
Sometimes it is known from the moment a child is born that early intervention services will be essential in helping the child grow and develop. Often this is so for children who are diagnosed at birth with a specific condition or who experience significant prematurity, very low birth weight, illness, or surgery soon after being born. Even before heading home from the hospital, this child’s parents may be given a referral to their local early intervention office.
Some children have a relatively routine entry into the world, but may develop more slowly than others, experience set backs, or develop in ways that seem very different from other children. For these children, a visit with a developmental pediatrician and a thorough evaluation may lead to an early intervention referral, as well. However a child comes to be referred, assessed, and determined eligible—early intervention services provide vital support so that children with developmental needs can thrive and grow.
What areas of child development are Early Intervention services designed to address?
In a nutshell, early intervention is concerned with all the basic and brand new skills that babies typically develop during the first three years of life, such as:
- physical (reaching, rolling, crawling, and walking)
- cognitive (thinking, learning, solving problems);
- communication (talking, listening, understanding);
- social/emotional (playing, feeling secure and happy); or,
- self-help (eating, dressing).
What if I have a Concern?
My child seems to be developing much slower than other children. Would he/she be eligible for early intervention services?
It is possible that your child may be eligible for early intervention, but more investigation is necessary to determine that. If you think that your child is not developing at the same pace or in the same way as most children his or her age, it is often a good idea to talk first to your child’s pediatrician. Explain your concerns. Tell the doctor what you have observed with your child. Your child may have a disability or what is known as a developmental delay, or he or she may be at risk of having a disability or delay. Developmental delay is a term that means an infant or child is developing slower than normal in one or more areas (Anderson, Chitwood, & Hayden, 1997). For example, he or she may not be sitting up (or walking or talking) when most children of that age are. The term at risk means that a child’s development may be delayed unless he or she receives early intervention services. So, if you are concerned about your child’s development, you will need to have your child evaluated to find out if he or she is eligible for early intervention services. This evaluation is provided at no cost to you. There are many people who can help you with this.
Where do I go for help?
There are a number of ways you can find help for your child. Since you are reading this article, we recommend that you go to the NICHCY State Specific Resources page, select your state, select “Early Intervention Program” located in the right navigation bar entitled Popular Searches. There, we have listed the main contact number for early intervention services in your state. Call the agency listed. Explain that you want to find out about early intervention services for your child. Ask for the name of a contact person in your area.
If you don’t have a State Resource Sheet for your state, visit our Web site at http://www.nichcy.org/Pages/StateSpecificInfo.aspx. All State Resource Sheets are available there. You can also call NICHCY at 1.800.695.0285 and ask one of our information specialists to give you the number for early intervention services in your state. How else might you find out about early intervention services in your community? Here are two ways: Ask your child’s pediatrician to put you in touch with the early intervention system in your community or region; Contact the Pediatrics branch in a local hospital and ask where you should call to find out about early intervention services in your area. It is very important to write down the names and phone numbers of everyone you talk to. You can use the Parent’s Record-Keeping Worksheet found further down on this page. Having this information available will be helpful to you later on.
What do I say to the early intervention contact person?
Explain that you are concerned about your child’s development. Say that you think your child may need early intervention services. Explain that you would like to have your child evaluated under IDEA. Write down any information the contact person gives you. The person may refer you to what is known as Child Find. One of Child Find’s purposes is to identify children who need early intervention services. Child Find operates in every state and conducts screenings to identify children who may need early intervention services. These screenings are provided free of charge. Each state has one agency that is in charge of the early intervention system for infants and toddlers with special needs. This agency is known as the lead agency. It may be the state education agency or another agency, such as the health department. Each state decides which agency will serve as the lead agency. The agency listed on the NICHCY State Resource Sheet under the heading “Programs for Infants and Toddlers: Birth Through 2” is your state’s lead agency.
What Happens Next?
Once you are in contact with the early intervention system, the system will assign someone to work with you and your child through the evaluation and assessment process. This person will be your temporary service coordinator. He or she should have a background in early childhood development and ways to help young children who may have developmental delays. The service coordinator should also know the policies for early intervention programs and services in your state. The early intervention system will need to determine if your child is eligible for early intervention services. To do this, the staff will set up and carry out a multidisciplinary evaluation and assessment of your child. Read on for more information about this process.
What is a Multidisciplinary Evaluation and Assessment?
IDEA requires that your child receive a timely, comprehensive, multidisciplinary evaluation and assessment. The purposes of the evaluation and assessment are to find out:
- the nature of your child’s strengths, delays, or difficulties, and
- whether or not your child is eligible for early intervention services.
Multidisciplinary means that the evaluation group is made up of qualified people who have different areas of training and experience. Together, they know about children’s speech and language skills, physical abilities, hearing and vision, and other important areas of development. They know how to work with children, even very young ones, to discover if a child has a problem or is developing within normal ranges.
Group members may evaluate your child together or individually. Evaluation refers to the procedures used by these professionals to find out if your child is eligible for early intervention services. As part of the evaluation, the team will observe your child, ask your child to do things, talk to you and your child, and use other methods to gather information. These procedures will help the team find out how your child functions in five areas of development: cognitive development, physical development, communication, social-emotional development, and adaptive development.
Following your child’s evaluation, you and a team of professionals will meet and review all of the data, results, and reports. The people on the team will talk with you about whether your child meets the criteria under IDEA and State policy for having a developmental delay, a diagnosed physical or mental condition, or being at risk for having a substantial delay. If so, your child is generally found to be eligible for services. If found eligible, he or she will then be assessed. Assessment refers to the procedures used throughout the time your child is in early intervention.
The purposes of these ongoing procedures are to: identify your child’s unique strengths and needs, and determine what services are necessary to meet those needs. With your consent, your family’s needs will also be identified. This process, which is family-directed, is intended to identify the resources, priorities, and concerns of your family. It also identifies the supports and services you may need to enhance your family’s capacity to meet your child’s developmental needs. The family assessment is usually conducted through an interview with you, the parents. When conducting the evaluation and assessment, team members may get information from some or all of the following:
- Doctor’s reports;
- Results from developmental tests and performance assessments given to your child;
- Your child’s medical and developmental history;
- Direct observations and feedback from all members of the multidisciplinary team, including you, the parents;
- Interviews with you and other family members or caretakers; and
- Any other important observations, records, and/or reports about your child.
Who pays for the Evaluation and Assessment?
It depends on your state’s policies or rules. Ask your local contact person or service coordinator about this. However, evaluations and assessments must be done by qualified personnel. As was said above, a multidisciplinary group of professionals will evaluate your child. The group may include a psychologist or social worker, an early interventionist or special educator, and an occupational or physical therapist. All assessments must be performed in your child’s native language. Under IDEA, evaluations and assessments are provided at no cost to parents. They are funded by state and federal monies.
Who is eligible for services?
Under the IDEA, “infants and toddlers with disabilities“ are defined as children from birth through age two who need early intervention services because they are experiencing developmental delays, as measured by appropriate diagnostic instruments and procedures, in one or more of the following areas:
- cognitive development.
- physical development, including vision and hearing.
- communication development.
- social or emotional development.
- adaptive development; or
- …have a diagnosed physical or mental condition that has a high probability of resulting in developmental delay.
The term may also include, if a state chooses, children from birth through age two who are at risk of having substantial developmental delays if early intervention services are not provided.” (34 Code of Federal Regulations §303.16)
My child has been found eligible for services. What’s next?
If your child and family are found eligible, you and a team will meet to develop a written plan for providing early intervention services to your child and, as necessary, to your family. This plan is called the Individualized Family Service Plan, or IFSP. It is a very important document, and you, as parents, are important members of the team that develops it.
What is an Individualized Family Service Plan, or IFSP?
The IFSP is a written document that, among other things, outlines the early intervention services that your child and family will receive. One guiding principal of the IFSP is that the family is a child’s greatest resource, that a young child’s needs are closely tied to the needs of his or her family. The best way to support children and meet their needs is to support and build upon the individual strengths of their family. So, the IFSP is a whole family plan with the parents as major contributors in its development. Involvement of other team members will depend on what the child needs. These other team members could come from several agencies and may include medical people, therapists, child development specialists, social workers, and others. Your child’s IFSP must include the following:
- your child’s present physical, cognitive, communication, social/emotional, and adaptive development levels and needs;
- family information (with your agreement), including the resources, priorities, and concerns of you, as parents, and other family members closely involved with the child;
- the major results or outcomes expected to be achieved for your child and family; the specific services your child will be receiving;
- where in the natural environment (e.g., home, community) the services will be provided (if the services will not be provided in the natural environment, the IFSP must include a statement justifying why not);
- when and where your son or daughter will receive services;
- the number of days or sessions he or she will receive each service and how long each session will last;
- whether the service will be provided on a one-on-one or group basis;
- who will pay for the services;
- the name of the service coordinator overseeing the implementation of the IFSP; and
- the steps to be taken to support your child’s transition out of early intervention and into another program when the time comes.
The IFSP may also identify services your family may be interested in, such as financial information or information about raising a child with a disability. The IFSP is reviewed every six months and is updated at least once a year. The IFSP must be fully explained to you, the parents, and your suggestions must be considered. You must give written consent before services can start. If you do not give your consent in writing, your child will not receive services. Each state has specific guidelines for the IFSP. Your service coordinator can explain what the IFSP guidelines are in your state.
What’s included in early intervention services?
Under IDEA, early intervention services must include a multidisciplinary evaluation and assessment, a written Individualized Family Service Plan, service coordination, and specific services designed to meet the unique developmental needs of the child and family. Early intervention services may be simple or complex depending on the child’s needs. They can range from prescribing glasses for a two-year-old to developing a comprehensive approach with a variety of services and special instruction for a child, including home visits, counseling, and training for his or her family. Depending on your child’s needs, his or her early intervention services may include:
- family training, counseling, and home visits;
- special instruction;
- speech-language pathology services (sometimes referred to as speech therapy);
- audiology services (hearing impairment services);
- occupational therapy;
- physical therapy;
- psychological services; medical services (only for diagnostic or evaluation purposes);
- health services needed to enable your child to benefit from the other services;
- social work services;
- assistive technology devices and services;
- nutrition services; and
- service coordination services.
How are early intervention services delivered?
Early intervention services may be delivered in a variety of ways and in different places. Sometimes services are provided in the child’s home with the family receiving additional training. Services may also be provided in other settings, such as a clinic, a neighborhood daycare center, hospital, or the local health department. To the maximum extent appropriate, the services are to be provided in natural environments or settings. Natural environments, broadly speaking, are where the child lives, learns, and plays. Services are provided by qualified personnel and may be offered through a public or private agency.
Will I have to pay for services?
Whether or not you, as parents, will have to pay for any services for your child depends on the policies of your state. Under IDEA, the following services must be provided at no cost to families: Child Find services; evaluations and assessments; the development and review of the Individualized Family Service Plan; and service coordination. Depending on your state’s policies, you may have to pay for certain other services. You may be charged a “sliding-scale” fee, meaning the fees are based on what you earn. Check with the contact person in your area or state. Some services may be covered by your health insurance, by Medicaid, or by Indian Health Services. Every effort is made to provide services to all infants and toddlers who need help, regardless of family income. Services cannot be denied to a child just because his or her family is not able to pay for them.
Parent’s Record-Keeping Worksheet
The sample record-keeping worksheet below can help you start a file of information about your child. As you contact different people and places, it’s a good idea to keep records of people you’ve talked with and what was said. As time goes by, you will want to add other information to your file, such as: Letters and notes (from doctors, therapists, etc.); Medical records and reports; Results of tests and evaluations; Notes from meetings about your child; Therapist(s’) reports; IFSP and IEP records; Your child’s developmental history, including personal notes or diaries on your child’s development; Records of shots and vaccinations; and Family medical histories. Make sure you get copies of all written information about your child (records, reports, etc.). This will help you become an important coordinator of services and a better advocate for your child. Remember, as time goes on, you’ll probably have more information to keep track of, so it’s a good idea to keep it together in one place.
This information is copyright free. Readers are encouraged to copy and share it, but please credit the National Dissemination Center for Children with Disabilities (NICHCY).