Early intervention: how it works and how to start

How to start, today

Find your state's Part C program. Every state has one, and the early intervention finder gives you the contact.

Call or email. Say: "I would like to make a referral for my child for an early intervention evaluation."

You will be asked for your child's name and date of birth, your contact details, and your concerns. That is it.

Write down the date you referred. The 45 day clock starts then. ¹

What to say about your concerns

Be specific and concrete.

Not: "I think he is behind."

Instead: "He is 8 months old and not rolling over. He uses his right hand and keeps his left fisted. He was born at 30 weeks."

Specific observations move things faster.

Who qualifies

States set their own eligibility criteria within the federal framework, so the details differ. In general, a child qualifies through one of these routes. ¹

A developmental delay, measured against expected development in one or more areas: physical, cognitive, communication, social and emotional, or adaptive.

A diagnosed condition with a high probability of resulting in delay. Conditions such as cerebral palsy, significant brain injury, hearing loss and many genetic conditions usually qualify a child automatically, without waiting for a delay to appear.

Being at risk, in some states, which may include very preterm birth.

Because states differ, a child who qualifies in one state may not qualify in another. If you are told your child does not qualify, ask for the decision and the criteria in writing.

Corrected age matters here

For a baby born early, development is judged from the due date for the first two years. Make sure the evaluators are using corrected age. ³

What happens after you refer

A service coordinator is assigned. They are your point of contact.

An evaluation is arranged, usually at your home, by a team.

If your child is eligible, an Individualized Family Service Plan meeting is held. All of that must happen within 45 days of the referral. ¹

The plan

The plan is written with you, not for you. It sets out:

• Your child's current abilities.
• The outcomes you want, in your words.
• The services, how often, how long, and where.
• Who provides each service.
• Who coordinates it.

It is reviewed at least every six months and rewritten at least once a year. ¹

Services that may be included

Physical therapy, occupational therapy, speech and language therapy, developmental instruction, vision and hearing services, nutrition, social work, assistive technology, and family training.

Getting a good plan

Bring your own goals. The plan is meant to reflect what your family wants. "I want him to be able to sit at the table with us for dinner" is a better goal than "improve trunk control," and it gets to the same place.

Ask for services in the natural environment. Federal rules say services are provided in the child's natural environment to the maximum extent appropriate. That usually means your home or your child care setting, not a clinic across town. It is a right, not a favor. ¹

Ask what the frequency is based on. If you are offered once a month, ask what that is expected to achieve.

Ask for a home program. What you do between visits matters more than the visits.

Ask for it in writing. Everything.

Bring notes. The milestone tracker prints a summary of what you have observed. It runs in your browser and nothing is sent anywhere.

When you disagree

You have rights and they are written into the regulations. ¹

Ask for the decision in writing, with the reasons.

Ask for the evaluation reports. You are entitled to them.

Ask for a review. You can request that the plan be reviewed at any time.

Use the dispute procedures. Part C includes mediation, state complaint procedures and due process hearings. Your service coordinator has to tell you about them, and the written notice of your rights should have been given to you.

Get help. Your state's Parent Training and Information Center helps families with exactly this, for free. ⁴ A Family-to-Family Health Information Center can also help. ⁵

Being persistent is not being difficult. Programs are stretched, and families who ask specific questions and follow up in writing get more.

What happens at age 3

Early intervention ends at 3. Special education under Part B begins, run by your school district. ⁶

The plan changes from an IFSP to an IEP, and the focus shifts from the family to education.

Start the transition early. Federal rules require a transition plan, and the process should begin months before the third birthday. Ask about it at around 2 years and 6 months. ¹

Eligibility criteria are different under Part B, and some children who qualified for early intervention do not qualify for special education, or qualify under a different category. Do not assume it carries over.

See IEP and 504 plans.