Early intervention: how it works and how to start

A therapist sitting on the floor with a young child, holding out a picture card.

The short answer

Early intervention is a free federal program for children under 3 who have a developmental delay or a diagnosed condition. It is set up by federal law, run by each state, and you can refer your own child today. ¹ ²

You do not need a doctor's referral. You do not need a diagnosis. The evaluation is at no cost to you, and after a referral the evaluation and first plan meeting must happen within 45 days. ¹

The numbers, up front

What it is: The Part C program under the Individuals with Disabilities Education Act, covering children from birth to age 3 ²
Who can refer: A parent can refer their own child directly. A doctor referral and a diagnosis are not required ¹
Cost of evaluation: Evaluation and assessment are provided at no cost to families ¹
The timeline: The evaluation and, if the child is eligible, the initial plan meeting must be completed within 45 days of the referral ¹
Where services happen: Services are provided in the child's natural environment to the maximum extent appropriate, which usually means home or child care rather than a clinic ¹
What the plan is called: An Individualized Family Service Plan, which covers the family and not only the child, and is reviewed at least every six months ¹

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 is in the rest of this guide

What happens after you refer
Getting a good plan
When you disagree
What happens at age 3

Free, and it stays free

Read the rest, and take it with you

Tell us where to send it and the whole guide opens, along with the printable version you can take to an appointment.

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.

Questions parents ask

Do I need a doctor to refer my child?

No. A parent can refer their own child directly, and no diagnosis is required. ¹ If your doctor has suggested waiting and you are worried, you can refer today anyway. The evaluation is free.

How long does it take?

Federal rules require the evaluation and, if the child is eligible, the initial plan meeting within 45 days of the referral. ¹ If your state is taking longer, that timeline is what to quote when you follow up. Note the date you referred.

Does it cost anything?

Evaluation and assessment are at no cost to families. ¹ Some states charge on a sliding scale for certain services, and some bill insurance with your consent. Ask what the arrangement is in your state before you sign anything.

They only offered once a month. Is that enough?

Ask what that frequency is expected to achieve and how progress will be measured. Frequency should be based on your child's needs and the goals in the plan, not on what is available. If you disagree, ask for the reasoning in writing and ask for a review. ¹

My child was evaluated and did not qualify. Now what?

Ask for the decision and the criteria in writing, and ask for the evaluation reports. You can request a re-evaluation later if things change, and you can use the dispute procedures. ¹ Your state parent center can help you decide what is worth pursuing. ⁴

Words on this page, in plain English

early intervention: The public program that provides therapy and support to children under 3 with delays or diagnosed conditions. It is required by federal law.
IFSP: Individualized Family Service Plan. The written plan for a child under 3 in early intervention. It covers the whole family, not only the child.
IEP: Individualized Education Program. The written special education plan for a school-age child, with goals, services, and minutes.

See the full glossary and records decoder

Where these facts come from

U.S. Government Publishing Office, Electronic Code of Federal Regulations. 34 CFR Part 303, Early Intervention Program for Infants and Toddlers with Disabilities. 2025. www.ecfr.gov/current/title-34/subtitle-B/chapter-III/part-30. Link checked September 3, 2026.
U.S. Department of Education. IDEA Part C, Infants and Toddlers with Disabilities. 2025. sites.ed.gov/idea/statute-chapter-33/subchapter-iii. Link checked September 3, 2026.
Eunice Kennedy Shriver National Institute of Child Health and Human Development. Preterm Labor and Birth. 2025. www.nichd.nih.gov/health/topics/preterm. Link checked September 3, 2026.
Center for Parent Information and Resources. Find Your Parent Center. 2025. www.parentcenterhub.org/find-your-center/. Link checked September 3, 2026.
Family Voices. Family-to-Family Health Information Centers. 2025. familyvoices.org/affiliate-organizations/. Link checked September 3, 2026.
U.S. Department of Education. IDEA Part B, Assistance for Education of All Children with Disabilities. 2025. sites.ed.gov/idea/statute-chapter-33/subchapter-ii. Link checked September 3, 2026.