Early Intervention Explained: Free Evaluations for Developmental Delays

What it is

• Early intervention (EI) is a US program, run by each state under federal law (IDEA Part C), for babies and toddlers from birth to their third birthday who have a developmental delay or a condition likely to lead to one.
• It covers speech and language, movement, thinking and learning, social and emotional skills, and self-help skills like eating.
• Services can include speech therapy, physical therapy, occupational therapy, developmental specialists, feeding help, hearing and vision services, and family coaching.
• Earlier support tends to help more, because young brains are changing quickly.

Who can refer, and how

• Anyone can call, including parents, grandparents, foster parents and childcare providers. You don't need a doctor's referral or a diagnosis.
• Find your state's program by asking your pediatrician, searching the CDC's "Learn the Signs. Act Early." site for your state's early intervention contact, or calling your local health department.
• Say: "I'm concerned about my child's development and I'd like an evaluation."
• Babies born very early, with low birth weight, with a hearing loss or certain diagnoses may qualify automatically.

What happens next

1. Intake: a service coordinator contacts you and explains the process.
2. Free evaluation: a team looks at all areas of development, often at home, through play and your answers.
3. Eligibility: each state sets its own criteria for how much delay qualifies.
4. Plan: if eligible, you and the team write an Individualized Family Service Plan (IFSP) with goals that matter to your family. By law this should happen within 45 days of referral.
5. Services: usually in everyday settings like home or childcare, with the therapist coaching you on ways to build skills into daily routines.

Cost

• The evaluation, the plan and service coordination are free. Some states bill insurance or use a sliding-scale fee for services, but no family can be turned away because they can't pay.
• Services are available regardless of immigration status. Interpreters should be offered for families who speak languages other than English.

Ages 3 to 5, and beyond

• At 3, children move from EI to their public school district (IDEA Part B), which offers free evaluations and, if eligible, preschool special education services through an Individualized Education Program (IEP). Planning for the switch begins several months before age 3.
• If your child is 3 or older and never had EI, contact your local school district's special education office and request an evaluation in writing, even if your child doesn't attend that district's schools. Schools have a legal duty to find and evaluate children who may need help.

Tips for parents

• Trust your instincts. Waiting to see often means losing helpful months.
• You can say yes to some services and no to others, and you can ask for changes.
• If your child doesn't qualify, ask what to watch for and when to ask again.

When to check in

• Raise any concern about development with the pediatrician and request an EI or school evaluation at the same time; you don't have to wait for one before the other.
• Ask again if things don't improve or new concerns appear. Eligibility can change.