As a parent, you want the best for your child and their future. You can give them the strong start that will help them to achieve success in life by taking advantage of early intervention services available to young children. Early intervention provides children up to 3 years old and their families with support, resources, and therapies that can change a child's developmental path.
This article will describe the process for qualifying for early intervention and discuss why it may make a world of difference for your child.
In this article:
This article is a part of a series where we describe the different types of developmental care and discuss how you as a parent can promote your child's development.
Developmental Care Series: 1. Developmental Monitoring: #MilestonesMatter 2. The Importance of Developmental Screening 3. The Critical Role of a Developmental Evaluation
What is early intervention?
Generally
Early intervention refers to the services that are available to infants and toddlers with developmental delays and disabilities and their families.
These resources can help a young child learn the skills they need to be successful in school and life, reduce the need for more costly special education and related services later on, and even change a child's developmental path.
Note: Although there are a variety of public and private services available to young children with developmental concerns, the term "early intervention" (EI) specifically refers to the formal process of identifying eligible children, assessing their abilities and needs, creating a care plan, and providing services through state early intervention programs. In this article, we will be discussing this formal process.
Who is eligible to receive early intervention services?
Ages
Early intervention services (EIS) are intended for families with children under age 3.
After age 3, a child can qualify for special education services through the local school district (even if the child does not attend public school).
If your child is over age 3 and you are concerned about their development, contact your local school district and ask to be connected to Child Find, a system within each school district that ensures that children with developmental delays or disabilities are identified and provided appropriate services.
Qualifying conditions
EIS are available to children with a developmental delay or disability.
Of the nearly 4 million babies born every year, 20% will have some form of developmental delay condition.
17% of US kids have a mental, behavioral, or developmental disorder.
2.3% of US kids have autism spectrum disorder (ASD)
Developmental delays
A developmental delay simply means that a child has not achieved certain developmental milestones by the expected age. Many delays are only temporary and a child may outgrow them in time.
For purposes of the Individuals with Disabilities Education Act (IDEA), which mandates EIS, the delay must be in one or more of the following developmental domains:
Physical development (including vision and hearing)
Cognitive development
Communication development
Social or emotional development
Adaptive development
However, each state defines "developmental delay" for itself, so the exact degree of delay required for eligibility will depend on the state.
EI cannot ensure that every child will outgrow a developmental delay, but it does give them the best opportunity to reach their full potential.
Developmental disabilities
A developmental disability is a long-term, chronic mental or physical condition with a specific diagnosis. Developmental disabilities include:
Autism
Down syndrome
Dyslexia
Cerebral palsy
Intellectual disability
The services offered by the early intervention system
The specific services provided to each child depends on their individual developmental needs. EIS includes (but is not limited to) the following services:
1. Physical therapy
Physical therapists (PTs) treat issues with a child's physical abilities—primarily gross motor skills such as rolling, sitting, and standing—as well as balance and coordination.
They can also provide therapy for children with plagiocephaly (a flat spot on their head) and torticollis, a condition where a baby tilts their head to one side and may struggle to turn their head to the opposite side.
2. Occupational therapy
Occupational therapists (OTs) help children learn the skills needed to perform the activities of daily life.
This includes helping kids with a wide range of skills, including:
Motor development: fine and gross motor skills
Sensory processing: how a child's brain responds to sounds, sights, smells, etc.
Feeding: how a child eats, drinks, and swallows
Self help/adaptive development: the skills to do everyday activities, such as dressing and using the toilet
Social interaction
Play
3. Speech and language therapy
Early speech intervention diagnoses and treats speech disorders in children under 3. It addresses issues such as speech delays, speech and sound disorders, stuttering, and voice disorders.
Speech and language therapy for young children looks a lot like play. The therapist will use some combination of sound imitation games, oral muscle exercises, identification of objects in books and pictures, and other activities with the goal of helping kids learn to communicate their ideas, clearly articulate words, and comprehend others' words and language.
4. Assistive technology
Assistive technology refers to devices that help a child function independently. This can include mobility aids (such as walkers or wheelchairs) or alternative communication systems.
5. Vision and hearing services
Vision and hearing services help children with diagnosed vision or hearing challenges.
6. Psychological and counseling services
Counselors or social workers help with a child's social and emotional development, address any challenging behaviors, and counsel on the parent-child relationship.
7. Family training and education
Family training and education involves educating a family about their child's condition. If the EIS involves any assistive technology, the family will also need to be trained in how to use the device.
Family training can also include therapists and family members working together to develop a strategy for incorporating developmental activities into the family's daily routines to encourage the child's development.
Early intervention for autism
Children with autism may receive a variety of EIS, depending on their specific needs and strengths. For example, a child might receive speech and language therapy to treat any communication delays, occupational therapy to address sensory processing differences, and/or nutritional therapy to ease symptoms through dietary changes.
Who provides early intervention services?
Early Intervention Programs
Under Part C of the Individuals with Disabilities Education Act (IDEA), every US state and territory is required to operate a publicly funded statewide program to provide EI to eligible children.
Finding a local early intervention program
If you have any concerns about your child's development, you can have your child evaluated for free through your local program.
To find your local early intervention program, visit the Centers for Disease Control and Prevention (CDC) website or request a referral from your healthcare provider.
Private providers
Some families choose to pursue therapy from private clinics for their children. For example, a family might seek in-clinic therapy if their child's delay does not meet the level required by state law. Alternatively, they might want their child to receive more therapy than the state early intervention program provides.
Private therapy in a clinic is not funded by the state and may not even be covered by health insurance if the child does not have a qualifying medical diagnosis.
Where are early intervention services provided?
Research has shown that very young children make the most progress in their natural environments. This means that EIS are generally provided in the child's home, school, childcare center, or another place in their community.
The early intervention process
Overview
Although it can vary somewhat by state, the EI process usually follows the following steps:
We will discuss these steps in more detail below.
Steps in the process (in detail)
1. Referring an infant or toddler
Some children are referred for EIS by a healthcare professional or educational/childcare provider because they notice concerning behaviors or delays.
However, parents can also self-refer for EIS—a doctor's referral is not required. You can even seek EIS before your child receives a diagnosis—it is available to any child with a certain degree of delay, as defined by the particular state.
To begin the EI process, simply call your state's Early Intervention Contact. State that you are concerned about your child’s development and would like to have them evaluated under Part C of the IDEA. You can use your child’s screening report from Pathfinder Health to support your concerns and provide details.
The contact will refer you to your community’s early intervention program or to Child Find.
2. Assigning a service coordinator
The early intervention program or Child Find will promptly assign a service coordinator, who will explain the EI process and guide the family through every step. They will be the family's point of contact throughout the EI process.
3. Preliminary screening
In some states, the early intervention program performs a preliminary screening of infants and toddlers to determine if there is a risk of developmental delay.
4. Evaluation
If the screening flags any concerns, the early intervention program will conduct a more detailed evaluation of the child to determine if they have a developmental delay or disability.
A developmental evaluation is generally performed by a team of different child development specialists. Depending on the specific types of developmental concerns involved, a child may be evaluated by some or all of the following specialists:
Child psychologist
Educational psychologist
Speech-language pathologist
Occupational therapist
Physical therapist
Early intervention specialist
Members of this team will collect data by interviewing the parents, observing the child, conducting standardized tests or assessments, and reviewing records such as medical reports, test results, and educational assessments.
This will help them gain a truly holistic view of the child's development across the 5 domains listed above.
The exact methods for determining eligibility will depend on the state in which the child lives. Each state sets its own evaluation and assessment procedures for measuring a child's development.
Note: In some states, children with a previously-diagnosed physical or mental condition that has a high probability of causing developmental delays do not have to undergo an evaluation. Other states will still perform an evaluation to determine the extent of a child’s EI needs.
Such conditions include chromosomal abnormalities (such as Down syndrome), genetic disorders (such as sickle cell anemia), and sensory impairments (such as deafness). Many states specifically identify the conditions that automatically qualify for early intervention.
5. Determining eligibility
Using all of this data, the team of professionals will determine if the child has a developmental delay or disability and is eligible for EIS. Eligibility will depend on state policies, which may differ in the degree of delay needed to qualify for EIS.
If a child is found to be not eligible for EIS, the team can provide suggestions for other available resources in the community. Parents can also have their child re-evaluated by the early intervention program at a later time.
6. Initial assessment of the child
If the child is found to be eligible for EIS, the EI team will conduct a detailed assessment to identify the child’s individual needs and the services that can best meet those special needs.
Generally, the assessment consists of reviewing the evaluation results and observing the child.
7. Initial assessment of the family
The early intervention program also administers an assessment tool and interviews family members to identify:
The specific concerns of the family related to the child's development
The family's priorities for the EIS process
The family's resources that can contribute to the child's development
The family assessment is voluntary, but is extremely helpful in creating the best possible IFSP, discussed below.
8. Individualized Family Service Plan
Once the EI team has gathered all necessary information about the child and family, the next—essential—step is to draft the Individualized Family Service Plan (IFSP), the written plan for all of the EIS and supports that the state will provide to the child and their family. Supporting the child’s family and utilizing their strengths are a key part of this plan.
Each state provides its own particular guidelines for this document. However, under the IDEA, every IFSP must include the following information:
The child’s current developmental level and needs in each of the 5 domains
Information about the family, including the information from the family assessment
Expectations and goals for the child and their family
The specific services to be provided to the child
Where the EIS will be provided. If the services will not be provided in the "natural environment" (such as home, preschool, or elsewhere in the community), the IFSP must explain why.
Frequency and duration of services
Who will pay for EIS. Some services are free in every state. Other services may be billed to a family's insurance or provided at reduced or no cost depending on the family's need.
A plan for transitioning older children out of the early intervention program and into other services
9. Informed consent for services
By law, the EI team must fully explain the IFSP to the parents and consider their suggestions.
Parents must give written consent for every service included in the IFSP for their child to receive that service.
10. Beginning services
Once parents have approved the IFSP and given informed consent for all services listed, the services must begin as soon as possible, generally within 2 weeks.
11. Reviewing the Individualized Family Service Plan
Young children are constantly growing, learning, and changing! For this reason, the EIS team and parents review the IFSP every 6 months and revise it at least once a year, if necessary, to account for the child's development.
12. Transitioning from EIS
Early intervention programs are designed for kids under age 3. Before a child's third birthday, the team will plan for their transition from EIS.
Many times, children grow out of their need for EIS. For example, a child with a speech delay who receives speech therapy may catch up to their peers and no longer require any services.
Other children will continue to need services. At age 3, they will transition to special education services provided by the local school district. The service coordinator will help the family make this transition.
Timing of the EIS process
Early intervention has the greatest impact when it begins as soon as possible. For that reason, there is a strict timeline for the EIS process.
Within 45 days of a child being referred (or self-referring) to the early intervention system, the system must complete the following steps:
Screening (if the state uses it),
Evaluation,
Initial child and family assessments, and
Drafting the IFSP if the child is determined to be eligible for services.
If the child is found eligible, the services must be made available to them as soon as possible after the parents give informed consent.
Why early intervention is critical
90% percent of a child's brain develops by age 5. This is the time when it has the highest neuroplasticity (the brain’s ability to essentially "rewire" itself to function in a different way).
This flexibility means that treatments and interventions have the greatest impact during the early years, especially birth to age 3.
So if you are concerned that your child is experiencing developmental delays, don't wait! Consult with your healthcare provider or self-refer to your local early intervention program as soon as possible—the earlier any issues are detected, the earlier your child can begin treatment.
Frequently Asked Questions
1. What is meant by early intervention?
Early intervention refers to the formal process of identifying children with developmental delays or disabilities, assessing their abilities and needs, creating a care plan, and providing services through state funded programs.
2. What age is best for early intervention?
Most states provide early intervention services until age 3, after which kids who still need services transition to other programs. The earlier a child begins treatment for a developmental issue, the more effective that treatment will be.
3. What is an example of early intervention?
An example of early intervention is speech therapy for a child who has a speech delay. A speech therapist might come to the child’s home to provide treatment to stimulate language development, or might meet with the child at their preschool.
4. What are three types of early intervention?
Types of early intervention include:
Occupational therapy
Physical therapy
Speech and language therapy
Psychological and counseling services
Assistive technology, such as communication devices
5. Is early intervention free?
As required by the IDEA, the initial screening, evaluation, and child and family assessments are always free. If a child qualifies for EIS, the costs of services will depend on the state and the family’s financial need. Some may be free, at a reduced cost, or billed to insurance.
6. What are the 3 forms of early intervention for autism?
Depending on the child, services for children with autism might include:
Occupational therapy
Speech and language therapy
Family training and counseling
Nutrition services
7. Do early intervention programs really work?
Yes! Children’s brains are more adaptable before age 3, so early intervention can have a big impact. With the right services, kids can learn valuable new skills, prepare for school, and may even catch up with their peers’ development.
8. What are the criteria for a child to be eligible for early intervention in NY State?
To be eligible for early intervention in NY State, a child must be under 3 years old and have a delay or disability related to their physical, cognitive, communication, social-emotional, and/or adaptive development.
9. What does an early intervention specialist do?
Early intervention specialists help young children with delays develop the critical skills for their age. They often work with kids too young to attend school and provide services in the child’s home. They can also help teachers develop plans to support specific children.
10. What are the key concepts to early intervention?
The 7 key principles for early intervention (EI) are:
Prioritize everyday experiences/interactions with familiar people in familiar places
Every family can help their child’s development with the right resources
An EI service provider should work with family members
The EI process must be tailored to the child and family’s needs/beliefs
The identified outcomes must be functional and based on family needs/priorities
The most effective EI comes from a primary provider with team and community support
EI must be based on recognized principles/practices, the best research, and relevant law.
11. What does early intervention do for speech?
Early intervention for speech addresses delayed babbling or talking, speech that is hard to understand, speech impediments (like stuttering) and other issues. The therapist will use play and other activities to model communication and stimulate a child’s language development.
12. How do you know if your child needs early intervention?
Signs that your child might need early intervention include:
Delays in achieving developmental milestones, including speech delays
Sensory issues, such as sensitivity to certain clothing, sounds, or foods
Poor eye contact or social skills
Lack of interest in toys or playing with others
Hyperactivity, impulsivity, or aggressive behavior
Regression of skills your child already achieved
13. What happens at an early intervention evaluation?
An evaluation is generally performed by a team of different child development specialists. They will review information provided by the family as well as other assessments, observe the child, and perform standardized tests before discussing the findings with the parents.
14. Does insurance cover early intervention?
It depends—some insurers cover early intervention services and some don’t. If certain services aren't covered by insurance, the amount a family pays varies by state. Some states cover all services, some charge families on a sliding scale. An eligible child will never be denied services because of inability to pay.
The Takeaway
EI is not something to fear or be ashamed of. It's the best way to get your child the services and treatment that they need at the earliest possible point—when it will be most effective.
Remember that the earlier the intervention, the better the outcome will be for your child. So don't delay if you have any concerns!
Sources:
Early Childhood Technical Assistance Center, Seven Key Principles and Practices for Providing Early Intervention Services in Natural Environments, available at https://ectacenter.org/topics/eiservices/keyprinckeyprac.asp.
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