Milestones

mom and toddler playing with a toy train
zorazhuang/E+/Getty Images

All Your Questions About Early Intervention For Babies & Toddlers Answered

It can be a critical component in helping your baby meet their milestones.

As a new mom, you know your baby best, right? You can classify almost any cry and coo from hangry to happy, and are attuned to what baby needs. But even though you can’t quite place your finger on it, you secretly suspect that something isn’t quite… right. That’s when understanding how Early Intervention works can make all the difference in getting your child the services they need to succeed.

Maybe you’ve noticed that your baby is sitting up yet, and they should be. Or that their speech is delayed while other kids their age are talking a mile a minute. Early Intervention (EI) can be the answer. “EI has been shown to impact a child’s ability to learn developmental skills, reduce delays and enhance school readiness,” Dr. Candice W Jones, MD, FAAP, a board-certified pediatrician explains to Romper. “Early detection and early intervention of developmental delays is critical to a child's lifelong health and well-being.

What Exactly Is Early Intervention?

Although the wording might sound a bit strong (after all, have you ever heard of a positive intervention?), Early Intervention is designed to get your child meeting their milestones so they are on point with their peers. “Early Intervention is a voluntary program that provides evaluations, services, and supports to families with children birth to 3 years old with developmental delays and disabilities,” Nicole Rose Awe, an Early Intervention Service Coordinator in Sullivan County, NY tells Romper. “The program focuses on providing services in a child’s natural environment to assist in the developmental, learning, and growing progress for toddlers and infants.” A state-wide program, Early Intervention falls under the Department of Health, as it follows a developmental model for children.

How Do You Know If Your Child Needs Early Intervention?

Those long questionnaires that they give you to fill out during some well-baby pediatrician appointments aren’t just to help you pass the time until you’re seen by the doctor. Nope, they’re a pivotal part of understanding if baby is on target (or nearing the target) towards their developmental milestones. “As pediatricians, we see children in the first few years of life very often, and it’s exactly for this reason,” Dr. Arunima Agarwal, MD, FAAP, a pediatrician, tells Romper.We can monitor these developmental skills to help identify if something is off.” The screening test questionnaires that you’re given, particularly at the 9, 18, and 30-month visits, are designed to ensure that your baby is developing normally and point out any potential red flags. If a pediatrician notes that your baby hasn’t started standing on their own alone during the 9-16 month window, or if they’re not stacking blocks by 18 months, your doctor will ask more questions and possibly recommend Early Intervention services. “This is why pediatricians push for physicals to be on time, so we can identify issues early,” explains Dr. Agarwal.

How To Know If You’re Eligible For Early Intervention

The process for Early Intervention begins with a referral. “This is when a parent (or other entity such as a pediatrician, daycare, or family member with parental consent) contacts the program local to their county and requests that an evaluation be conducted for a child under the age of 3 due to developmental concerns,” explains Rose.

Although Early Intervention qualifications vary from state-to-state, there are instances in which a child might be considered an “automatic qualifier,” says Rose. “In New York, for example, children who are diagnosed with disabilities or conditions such as Downs Syndrome, Cerebral Palsy, Autism, ADD/ADHD or Muscular Dystrophy (etc.) qualify for Early Intervention automatically as these conditions are correlated to developmental delays in children,” she says. “However, even when a child automatically qualifies for services, an evaluation will still be conducted in order to assess current level of functioning.”

Here’s How Early Intervention Works

“Once the referral process has started, an Initial Service Coordinator is assigned to each child’s case in order to facilitate the evaluation,” explains Rose. “The program has 45 days from the day of referral in order to have the program process done, meaning that the child’s evaluation must be completed and an IFSP must be written up before the 45-day date is up.” You then choose the evaluation team based from a list that includes any available evaluation team (which will consist of two people who specialize in different areas of development) in the county working on your specific case.

Evaluations use standardized testing (which is approved by the state) to compare your kiddo to other children their age. “Some tests that are commonly used are the Dayc-2 Developmental Assessment and the Bayley Developmental Screening Tool,” says Rose. “The results of the evaluation will determine the next step for the family.”

Now, if your child isn’t eligible (meaning that your child’s score didn’t show a qualifying delay in any areas of development), you will be given suggestions and recommendations of what to work on with your kiddo. But if your child doesn’t qualify for services now, it doesn’t mean that you can’t apply again… and again. “The family can have the child evaluated as many times as they wish, for as long as the child is found not eligible,” says Rose.

chabybucko/E+/Getty Images

Is Early Intervention Mandatory?

While Early Intervention is not mandated, it’s highly recommended, especially if your child is showing any possible signs of delay. “The program also gives parents rights when they enter the program, meaning parental consent must be granted in order to be part of the program,” says Rose. “Even if a child is found eligible, a parent can decline any services from the program at any time unless there is a court order in place. This is because it is voluntary.”

Who Pays For Early Intervention?

So, here’s the good thing. Early Intervention is created to present no extra cost to families, Rose says. “Early Intervention is a free program to parents,” explains Rose. “Insurance information is collected during the referral process by the Initial Service Coordinator, and this is because some insurances can be billed for services and evaluations.” The Initial Service Coordinator may contact your insurance provider (with your consent) to see if your insurance can be billed. But if you decline to provide your insurance info, or if you don’t have healthcare coverage, “then the cost for services simply comes out of tax escrow/funding from the state,” she says. “Parents are not responsible for any caps, copayments or out-of-pocket expenses of any kind for the program or services.”

Here’s What Early Intervention Looks Like For Parents

Before your child begins receiving services, a plan will be created consisting of goals created by both you and the evaluators to monitor the progress that you’d like to see while they’re in the program. “The evaluators recommend services based off of the child’s scores/concerns, and the IFSP includes each service and provider that will work on the child’s case,” says Rose. Services usually start at once a week “to avoid overwhelming families and children,” Rose explains, and an Ongoing Service Coordinator will manage your kiddo’s case while they’re receiving services. Plans run for every six months to see the amount of progress and growth your child has experienced so far, and then it will renew with parental consent.

As a parent, you are also going to be responsible for helping to continue the work that your providers give to your child. “If children are receiving a type of therapy once a week, which is the typical frequency, this means that what families and parents do while the child is not in therapy is super important,” says Rose. “Any suggestions and directions from the therapist are important to carryover and keep consistent as that is what allows a child to progress and grow.” After all, consistency is a key motivating factor in Early Intervention, and the goal is for parents and providers to work seamlessly together in the best interests of your child.

Can Parents Request Early Intervention For Their Child?

Absolutely! Although some children receive referrals for EI through their pediatrician or school system, you should reach out directly to your local EI program office if you’re seeing signs that your child might need services. “Parents know their child best,” says Dr. Jones. “If you have any concerns that your child is not playing, learning, speaking or moving correctly, please contact your pediatrician or call your local EI program. Don’t wait and see, because early intervention is key!”

If you’re not sure where to even start, the Centers for Disease Control (CDC) has Early Intervention information. It also has a state-by-state breakdown of where to find Early Intervention Program services for your little sweetie. If you opt to get services on your own, (a doctor’s referral is always helpful, but not required), it’s still a good idea to connect with your pediatrician to let them know about your concerns regarding your child’s development. “Try to let doctor know first so they know something is going on and can help perform further tests or monitoring,” advises Dr. Agarwal.

What Services Are Included In The Early Intervention Program?

Early Intervention can help with a whole host of developmental delays or disabilities. “The services can include early intervention teachers, speech and language pathologists, occupational therapists, physical therapists, audiologists, as well as social workers,” Kassie Hanson, CCC-SLP, a clinically certified speech-language pathologist tells Romper. “Research consistently shows the importance of early intervention for children with delays or disabilities.”

But the services don’t stop there. In addition to the above, your child may also get “aquatic therapy, vision services, nutritional services, assistive technology services, service coordination, and anything that is found to be developmentally appropriate for any child,” says Rose. “The services a child receives is unique to each child and is based off of the results of the child’s evaluations and the recommendations from the evaluators.”

Where Are Early Intervention Services Held?

Thankfully, you might not even have to change out of your PJs to have your child receive services. “Many early intervention programs are in-home, meaning the provider will come to your house and help you with whatever your child needs,” explains Hanson. “While this may seem overwhelming at first, it’s to your advantage: Your early interventionist can help you with everyday activities and routines that might be hard for you and your family.”

“Although Early Intervention focuses on natural environments, there are some cases where services can be provided in a child’s daycare setting or at a facility setting,” adds Rose. “A facility setting would include an agency site or specialized business that provides services for children, where the parents can transport the child to receive services out of the home.”

What Happens After Early Intervention?

Since Early Intervention is a birth to age 3 program, you’ll need to determine with your child’s team if services should continue. “There are also services available for children after the age of 3, called the Committee for Preschool Special Education (CPSE) which is run separate from Early Intervention,” says Rose. “The CPSE is based off of the school district that the family lives in.” For services under CPSE, a family would contact their school district to register their child and begin the evaluation process there. CPSE evaluations can start at 30 months of age, Rose explains, and many parents in Early Intervention will simultaneously do CPSE in order to avoid gaps in services.

Early Intervention is an awesome resource and support system for families with children who might be having developmental delays. Children who participate in Early Intervention can get the help necessary to meet their milestones and hopefully give them the best and brightest start in life possible.

Experts:

Nicole Rose Awe, an Early Intervention Service Coordinator in Sullivan County, NY

Dr. Candice W Jones, MD FAAP, a board-certified pediatrician

Dr. Arunima Agarwal, MD, FAAP, a pediatrician

Kassie Hanson, CCC-SLP, a clinically certified speech-language pathologist