Early intervention is a federal program under IDEA Part C that provides free evaluations and a range of services — speech-language therapy, occupational therapy, physical therapy, developmental and behavioral support, family training, service coordination, and assistive technology — for any child under age 3 with a developmental delay or qualifying condition. Services are planned around the family in a document called an Individualized Family Service Plan (IFSP).

What is early intervention, exactly?

Early intervention (EI) is the federally funded program for children from birth to their third birthday who have a developmental delay or a diagnosed condition (autism included) that is likely to cause one. It was created by Part C of the Individuals with Disabilities Education Act (IDEA) and is run by each state under a federal framework. Every state has its own name for the program (“Birth-to-Three,” “First Steps,” “Help Me Grow,” etc.), but the federal rules are the same.

Two things to know up front:

  • Evaluation is free. Federal law requires the initial evaluation and eligibility determination at no cost to the family, regardless of income.
  • You can self-refer. A pediatrician’s referral helps but is not required. Any family can contact their state EI program directly.

What services are included?

The IDEA Part C regulations list 17 service categories an EI program may provide. Not every child needs every service; the IFSP team selects what fits the child and family. The most common for autistic toddlers:

  • Speech-language therapy. Builds early communication — gestures, eye contact, joint attention, first words, AAC (augmentative and alternative communication) tools for nonspeaking or limited-speech children.
  • Occupational therapy. Addresses fine motor skills, feeding, self-care, sensory processing, and play.
  • Physical therapy. Gross motor skills, balance, coordination, muscle tone.
  • Developmental services. Often called “developmental therapy” or “special instruction.” A specialist who works on overall development, often through play-based, family-coached sessions.
  • Behavioral support. Approaches vary by state and provider; this may include Applied Behavior Analysis (ABA), positive behavior support, or relationship-based developmental approaches like DIR/Floortime. (Note: the autistic community has substantive ongoing debate about ABA in particular; families are entitled to ask any provider about their approach and choose what fits their values.)
  • Family training and counseling. Teaching parents and caregivers strategies to use in everyday routines — this is one of the strongest evidence-based components of EI.
  • Service coordination. A single point of contact who helps the family navigate the system, schedule services, and prepare for transition at age 3.
  • Assistive technology. Devices and supports, including AAC tablets, switches, and adapted toys.
  • Audiology, vision services, nursing, nutrition, social work, psychological services, and transportation as needed.

What is an IFSP?

The Individualized Family Service Plan (IFSP) is EI’s version of an IEP. It documents the child’s present levels, the family’s priorities and concerns, measurable outcomes, the specific services to be provided (with frequency and location), the natural environments where services happen, and the service coordinator.

A distinguishing feature: an IFSP focuses on the family, not just the child. That reflects the research that family-coached, routine-based intervention drives the best outcomes for very young children. The IFSP is reviewed every 6 months and rewritten at least once a year.

Where do services happen?

Part C requires services to be delivered in the child’s “natural environment” to the maximum extent appropriate — for most families that means at home, at child care, or in community settings where the child spends time. Center-based services are allowed when the IFSP team documents why the natural environment won’t work.

What does it cost?

Federal law requires evaluations, IFSP development, and service coordination to be free. For ongoing therapy services, states vary: some are entirely free, some bill private insurance or Medicaid, and some use a sliding family-fee scale. No family can be turned away from EI for inability to pay.

What happens at age 3?

EI ends on the child’s third birthday. Before then, the IFSP team meets with the local school district to plan transition to IDEA Part B (school-age special education). Some children transition to a school-district preschool program with an IEP; others move to community-based supports. Families have the right to a smooth handoff and to participate in the transition planning meeting.

How do you start?

  1. Find your state’s EI program. The CDC maintains a directory below.
  2. Call or write to request an evaluation. State the child’s name, date of birth, and your concerns. You don’t need a diagnosis — concerns are enough.
  3. The state has 45 days from your referral to complete the evaluation and, if your child is eligible, hold the first IFSP meeting.
  4. If your child is found ineligible and you disagree, you have the right to mediation or a due-process hearing.

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