What Is Early Intervention? - The 4 Ws of Early Intervention

The term “early intervention” refers to services and therapeutic interventions that allow children to reach their developmental milestones. According to developmental-behavioral pediatrician Dr. Josh Mandelberg, making small changes early can have a big impact on a child’s development over the years.

With early intervention services, professionals such as developmental-behavioral pediatricians, occupational therapists, physical therapists, and speech therapists will evaluate your child to identify areas of concern, such as delays in socialization, behavior, development, or learning. They’ll then put together a plan to address those areas with different types of therapy.

“Especially in those early years, it’s important to be working on helping support kids develop their socialization skills, communication and play, behavior, regulation, self-soothing, and confidence,” Dr. Mandelberg tells us. He adds that it can be easier to focus on these areas in the preschool years and earlier, “before you get to elementary school and things get more complicated with academics and requirements that might happen at different grade levels. When you’re in preschool, there’s more flexibility with the child’s schedule and what can be incorporated into their daily routine.”

Who can receive early intervention services?

Early intervention for children under age three is mandated by Part C of the Individuals with Disabilities Education Act (IDEA), the federal law governing special education. Part C of IDEA is a comprehensive nationwide program of early intervention services for infants and toddlers 0-3 years of age with disabilities.

The name of the program that coordinates early intervention services varies by state. For example, in California, this program is called Early Start. Use this page from the CDC to find the website and contact information for your state’s early intervention program.

While many early intervention services are free to families for children who qualify, some programs will require you to first go through other funding sources like private health insurance.

Other public benefits such as Medicaid and state disability agencies can help cover health care and support for some children under age 3.

While Medicaid programs in each state are traditionally income-based, many people with disabilities are eligible for programs that expand access to coverage to prevent institutionalization. Medicaid can help cover medical and therapeutic services, equipment, and supplies for your child, even if you already have primary insurance. However, Medicaid will only step in after your health insurance has paid its share of costs.

Insurance

Once your child is enrolled in an early intervention program, it’s a good idea to talk with your service coordinator about what services are free to you and what can be covered through your insurance carrier. Leslie Lobel, health plan advocate, explains more in this clip:

School district

For children with certain low-incidence disabilities (hearing impairments, vision impairments, and severe orthopedic impairments), school districts will provide services instead of or in addition to state-run early intervention programs. The school district is responsible for 1) direct services for children age 0-3 under IDEA Part C, and 2) preschool and special education services for children age 3-5 under IDEA Part B in coordination with local education agencies.

LEAs

LEAs, or Local Education Agencies, may use funds allocated to them by Title 1, Part A, to support early learning programs such as Head Start or state-run preschools. They may also use funding to provide services to children who are eligible under Title 1, such as children who qualify to attend a Head Start program but have needs that are unmet or require additional services.

Head Start

Head Start is an early learning program that is federally funded and free to families with low income or those who meet other eligibility requirements. Families who are experiencing homelessness or have children in the foster care system are also eligible for Head Start services. These programs focus on school readiness and encourage parental involvement. In fact, programs must match 20% of their federal funds through alternative means. They can collect what the program calls “in-kind” dollars by counting volunteer hours, or calculating the value of donated supplies.

Head Start programs receive federal funding but are created by local agencies, such as school districts, county education offices, and non-profits. All Head Start programs have to demonstrate that 10% of children served are children with disabilities, identified by having an IFSP. Early Head Start often achieves this proportion by identifying children who may be eligible and referring them to the Regional Center or SELPA for evaluation. These agencies may also refer families who meet the income qualifications. If they cannot meet the 10% requirement in this way, programs can waive the income requirements for a child with a disability. You can find a local Head Start program using this locator.

Part C of IDEA requires that infants and toddlers eligible for early intervention receive services in natural environments as much as possible. However, in some cases, services may also be provided in a clinical setting, such as a therapy clinic or a center-based program. For more information on each, see our article Natural Setting: Early Intervention in the Home or Clinic.

You may have specific needs or preferences regarding therapeutic setting, but ease of access will depend on your funding route, and you may need to fight for your child’s needs. The settings that are most readily available will depend on how you’re accessing and funding early intervention services.

Public Benefits Specialist Lisa Concoff Kronbeck explains, “With early intervention, you go through your private insurance first. And with private insurance, the in-network providers will usually be in a clinic-based setting. If it's a PPO that will accept a superbill from an out-of-network provider, you might be able to find a therapist who can come to your home and then issue superbills that you can submit to your insurance. But if it's an HMO, services are generally going to be in a clinic. So if funding is coming through private insurance, it's going to depend on what your insurance covers.”

Funding for in-home services won’t be approved because you just prefer having a service at home; there has to be a reason why the child needs it. For people who don’t have private primary insurance, Concoff Kronbeck explains, “[Medicaid] is generally not going to provide in-home therapies because managed care plans have a closed network of providers, or the plans contract with outside clinics.”

On the other hand, if you feel that services need to be in a clinic, you should discuss your concerns with the provider who does the initial therapy assessment (or with the therapist, if you’re already receiving home-based services). If the therapist recommends clinic-based services, they should indicate that in the assessment. If you feel that a clinic-based environment would be more appropriate but the therapist disagrees, you may wish to have your doctor write a letter of medical necessity. As Concoff Kronbeck says, “The law says that they should receive services in their natural environment as much as possible, not they must receive services always in their natural setting.”