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, MD, FAAP, 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.”
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 and their families. In California, this program is called Early Start. According to the Department of Developmental Services (DDS) website, Early Start is a multi-agency effort by the DDS and the California Department of Education that encourages partnerships between families and professionals, family support, and coordination of services. The statewide system of early intervention services is available throughout California and can be accessed through Regional Centers for developmental disabilities, county offices of education, local school districts, health or social service agencies, and family resource centers.
Early Start services are coordinated and funded by Regional Centers and/or Special Education Local Planning Areas (SELPAs). Each child enrolled in Early Start will have an Individualized Family Service Plan (IFSP) that is created by a multidisciplinary team that includes the parent or legal guardian as a member.
To learn more about who qualifies for Regional Center services and what types of therapy may be provided for your child, read Regional Center Eligibility and Services: Early Intervention (0–36 months). For most children after age three, the school district provides special education services under an Individualized Education Plan. Some children over age three are still eligible for Regional Center services if they have a qualifying disability. You can find out more about whether your child might qualify by reading Regional Center Eligibility and Services: The Transition from Early Intervention to Lanterman Act at Age Three.
If your child has been diagnosed with or is at risk of developmental delays or disabilities, your doctor may have advised you to apply for Regional Center early intervention services. Children 0-3 years of age across California receive early intervention services from Regional Centers if they have been diagnosed with, or are at risk for, developmental delays or developmental disabilities. (Note that some children may be eligible for continued Regional Center services under the Lanterman Developmental Disabilities Act after they turn 3, if they have been diagnosed with a developmental disability as defined by California law.)
Regional Centers are a statewide network of local agencies that serve children and adults with developmental disabilities as defined by California law, such as autism, intellectual disability, and cerebral palsy. Each Regional Center operates independently, so services offered (as well as eligibility criteria for specific services) may vary slightly, but many children under age 3 can receive occupational, physical, and speech therapy from the Regional Center during this time, along with other early intervention services. Check out our article How to Get Started with Regional Center for more information about how to apply; you do not need a doctor’s referral.
While many early intervention services are free to families, some are not — for example, Regional Centers fund services as a payer of last resort, meaning you have to first go through other funding sources like private health insurance. You can ask your Regional Center about what services are free to you and what can be covered through your insurance carrier. Regional Centers may also have family cost-sharing requirements for certain services and/or an annual family program fee for families above a certain income, although this requirement is waived for children receiving Medi-Cal. For families with household income below 400% of the federal poverty level, Regional Centers can also assist with copayments for services documented in the IFSP.
Fran Goldfarb, Core Function Director of Community Education, Information Dissemination, and Technical Assistance at the USC University Center for Excellence in Developmental Disabilities (UCEDD), advises families with children in the Early Start program to work with their Regional Center service coordinator or whoever is at the center of their Early Start team to help prioritize and create a plan of care. Regional Center is supposed to take a 360-degree look at a child to help the family identify services that are needed. Even if Regional Center is unwilling or unable to fund those services directly, they’re still obligated to help families find access to those services.
In addition to Regional Center, other public benefits such as Medi-Cal and In-Home Supportive Services (IHSS) can help cover health care and support for some children under age 3.
Medi-Cal is California’s Medicaid program. While it is traditionally income-based, many people with disabilities are eligible for programs that expand access to Medi-Cal to prevent institutionalization by broadening the financial criteria or applying different thresholds. Medi-Cal can help cover medical and therapeutic services, equipment, and supplies for your child, even if you already have primary insurance. However, Medi-Cal, like the regional center, is the payor of last resort, meaning that Medi-Cal will only step in after your health insurance has paid its share of costs.
Children with disabilities who are Regional Center clients under the Lanterman Act (children over age 3 and some children under age 3) may qualify for Medi-Cal’s institutional deeming waiver program, which provides access to Medi-Cal regardless of parental income.
Medi-Cal and California Children’s Services (CCS) can work together to help coordinate your child’s care team. CCS can provide physical and occupational therapy as well as durable medical equipment if your child has an eligible diagnosis.
In-Home Supportive Services (IHSS) is a Medi-Cal program that provides home-based personal care and related services so that people with disabilities can remain safely in their communities instead of institutions. Although IHSS doesn’t provide early intervention therapies, the program can fund caregiver services in your home so that you have additional resources to support your child. You can even be paid by IHSS to provide certain types of care for your child at home. There is no minimum age requirement to receive IHSS. However, IHSS hours are awarded to children based solely on care needs that exceed those of a typically-developing child, so it is unusual for children to qualify for IHSS before the age of 3 unless they have extensive medical care needs or extreme supervision needs.
If your child has an eligible diagnosis, CCS can be very good at helping you manage care. While CCS can provide physical and occupational therapy as well as durable medical equipment, they are also a specialty care clinic that can provide and coordinate all the care needed for the diagnosis under which the child qualifies. (However, as Goldfarb also points out, CCS will only support that condition; for example, if you have a child who has an intellectual disability as well as a heart condition, CCS will only treat the heart condition and not the intellectual disability.)
Goldfarb tells us that family resource centers can be wonderful because they’re often staffed by parents of children with disabilities who are very experienced at navigating the Early Start program.
Kathryn Smith, RN, MN, DrPH, associate director for policy at UCEDD and nurse care manager at the Boone Fetter Clinic at Children’s Hospital Los Angeles (CHLA), recommends that parents reach out to Early Start and become involved in all the systems while they’re waiting for an assessment:
Special Education Local Planning Agencies, or SELPAs, are agencies that work with districts and private schools to provide special education funding. Their funding is based on the number of students district-wide, including all students, both with and without disabilities. In most cases, Regional Centers will be responsible for providing early intervention services. However, for children with certain low-incidence disabilities, the SELPA will provide services instead of or in addition to the Regional Center. A SELPA is a consortium of local school districts, county education offices, and charter schools tasked with certain special education responsibilities for children with disabilities within its geographic region.
California Education Code Section 56026.5 defines low-incidence disabilities as severely disabling conditions with an incidence rate of less than 1% of statewide K-12 enrollment - specifically, “hearing impairments, vision impairments, severe orthopedic impairments, or any combination thereof.”
For children age 0-5 with low-incidence disabilities, the SELPA is responsible for 1) direct services via Early Start 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.
A child may have an IFSP with both the SELPA and the Regional Center. However, since the regional center is the payor of last resort, services provided by the SELPA will be considered generic resources and the regional center will not duplicate services. If your child is enrolled with both the SELPA and the regional center, and you feel that a particular service offered by the regional center is more appropriate than what is offered by the SELPA, you will need to demonstrate why the SELPA service, as a generic resource, does not meet your child’s needs.
While many early intervention services are free to families, some are not — for example, Regional Center funds services as a payer of last resort, meaning you have to first go through other funding sources like insurance or Medi-Cal, if applicable. 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, Undivided's Director of Health Plan Advocacy, explains more in this clip:
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 is an early learning program that is federally funded and free to low-income families 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.
For more information about funding, see our article How Do We Pay For It All? Undivided’s Guide to Funding Resources.
Now that you know more about what early intervention is and how it can help families, read about when you should start early intervention services and therapies.
Save your favorite resources and access a custom Roadmap.
Get Started
