Rhode Island Medical Home Portal - Early Intervention Part C Program

What is Early Intervention?

You may have heard the term early intervention from your doctor, a provider, or another parent. If you are not sure what it means, you are not alone. We will explain the difference between the common use of the term early intervention - intervening or acting early to diagnose and treat children who may face extra challenges - and the federally funded Early Intervention Part C program which provides the services for children with developmental delays through the Early Intervention program in your state.

To help keep things clear, we will usually refer to the concept of early intervention as "acting early" and we will refer to the federally-funded program as the "Early Intervention (EI) program." The topic of early intervention (acting early) is rather confusing as there are various agencies, funding streams, laws, and even creative solutions you'll need to be aware of, utilize, and/or come up with to help your child.

Early Intervention Part C of IDEA All About It is for children with disabilities from birth through age two, until their third birthday.

The Family and Early Intervention Partnership

Your child birth to age 3 may be referred to the Early Intervention program, Part C of IDEA, because of developmental concerns, which may arise if he or she was born prematurely, is slow in reaching developmental milestones, or has been diagnosed with a disability, genetic syndrome or dystrophy, that makes him or her eligible for Early Intervention program services. Whatever the reason, a partnership between your family and the local Early Intervention program is important.

Family plays a critical role in supporting the development of a child. Many parents can tell when something just isn’t right, even though they may not know exactly what it is that is different about their child. As a parent, you may notice that your child isn’t reaching expected developmental milestones, like walking, interacting, or talking. If you have concerns about your child’s development or abilities, it’s time to make an appointment with your Medical Home/primary care clinician. You and/or your child’s clinician can contact the Early Intervention program for assessment. Your clinician may also have your child further evaluated by additional specialists, depending on your concerns and your child’s delays. Although the “normal” window for reaching developmental milestones is somewhat wide, delays may signal an underlying condition.

The Medical Home and Early Intervention Partnership

The primary care clinician in your child’s Medical Home will track milestones using standardized developmental screening tools (see: Developmental Screening). If developmental problems or delays are suspected, your child can be referred for evaluation using additional and more specific tools.

"Early identification of children with developmental delays is important in the primary care setting. The pediatrician is the best-informed professional with whom many families have contact during the first 5 years of a child's life. Parents look to the pediatrician to be the expert, not only on childhood illnesses, but also on development. Early Intervention services for children from birth to 3 years of age and Early Childhood Education Services for children 3 to 5 years of age are widely available for children with developmental delays or disabilities." [Committee: 2001]

You can help the Medical Home (primary care clinician) provide the best care by updating any information about the programs and services your child is involved with such as the EI program. Having a comprehensive record-keeping system or file of your child's medical history, visits with specialists and therapist, immunization records, and insurance providers to share will help to ensure the best possible care for your child’s health and development. See Medical Summary ( PDF Document

18 KB) and Care Notebook.

Early Intervention Program from Birth - 3

The Early Intervention program, as discussed on this page, is a specific type of service for young children that is available in all states, as required by law. The Individuals with Disabilities Education Act (IDEA) provides federal funds for special education services (see: IDEA Parent Guide (National Center for Learning Disabilities) ( PDF Document

1.1 MB)). In 1997, an amendment to IDEA mandated early identification and intervention for infants and toddlers with special health care needs through the development of a community-based service system (Part C). To meet this mandate, states were granted federal financial assistance to deliver interagency, multidisciplinary services for all eligible young children. Funding for IDEA programs comes from the U.S. Department of Education to a state agency which may coordinate and contract with local programs. Local programs may have varying names but are a part of the same Early Intervention, Part C program system. The local programs are responsible for finding and providing services for children with developmental delays or disabilities from birth to age three.

If your infant or toddler is found eligible for the Early Intervention (EI) program, you will work closely with the local program provider to identify the strengths and needs of your child and family. As a parent or guardian, you will play a critical role in the services identified in the Individual Family Service Plan (IFSP).

What Types of Services Will Be Provided?

Examples of Early Intervention program services include developmental evaluation (including evaluation of speech, language, motor, cognitive, and social development), occupational therapy, physical therapy, speech and language therapy, special instruction, nutritional services, nursing services, and family training. Early Intervention therapists and home visitors may have special early intervention training or credentials above and beyond their professional license or certification. The types of services that are provided for any child will depend on state rules and the recommendations from the Individualized Family Service Plan (IFSP) Team. Some families will need to supplement these EI services with additional services depending on the needs of the child.

Who Is Eligible for the Early Intervention Program?

Infants and toddlers with developmental delays that meet certain criteria are eligible for the Early Intervention program. While the federal law provides general guidelines, individual states set their own specific eligibility criteria. Federal law suggests that children, ages birth to three years old, may be eligible if they have an identified developmental delay or a diagnosed condition that is likely to cause a developmental delay. States may set eligibility based on developmental evaluation test scores and lists of certain diagnoses.

The Referral and Evaluation Process

You can refer your infant or toddler up to age three to the Early Intervention program yourself or your Medical Home team can initiate the referral. Once a referral is received by the Early Intervention program, the service coordinator schedules an appointment with your family to gather information and describe the available services, resources, and evaluation processes. Then, a multidisciplinary evaluation for your child will be scheduled to focus on specific child development skills. Qualified personnel use a variety of tests to assess cognitive, language, motor, social, emotional, behavioral, and self-help skills. The evaluation process includes a complete assessment of your family's concerns, priorities, and resources. Evaluation and assessment services are provided at no cost to families.

As part of the initial evaluation, the service coordinator may request information from your Medical Home, including well child visit records, and vision, hearing, and developmental test results. Federal regulations require that the evaluation and assessment process be completed within 45 days of the referral. Health and development information provided by your primary care clinician and other providers can be essential to help the Early Intervention program team assess levels of functioning and eligibility of your infant or toddler.

The IFSP

Following the initial assessment and eligibility determination, an Individualized Family Service Plan, or IFSP, is developed with input from the family, Early Intervention program staff, and other appropriate staff or professionals.

The IFSP team uses the assessment process, and the needs of your family, to determine the location, frequency, intensity, and duration of services to be provided. The child's current level of functioning will be documented, and goals set for each identified need. The team will develop strategies to meet the outcomes, and a six-month re-evaluation date will be set. The IFSP is reevaluated each year, but it can be revised at any time if your child's needs change. By the time your child is 2 years old, the Early Intervention program will help you plan for the transition to preschool services. See: Utah Parent Center Videos.

Where Are Services Provided?

Children are served in a variety of environments that may include their family home, child care center, play group, or local community center. Service providers use natural learning environments and activities that meet each child's changing needs to promote functional skills, development, and learning. No matter where your child meets with his or her Early Intervention program team, he or she will be served according to the goals and strategies developed in the IFSP.

Funding of Services

State and Federal agencies are responsible for providing specific services at no charge, though funding varies from state to state. These services include:

Child Find and Referral: Early Intervention programs locate infants and toddlers who may have disabilities and evaluate them for eligibility for Early Intervention.
Assessment and Evaluation: Formal testing is done to determine if the infant or toddler has a disability.
Individualized Family Services Plan (IFSP) Development and Review: The IFSP describes the Early Intervention services that the family and child will receive.
Procedural Safeguards (Family Rights): Families receive a document that describes the protections and legal rights provided by the IDEA law.
Service Coordination: Staff at Early Intervention programs help families determine their needs and access services to reach their goals.

For other services, the state will determine who pays. Some states provide some services for free, while other services may be provided based on a sliding scale, in which the family’s cost will be based on their income. In some states, Medicaid or insurance companies will pay for some services, such as physical therapy, nutrition services, home visits, or speech therapy, to name just a few. See: Overview of Early Intervention. IDEA Part B is the Special Education program for children with disabilities from their third birthday to age twenty-two, and is discussed on the Special Education page.

Additional Early Services

For more information about other early services and eligibility, see: Additional Early Services.

Resources

Information & Support

For Parents and Patients

Rhode Island Early Intervention Program ( PDF Document 405 KB)
Early Intervention (EI) is a program designed to help families support the growth and development of their infants and toddlers, birth through 3, who are delayed in their development or have a diagnosed condition known to cause developmental delay. Providers and RI Parent Information Network. 2016

Center for Parent Information & Resources Locator
Parent Centers provide education and referrals for families with a child who has a disability, as well as the professionals who work with them. Each state has a parent center.

Special Education Services for Preschoolers with Disabilities
Services for preschool children (ages 3 through 5) are provided free of charge through the public school system. These services are available through the same law—the Individuals with Disabilities Education Act—that makes available: early intervention services (Part C of IDEA), and services for school-age children, in grades K through 12 (Part B of IDEA) .

State Part C Early Intervention Coordinators
Lists state contacts for Early Intervention (Part C) agencies and is an easy way to locate the person in charge of your state’s Early Intervention programs; National Early Childhood Technical Assistance Center (ECTA Center).

Talaris Child Development Timeline
Provides a helpful, interactive timeline for parent’s to look at a child’s developmental milestones in different areas including physical, social, learning, and communication.

Learn the Signs. Act Early (CDC)
Offers many tools, videos, lists, learning materials, and an app to track a child’s developmental milestones (ages 2 months to 5 years) and act if concerned about progress; Centers for Disease Control and Prevention.

IFSP form (Individual Family Service Plan) ( PDF Document 224 KB)
Sample Individual Family Service Plan.

Medical Summary ( PDF Document 18 KB)
This sample summary or individual health plan provides a way to keep track of personal contact information, diagnoses, problems, medications, immunizations, providers, specialists, medical equipment, and more.

Medical Summary ( Word Document 35 KB)

IDEA97 compared to IDEA04
Comparison of IDEA 97 legislation to 2004 changes.

Bright Futures Initiative (AAP)
A national health promotion initiative dedicated to the principle that every child deserves to be healthy and that optimal health involves a trusting relationship between the health professional, child, family, and community as partners in health practice. Information on healthy emotional, behavioral and cognitive development; American Academy of Pediatrics.

Healthy Minds, from Zero to Three
Created by the National Center For Infants, Toddlers and Families. Here you will find PDF handouts about development.

First Signs
A national nonprofit organization dedicated to educating parents and pediatric professionals about the early warning signs of autism and other developmental disorders. Includes developmental milestones, red flags, and communication needs of parents and physicians.

IDEA All About It
A website is full of information about IDEA. Summaries of IDEA’s requirements, which shape what school systems do; IDEA itself—to read IDEA’s exact words; guidance on IDEA from the Office of Special Education Programs at the U.S. Department of Education; and training materials on IDEA. IDEA Part B (ages 3-21) and Part C (ages birth-3). A legacy resource from NICHCY, now with the Center for Parent Information and Resources.

IDEA-related Acronyms, Abbreviations, and Terms
From the U.S. Department of Education, alphabetically listed acronyms related to IDEA.

IDEA Parent Guide (National Center for Learning Disabilities) ( PDF Document 1.1 MB)
A comprehensive guide for parents on rights and responsibilities under the Individuals with Disabilities Education Act (IDEA 2004). Helps parents determine if their child might be eligible for services, what kind of services to expect, how to request an evaluation, how to develop a plan for services, and what their legal rights are. (105 pages, 2014)

IDEA State Eligibility
From the U.S. Department of Education, definitions of terms and rules for IDEA Part B (Assistance for Education of All Children with Disabilities).

A parent's guide to Section 504 in public schools
An article addressing basic qustions pertaining to the implementation of Section 504 in public school systems. GreatKids for special needs, with GreatSchools.org.

Services in Rhode Island

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Developmental Pediatrics

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Helpful Articles

Reynolds AJ, Temple JA, Robertson DL, Mann EA.
Long-term effects of an early childhood intervention on educational achievement and juvenile arrest: A 15-year follow-up of low-income children in public schools.
JAMA. 2001;285(18):2339-46. PubMed abstract

Committee on Children with Disabilties.
Developmental surveillance and screening of infants and young children.
Pediatrics. 2001;108(1):192-6. PubMed abstract / Full Text
This article encourages physicians to use standardized developmental screening tools and suggests that testing children at periodic intervals will increase accuracy and further early intervention.

Authors & Reviewers

initial publication: May 2013

Current Authors and Reviewers:

Authors:	Alfred N. Romeo, RN, PhD
	Gina Pola-Money
	Lynne M. Kerr, MD, PhD

Page Bibliography

Committee on Children With Disabilities.
Role of the pediatrician in family-centered early intervention services.
Pediatrics. 2001;107(5):1155-7. PubMed abstract / Full Text