During your child’s first three years of life he or she makes a tremendous amount of growth both physically and cognitively. It is so exciting to watch your child begin to crawl, take his or her first step, start to understand familiar words and phrases, and say his or her first word! While every child develops at his or her own pace, some children may need additional support and therapy to achieve various milestones.
Suspecting your child may be delayed in his or her development can be a scary thing. However, there is a very broad range of what is considered “normal” and seeking guidance from experienced and knowledgeable early childhood professionals (e.g., speech language pathologist, occupational therapist, pediatrician, audiologist) can provide you with information about what is expected for your child’s age as well as how to best support your child’s development wherever he or she is currently.
As a caregiver, you may have heard of the term Early Intervention (also referred to as EI). The Early Intervention Program (EIP) provides services to children under three years old and their families, when a child has or is at risk for a developmental delay across any of five developmental areas:
Cognitive development
Communication development
Physical development, including vision and hearing
Social or emotional development
Adaptive development
In the 80’s, U.S. Congress mandated an Early Intervention Program under the Individuals with Disabilities Education Act (IDEA). Early Intervention is a publicly funded program that provides services (e.g., speech therapy, occupational therapy, feeding therapy, physical therapy, etc.) for free or at a reduced cost to any child who is considered eligible. Every US state and territory provides these services through its own program with specific regulations for which children are eligible. The remainder of this post will focus specifically on Manhattan’s Early Intervention program, but can still provide helpful insight if you are in a different state. Other state contact information can be found here: https://www.cdc.gov/ncbddd/actearly/parents/state-text.html
If you have concerns about your child’s development in any of the five domains, the first step is to make a referral to your state’s Early Intervention Program to schedule an evaluation. A referral can be made by your pediatrician or you can make a referral yourself by contacting your local Early Intervention Program. In Manhattan, you can call 311 or 212-639-9675 and ask for Early Intervention. If you are making the call to your local Early Intervention Program, you can say something like, “I have concerns about my child’s _____ (e.g., communication) development and would like to have my child evaluated to see if he or she is eligible for early intervention services.”
Once you are connected with your state’s Early Intervention Program, you will be assigned a service coordinator who will work with you to help you understand Early Intervention services and to set up your child’s evaluation at a mutually convenient time. Early Intervention evaluations are “multidisciplinary,” which means that your child will be evaluated by a team of professionals. The team is usually made up of at least two individuals with different specialties, depending on your child’s specific needs (e.g., speech-language pathologist, occupational therapist, physical therapist). During the evaluation, professionals will ask questions to gain more information about your child’s medical and background history and current stage of development. Professionals will also observe you interact with your child as well as engage with your child themselves to learn more about his or her specific areas of strengths and difficulties. At the end of the evaluation, professionals will typically provide initial observations and recommendations, but a determination for Early Intervention Services will be made later at a meeting with your service coordinator. After the evaluation, evaluators will complete a written report detailing your child’s areas of strengths and difficulties, whether therapy is recommended at this time, and often strategies for how you can best support your child at home.
A child is determined to be eligible for services based on one of the following criteria:
Developmental Delay: A child is determined to be eligible because he or she has a significant delay in one or more developmental areas determined by a comprehensive multidisciplinary evaluation
Diagnosis: A child can also be determined to be eligible because he or she is diagnosed with a physical or mental condition that has a high probability of resulting in a significant developmental delay or disorder as a child gets older, even though he or she may not currently have an observable delay (e.g., hearing loss)
If there is something that you don’t understand about the process or your child’s evaluation, speak up and ask questions! It’s the job of the early intervention team to help you understand what your child’s evaluation means and how you can best support your little one.
If your child does not qualify for Early Intervention services, it does not necessarily mean that your child would not benefit from therapy or additional supports to foster his or her development at this time. Keep in mind that to qualify for early intervention, your child needs to have a “significant delay”. Therefore children with a “moderate” or “mild” delay in their development won’t qualify for state funded services through the Early Intervention Program. An early childhood professional on the multidisciplinary team can help provide guidance if you should continue to pursue securing services for your child either through your insurance, at a university clinic, or by a private therapist; or continue to monitor your child’s development and incorporate different strategies and learning experiences into your child’s daily routines. Some children need extra support to grow and develop; early intervention and early therapies can help make a profound difference in your child’s development!
If you still have questions about Early Intervention, please do not hesitate to reach out! If you have a question it is likely that someone else does too and I would love to continue to update this post to answer those questions!