Early Intervention: How to Access Services for Children Birth to 3 in Washington

A Brief Overview

  • The right help can be critical for infants and toddlers with disabilities and/or developmental delays. This article covers early learning basics for Washington families.
  • Part C of the Individuals with Disabilities Education Act (IDEA) outlines the process for states to provide services to any child with an area of delay.
  • A website called Parent Help 123 provides questionnaires and tools to assess child development based on milestones that are part of everyday moments.
  • Families concerned about a child’s development can call the state’s Family Health Hotline at 1-800-322-2588. This toll-free number offers help in English, Spanish and other languages.
  • No special education or early intervention rights are waived due to circumstances of the COVID-19 pandemic.

Full Article

New parents may struggle to know whether their child’s growth and development are on track. They may have a feeling that a milestone is getting missed, or they may observe siblings or other children learning and developing more quickly. Sometimes a parent just needs reassurance. Other times, a child has a developmental delay or a disability. In those cases, early interventions can be critical for lifelong learning and skill building.

In Washington, the Department of Children, Youth and Families (DCYF) administers services for eligible children from birth to age 3 through Early Support for Infants and Toddlers (ESIT). Families can contact ESIT directly, or they can reach out to their local school district to request an evaluation to determine eligibility and consider what support a child might need. The ESIT website includes videos to guide family caregivers and a collection of Parent Rights and Leadership resources, with multiple language options.

Children who qualify receive services through an Individualized Family Service Plan (IFSP). Early learning programs are designed to enable success in the child’s natural environment, which might be the home and/or a childcare or preschool setting.

The right to early intervention services is guaranteed by Part C of the federal Individuals with Disabilities Education Act (IDEA). Part B of the IDEA protects an eligible school-age student’s right to an Individualized Education Program (IEP), and Part A includes general guidance about the rights of children 0-21 with disabilities.

Family caregivers, childcare professionals, teachers, or anyone else can refer a child for an early learning evaluation if there is reason to suspect that a disability or developmental delay may be impacting the child’s growth and progress. The school district’s duty to seek out, evaluate and potentially serve infants, toddlers or school-aged students with known or suspected disabilities is guaranteed through the IDEA’s Child Find Mandate.

First Step: Evaluate to determine eligibility

After a referral is accepted, a team of professionals uses standardized tools and observations to evaluate a child’s development in five areas:

  1. Physical: Reaching for and grasping toys, crawling, walking, jumping
  2. Cognitive: Watching activities, following simple directions, problem-solving
  3. Social-emotional: Making needs known, initiating games, starting to take turns
  4. Communication: Vocalizing, babbling, using two- to three-word phrases
  5. Adaptive: Holding a bottle, eating with fingers, getting dressed

A child is eligible for services if the evaluation result shows that the child has a 25% percent delay or if a statistical measure shows a 1.5 standard deviation below measures of typically developing same-age peers. A child may also be eligible if diagnosed with a specific physical or mental condition, such as Down Syndrome, that is known to cause a delay in development.

Next Step: Develop a service plan

Services are designed to meet the child’s individual needs. Options might include, but are not limited to:  

  • Assistive technology (devices a child might need)
  • Audiology or hearing services
  • Speech and language services
  • Counseling and training for a family
  • Medical services
  • Nursing services
  • Nutrition services
  • Occupational therapy
  • Physical therapy
  • Psychological services

Services are typically provided in the child’s home or other natural environment, such as daycare. They also can be offered in a medical hospital, a clinic, a school, or another community space. 

Individualized Family Service Plan (IFSP): What is the plan?

The Individualized Family Service Plan (IFSP) is a whole family plan, with the child’s primary caregivers as major contributors to its development and implementation. The custodial caregivers must provide written consent for services to begin.  

The IFSP team always includes:

  • Parents/Caregivers and anyone else the primary caregivers request to participate
  • A Family Resource Coordinator (FRC)
  • Professionals directly involved in evaluations or assessments of the child
  • Providers of early intervention services for the child and family
  • Depending on the child’s needs, the IFSP team might also include:  
  • Medical practitioner
  • Therapist
  • Child development specialist
  • Social worker

The IFSP establishes goals, or outcomes, that the team identifies based on the evaluation, family concerns, and other input. Services are identified to support the child and family in reaching those outcomes. The plan is reviewed every 6 months and includes these elements:

  • The child’s present levels of development in each of the five areas: physical, cognitive, communication, social/emotional, and adaptive
  • Identified needs
  • Family caregiver agreement and information about available resources, priorities, and concerns
  • The major results or outcomes expected to be achieved by child and family
  • Specific services the child will receive and where/when
  • Payment source for the services
  • Name and contact information for the Family Resource Coordinator (FRC)
  • Steps to support the child’s transition out of early intervention by age 3, a process that begins by age 2.5. PAVE has an article with more detail: Early Learning Transition: When Bith-3 Services End.
  • Family support, such as parenting tips or financial guidance

Cost of Services

Washington State provides most early learning services at no cost to families of eligible children.  Some services covered by insurance are billed to a child’s health insurance provider, with the signed consent of a family caregiver.

Part C of the IDEA requires states to provide the following services at no cost to families: Child Find (outreach and evaluation), assessments, IFSP development and review, service coordination.

The Centers for Disease Control and Prevention (CDC) manages a campaign to Learn the Signs. Act Early. The website includes tools for tracking milestones and materials for families to learn more and plan home-based activities to promote skill development.

“Early intervention services can change a child’s developmental path and improve outcomes for children, families, and communities,” the CDC states. “Help your child, help your family!”

Additional Resources

The Center for Parent Information and Resources (CIPR—ParentCenterHub.org) provides an Overview of Early intervention.

The US Department of Education Office of Special Education Programs (OSEP) provides funding for the Early Childhood Technical Assistance Center (ectacenter.org), based at the University of North Carolina, Chapel Hill. The center builds state and local capacity to improve outcomes for young children with disabilities and their families.

PAVE’s Parent Training and Information (PTI) staff provide information, training, resources, and technical assistance to help family caregivers, students and professionals understand rights and responsibilities within education systems, including those for early learning. For support, complete an online help request at wapave.org or leave a message at the helpline: 1-800-572-7368/press 115.

Early Intervention Services

Great Information on Early Intervention Services

After 121 days in the Neonatal Intensive Care Unit, I took my son to his assigned pediatrician at Elmendorf Air Force Base in Anchorage, Alaska and was told I needed to arrange for custodial care for him. When I asked the doctor, “What is custodial care?” He stated that my son would never walk, talk or be able to feed himself and I should find an institution for him. Thank God for Early Intervention services! After graduating from high school and working for a local CBS television affiliate in Anchorage, Alaska for three years, he is now attending Bates Technical College studying Television Broadcast Operations and Production.

Early Intervention (EI) services are vital for improving outcomes for children who experience developmental delays. Here are two of the many resources online or available in local libraries that can help you determine whether your child is developing at a normal rate:

US Center for Disease Control

To learn about typical development, read the birth-to-6 pre-screening chart in English or Spanish

If your baby was born prematurely, your pediatrician will adjust for his or her age and recommend a developmental follow up clinic to make sure milestones are being met on time. Now this is part is important. If you do notice signs that your baby or toddler is not doing certain things, talk with your pediatrician so vision and hearing screenings can be completed and a referral can be made to your local EI lead agency. If your child is over the age of three, you can receive referrals from your doctor for private therapists and contact your local school district to request an evaluation for special education services.

For children under three years of age, once a referral has been made, a Family Resources Coordinator (FRC) will be assigned to help you access developmental evaluations and family centered services. The services offered will be based on what your child needs and what you want for your child. They can take place in your home or at the therapy center. The FRC will help you create an Individual Family Service Plan that develops outcomes for each developmental area needing attention that can monitor your child’s progress. In the state of Washington, the evaluation to determine whether your child qualifies for early intervention and resources coordination services are provided at no cost. Therapy services can be funded by your family’s health insurance and only with your signed consent. If you choose not to access your family’s health insurance, a monthly service fee will be billed based on your family’s income.

For more information on early intervention services and other early learning topics in Washington visit the Washington State Department of Early Learning.

The most important things that was told to me by the first physical therapist who worked with my son was, “You are the expert for your child.”  The second most important thing that was told to me by a young woman who is nonverbal, experiences autism, attends college and uses assistive technology to communicate was, “Have high expectations.”  Early intervention services make a huge difference in children’s lives and they achieve more as a result of getting that extra help.  Don’t wait, please ask

Photo by phil41dean via flickr.com