Infant and Early Childhood Mental Health (IECMH) is a term that describes how young children develop socially and emotionally. They learn about their emotions form close and secure relationships with their caregivers and family members. They learn and explore the environment – all in the context of family, community, and culture.
Families concerned about a child’s development can call the Family Health Hotline at 1-800-322-2588, with support in multiple languages. Parents can complete a developmental screening online for free at Parent Help 123.
PAVE’s Parent Training and Information (PTI) staff help families understand and navigate service systems for children 0-26. Click Get Help on the PAVE website or call 800-572-7368.
Early Support for Infants and Toddlers (ESIT) helps young children with disabilities or delays to learn and supports their unique development.
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New parents may struggle to know whether their child’s emotional development is on track. They may have a feeling that a milestone is missed, or they may observe siblings or the emotional well-being of other children and notice their child is developing differently. Sometimes a parent just needs reassurance. Other times, a child may have a developmental delay or a disability. In those cases, early support, including Infant Early Childhood Mental Health (IECMH) can be critical to a child’s lifelong learning and development.
IECMH is a term that describes how very young children develop socially and emotionally. They form relationships with other people. They learn about their emotions and how to control them. This happens in the settings of their family, community, and culture. (Zero to Three, Basics of Early Childhood Mental Health, 2017).
According to Best Starts for Kids, relationships are at the heart of human development and thriving for infants, toddlers, and young children. Relationships with parents and caregivers give very young children the social and emotional foundations they need to learn and thrive.
The Washington Health Care Authority reports around 1 in 6 young children has a diagnosed mental, behavioral, or developmental condition (Cree et al., 2018). These conditions may be treated with infant early childhood mental health (IECMH) services.
Services work to improve the quality of the child’s relationship with parents or caregivers. They can:
Help the distress of the mental health concern.
Support the return to healthy development and behavior.
When families receive Early Support for Infants and Toddlers (ESIT) services for a child, the child is tested as part of an Individualized Family Service Plan (IFSP).
The evaluation looks at the child’s ability to:
Identify and understand their own feelings;
Accurately notice and understand other people’s emotional states.
Manage strong emotions in a positive way.
Control their behavior.
Develop empathy (understand how people feel based on the child’s own experience)
Make and support relationships.
The evaluation may show the child is not developing well in some of these areas. IECMH services may help.
Some examples of Infant and Early Childhood Mental Health services include:
Early Childhood Mental Health Consultation
Parent training
Childcare provider training
Group training
Parent Behavioral Therapy
Cognitive Behavioral Therapy
Infant/Child – Parent Psychotherapy
Play therapy
If you are concerned about a child’s development:
To learn about typical development, read the birth-to-6 pre-screening chart in English or Spanish
Please Ask is a three-minute video that shows the importance of referring infants and toddlers for early intervention. ESIT is a part if the Department of Children, Youth and Families
This two-part video series provides information about the rights of babies, toddlers, and young children with developmental delays or disabilities.
Part 1 provides information about early support services for babies through age 3. An interactive exercise is included to help families better understand how to participate in development of functional outcomes as part of the Individualized Family Service Plan (IFSP). The video includes information about how early support services are provided and delivered in Washington State and where to begin. Keep in mind that early services are provided in the natural environment—places where babies and toddlers would spend their days if there was no disability.
Part 2 includes information about the transition from early services into preschool and primary school. Families will learn how decisions are made about eligibility for an Individualized Education Program (IEP) and how to participate in educational decision-making for their child. Inclusion in general education is covered, with information about federal requirements for services in the Least Restrictive Environment, to the maximum extent appropriate. The video explains the components of an IEP and provides advocacy tips to support parents and children throughout their educational years.
Families can reach out for individualized assistance from our Parent Training and Information (PTI) staff at PAVE. Click Get Help or call 800-572-7368.
After you view the video, please take a quick moment to complete our survey. Your feedback is valuable!
Early intervention services help infants and toddlers with disabilities or delays to learn and catch up in their development. This article covers some basics about services for young children in Washington State.
Families concerned about a child’s development can call the Family Health Hotline at 1-800-322-2588, with support in multiple languages. Parents can complete a developmental screening online for free at Parent Help 123.
PAVE’s Parent Training and Information (PTI) staff help families understand and navigate service systems for children 0-26. Click Get Help at wapave.org or call 800-572-7368.
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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 missed, or they may observe siblings or other children learning and developing differently. 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 to a child’s lifelong learning.
Seek guidance from a Family Resource Coordinator (FRC)
Washington families concerned about a young child’s development can call the Family Health Hotline at 1-800-322-2588 (TTY 1.800.833.6384) to connect with a Family Resource Coordinator (FRC). Support is provided in English, Spanish and other languages. Families can access developmental screening online for free at Parent Help 123 developmental screening tool.
Several state agencies collaborated to publish Early Learning and Development Guidelines. The booklet includes information about what children can do and learn at different stages of development, focused on birth through third grade. Families can purchase a hard copy of the guidelines from the state Department of Enterprise Services. Order at: myprint.wa.gov. A free downloadable version is available in English and Spanish from OSPI’s website on a page labeled: Early Learning and Development Guidelines.
Washington early services are provided by ESIT
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.
Early intervention services are provided in the child’s “natural environment,” which includes home and community settings where children would be participating if they did not have a disability. According to ESIT, “Early intervention services are designed to enable children birth to 3 with developmental delays or disabilities to be active and successful during the early childhood years and in the future in a variety of settings—in their homes, in childcare, in preschool or school programs, and in their communities.”
Early services are delivered through an IFSP
Children who qualify receive services through an Individualized Family Service Plan (IFSP). The right to an IFSP is protected by Part C of the Individuals with Disabilities Education Act (IDEA). The IDEA is a federal grant program that provides funding for states to implement early learning and special education programs. Part B of the IDEA protects an eligible school-age student’s right to an Individualized Education Program (IEP). Part A includes general guidance about the educational rights of children 0-21.
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
Early intervention is intended for infants and toddlers who have a developmental delay or disability. Eligibility is determined by evaluating the child (with parental consent) to see if the little one does, in fact, have a delay in development or a disability. Eligible children can receive early intervention services from birth to the third birthday.
After a referral is accepted, a team of professionals uses standardized tools and observations to evaluate a child’s development in five areas:
: Reaching for and grasping toys, crawling, walking, jumping
: Watching activities, following simple directions, problem-solving
: Making needs known, initiating games, starting to take turns
: Vocalizing, babbling, using two- to three-word phrases
: Holding a bottle, eating with fingers, getting dressed
The tools used to evaluate a child provide scores that are compared with the scores of children who are typically developing. Eligibility is met based on one or more of these conditions:
Next Step: Develop a service plan
If an infant or toddler is eligible, early intervention 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 IFSP is a whole family plan, with the child’s primary caregivers as major contributors to its development and implementation. Parents/custodial caregivers must provide written consent for services to begin. In Washington, Family Resource Coordinators (FRCs) help write the IFSP. Team members may include medical professionals, therapists, child development specialists, social workers, and others with knowledge of the child and recommendations to contribute.
The IFSP includes goals, and progress is monitored to determine whether the plan is supporting appropriate outcomes. The plan is reviewed every six months and is updated at least once a year but can be reviewed at any time by request of parents or other team members. The IFSP includes:
The child’s current developmental levels and needs in physical, cognitive, communication, social/emotional, and adaptive areas
Family information: resources, priorities, and concerns of parents/caregivers.
Major results/outcomes expected from the child and family
Specific services:
Where services are provided—any services provided outside the child’s “natural environment” of home/daycare/community require a statement explaining the rationale for the placement
When the child receives services—the number of days or sessions for each service, and how long each session will last
Who pays for the services
Name and contact information for the Family Resource coordinator (FRC) responsible for IFSP implementation
Steps to begin at age 2.5 to support the child’s transition out of early intervention and perhaps into school-based services.
If relevant, additional services or information for the family—such as financial guidance or parenting support
Dispute resolution options are available
If parents have a concern or disagree with any part of the early intervention process, they can contact their Family Resource Coordinator (FRC). If issues remain unresolved, families may choose from a range of dispute resolution options that include mediation, due process, and more. ESIT provides access to a downloadable parent rights brochure with information about dispute resolution options in multiple languages.
Most services are free to families
Washington State provides most early intervention 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. The early intervention system may not use health care insurance (private or public) without express, written consent.
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, and service coordination.
More resources
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 encourages. “Help your child, help your family! Families benefit from early intervention by being able to better meet their children’s needs from an early age and throughout their lives.”
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.
The Individualized Family Service Plan (IFSP) ends when a child turns 3. A transition to a preschool plan with an Individualized Education Program (IEP) requires a new evaluation and is a team-led process:
Planning begins 6-9 months before the third birthday.
The Family Resource Coordinator (FRC) schedules a transition conference to design a written Transition Plan.
The transition includes an evaluation that is conducted by the local school district and usually begins 2-3 months before the child’s third birthday.
If the child is determined eligible, the child will transition from a family-centered program of early learning (IFSP) into a school-based program (IEP).
Parent participation is critical: You are an important member of the transition planning team!
To qualify for an IEP, the child must meet evaluation criteria under the Individuals with Disabilities Education Act (IDEA). Criteria for Birth-3 services (Part C of the IDEA) are slightly different than the criteria for Special Education programming available for ages 3-21 (Part B of the IDEA).
To qualify for an IEP: (1) The student is determined to have a qualifying disability. (2) The disability adversely impacts education. (3) The evaluation indicates a need for specially designed instruction.
Differences in Eligibility
IDEA Part C (Also called Early Intervention -IFSP)
IDEA Part B
(Also called Special Education – IEP)
25% or 1.5 SD (Standard Deviation) Below the mean in one area of development – OR-
2 SD (Standard Deviation ) below the mean in one or more areas of development – OR –
Diagnosed physical or medical condition that has a high probability of resulting in delay
1.5 SD below the mean in two or more areas of development
Qualifying Disability Categories for IEP:
Developmental Delay (ages 3-8)
Specific Learning Disability
Intellectual Disability
Autism
Hearing Impairment
Emotional Disturbance
Deaf-blindness
Multiple Disabilities
Orthopedic Impairment
Other Health Impairment
Deafness
Speech/Language Impairment
Traumatic Brain Injury
A child who doesn’t qualify for an IEP:
May qualify for a Section 504 plan, which provides accommodations under the Rehabilitation Act of 1973 when:
The disability significantly limits one or more major life activities.
The student needs accommodations to access the general education curriculum.
May qualify for other services like Head Start, co-operative pre-school, paid pre-school or day care with early achievers, play-to-learn programs, and other early learning opportunities in a community setting.
Use this checklist to help track your family’s transition steps:
6-9 months before the child’s third birthday:
The Family Resource Coordinator (FRC) starts talking about transition.
The FRC transmits your child’s records to the school system, with your written consent. The most recent IFSP and evaluations/assessments are included.
If your child is potentially eligible for Part B services, a transition conference is scheduled.
Community resources are located.
Transition Conference:
Parent’s rights in special education are explained.
Options for early childhood special education and other appropriate services are discussed.
A transition time line is developed.
A transition plan is written into the IFSP.
Evaluation:
If you agree, you sign consent for evaluation.
Records from Early Intervention Services are received at the school.
Information from the family is considered.
Evaluation is completed, and the eligibility meeting is held within 35 school days so that an IEP can be developed before the child’s third birthday.
IEP Meeting:
The IEP meeting is scheduled with a formal written invitation with date, time and location.
Discussion and decision-making include the family, the FRC (with parent permission), and an early childhood special education staff member.
Eligibility for special education is decided.
If the child is eligible, the Draft IEP is brought to the team meeting and you will have the opportunity to agree or disagree.
You receive a copy of your rights and procedural safeguards.
If you agree, you sign consent for services to begin.
The IEP in action:
The child makes the transition from Early Intervention to Early Childhood Special Education or another pre-kindergarten arrangement, if chosen.
The IEP is in place by our child’s third birthday.
The team of professionals and parents continue working together to resolve any issues that arise.
All IEP team members communicate during this time of change.
Services for families with infants and very young children include family-focused, home-based support. Families are served with an Individualized Family Service Plan (IFSP). An IFSP ends when the child turns 3.
A child who qualifies for an Individualized Education Program (IEP) receives those services at school. Not all children who qualified for an IFSP will quality for an IEP. An IEP is for children ages 3-21, or until high-school graduation.
Families may transition from getting in-home help for their child with special needs to participating as members of an IEP team. This can feel like a big change. The information in this article can empower parents.
Transition planning starts at least half a year before the child’s third birthday. Providers, teachers, school administrators and the family start thinking and collaborating early about what the child might need to do well.
Read on to learn what parents need to know when a young child with special needs makes the transition from Birth-3 services into preschool or another program.
A parent-support agency called Informing Families provides a 12-minute video to guide parents through the early-learning transition process.
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When a child is born with a disability or the family realizes early that an impairment might impact a young child’s ability to learn and develop at a typical rate, the family can get help from the state. Early Support for Infants and Toddlers (ESIT) is managed by Washington’s Department of Children, Youth, and Families (DCYF).
Services for families with infants and very young children include family-focused, home-based support. When a child is ready to graduate from those early-learning services, the school district determines whether to conduct an educational evaluation to see whether the child qualifies for school-based services. If a child qualifies, the family and school district work together to generate an Individualized Education Program (IEP), which can begin at age 3 in preschool.
A child who qualifies for an IEP receives those services at school. Families transition from getting in-home help for their child with special needs to participating as members of the IEP team. The goals change, and parents help teachers and school staff talk about what the child needs to successfully access school and learning. This transition can be disorienting to some families. Read on for more detail.
Early Intervention can start from birth
Early intervention services are guaranteed by the Individuals with Disabilities Education Act (IDEA), under “Part C” of the IDEA. The U.S. Department of Education manages a federal grant program under the Office of Special Education Programs (OSEP) that helps states manage early intervention programs to support infants and young children and their families.
Part C services are available for infants and young children who:
Experience developmental delays, which are medically diagnosed to impact cognitive, physical, communication, social-emotional and/or adaptive skills
Have a diagnosed physical or mental condition that has a high probability of resulting in a developmental delay
Washington’s ESIT program assigns agencies in each county to serve as a “lead agency” to coordinate early learning services and testing. The lead agency works with service providers and the family to review a child’s medical record, discuss any observations by caregivers, and conduct screenings to see what’s going on and whether the issues of concern meet criteria under Part C for early intervention.
When a child is found eligible for services, a Family Resource Coordinator (FRC) manages the case. The FRC helps to develop an Individualized Family Service Plan (IFSP). Each plan is unique and may involve individualized instruction, therapy services and supported access to community resources. The plan is designed around the needs of the child and family and is not based on a predetermined program model.
Family-based, early learning services end on the child’s third birthday. A new educational evaluation is required to see whether the student qualifies for an IEP under “Part B” of the IDEA.
Part B services are available for children ages 3-21 (or until high-school graduation) who:
Are significantly affected by that disability at school (“Significant Educational Impact” is determined with evidence and data)
Require specialized instruction to overcome the barriers of that disabling condition
To qualify for an IEP under the IDEA, a student meets criteria in one of 14 disability categories
Autism
Deaf-blindness
Deafness
Emotional Disturbance
Hearing Impairment
Intellectual Disability
Multiple Disabilities
Orthopedic Impairment
Other Health Impairment
Specific Learning Disability
Speech / Language Impairment
Traumatic Brain Injury
Visual Impairment/Blindness
Developmental Delay (ages 0-8)
Note that the disability category of developmental delay can qualify a child for free, family-focused services to age 3 and school-based, IEP services through age 8.
Helpers get creative during “Part C-to-B Transition” planning
The FRC helps the family and school district get ready. Often this is referred to as “Part C-to-B Transition” planning, so it’s helpful when families understand that Parts C and B come from federal law, the IDEA (Individuals with Disabilities Education Act), designed to ensure that children with disabilities get the help they need to be successful at school and prepared for life.
For families who have received services through the state’s early-learning program (ESIT), Part C-to-B Transition planning starts at least half a year before the child’s third birthday. Providers, teachers, school administrators and the family start thinking and collaborating about what the child might need to do well. The work includes a “Transition Planning Conference,” which happens about 90 days before a child turns 3. The participants at this meeting write a plan for what services or community supports the child might receive.
Each plan is unique and designed to respond to individual needs. A child’s plan might indicate need for a specific child-care setting or medical-based therapies. The plan might include a referral to a specific, state-funded special-education preschool program through Head Start or the Early Childhood Education and Assistance Program (ECEAP, pronounced “E-Cap”). A transition plan also can name local playgroups or parent-support networks to connect the family to community resources. If a child’s educational evaluation has determined that the child is eligible for an IEP, then information about that is included.
Not all children who qualified for early-learning support will qualify for an IEP. Children who are not eligible for IEP services might be eligible to receive accommodations and support through a Section 504 Plan.
Early learning isn’t the only pathway to an IEP evaluation
Children who didn’t receive early-learning interventions can also be evaluated to determine whether they qualify for school-based services that can start as young as age 3 and can continue through age 21, or until a student graduates from high school.
Anyone with concerns about a child can refer the child for an educational evaluation. These referrals usually come from parents, teachers, medical providers or early-learning specialists. When a concerned adult formally requests an evaluation from the school district (best-practice is to make the request in writing), then the district is bound by the IDEA to respond to that request within 25 school days. PAVE provides a comprehensive article about the evaluation process.
The school district has a responsibility under the Child Find mandate of the IDEA to seek out and evaluate children with known or suspected disabilities who may need services.
When a school district agrees to evaluate, parents sign consent for the assessments to begin. The IDEA requires schools to complete an evaluation within 35 school days. For a child receiving early-learning services, the first IEP meeting is required on or before the child’s third birthday.
Families may invite whomever they want to an IEP meeting. For example, they can invite the Family Resource Coordinator (FRC), a family member, a friend or any other support person.
If the school district does not conduct an educational evaluation, or if the evaluation indicates that the child doesn’t qualify for school-based, IEP services, parents have the right to disagree with the school’s decision. The family can request a written statement that describes the school district’s position, with any information or data that was used to justify the decision.
PAVE’s Parent Training and Information (PTI) center provides technical assistance and can help parents understand how to participate in their child’s learning. Got to: wapave.org/get-help or call (253) 565-2266, 1-800-5-PARENT ext.115
The Arc of Washington hosts local Parent-to-Parent (P2P) programs across the state. Families can request a “support parent match” to talk with another parent who has already navigated this process. Visit Arcwa.org for more information.
