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UNITED STATES ROADMAP

ROADMAP POLICIES AND STRATEGIES

EFFECTIVE POLICIES

EFFECTIVE STRATEGIES

Methods and Sources
FAQ
Additional Roadmap Resources
THE POLICY IMPACT CALCULATOR

EARLY INTERVENTION SERVICES

Part C of the federal Individuals with Disabilities Education Act (IDEA) provides funds for states to establish Early Intervention (EI) programs, which offer services for infants and toddlers (birth to age 3) with disabilities or developmental delays, regardless of family income.1 States must develop a set of eligibility criteria and then identify, evaluate, and provide appropriate services and therapies to all children who meet the state’s thresholds for delays, disabilities, or risk for delayed development.

State EI programs have a variety of names (e.g., “Birth to Three” in Connecticut, “Early Childhood Intervention” (ECI) in Texas, and “First Steps” in Kentucky), but the Roadmap uses Early Intervention or EI for consistency across states.

Access to EI Services Can Prevent Further Delays and Reduce the Need for Special Education Services

Access to EI services, such as speech therapy for a child with language delays, or physical therapy for a child with motor challenges, can improve the developmental trajectories of infants and toddlers and prevent further delays. Timely services may also reduce the need for special education or more intensive supports when children are older.2 Family-centered services that involve parents have been shown to be more effective than therapies for children alone because caregivers can learn how to interact with and care for their child in a way that will best support the child’s development.3

States Determine Eligibility Criteria for EI Services

One pathway for infants and toddlers to become eligible for EI services is to meet the criteria for demonstrating a developmental delay (e.g., a 30% or greater delay in one or more developmental areas). The definition of a qualifying delay is set by each state and states vary in how broad (most inclusive, serving less severe delays) or narrow (requiring the most severe delays) requirements are. Using a broad eligibility threshold means that a state may serve children with less severe delays than states that report moderately inclusive or narrow criteria, but states with broader eligibility criteria do not necessarily serve more children than states with more restrictive criteria.  

EI Services Can Save States Money in the Long Run

A recent analysis of six states found that Early Intervention services helped between 760 and 3,000 children per state to avoid special education services at age 3, with a 1-year cost avoidance of between $7.6 million to $68.2 million depending on the state.4 Three-year cost avoidance estimates, which accounted for children re-entering special education services after an initial exit, still projected substantial cost savings.5

State EI Programs Face a Variety of Challenges, Including Inadequate Funding and Inequities in Children’s Access

The number of children enrolled in Early Intervention services has trended upwards in the past 2 decades, but federal per-child Part C funding has declined, which requires greater state support for services.6 State leaders consistently report that ensuring adequate funding remains one of the most critical challenges for their EI programs.7

The percentage of children ages birth to 3 who are served varies significantly across states,8 in part because of differences in state eligibility policies;9 states’ outreach efforts to hospitals, child care centers, and other organizations;10 and resource availability.11

Children from lower-income families and communities of color do not have equitable access to EI services. The most recent national data show that 7% of Black children ages birth to 3 are served in EI over the course of a year, compared to 8.1% of White children.12 A widely cited study found that by 24 months old, Black children identified as likely eligible for EI were five to eight times less likely to receive services than White children, depending on the reason for eligibility.13 A study of low birthweight infants found significantly lower EI referral rates for infants of Black non-Hispanic mothers than all other racial groups.14 These inequities in EI access may contribute to disparities in children’s later outcomes.

States also vary in how consistently they refer children who have experienced abuse and neglect to EI programs. A study of children ages birth to 3 involved in child welfare investigations estimated that over 35% had delays or risk factors that would make them eligible for EI services, but only 12.7% of those in need were receiving services.15

Search the Prenatal-to-3 Policy Clearinghouse for an ongoing inventory of rigorous evidence reviews, including more information on Early Intervention services.

The most rigorous evidence suggests that Early Intervention services can improve children’s outcomes in areas including cognitive development, language/communication skills, behavior, and motor skills. Other evidence suggests positive outcomes for parental health and wellbeing, such as maternal self-confidence and role satisfaction.

More Research Is Needed to Determine the Potential of Early Intervention Services to Decrease Racial and Ethnic Disparities

Children from families with lower incomes and communities of color do not have equitable access to Early Intervention services and often experience disruptions and roadblocks from referral to evaluation and enrollment. Rigorous evidence suggests children with mothers who have more education or families with higher incomes benefit more from Early Intervention Services.16,17 Additionally, Black or Hispanic children in one study did not improve cognitive scores as much as children who identified as White, Asian, or Other.18

The reasons for these disparities should continue to be studied and rectified to ensure all infants and toddlers can benefit and reach their developmental potential, regardless of race, ethnicity, or socioeconomic status.

For more information on what we know and what we still need to learn about Early Intervention services, see the evidence review on Early Intervention services.

In contrast to the evidence for the four state-level policies that are included in this Roadmap, the current evidence base does not identify a specific policy lever that states should adopt and fully implement to improve access to Early Intervention for all the children who need the services.

We identified three key state policy levers that states can implement to improve access to Early Intervention (EI) services. The three state policy levers include:

  • Allow very low birthweight (defined as <1,500 grams) as a diagnosable or at-risk qualification for EI services,
  • Allow at-risk for delay as a qualifier for EI services, and
  • Eliminate family fees for children receiving EI services.
Key Policy Lever: Allow Very Low Birthweight as a Diagnosable or At-Risk Qualification for EI Services

Children may be automatically eligible for EI based on a state’s unique list of qualifying diagnosed/established conditions (often including very low birthweight and prematurity, at various thresholds). States may also choose to automatically qualify children based on factors that may place children at risk for delays or disabilities.

No state includes low birthweight (defined as <2,500 grams or approximately 5 pounds, 8 ounces) as a diagnosable or at-risk eligibility criteria. However, a total of 21 states qualify children born very low birthweight for EI (defined as of <1,500 grams, or approximately 3 pounds and 5 ounces).

In the last year, North Dakota, Utah, and Wyoming all added very low birthweight to their states’ qualifying diagnosed conditions. States may also define very low birthweight differently or require extremely low birthweight (defined as <1,000 grams) to qualify for services.

Currently, 26 states qualify children born premature (often requiring very preterm or extremely preterm birth, born earlier than 32 or 28 weeks, respectively). The conditions of low birthweight and prematurity are closely correlated with one another, however, not all states that include very low birthweight in EI eligibility criteria allow children born premature to qualify, and vice versa. Additionally, some states with high rates of low birthweight or prematurity do not include these conditions as part of their EI eligibility policies.

Key Policy Lever: Allow At-Risk for Delay as a Qualifier for EI Services

Beyond eligibility for diagnosed developmental delays, allowing children to qualify based on a set of biological, environmental, or social risk factors is important for serving the youngest infants, who may not show developmental delays until later. Six states (California, Florida, Massachusetts, New Hampshire, New Mexico, and West Virginia) report to the federal government that they choose to serve children who are at risk for delays or disabilities, even if the children do not have an established delay or disability.

Each of the six states has a specific list of risk factors that can qualify a child for EI services, and the states can determine how many risk factors children must have to qualify (some states require five or more risk factors to be present simultaneously, for example). Some of these risk factors include social circumstances, such as low income or homelessness, but others are more clinical, such as low Apgar scores or prenatal drug exposure.

States can also choose whether at-risk children can receive services for the entire birth-to-3 period, or only until a certain age. These states may also limit which EI services at-risk children can receive, and for how long, to ensure that sufficient resources remain available for children with established delays and medical conditions.

Other states may serve children who are at-risk based on their state policies, but the states may not report this practice to the federal government in the same way as the six states listed above.19

Key Policy Lever: Eliminate Family Fees for Children Receiving EI Services

In addition to eligibility criteria that are inclusive of children with less severe delays and children at risk for delays, states can take steps to reduce barriers to family participation in EI services. To support EI services, states may rely on cost-sharing measures beyond federal, state, and local funding sources.20 One example of a cost-sharing mechanism is to assess family fees, which are similar to copays for services, often on a sliding scale. However, research has shown that implementing family fees for EI services may reduce children with low incomes’ participation in the program, even when sliding scales would preclude them from out-of-pocket costs, because parents may not be aware of the financial assistance available to them and may be deterred from pursuing services.21

In the 2023 survey to which all 50 states and the District of Columbia responded, 17 states reported that they rely to some extent on family fees to pay for services, whereas most states do not report this practice. Five states (Iowa, Maryland, Michigan, Minnesota, and Nebraska) are designated as “birth mandate” states, which means that children with disabilities are guaranteed free public education services from ages 0 to 21, including EI services from ages 0 to 3 for those eligible, and family fees are therefore prohibited.22 Including the five birth mandate states, 34 states report eliminating family fees. If states can leverage sufficient funding from other sources and eliminate the use of family fees, this may help more low-income families to access EI services.23

States Can Use a Variety of Funding Streams to Support EI

The available resources that states can marshal to support EI are critical to serving a higher percentage of children. Part C federal funds allocated to states are intended to supplement, not supplant, state resources, and therefore, most states access a variety of funding streams beyond the federal Part C allocation to serve more children.

The portion of federal Part C funds awarded to each state is based on the number of children under age 3 in a state as compared to other states,24 rather than based on the number of children actually served in EI or in need of EI services, and therefore, states that serve more children than other states typically must invest more of their own state resources. Over time, as the federal per-child amount has declined, states have begun to invest more of their own state resources in EI services, and many have set up the necessary infrastructure to allow EI programs to bill private insurance25 and have reduced or eliminated the collection of family fees.

States vary in whether they primarily rely on federal funding, state resources, or local funding to support their EI systems. In a 2023 survey, a total of 33 states reported that they rely most heavily on their own state resources to sustain their EI programs; 15 states reported relying most heavily on federal funds, and 3 reported local funding as their primary funding source.26 In the survey, 32 states reported billing private insurance to cover EI services, which can free up public funding to serve children without private coverage. 

Maximizing Medicaid Funding Is a Cost-Effective Approach to Serve More Children

An important funding source for EI services is Medicaid,27 and states vary in the extent to which they take advantage of Medicaid funding to support their EI programs.28 States that have fostered closer partnerships between their Medicaid agencies and Part C programs have been able to increase the number of children they serve.29 For example, states may cross-reference Medicaid and Part C data to identify children in Part C who are also eligible for Medicaid, to ensure that their EI providers bill Medicaid.30 This practice can free up other funding streams to allow states to serve more children who are not Medicaid-eligible.

States’ efforts to maximize Medicaid are critical because Part C federal funding to the states is based on a state’s overall infant/toddler population, whereas federal Medicaid matching funds are not limited in this way.31 Per the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) provision in federal law, Medicaid-enrolled children under age 21 are entitled to any services that are deemed “medically necessary” by a qualified provider, and this may include EI services.32 Given this, another way states can maximize Medicaid funding for EI services is to increase the number and type of EI services that can be reimbursed by Medicaid.

Collaborations Among Multiple State Agencies Can Promote More Seamless Services for Children

In addition to fostering collaboration with Medicaid, states whose Part C programs work closely with other agencies, including child welfare and state public education systems, have been able to ensure that children experiencing maltreatment receive the services they need, and ensure that children experience a more seamless transition from Part C to Part B special education services at later ages, respectively.

Children involved in the child welfare system have been found to be at an increased risk for developmental delays given the effects of physical and psychological maltreatment.33 The federal Child Abuse Prevention and Treatment Act, or CAPTA (passed in 1974 and amended numerous times since) requires that states develop processes and procedures to refer children who have experienced substantiated abuse or neglect to EI programs.34

States vary in how consistently they make these referrals. Only seven states (Alaska, Iowa, Maine, Nebraska, Ohio, Utah, and Wyoming) report that they refer 100% of eligible children who have experienced substantiated maltreatment to Part C agencies, based on 2022 federal data, and nearly two-fifths of states were not able to report any data on their referrals.35 States have discretion to refer children in substantiated cases directly to an evaluation, or to instead require that child welfare systems do a pre-screening to determine whether an EI evaluation is necessary. In a 2020 survey, only 12 states reported that they refer children directly to an evaluation, without requiring a pre-screening.36

For more information on the state policy levers that help maximize the effectiveness of Early Intervention programs see our State Policy Lever Checklists.

State EI programs vary considerably in the percentage of children under age 3 who are served, which is impacted by policy choices regarding eligibility criteria, the funding streams states access to support their programs, the level of collaboration between Part C programs and other state agencies, such as Medicaid and child welfare, and in other ways that have implications for the strength of a state’s program.

The Percentage of Children Served by Early Intervention Services Is the Most Consistent Measure to Compare States’ Success

The share of children served is one of the only indicators that allows for a consistent, meaningful comparison of states’ EI programs across the country; in most other ways, states’ programs are so different and context-dependent that it is difficult to compare them to one another meaningfully based on a single indicator.

Available state data show the percentage of children who are served in EI out of all infants and toddlers ages birth to 3, but the data do not indicate the percentage of children served out of those who are eligible or in need of services. National research suggests that the prevalence of children under age 3 with delays and disabilities whose development could improve with EI services is between 13% and 20%.37 Rates of low birthweight can also serve as a proxy for different levels of need for EI services across states, because research shows that low birthweight is a risk factor for the kinds of delays and disabilities that may improve if children receive EI services.38

States Vary Considerably in the Percentage of Children Under Age 3 Served in EI

Recent national data show that, in the median state, 7.5% of children under age 3 received any EI services over a 12-month period, but this percentage varies considerably by state, from a low of 2.5% in Arkansas to a high of 20.2% in Massachusetts. Fourteen states serve 10% or more of infants and toddlers in EI services, and six states serve 5% or fewer over the course of a year.

When EI service rates are calculated using a point-in-time approach, rather than a cumulative count over a full year, the national percentage of children served is 4%. States range from serving less than 2% (Arkansas, Oklahoma, Mississippi, and Montana) to 11.2% (New Mexico) of their birth-to-3 population on any given day. 

We use the cumulative, rather than point-in-time data in this Roadmap based on recommendations from national experts in Early Intervention.39 The cumulative data capture services received throughout the year, rather than just services provided on the day that a point-in-time count occurred. The cumulative measure also accounts for the fact that children will require services for varying lengths of time.

Disparities in Rates of Low Birthweight Across Race and Ethnicity Can Shed Light on the Disproportionate Need for EI Across Race and Ethnicity

Comparing the rate of babies born low birthweight overall and by race and ethnicity in a state to the share of children served in EI can highlight states’ progress in serving children in need and doing so equitably. Most states require very low birthweight (less than 1,500 grams), or extremely low birthweight (less than 1,000 grams) to qualify for EI. The rate of low birthweight (based on a standard of 2,500 grams) by race and ethnicity may serve as a rough proxy to indicate variation in the need for EI across race and ethnicity.

In the US, Black children are twice as likely to be born low birthweight than White or Hispanic children, therefore if access to EI services was equitable, a relatively higher percentage of Black children should receive EI services compared to their White or Hispanic counterparts. Yet, a smaller percentage of Black children actually receives EI services. Nationally, only 7.0% of Black children ages birth to 3 are served in EI over the course of a year, compared to approximately 8% of both White and Hispanic children. Children classified as “Other” for race/ethnicity, which includes Asian children, are served at a rate of 6.6%.

States have substantial latitude in how they implement their EI programs. Over the last year, several states took legislative or administrative action to enhance their EI services, specifically through increasing access to and eligibility for EI services for many families, improving reimbursement rates and processes for providers, and improving the funding of their programs.

3 States Expanded Eligibility Criteria to Include Very Low Birthweight

In the last year, North Dakota, Utah, and Wyoming all newly reported very low birthweight as a qualifying diagnosed condition or at-risk condition for their eligibility criteria. North Dakota and Wyoming also both reported including prematurity at varying levels as qualifying or risk factors for EI eligibility.

Ohio introduced legislation to expand its eligibility criteria by adding extreme prematurity as a qualifying condition. The bill passed the House in June 2024, but as of October 1, 2024, the bill had not passed the Senate.

States Funded Potential Caseload Growth

Several states took legislative action to provide additional funding to support EI caseload growth. For example, Illinois, Iowa, and Oregon increased appropriations for EI to serve more families. North Carolina also enacted a budget that includes recurring funds to provide services to an additional 10,000 children who may become eligible based on new eligibility standards under consideration in a feasibility study.

States Increased Workforce Supports Through Rate Increases and Process Improvements

States also took legislative action to address provider shortages, including efforts to improve provider reimbursement rates and processes. Colorado, Georgia, New York, Rhode Island, and Virginia all enacted legislation to increase provider reimbursement rates. Florida enacted legislation to provide funding for a new Early Steps administration system within the state Department of Health to help address the early interventionist shortage. Additionally, North Carolina’s budget provided funding for staffing increases and a centralized provider network system, as well as professional development for providers. Finally, Washington enacted a bill to improve the timeliness with which early interventionists are reimbursed.

States also enacted legislation to conduct studies to identify strategies to address provider shortages and to examine salary inequities and potential rate increases for early interventionists. North Carolina appropriated funding to conduct a feasibility study on increased rates and expanded eligibility criteria for EI, and Mississippi appropriated funding to study the EI system and the laws that govern EI in the state. Mississippi also enacted a bill to support the state’s EI task force, which must submit a report that proposes legislation and rule changes, based upon its recommendation on issues such as reimbursement rates and eligibility criteria by January 1, 2025.

Although unsuccessful, legislation was also introduced in several other states to provide workforce supports to those providing EI services. For example, Kentucky legislators introduced legislation which would have required the state to develop a comprehensive system of training and personnel development to build a qualified EI workforce. The bill did not pass this session. Additionally, legislators in Oklahoma introduced a bill which would have created a task force to study and make recommendations for improving access to high-quality early childhood services, including EI. But, the bill did not pass this session.

States Modified Governance Structures, Impacting EI Programs

Other states took action to improve governance that impacts state EI programs, by shifting management of state EI programs to new or different departments. Arizona, Delaware, Illinois, and Louisiana all enacted legislation to relocate EI services to new or different state departments as part of their restructuring of the governance of early childhood programs. For example, effective July 2024, Illinois created a new agency under which EI is now housed, the Department of Early Childhood.

Delaware enacted legislation to support staff positions responsible for a planned transition of its Part C program from the Department of Health and Social Services to the Department of Education by July 2028. Moreover, Arizona enacted a bill that designates the Department of Economic Security as the lead agency for coordinating Part C programs, and Louisiana enacted legislation to transfer EI to its Department of Health effective May 2024.

Although all states administer EI differently, shifting EI to different departments may help with ensuring state programs have resources needed to streamline enrollment and funding. For example, placing EI in the department of education may help children transition from Part C services to early childhood special education when they turn 3, whereas coordination between Medicaid and EI under the health department governance may help maximize Medicaid funding to preserve limited Part C funds for serving more children.

For more information on each state’s progress on Early Intervention services, find our individual state summaries under Additional Resources below (and here).

Click here to view the compiled 2024 Roadmap Early Intervention services progress summaries for all 50 states and the District of Columbia.

  1. Dragoo, K. (2019). The Individuals with Disabilities Education Act (IDEA), Part C: Early Intervention for infants and toddlers with disabilities. Congressional Research Service. https://sgp.fas.org/crs/misc/R43631.pdf
  2. Ullery, M. A. & Katz, L. (2016). Beyond Part C: Reducing middle school special education for Early Intervention children with developmental delays. Exceptionality, 24(1), 1-17. https://doi.org/10.1080/09362835.2014.986601
  3. Shonkoff, J. & Hauser-Cram, P. (1987). Early intervention for disabled infants and their families: A quantitative analysis. Pediatrics, 80(5), 650–658. https://pediatrics.aappublications.org/content/80/5/650 [Early Intervention Evidence Review Study F]
  4. Emerald Consulting. (n.d.). Cost avoidance return on investment. Document provided to the Prenatal-to-3 Policy Impact Center by Maureen Greer, Executive Director at the IDEA Infant & Toddler Coordinators Association, via email on April 1, 2020.
  5. Emerald Consulting. (n.d.). Cost avoidance return on investment. Document provided to the Prenatal-to-3 Policy Impact Center by Maureen Greer, Executive Director at the IDEA Infant & Toddler Coordinators Association, via email on April 1, 2020.
  6. Early Childhood Technical Assistance Center. (2021). Part C Infant and Toddler Program Federal Appropriations and National Child Count 1987-2020. https://ectacenter.org/partc/partcdata.asp#appropriations
  7. IDEA Infant & Toddler Coordinators Association. (2020). Tipping points survey: Demographics and challenges. https://www.ideainfanttoddler.org/pdf/2020-Tipping-Points-Survey.pdf
  8. Point-in-time service percentages. US Department of Education. (July 6, 2022). Number of infants and toddlers and percentage of population, receiving early intervention services under IDEA, Part C, by age and state: 2021 [Data Set]. Retrieved on June 1, 2023 from https://data.ed.gov/dataset/idea-section-618-data-products-static-tables-part-c; Cumulative service percentages: Numerators from US Department of Education. (July 6, 2022). Cumulative number of infants and toddlers ages birth through 2 receiving early intervention services under IDEA, Part C, by race/ethnicity and state: 2021 [Data Set]. Retrieved on June 1, 2023 from https://data.ed.gov/dataset/idea-section-618-data-products-static-tables-part-c
    Denominators from US Census Bureau, Population Division. (2022). Annual state resident population estimates for 6 race groups (5 race alone groups and two or more races) by age, sex, and Hispanic origin: April 1, 2020 to July 1, 2021 – scest2021-alldata6.csv [Data Set]. Retrieved August 31, 2022 from https://www.census.gov/data/tables/timeseries/demo/popest/2020s-state-detail.html.
  9. Barger, B., Squires, J., Greer, M., Noyes-Grosser, D., Martin, J., Rice, C., Shaw, E., Surprenant, K., Twombly, E., London, S., Zubler, J., & Wolf, R. (2019). State variability in diagnosed conditions for IDEA Part C eligibility. Infants & Young Children, 32(4), 231–244. http://doi.org/10.1097/IYC.0000000000000151
  10. Part C Child Count and Settings. SY 2019-20 Reporting Year. Data Notes. https://www2.ed.gov/programs/osepidea/618-data/collection-documentation/data-notes/part-c/child-count-and-settings/c-childcountsettings-datanotes-2019-20.pdf
  11. Texans Care for Children. (2020). Supporting Texas infants and toddlers with disabilities during the pandemic. https://static1.squarespace.com/static/5728d34462cd94b84dc567ed/t/5fab103aec781e3dbf1edc63/1605046345289/2020-eci-report.pdf
  12. Numerators from US Department of Education. (February 8, 2024). Cumulative number of infants and toddlers ages birth through 2 receiving early intervention services under IDEA, Part C, by race/ethnicity and state: 2022/2023 [Data Set]. Retrieved on July 25, 2024 from https://data.ed.gov/dataset/idea-section-618-data-products-static-tables-part-c
    Denominators from US Census Bureau, Population Division. (2023). Annual state resident population estimates for 6 race groups (5 race alone groups and two or more races) by age, sex, and Hispanic origin: April 1, 2020 to July 1, 2022 – scest2022-alldata6.csv [Data Set]. Retrieved June 23, 2023 from https://www.census.gov/data/tables/timeseries/demo/popest/2020s-state-detail.html
  13. Advocates for Children of New York and Citizens’ Committee for Children of New York, Inc. (2019). Early inequities: How underfunding Early Intervention leaves low-income children of color behind. https://cccnewyork.org/data-publications/early-inequities-how-underfunding-early-intervention-leaves-lowincome-children-of-color-behind/
  14. Advocates for Children of New York and Citizens’ Committee for Children of New York, Inc. (2019). Early inequities: How underfunding Early Intervention leaves low-income children of color behind. https://cccnewyork.org/data-publications/early-inequities-how-underfunding-early-intervention-leaves-low-income-children-of-color-behind/
  15. Casanueva, C., Cross, T., & Ringelsen, H. (2008). Developmental needs and Individualized Family Service Plans among infants and toddlers in the child welfare system. Child Maltreatment, 13(3), 245–258. https://doi.org/10.1177%2F1077559508318397
  16. Teti, D., Black, M., Viscardi, R., Glass, P., O’Connell, M., Baker, L., Cusson, R., & Reiner Hess, C. (2009). Intervention with African American premature infants: Four-month results of an Early Intervention program. Journal of Early Intervention, 31(2), 146–166. https://doi.org/10.1177%2F1053815109331864 [Early Intervention Evidence Review Study B]
  17. Ramey, C., Bryant, D., Wasik, B., Sparling, J., Fendt, K., & LaVange, L. (1992). Infant Health and Development Program for low birth weight, premature infants: Program elements, family participation, and child intelligence. Pediatrics, 3, 454–465. https://pediatrics.aappublications.org/content/89/3/454.long [Early Intervention Evidence Review Study C]
  18. Ramey, C., Bryant, D., Wasik, B., Sparling, J., Fendt, K., & LaVange, L. (1992). Infant Health and Development Program for low birth weight, premature infants: Program elements, family participation, and child intelligence. Pediatrics, 3, 454–465. https://pediatrics.aappublications.org/content/89/3/454.long [Early Intervention Evidence Review Study C]
  19. M. Greer, Executive Director, IDEA Infant & Toddler Coordinators Association, personal communication, May 24, 2021. S. Smith, Co-Director, National Center for Children in Poverty, personal communication, May 18, 2021.
  20. Vail, C., Lieberman-Betz, R., & McCorkle, L. (2018). The impact of funding on Part C systems: Is the tail wagging the dog? Journal of Early Intervention, 40(3), 229–245. https://doi.org/10.1177%2F1053815118771388
  21. Grant, R. (2005). State strategies to contain costs in the Early Intervention program: Policy and evidence. Topics in Early Childhood Special Education, 25(4), 243–250. https://doi.org/10.1177%2F02711214050250040501
  22. IDEA Infant & Toddler Coordinators Association. (2023). Funding structure. Retrieved on August 5, 2023, from https://www.ideainfanttoddler.org/pdf/Funding-Structure.pdf
  23. IDEA Infant & Toddler Coordinators Association. (2023). Funding structure. Retrieved on August 5, 2023, from https://www.ideainfanttoddler.org/pdf/Funding-Structure.pdf
  24. Vail, C., Lieberman-Betz, R., & McCorkle, L. (2018). The impact of funding on Part C systems: Is the tail wagging the dog? Journal of Early Intervention, 40(3), 229–245. https://doi.org/10.1177%2F1053815118771388
  25. IDEA Infant & Toddler Coordinators Association. (2023). Funding structure. Retrieved on August 5, 2023, from https://www.ideainfanttoddler.org/pdf/Funding-Structure.pdf
  26. IDEA Infant & Toddler Coordinators Association. (2023). Funding structure. Retrieved on August 5, 2023, from https://www.ideainfanttoddler.org/pdf/Funding-Structure.pdf
  27. Dragoo, K. (2019). The Individuals with Disabilities Education Act (IDEA), Part C: Early Intervention for infants and toddlers with disabilities. Congressional Research Service. https://fas.org/sgp/crs/misc/R43631.pdf
  28. Grant, R. (2005). State strategies to contain costs in the Early Intervention program: Policy and evidence. Topics in Early Childhood Special Education, 25(4), 243–250. https://doi.org/10.1177%2F02711214050250040501
  29. IDEA Infant & Toddler Coordinators Association. (2023). Funding structure. Retrieved on August 5, 2023, from https://www.ideainfanttoddler.org/pdf/Funding-Structure.pdf
  30. Vail, C., Lieberman-Betz, R., & McCorkle, L. (2018). The impact of funding on Part C systems: Is the tail wagging the dog? Journal of Early Intervention, 40(3), 229–245. https://doi.org/10.1177%2F1053815118771388
  31. Smith, S., Ferguson, D., Burak, E. W., Granja, M. R., & Ortuzar, C. (2020). Supporting social-emotional and mental health needs of young children through Part C early intervention: Results of a 50-state survey. National Center for Children in Poverty, Bank Street Graduate School of Education, and the Georgetown University Health Policy Institute’s Center for Children and Families. https://www.nccp.org/wp-content/uploads/2020/11/Part-C-Report-Final.pdf
  32. 32 Early and Periodic Screening, Diagnostic, and Treatment (EPSDT). Medicaid.gov. https://www.medicaid.gov/medicaid/benefits/early-and-periodic-screening-diagnostic-and-treatment/index.html
  33. Smith, S., Ferguson, D., Burak, E. W., Granja, M. R., & Ortuzar, C. (2020). Supporting social-emotional and mental health needs of young children through Part C early intervention: Results of a 50-state survey. National Center for Children in Poverty, Bank Street Graduate School of Education, and the Georgetown University Health Policy Institute’s Center for Children and Families. https://www.nccp.org/wp-content/uploads/2020/11/Part-C-Report-Final.pdf
  34. Smith, S., Ferguson, D., Burak, E. W., Granja, M. R., & Ortuzar, C. (2020). Supporting social-emotional and mental health needs of young children through Part C early intervention: Results of a 50-state survey. National Center for Children in Poverty, Bank Street Graduate School of Education, and the Georgetown University Health Policy Institute’s Center for Children and Families. https://www.nccp.org/wp-content/uploads/2020/11/Part-C-Report-Final.pdf
  35. 35 US Children’s Bureau. Child Maltreatment (2022). https://www.acf.hhs.gov/sites/default/files/documents/cb/cm2022.pdf
  36. Smith, S., Ferguson, D., Burak, E. W., Granja, M. R., & Ortuzar, C. (2020). Supporting social-emotional and mental health needs of young children through Part C early intervention: Results of a 50-state survey. National Center for Children in Poverty, Bank Street Graduate School of Education, and the Georgetown University Health Policy Institute’s Center for Children and Families. https://www.nccp.org/wp-content/uploads/2020/11/Part-C-Report-Final.pdf
  37. Grant, R. & Isakson, E. (2013). Regional variation in early intervention utilization for children with developmental delay. Journal of Early Intervention, 17, 1252–1259. https://doi.org/10.1007/s10995-012-1119-3
  38. Rauh, V., Achenbach, T., Nurcombe, B., Howell, C., & Teti, D. (1988). Minimizing adverse effects of low birthweight: Four-year results of an early intervention program. Child Development, 59(3), 544–553. https://www.ncbi.nlm.nih.gov/pubmed/2454783 [Early Intervention Evidence Review Study D]
  39. M. Greer, Executive Director, IDEA Infant & Toddler Coordinators Association, personal communication, May 24, 2021. S. Smith, Co-Director, National Center for Children in Poverty, personal communication, May 18, 2021.
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