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UNITED STATES ROADMAP

ROADMAP POLICIES AND STRATEGIES

EFFECTIVE POLICIES

EFFECTIVE STRATEGIES

EMERGING STRATEGIES

INTERACTIVE
THE POLICY IMPACT CALCULATOR
Methods and Sources
FAQ
Additional Roadmap Resources

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 or disabilities and, in states that choose to serve them, children at 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 Improved developmental trajectories can provide long-term cost savings for states. Family-centered services that involve parents have been shown to be more effective than therapies provided to children alone because caregivers can learn ways to interact with and care for their child 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 demonstrate a developmental delay that meets a state’s criteria (e.g., a 30% or greater delay in one or more developmental areas). Each state defines what constitutes a qualifying delay, and states vary in how broad (most inclusive, serving children with less severe delays) or narrow (requiring more severe delays) their criteria 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.

State EI Programs Face a Variety of Challenges, Including Inadequate Funding and Inequitable Access

The number of children enrolled in Early Intervention services has trended upward over the past 2 decades, but federal per-child Part C funding has declined, requiring greater state support for services.4 State leaders consistently report that ensuring adequate funding remains one of the most critical challenges for their EI programs.5

The percentage of children ages birth to 3 who are served varies significantly across states,6 in part because of differences in state eligibility policies;7 states’ outreach efforts to hospitals, child care centers, and other organizations;8 and resource availability.9

Children from lower-income families and communities of color do not have equitable access to EI services. The most recent national data show that 7.7% of Black children ages birth to 3 are served in EI over the course of a year, compared to 8.3% of White children.10 A widely cited study found that by age 24 months, 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.11 A study of low birthweight infants found significantly lower EI referral rates for infants of Black non-Hispanic mothers than all other racial groups.12 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.13

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 and 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 between referral, evaluation, and enrollment. Rigorous evidence suggests that the benefit of Early Intervention services may vary by family socioeconomic characteristics. Some studies have found larger benefits among children whose mothers have more education or whose families have higher incomes.14,15 Additionally, in one study, Black and Hispanic children experienced smaller improvements in cognitive scores than children who identified as White, Asian, or Other.16

The reasons for these disparities should continue to be studied and rectified to ensure all infants and toddlers can benefit from EI services 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.

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 policy levers that states can implement to improve access to Early Intervention (EI) services:

  • 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 or 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 them at risk for delays or disabilities.

No state uses low birthweight (defined as <2,500 grams or approximately 5 pounds, 8 ounces) itself as a diagnosable or at-risk eligibility threshold. 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). Additionally, 15 states have more stringent requirements for qualification based on birth weight such as a threshold of <1,000 grams (approximately 2 pounds and 3 ounces). Children born very low birthweight or prematurely face an increased risk of developmental delays and disabilities, as well as other health complications, making early identification and access to EI services particularly important.17

Currently, 26 states qualify children born prematurely (often requiring very preterm or extremely preterm birth, before 32 or 28 weeks of gestation, 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 also allow premature birth 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 based on developmental delays or diagnosed conditions, 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 a child must have to qualify. Some states, for example, require five or more simultaneous risk factors, including both social circumstances, such as low income or homelessness, and other clinical factors, 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.18

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.19

Family fees are one example of a cost-sharing mechanism used by states. Similar to copays for services, family fees are often assessed on a sliding scale. However, research has shown that implementing family fees for EI services may reduce participation among children from families with low incomes, 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.20

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 birth to age 21, including EI services from birth to age 3 for those eligible, and family fees are therefore prohibited.21

Including the five birth mandate states, 35 states report eliminating family fees, down from 36 in 2024. Although Pennsylvania previously did not use family fees, in 2025, the state reported that it relies to some extent on family fees to pay for services. If states can leverage sufficient funding from other sources, such as private insurance and state funds, and eliminate the use of family fees, this may help more families with low incomes access EI services.22

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,23 rather than based on the number of children actually served in EI or in need of EI services. 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 insurance24 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 2024 survey, a total of 34 states reported that they rely most heavily on their own state resources to sustain their EI programs; 14 states reported relying most heavily on federal funds, and 3 reported local funding as their primary funding source.25 

Additionally, as of 2025, 34 states reported billing private insurance to cover EI services, which can free up public funding to serve children without private coverage. This is up from 31 states in 2024, with Alabama, Pennsylvania, and South Carolina reporting that they now bill private insurance to support their EI services.

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

An important funding source for EI services is Medicaid,26 and states vary in the extent to which they take advantage of Medicaid funding to support their EI programs.27 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.28 For example, states may cross-reference Medicaid and Part C data to identify children in Part C who are also eligible for Medicaid and help ensure that their EI providers bill Medicaid.29 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.30 Under 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.31

Given this rule, another way states can maximize Medicaid funding for EI services is to increase the number and types of EI services that can be reimbursed by Medicaid, although states’ ability to expand Medicaid covered services related to EI may be affected by broader federal Medicaid changes beginning in Fiscal Year 2026.

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

In addition to fostering collaboration with Medicaid, close collaboration between state Part C programs and other agencies, including child welfare and state public education systems, can help ensure that children experiencing maltreatment receive the services they need. This coordination can also play an important role in helping children experience a more seamless transition from Part C to Part B special education services at later ages, respectively.

Given the effects of physical and psychological maltreatment, children involved in the child welfare system have been found to be at an increased risk for developmental delays.32 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 under age 3 who have experienced substantiated abuse or neglect to EI programs.33

States vary in how consistently they make these referrals. Based on 2024 federal data, only seven states (Alaska, Iowa, Maine, Nebraska, Ohio, Utah, and Wyoming) report that they refer 100% of children eligible for referral following substantiated experiences of maltreatment to Part C agencies, and an additional six states (Georgia, Idaho, Minnesota, Nevada, North Dakota, and Rhode Island) report referring nearly all eligible children who experience maltreatment to EI services. Nearly 40% of states did not report any data on their referrals.34  

States can either require their child welfare systems to conduct a pre-screening to determine whether an EI evaluation is necessary, or states can refer children in substantiated maltreatment cases directly to an evaluation. In a 2020 survey, only 12 states reported that they refer children directly to an evaluation without a pre-screening.35

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 influenced by policy choices regarding eligibility criteria, the funding streams states access to support their programs, and the level of collaboration between Part C programs and other state agencies, such as Medicaid and child welfare, as well as other factors that can affect the reach and strength of a state’s program.

The Percentage of Children Served by Early Intervention Services Is the Most Consistent Measure for Comparing States’ EI Programs

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 using 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 among 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%.36 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.37 Nationally, 8.5% of infants were born low birthweight in 2024, but rates vary substantially by race and ethnicity, with Black infants more than twice as likely to be born low birthweight compared to White and Hispanic infants.38

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

Recent national data show that, in the median state, 7.8% 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 2.7% in Arkansas to a high of 18.8% in New Mexico. Due to data quality limitations, Massachusetts is not included in the most recent cumulative estimates; however, the state has historically served a relatively high share of children through EI and, between 2022 and 2023, served 20.2% of children under age 3 – the highest rate nationally. Fifteen states serve more than 10% of infants and toddlers through EI services, and six states serve less than 5% 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 4.2%. States range from serving less than 2% (Arkansas, Oklahoma, and Mississippi) to 10.8% (Massachusetts) of their birth-to-3 population on any given day.

Based on recommendations from national experts in Early Intervention, we primarily focus on the cumulative, rather than the point-in-time data, for this Roadmap.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 receive 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. About half of states require very low birthweight (less than 1,500 grams), or extremely low birthweight (less than 1,000 grams) for children to qualify for EI based on birthweight alone. 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 (15.0%) to be born low birthweight than White (7.0%) or Hispanic (7.8%) children. Although low birthweight is only one indicator of potential need for EI, these disparities suggest that, with equitable access, Black children could be expected to receive EI services at relatively higher rates than White or Hispanic children. Yet, a smaller percentage of Black children actually receive EI services. Nationally, only 7.7% of Black children ages birth to 3 are served in EI over the course of a year, compared to 8.3% of White children and 7.9% Hispanic children.

States have substantial latitude in determining who qualifies for EI, how services are financed and delivered, and how children and families move into and throughout their EI systems. Over the last year, states continued to take legislative and administrative action affecting access to EI, including by changing eligibility criteria, extending how long children can remain in services, and strengthening the provider and program infrastructure needed to connect eligible children with services. States also continued investing state funds in EI as changes in federal administration and Medicaid financing introduced new uncertainty for a range of state programs.

Alaska and Montana Expanded Eligibility Criteria for Early Intervention Services

In the last year, six states (Alaska, Idaho, Massachusetts, Montana, North Carolina, and Wisconsin) considered legislative or regulatory action directly affecting which children qualify for EI services. Alaska’s proposal went into effect and Montana’s is expected to take effect before the end of 2026.

In 2025, legislators in Alaska included language in the budget directing the Department of Health to lower the state’s developmental delay threshold from 50% to 25% in one developmental area or 20% in two or more developmental areas. However, funding associated with the expansion was vetoed by Governor Dunleavy, and the new criteria were not implemented. In the last year, legislators returned to the issue, this time codifying the expanded eligibility criteria in state law. Although Governor Dunleavy also vetoed $3.02 million included in the Fiscal Year 2027 budget allocated to support the expansion, this time the funding veto did not prevent the eligibility change from taking effect in July 2026.

In Montana, although the state did not hold a legislative session in 2026, the state Department of Public Health and Human Services proposed lowering its eligibility thresholds from 50% to 40% in one developmental area and from 25% to 20% in two or more areas. The public comment period for this change concluded in July 2026, and the rule is set to take effect in October 2026.

Legislators in Massachusetts and Wisconsin introduced bills that would automatically qualify additional children based on specific health conditions. Massachusetts proposed automatic eligibility for children with neonatal abstinence syndrome or prenatal substance exposure, and Wisconsin proposed making children with elevated blood lead levels eligible. Neither of the proposals passed. North Carolina legislators introduced a bill to study broader eligibility criteria and provide substantial funding to serve children who would become newly eligible, but the legislation did not pass.

Idaho moved in the opposite direction. The Department of Health and Welfare proposed eliminating an existing eligibility pathway for children with either a 30% developmental delay or a 6-month delay, whichever is less. As of September 2026, the proposed rule had not been finalized.

Several States Focused on Preventing Gaps in EI Services and Improving Transitions

States also took steps to reduce disruptions in EI services as children age out of Part C or move between programs, systems, or jurisdictions. Under IDEA, Part C EI services generally end when a child turns 3, when eligible children move on to preschool special education services under Part B. Without coordinated transition policies, children can experience gaps in services between the end of EI and the start of Part B services.

In the last year, Maine published updated policies allowing eligible children to remain in its Extended EI option beyond age 3 until the school year following their fourth birthday. Rhode Island enacted a more limited extension for children who turn 3 between May and August, allowing them to remain in EI until September. The option must be implemented by January 2028. New Jersey and Virginia legislators proposed broader extensions beyond age 3, although those bills did not pass.

States also focused on transitions within the service system. California enacted legislation strengthening coordination as children move from Part C EI to Part B special education or other preschool programs, and Arizona established transition requirements for children living outside local school district boundaries. Connecticut enacted protections intended to minimize service disruptions for military families moving into the state while their child is receiving EI elsewhere.

States Took Steps to Strengthen EI Provider Capacity and Program Infrastructure

States also focused on whether EI systems have sufficient provider capacity and infrastructure to connect eligible children with services and deliver those services once children are enrolled. California included approximately $15 million in ongoing funding to update reimbursement rates for center-based EI service providers, and Pennsylvania implemented a 7% reimbursement rate increase for most EI services.

Rhode Island legislators funded the EI Medicaid reimbursement rate recommended through a 2025 state rate review. New York extended authorization for certified school psychologists to conduct EI evaluations through June 2028, helping maintain the pool of professionals available to evaluate children for services. West Virginia legislators considered, but did not pass, legislation that would have increased reimbursement rates for contracted Birth to Three providers by 25%.

Other states focused on strengthening the pathways through which children are identified, referred, and connected to EI. New Mexico enacted legislation requiring participating child care providers to identify and refer at-risk children to the state’s EI program. Florida continued investing in the operation and maintenance of its EI administrative system, and Mississippi and Oklahoma enacted legislation focused on studying potential improvements to their systems.

States Continue to Invest in Early Intervention Services Amid Changes in Federal Administration

As of September 2026, at least 27 states have enacted state budgets for Fiscal Year 2027 that include funding for EI services. States continued these investments as the federal government began changing how IDEA programs are administered. In June 2026, the US Department of Education and the US Department of Health and Human Services (HHS) entered an agreement under which HHS will support the administration of IDEA programs, including Part C EI grants. The Department of Education retains its statutory responsibilities and oversight of IDEA, but HHS will take on much of the day-to-day administration of the programs, including administration, monitoring and compliance activities, and data collection and reporting.40 Fiscal Year 2026 IDEA grants will continue to be awarded through the Department of Education’s grant system, though subsequent awards are expected to be awarded and managed through HHS.

This agreement changes how IDEA programs are administered at the federal level but does not change states’ responsibilities under IDEA or the statutory requirements governing Part C. The Trump administration’s proposed Fiscal Year 2027 budget also includes a $50 million increase for IDEA Grants for Infants and Families, although Congress had not enacted appropriations as of September 2026.41

Federal Medicaid Changes May Put Pressure on State EI Financing

Medicaid is an important source of funding for EI services, and states can use it to pay for covered services provided to Medicaid-enrolled children participating in EI. Most states use Medicaid to help finance Part C services, and states report that more than half of children served through Part C are enrolled in Medicaid.42 Federal IDEA funds generally serve as the payer of last resort when other public or private funding is unavailable. Federal Part C funding has also not kept pace with the growing number of children served nationally,43 increasing the importance of other funding sources such as Medicaid.

In 2025, the federal government enacted the One Big Beautiful Bill Act (OBBBA), which made significant changes to Medicaid eligibility, enrollment, and financing. Projected to reduce federal Medicaid spending by more than $915 billion between 2025 and 2034, the law is also expected to increase the number of people without health insurance by 7.5 million by 2034.44 In the last year, states began implementing OBBBA’s requirements while also preparing for reductions in federal Medicaid funding. Those reductions could place additional pressure on state budgets and require states to make difficult choices about how to fund Medicaid and other programs.

Although OBBBA does not directly reduce IDEA Part C funding, these Medicaid changes could affect EI programs downstream. Because Medicaid helps finance EI services in most states, reductions in federal Medicaid funding could put pressure on the resources available for EI services and provider reimbursements.45 States could also face greater pressure to rely on limited federal Part C, state, or local funds to sustain EI services. The extent of these effects will depend on how states respond to federal funding reductions, but they introduce additional uncertainty for states seeking to maintain and build on EI investments and provider capacity in the coming years.

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 2026 Roadmap Early Intervention services progress summaries for all 50 states and the District of Columbia.

View our Policy Impact Calculator, which illustrates how policies, such as state minimum wage, paid family and medical leave, out-of-pocket child care expenses, taxes and tax credits, as well as federal nutrition benefits, interact to impact overall household resources.

  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. Early Childhood Technical Assistance Center. (2024). Part C Infant and Toddler Program Federal Appropriations and National Child Count 1987–2023. https://ectacenter.org/partc/partcdata.asp
  5. IDEA Infant & Toddler Coordinators Association. (2024). Tipping points survey: Demographics and challenges. https://www.ideainfanttoddler.org/pdf/2024-Tipping-Points-Survey.pdf 
  6. Point-in-time service percentages. US Department of Education. (July 8, 2025). Number of infants and toddlers and percentage of population, receiving early intervention services under IDEA, Part C, by age and state and race/ethnicity: 2023/2024 [Data Set]. Retrieved on June 12, 2026, from https://data.ed.gov/dataset/idea-section-618-data-products-static-tables-part-c. Cumulative service percentages: US Department of Education. (July 8, 2025). Number of infants and toddlers and percentage of population, receiving early intervention services under IDEA, Part C, by age and state and race/ethnicity: 2023/2024 [Data Set]. Retrieved on June 12, 2026, from https://data.ed.gov/dataset/idea-section-618-data-products-static-tables-part-c. Denominators from US Census Bureau, Population Division. (2024). 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, 2024 – scest2024-alldata6.csv [Data Set]. Retrieved June 30, 2025, from https://www.census.gov/data/tables/timeseries/demo/popest/2020s-state-detail.html.
  7. 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
  8. 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
  9. 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
  10. Numerators from US Department of Education. (July 9, 2025). Cumulative number of infants and toddlers ages birth through 2 receiving early intervention services under IDEA, Part C, by race/ethnicity and state: 2023/2024 [Data Set]. Retrieved on June 12, 2026, from https://data.ed.gov/dataset/idea-section-618-data-products-static-tables-part-c. Denominators from US Census Bureau, Population Division. (2024). 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, 2024 – scest2024-alldata6.csv [Data Set]. Retrieved June 30, 2025, from https://www.census.gov/data/tables/timeseries/demo/popest/2020s-state-detail.html.
  11. 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/
  12. 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/
  13. 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
  14. 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]
  15. 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]
  16. 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]
  17. 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 [Evidence Review Study D]
  18. 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.
  19. 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
  20. 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
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  24. IDEA Infant & Toddler Coordinators Association. (2025). Funding structure. Retrieved on May 22, 2026, from https://www.ideainfanttoddler.org/pdf/Funding-Structure.pdf
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  26. 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
  27. 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
  28. First Five Years Fund (2023). New GAO Report Highlights IDEA Early Intervention Programs. Retrieved on June 16, 2025, from https://www.ffyf.org/2023/10/27/new-gao-report-highlights-idea-early-intervention-programs/
  29. 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
  30. 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
  31. 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
  32. 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
  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. US Children’s Bureau. Child Maltreatment 2024 (2026). https://acf.gov/sites/default/files/documents/cb/cm2024.pdf
  35. 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
  36. 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
  37. 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]
  38. Numerators from US Department of Education. (July 9, 2025). Cumulative number of infants and toddlers ages birth through 2 receiving early intervention services under IDEA, Part C, by race/ethnicity and state: 2023/2024 [Data Set]. Retrieved on June 12, 2026, from https://data.ed.gov/dataset/idea-section-618-data-products-static-tables-part-c Denominators from US Census Bureau, Population Division. (2024). 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, 2024 – scest2024-alldata6.csv [Data Set]. Retrieved June 30, 2025, from https://www.census.gov/data/tables/timeseries/demo/popest/2020s-state-detail.html. 
  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.
  40. McMahon, L. (2026, June 16). Secretary McMahon’s Letter to Parents of Individuals with Disabilities. US Department of Education. https://www.ed.gov/about/news/speech/secretary-mcmahons-letter-parents-of-individuals-disabilities 
  41. Office of Budget and Management, White House. (2026, August). Budget of the U.S. Government, Fiscal Year 2027. https://www.whitehouse.gov/wp-content/uploads/2026/04/budget_fy2027.pdf
  42. IDEA Infant & Toddler Coordinators Association. (2025). ITCA Finance Survey Report. Retrieved on June 10, 2026, from https://www.ideainfanttoddler.org/pdf/2025-ITCA-Finance-Survey-Results.pdf
  43. Early Childhood Technical Assistance Center. (2024). Part C Infant and Toddler Program Federal Appropriations and National Child Count 1987–2023. https://ectacenter.org/partc/partcdata.asp 
  44. Congressional Budget Office. (2025, October). Supplemental Cost Estimate, Public Law 119-21. https://www.cbo.gov/system/files/2025-10/PL-119-21-Medicaid%20_0.pdf
  45. Burak, E. W. & Johnson, K. (2025, April 11). Medicaid Cuts Would Weaken Early Intervention for Infants and Toddlers with Disabilities and Developmental Delays. https://ccf.georgetown.edu/2025/04/11/medicaid-cuts-would-weaken-early-intervention-for-infants-and-toddlers-with-disabilities-and-developmental-delays/

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