EARLY INTERVENTION SERVICES
WHAT ARE EARLY INTERVENTION SERVICES AND WHY ARE THEY IMPORTANT?
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.2
Early Intervention 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.3
WHAT PROGRESS HAVE STATES MADE SINCE THE 2020 ROADMAP TO INCREASE ACCESS TO EARLY INTERVENTION SERVICES?
The Number of States That Include Very Low Birthweight as a Diagnosable or At-Risk Qualifying Condition Steadily Increased
Children may be automatically eligible for Early Intervention (EI) based on developmental delays and a state’s unique list of qualifying diagnosed/established conditions (often including very low birthweight and prematurity, at various thresholds). The 2020 Roadmap focused on states’ categorization of eligibility thresholds as broad, moderate or narrow. Roadmap data collection on specific eligibility thresholds began in 2021 and since that time, a handful of states have implemented changes to their eligibility policies for EI.
In 2021, 16 states included very low birthweight as a qualifying diagnosed or at-risk condition. This total grew to 17 states in 2022, 18 states in 2023, and 21 states in 2024. However, many states with high rates of low birthweight do not include this condition, at any level, as a part of their EI eligibility policies.
States Have Increased Funding for EI Programs and Increased Reimbursement Rates to EI Providers
Since October 2020, states have taken action to serve more families, including efforts to improve provider reimbursement rates and processes. In 2024, Colorado, Georgia, New York, Rhode Island, and Virginia all enacted legislation to increase provider reimbursement rates.
Additionally in 2024, North Carolina’s budget provided funding for staffing increases and a centralized provider network system, as well as professional development for providers. Washington enacted a bill to improve the timeliness with which early interventionists are reimbursed. Other states have sought to address workforce concerns by launching task forces and conducting studies on addressing provider shortages and optimal provider rates.
For more information on state progress to increase access to Early Intervention services, check out the 2024 Prenatal-to-3 State Policy Roadmap.
Moving Forward: Addressing EI Access, Workforce, and Funding Challenges
Workforce challenges, such as the recruitment and retention of qualified professionals, are likely to remain prominent in the EI policy landscape. Across the country, there is not enough staff for EI programs to prevent waitlists and serve all children within 45 days of referral, as required by law.
EI access rates remain stagnant, and significant variation in access still exists across states and by race and ethnicity. 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, rates of low birthweight can serve as a proxy for different levels of need.4 Black children are twice as likely to be born low birthweight than White or Hispanic children, yet a smaller percentage of Black children actually receive EI services, indicating inequitable access.5 Moving forward, states can consider ways to reduce disparities in access to EI services, alongside improving overall EI access.
To address workforce challenges and alleviate stressors on the EI system, states may increase reimbursement rates and explore options such as loan forgiveness, scholarships, and workforce training programs to help recruit and retain staff. As states consider different workforce supports, more research is needed to understand how best to incentivize participation in EI programs.
Additionally, following recent federal guidance, states should fully maximize funding from the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) provision in federal law to ensure EI programs have the resources they need. Ongoing, sustained state investments in EI programs are needed to ensure all children in need of services are referred by EI services.
NOTES AND SOURCES
- EI data collection in the 2020 Roadmap focused on eligibility by categories: broad, moderate, and narrow. Specific thresholds for low birthweight or allowing at-risk for delay qualifications were not collected. As a result, progress over time is tracked specifically from 2021 to 2024.
- 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
- 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
- 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
- See the 2024 Prenatal-to-3 State Policy Roadmap or Methods and Sources for additional details on the percent of children born low birthweight and percent of children (including by race and ethnicity) served in EI.
