Understanding How Infants and Toddlers with Disabilities or Developmental Delays Receive Support

All infants and toddlers and their families should have access to a comprehensive set of services that support their health and development. This is especially important for children who experience delays in their development, which can be a cause for concern.

In California, children with disabilities or developmental delays can receive early intervention services through the Early Start program. Early intervention services promote a child’s growth and development and support their families. This report provides a high-level overview of California’s early intervention system with a focus on the Early Start program.

What Are Early Intervention Services and Why Are They Important?

The early years of a child’s life are a significant period of growth.¹“Early Brain Development,” US Department of Health & Human Services (webpage), accessed September 19, 2022, https://www.cdc.gov/ncbddd/childdevelopment/early-brain-development.html. While all children grow and develop at their own rate, some infants and toddlers experience delays in their development, such as when they’re not playing, learning, speaking, eating, or moving when expected in their early years, which can be a cause for concern. Early intervention services help to enhance the growth and development of a child and are delivered through a partnership between families and professionals. These services can change a child’s development and improve outcomes for children, families, and communities.² “Why Act Early,” US Department of Health & Human Services (webpage), accessed September 19, 2022, https://www.cdc.gov/ncbddd/actearly/whyActEarly.html.

California’s early intervention program is called Early Start.³ “Early Start,” California Department of Developmental Services (webpage), accessed September 19, 2022, https://www.dds.ca.gov/services/early-start/. It was established in response to federal legislation, the Individuals with Disabilities Education Act (IDEA), which guarantees a free appropriate public education to eligible children with disabilities and ensures special education and related services are provided to those children.⁴“About IDEA,” US Department of Education (webpage), accessed September 19, 2022, https://sites.ed.gov/idea/about-idea/; “Early Start Laws and Regulations” California Department of Developmental Services (webpage), accessed September 19, 2022,https://www.dds.ca.gov/services/early-start/laws-and-regulations/. The Early Intervention Program for Infants and Toddlers with Disabilities, which is part of IDEA, supports states in providing services and supports for children from birth through age 2. These children and their families receive early intervention services under a component of the federal law known as  IDEA Part C, whereas children and youth ages 3 to 21 receive special education and related services under another piece of the federal law known as IDEA Part B.

Who Provides Early Intervention Services?

Early intervention services in California are provided by two agencies: regional centers and schools (school districts and county offices of education).⁵ Legislative Analyst’s Office, Evaluating California’s System for Serving Infants and Toddlers With Special Needs (January 4, 2018), https://lao.ca.gov/Publications/Report/3728#Introduction. Regional centers are community-based non-profit agencies that provide or arrange for services to Californians of all ages who meet eligibility criteria, including infants and toddlers with developmental delays or disabilities.⁶ To be eligible for services, a person must have a disability that begins before the individual’s 18th birthday that is expected to continue indefinitely and present a substantial disability. See “Information About Regional Centers,” California Department of Developmental Services (webpage), accessed September 20, 2022, https://www.dds.ca.gov/rc/information-about-regional-centers/. There are 21 regional centers across California and they serve the majority of infants and toddlers who are eligible for early intervention services.⁷ “Regional Center Listings,” California Department of Developmental Services (webpage), accessed September 20, 2022, https://www.dds.ca.gov/rc/listings/. Regional centers are overseen by the Department of Developmental Services.

Schools are responsible for providing services to infants and toddlers whose disabilities are solely due to vision, hearing, or orthopedic impairments.⁸ Evaluating California’s System. There are also some school districts and county offices of education across California that provide services to all eligible children.⁹Evaluating California’s System These schools have a long history of providing early intervention services to infants and toddlers.

What Types of Early Intervention Services Can Infants and Toddlers Receive?

Early intervention services in California are designed to meet the developmental needs of each eligible infant or toddler and the needs of the family related to the infant’s or toddler’s development.¹⁰ “IDEA Sec. 303.13 Early intervention services,” US Department of Education (webpage), accessed September 19, 2022, https://sites.ed.gov/idea/regs/c/a/303.13. Services must be provided in a child’s natural environment, such as their home or in a group setting among their peers.

Types of early intervention services include:

Who Is Eligible to Receive Early Intervention Services?

Regional centers determine eligibility through diagnosis and assessment.¹³“Regional Center Eligibility & Services,” California Department of Developmental Services (webpage), accessed September 20, 2022, https://www.dds.ca.gov/general/eligibility/. Infants and toddlers from birth through age 2 may be eligible for early intervention services through California’s Early Start program if they meet one of the following criteria:¹⁴“What is Early Start,” California Department of Developmental Services (webpage), accessed September 19, 2022, https://www.dds.ca.gov/services/early-start/what-is-early-start/.

• The child has a developmental delay of at least 25% in one or more areas of cognitive, communication, social or emotional, adaptive, or physical and motor development including vision and hearing.
• The child has an established risk condition with a high probability of resulting in delayed development.
• The child is considered to be at a high risk of having a substantial developmental disability.

What Are the Steps to Receiving Early Intervention Services?

A child must be referred to California’s Early Start Program to receive early intervention services.¹⁵ “Early Start.” Referrals can be made by health care providers, family members, child care providers, and neighbors.

Within 45 calendar days of the referral date, the regional center or school is required to:

Who Pays for Early Intervention Services?

If a child is deemed eligible to receive services through California’s Early Start program, regional centers arrange and/or purchase services, but they are technically funders of last resort.¹⁶“IDEA Part C,” University of California, San Francisco (webpage), accessed September 20, 2022, https://odpc.ucsf.edu/communications-paper/idea-part-c. This means that regional centers require families to obtain certain services through Medi-Cal (California’s Medicaid program) or through their private insurance plan. However, there is no charge for regional centers to determine a child’s eligibility or to provide service coordination. The regional center will also pay for services while families wait for their insurance plan or Medi-Cal to approve the service.

Payment for early intervention services can be a challenging and burdensome process for families.¹⁷First 5 Center for Children’s Policy, Early Identification and Intervention for California’s Infants and Toddlers: 6 Key Takeaways (September 8, 2020),https://first5center.org/publications/early-identification-and-intervention-for-californias-infants-and-toddlers-6-key-takeaways. The process often hinders timely access to services.¹⁸To learn more about families’ experience accessing early intervention services in California, see First 5 Center for Children’s Policy, A Family’s Journey Through the Early Identification and Intervention System (September 8, 2020),https://first5center.org/publications/briannas-journey-through-the-early-identification-and-intervention-system.