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Early Intervention

Early intervention is an integrated developmental service available to the families of children, between birth and three years of age, for whom there are developmental concerns due to identified disabilities, or whose typical development is at risk due to certain birth or environmental circumstances.

Early intervention programs provide comprehensive, integrated services, utilizing a family-centered approach to facilitate the developmental progress of eligible children. Early intervention services are designed to meet the developmental needs of each child and the needs of the family related to enhancing the child's development. Services are selected in collaboration with families and focus on the concerns, priorities and available resources of the family in relation to the child's needs; parent(s) are involved in the process of assessment, development of the Individualized Family Service Plan and on-going programming. The family's growth toward independence in planning for the child's continuing and changing needs is supported and encouraged.

Early intervention staff works in partnership with those individuals present in the child's natural environment, which may include settings other than the child's home. Staff disciplines on individual teams may include speech, occupational and physical therapists, developmental educators, social workers, psychologists and nurses. In additional, early intervention programs may contract with consultants in areas such as nutrition, adaptive equipment, and behavior management.

Any Massachusetts child up to three years of age and his/her family may be eligible for Early Intervention services if the child:

  • Is not reaching age-appropriate milestones in one or more areas of development.
  • Is diagnosed with a physical, emotional, or cognitive condition that may result in a developmental delay.
  • Is at risk for developmental delay due to various biological and/or environmental factors.

An EI team serves the child and family in what are called "natural environments", for example, in family homes, childcare centers, community play groups, or libraries. Serving children in natural environments helps them to participate more easily in their everyday activities and with their peers.

There is an annual fee for some families based on family size and income. Families do not bear the cost of insurance co-payments and deductibles. The Massachusetts Department of Public Health, Medicaid, Massachusetts health insurance and health maintenance organizations (HMOs) pay for services.

Referrals to early intervention programs are an open process and are made directly to the individual program. Referrals may be made by any individual concerned about a child's development and are often made by family members, physicians, hospitals, community social service agencies and family friends. Families are encouraged to refer themselves, but if referred by someone else, the family will be contacted to request permission to proceed.

Early intervention accepts referrals for evaluations of eligibility for services. Within forty-five days of referral, an evaluation/assessment will take place and, if eligibility is established and the family elects to receive services, an Individualized Family Service Plan (IFSP) will be developed by the team of which the family is a member.

When making a referral to an early intervention program, it is important to have pertinent information available. The following is a list of information to supply to the program at the time of referral:

  • Child's name
  • Parent's name
  • Address
  • Telephone numbers (work and home)
  • Date of Birth
  • Primary Pediatrician
  • Other physicians/agencies/services involved
  • Reason for referral
  • Insurance coverage

Eligibility

Eligibility for early intervention is determined through an evaluation by a multidisciplinary team exercising sound clinical judgment and using a developmental inventory scale approved by the Massachusetts Department Public Health.

A child is considered eligible for early intervention when:

  1. The child has a known disabling physical or mental condition including but not limited to diagnosed chromosomal, neurological, metabolic disorders, or visual impairments not corrected by medical intervention or prosthesis or hearing impairments, or
  2. The child exhibits a delay in one or more areas of development, including cognitive development, physical development including vision and hearing, communication development, adaptive development, or social or emotional development, or
  3. The child has questionable quality of developmental skills and functioning based on clinical judgment of a multidisciplinary team. A child found to be eligible based on clinical judgment is eligible for a six month period following which an eligibility evaluation is used to determine further eligibility for services, or
  4. The child is at risk for developmental delays or disorders due to any four or more risk factors from either of the two following lists being present:

Child Characteristics

  • Birth weight less than 1200 grams
  • Gestational age less than 32 weeks
  • NICU admission more than 5 days
  • Apgar less than 5 @ 5 minutes
  • Total hospital stay more than 25 days in 6 months
  • Diagnosis of Intrauterine Growth Retardation (IUGR) or Small for Gestational Age (SGA)
  • Weight or height for age, or weight for height, less than 5th percentile; weight for age dropped more than two major percentiles in 3 months (less than 12 months of age) or in 6 months (12-24 months of age)
  • Chronic feeding difficulties
  • Insecure attachment/interactional difficulties
  • Blood lead levels measured 15 1g/dl
  • Suspected Central Nervous System abnormality
  • Multiple trauma or losses

Family Characteristics

  • Maternal age at child's birth less than 17 or maternal history of 3 or more births before age 20
  • Maternal education less than or equal to 10 years
  • Parental chronic illness or disability affecting care-giving ability
  • Family lacking social supports
  • Inadequate food, shelter, and clothing
  • Open or confirmed protective service investigation
  • Substance abuse in the home
  • Domestic violence in the home

Guideline: Developmental delay by age and month of delay

  • 6 months = 1.5 months
  • 12 months = 3 months
  • 18 months = 4 months
  • 24 months = 6 months
  • 30 months = 6 months