Child development
How Early Intervention Works, State by State
SaveEarly intervention is one federal program run a different way by each state that operates it. This guide names the agency families actually call in the 47 states consolidated here, explains the 45-day evaluation clock the federal law sets, and flags which of them charge a sliding-scale family fee for ongoing services.
Last updated: August 2026History
What the federal law fixes, whatever the state
A parent can refer. You do not need a pediatrician's referral or a diagnosis. If you are worried about how your child communicates, moves, plays or relates, you can call the state program yourself.
Forty-five days. From the referral, the program has 45 days to complete the evaluation and, if the child qualifies, hold the meeting that writes the plan. That clock is federal and it is enforceable.
Evaluation is free. The evaluation itself carries no charge to families in any of the state programs below. Services happen where the child is — home or childcare, not a clinic — because the law asks for natural environments.
How early intervention works in each state
Each row is that state's own published summary, naming the lead agency and the program families actually call. This table covers 47 states: West Virginia, Wisconsin and Wyoming are not among them, because no state page exists for them to consolidate. For those three, call that state's own early intervention program directly; the federal 45-day clock still applies there.
| State | What the state's own guide reported |
|---|---|
| Alabama | In Alabama, early intervention for children birth to 3 runs through a single statewide program, Alabama's Early Intervention System, administered by the Alabama Department of Rehabilitation Services. A parent can refer a child directly, without waiting on a doctor's referral, and state policy requires a completed evaluation within 45 days. |
| Alaska | Alaska's early intervention program, the Infant Learning Program, changed dramatically in 2026: the state lowered its eligibility threshold from a 50 percent developmental delay, one of the strictest standards in the country, to 25 percent, opening services to roughly 1,600 more children. |
| Arizona | Arizona's early intervention system for children under three is AzEIP, the Arizona Early Intervention Program, run by the Department of Economic Security. A parent can refer a child directly online, without a pediatrician's referral or a diagnosis. AzEIP then has 45 days to evaluate the child and, if the child qualifies, write an Individualized Family Service Plan. Most families pay little or nothing toward services, though cost-sharing can apply above certain income levels. |
| Arkansas | Arkansas delivers Part C early intervention through First Connections, run by the Department of Human Services' Division of Developmental Disabilities Services. Any parent can refer a child directly to the program's Central Intake Unit, without a doctor's referral. First Connections then has 45 days to complete an evaluation and, for an eligible child, write an Individualized Family Service Plan. Unlike some states, Arkansas charges no family fees at all, regardless of household income or insurance status. |
| California | California's Part C early intervention system is called Early Start, and it runs through 21 regional centers rather than a single state office, under the Department of Developmental Services. |
| Colorado | Colorado's Part C early intervention system, called Early Intervention Colorado, moved to a new state department in 2022: the Colorado Department of Early Childhood now leads the program, working through regional Community Centered Boards that handle referrals and evaluations locally. |
| Connecticut | Connecticut's Part C early intervention program is called Birth to Three, led by the state's Office of Early Childhood. A family can refer a child directly for an evaluation, without a doctor's note. |
| Delaware | Delaware's Part C early intervention system is Birth to Three, administered by the Department of Health and Social Services through its Division of Public Health. A parent can refer a child directly, without a doctor's referral or a diagnosis. |
| Florida | Florida's Part C program, Early Steps, evaluates children from birth to 36 months for free, and any parent, caregiver, or doctor can refer a child directly — no diagnosis required. |
| Georgia | Georgia's Part C program, Babies Can't Wait, evaluates any child under 3 regardless of family income, and a parent can refer their own child without a doctor's note. |
| Hawaii | Hawaii's Part C program, run by the Department of Health's Early Intervention Section, evaluates any child under 3 at no cost, on every island, regardless of family income. |
| Idaho | Idaho's Part C program, the Infant Toddler Program, evaluates any child under 3 for free through the Department of Health and Welfare, and a parent can refer their own child without a doctor's note. |
| Illinois | Illinois's Part C program evaluates any child under 3 for free, and a parent can refer their own child without a doctor's note. A child qualifies with a 30 percent delay in one developmental area, a diagnosed condition known to cause delay, or documented risk of substantial delay — and as of July 2026, the program is run by a newly created state agency, the Illinois Department of Early Childhood, not the Department of Human Services that ran it for decades. |
| Indiana | Early intervention in Indiana runs through First Steps, the state's IDEA Part C program for children from birth to their third birthday who have a developmental delay or a diagnosed condition likely to cause one. Any parent, grandparent, doctor, or childcare provider can refer a child directly — no doctor's order and no autism diagnosis required — and the state must complete an evaluation and, if eligible, a service plan within 45 days. |
| Iowa | Early intervention in Iowa is called Early ACCESS, the state's IDEA Part C program for children under three with a developmental delay or a diagnosed condition likely to cause one. |
| Kansas | Early intervention in Kansas is called Infant-Toddler Services, still known locally by its older nickname 'tiny-k,' and it covers children from birth to their third birthday with a developmental delay or a diagnosed condition likely to cause one. |
| Kentucky | Early intervention in Kentucky runs through First Steps, formally the Kentucky Early Intervention System, serving children from birth to their third birthday with a developmental delay or an established risk condition. Any parent, grandparent, or pediatrician can refer a child directly to a regional Point of Entry office — no diagnosis required — though families above a certain income may owe a capped monthly Family Share fee. |
| Louisiana | Early intervention in Louisiana is called EarlySteps, the state's Part C program for children from birth to their third birthday with a developmental delay or a diagnosed condition likely to cause one. |
| Maine | Early intervention in Maine runs through Child Development Services (CDS), the state's Part C program for children from birth to their third birthday with a developmental delay or a diagnosed condition likely to cause one. |
| Maryland | Maryland's Part C early intervention program, the Maryland Infants and Toddlers Program, is administered statewide by the Maryland State Department of Education but delivered locally through 24 separate county-level programs. A parent can refer a child directly, without a doctor's referral, and federal law requires a completed evaluation within 45 days. |
| Massachusetts | Massachusetts calls its Part C early intervention system Early Intervention, and it is run by the Department of Public Health rather than the state's education agency, an unusual choice most states don't make. Services are delivered by independent provider agencies that DPH certifies, a parent can refer directly without a doctor's note, and evaluation must happen within 45 days. |
| Michigan | Michigan's Part C early intervention program is called Early On Michigan, administered by the Michigan Department of Education and delivered locally through the state's regional Intermediate School Districts. |
| Minnesota | Minnesota organizes its Part C early intervention system as an interagency effort, coordinating the Department of Education, the Department of Human Services, and the Department of Health, rather than running everything through one office. A parent can refer a child directly to their local school district, without a doctor's visit, and evaluation must happen within 45 days. |
| Mississippi | Mississippi's Part C early intervention program, Mississippi First Steps, is run by the Mississippi State Department of Health rather than the education agency most states use, and delivered through regional public health district offices. A parent can refer a child directly, without a doctor's visit, and evaluation must happen within 45 days. |
| Missouri | Missouri's Part C early intervention program, Missouri First Steps, is administered by the Department of Elementary and Secondary Education and delivered through regional System Point of Entry agencies rather than one statewide office. A parent can refer a child directly, without a doctor's visit, and evaluation must happen within 45 days. |
| Montana | Montana families can refer a child under three for early intervention themselves, without a doctor's note, through Montana Milestones, the state's Part C program under DPHHS. A referral starts a free evaluation that must happen within 45 days. |
| Nebraska | Nebraska families can refer a child under three for early intervention themselves, with no doctor's note required, through the Early Development Network, which the Department of Education and the Department of Health and Human Services jointly run. A referral starts a free evaluation that must happen within 45 days. |
| Nevada | Nevada families can refer a child under three for early intervention themselves, without a doctor's note, through Nevada Early Intervention Services, run by the state's Aging and Disability Services Division. A referral starts a free evaluation that must happen within 45 days. |
| New Hampshire | New Hampshire families can refer a child under three for early intervention themselves, without a doctor's note, through Family Centered Early Supports and Services, or FCESS, run by the state's Department of Health and Human Services. A referral starts a free evaluation that must happen within 45 days. |
| New Jersey | New Jersey families can refer a child under three for early intervention themselves, without a doctor's note, through the New Jersey Early Intervention System, entered through a county-based System Point of Entry. A referral starts a free evaluation that must happen within 45 days. |
| New Mexico | New Mexico families can refer a child under three for early intervention themselves, without a doctor's note, through the Family Infant Toddler Program, run by the Early Childhood Education and Care Department rather than a health or education agency. A referral starts a free evaluation that must happen within 45 days. |
| New York | In New York, any parent, pediatrician, or caregiver can refer a child under three directly into the state's Early Intervention Program by contacting the family's county health department, without a doctor's referral or a diagnosis first. A county-based service coordinator must complete a full evaluation within 45 days. |
| North Carolina | North Carolina delivers early intervention for children under three through its Infant-Toddler Program, coordinated regionally by Children's Developmental Services Agencies rather than a single state office. |
| North Dakota | North Dakota's early intervention program serves children under three through the state's Health and Human Services agency, and any parent or pediatrician can refer a child directly without a diagnosis or a doctor's order. |
| Ohio | Ohio Early Intervention serves children under three through a county-based system overseen by the state's early childhood agency, and a parent can refer a child directly without a doctor's referral or a diagnosis. State policy holds every county to the federal 45-day evaluation timeline. |
| Oklahoma | Oklahoma runs its early intervention system for children under three as a single, branded statewide program called SoonerStart, overseen by the Oklahoma State Department of Health. |
| Oregon | Oregon runs its early intervention system for children under three under Early Intervention and Early Childhood Special Education, known as EI/ECSE, and it is one of the few states where the lead agency is the Department of Education rather than a health or human services department. |
| Pennsylvania | Pennsylvania's Early Intervention Program serves children from birth to age three who have a 25% delay in any one developmental area, or a diagnosed condition likely to cause one, and it is free to every eligible family regardless of income or insurance. Parents can refer a child directly to their county's program, no pediatrician's note or completed diagnosis required, and the state must complete an evaluation within 45 days. |
| Rhode Island | Rhode Island's Early Intervention Program serves children from birth to age three with a developmental delay or an established condition, and state regulation guarantees an evaluation and, if eligible, a written service plan within 45 days of referral. Services cost families nothing. |
| South Carolina | South Carolina calls its early intervention system BabyNet, and it evaluates and serves children from birth to age three who have a developmental delay or a diagnosed condition likely to cause one. |
| South Dakota | South Dakota runs its early intervention system as Birth to Three, serving children from birth to age three who have a developmental delay or a diagnosed condition likely to cause one. The state's Department of Education administers it, evaluation must happen within 45 days of referral, and any parent can refer a child directly, without waiting for a pediatrician's note or a finished diagnosis. |
| Tennessee | Tennessee's Early Intervention System, known as TEIS, serves children from birth to age three who have a developmental delay or a diagnosed condition likely to cause one, at no cost to eligible families. The Department of Intellectual and Developmental Disabilities has run TEIS since 2020, evaluation must happen within 45 days of referral, and any parent can refer a child directly without a doctor's note. |
| Texas | Texas calls its early intervention system ECI, for Early Childhood Intervention, and it serves children from birth to age three who have a developmental delay, disability, or certain medical diagnoses affecting development. |
| Utah | Utah's early intervention program is called Baby Watch, and any parent, guardian, or concerned professional can refer a child under three directly, without a doctor's referral or a completed diagnosis. |
| Vermont | Vermont's early intervention program is Children's Integrated Services, or CIS, and any parent or concerned professional can refer a child under three directly, without a doctor's referral or a completed diagnosis. |
| Virginia | Virginia's early intervention program is Infant & Toddler Connection of Virginia, and a parent can refer a child under three directly, without a doctor's referral or a completed diagnosis. |
| Washington | Washington's early intervention program is Early Support for Infants and Toddlers, or ESIT, and a parent, doctor, or caregiver can refer a child under three directly, without needing a diagnosis first. |
What differs, and why it matters
Three things vary. Who runs it: education, health, or a developmental disabilities agency, sometimes delivered county by county rather than centrally. Eligibility thresholds: states set how much delay qualifies, so a child eligible in one state may not be in the next. Family fees: the evaluation carries no charge, but many states apply a sliding-scale cost participation to ongoing services based on household income, and some charge nothing.
What does not vary is the value of referring early. Waiting for a diagnosis wastes the window the program exists to use.
Making the referral call
Find your state's row, call the program named there, and say you would like to refer your child for an evaluation. Write down the referral date — that starts the 45-day clock. If your child turns three during the process, ask about the transition to the school district's preschool special education services, which is a separate program with separate rules.
Related: what happens inside an early intervention evaluation · how surveillance and screening differ.
Common questions
Related
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Say it back
How would you explain this to someone you love?
Two or three sentences, just as you’d say it. Gale reflects back what you focused on — a mirror, not a quiz.
When to Raise a Concern Sooner Rather Than Later
- —Loss of skills a child previously had — words, gestures, or motor abilities
- —No babbling, pointing, or gestures by around twelve months
- —No single words by around sixteen months, or no two-word phrases by around two years
- —A parent's persistent sense that something has changed
Loss of previously acquired skills warrants a prompt call to your pediatrician, not a wait-and-see period. Seizure activity, a sudden change in alertness, or a child who is difficult to rouse is an emergency: call 911.
This article describes state early intervention programs. It is general information, not medical advice; program names and fee rules change, so confirm with the agency named for your state.
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References
- 1.U.S. Department of Education, Office of Special Education Programs (2024). Part 303 (Part C) — Early Intervention Program For Infants And Toddlers With Disabilities. IDEA — sites.ed.gov/idea. link ✓Source carried forward from the state pages consolidated here; it is cited by 47 of them.
- 2.Center for Parent Information and Resources (OSEP-funded) (2023). Part C of IDEA: Early Intervention for Babies and Toddlers. Center for Parent Information and Resources. link ✓Source carried forward from the state pages consolidated here; it is cited by 46 of them.
- 3.Centers for Disease Control and Prevention (2024). Accessing Services for Autism Spectrum Disorder. CDC — Autism Spectrum Disorder (ASD). linkSource carried forward from the state pages consolidated here; it is cited by 41 of them.
- 4.U.S. Department of Education, Office of Special Education Programs (2024). IDEA Part C: Early Learning and Early Childhood. IDEA — sites.ed.gov/idea. link ✓Source carried forward from the state pages consolidated here; it is cited by 40 of them.
- 5.Early Childhood Technical Assistance Center (federally funded) (2024). Part C of IDEA. ECTA Center. link ✓Source carried forward from the state pages consolidated here; it is cited by 35 of them.
- 6.U.S. Department of Education (2024). IDEA Early Intervention Program for Infants and Toddlers with Disabilities (Part C). U.S. Department of Education. link ✓Source carried forward from the state pages consolidated here; it is cited by 29 of them.
6 sources, numbered by first appearance. General health information, not medical advice. AI-assisted editorial content — citations link their sources. Editorial policy