How Early Intervention Works in the District of Columbia

Who qualifies for Strong Start in D.C.?

A child under 3 living in the District qualifies for Strong Start if an evaluation finds a 25 percent delay in at least one developmental area — communication, motor, cognitive, adaptive, or social-emotional — or a diagnosed condition with a high probability of causing delay, such as Down syndrome or a significant vision or hearing loss.

Evaluators can also rely on informed clinical opinion, weighing what they observe in the room even when a single standardized score sits just above the cutoff. A child does not need a completed autism evaluation, or any diagnosis at all, to enroll — families who are months into a wait for a developmental-behavioral pediatrician can start Strong Start services in parallel, because early intervention eligibility and an autism diagnosis are decided by two different processes 1Ref 1Centers for Disease Control and Prevention (2024).Accessing Services for Autism Spectrum Disorder.Families can access Part C early intervention before a formal autism diagnosis is complete..

• Communication delay (talking, understanding language, gestures)
• Motor delay (sitting, walking, using hands)
• Cognitive delay (thinking, learning, problem-solving)
• Social-emotional delay (relating to caregivers and other children)
• Adaptive delay (feeding, dressing, self-help skills)

Does a doctor have to refer my child?

No. Any parent, caregiver, childcare provider, or physician can refer a child directly to Strong Start, and the intake process treats a parent's own concern as sufficient grounds to schedule an evaluation — no pediatrician's note or prior testing is required 2Ref 2Center for Parent Information and Resources (OSEP-funded) (2023).Part C of IDEA: Early Intervention for Babies and Toddlers.Parents can refer their own child directly to Part C, without needing a physician's referral..

A family does not need immigration paperwork, proof of insurance, or a doctor's referral to start. A referral can be submitted online through OSSE's Strong Start portal or by phone, and the evaluation itself is conducted by an early intervention specialist who assesses the child, not by the person who referred them. A parent who is simply unsure whether what they're seeing is a developmental delay does not need to be certain before calling — that judgment is the evaluation team's job.

What happens after a referral, and how long does it take?

Federal regulations require the evaluation team to assess the child and convene the family's first Individualized Family Service Plan (IFSP) meeting within 45 calendar days of referral 3Ref 3U.S. Department of Education, Office of Special Education Programs (2024).Part 303 (Part C) — Early Intervention Program For Infants And Toddlers With Disabilities.Federal Part C regulations require evaluation and the initial IFSP meeting within 45 days of referral., and Strong Start applies that same clock to every family across all eight wards, regardless of which part of the District they call home or how the referral was submitted.

The Individualized Family Service Plan (IFSP) is built around the family's daily routines, not a clinic schedule — a goal might be phrased around mealtime or bath time rather than a therapy room, because Part C services are delivered in the child's natural environment: home, childcare, or another place the family already spends time. The IFSP names the specific services (speech, occupational or physical therapy, developmental instruction), how often they happen, and who is coordinating them, and it is reviewed at least every six months.

What does Strong Start cost a D.C. family?

Nothing. Strong Start is one of a smaller group of Part C programs nationally that charges no family fee at all — not a co-pay, not a sliding-scale contribution — and enrollment does not depend on income, private insurance, or a family's legal or employment status.

Strong Start charges $0 to every eligible family, regardless of income. That is a real point of difference from several neighboring jurisdictions, some of which bill a monthly fee on a sliding scale for direct therapy once a family's income passes a set threshold. The District funds Strong Start through a combination of its federal Part C grant and District appropriation, and a family's Medicaid or private insurance may be billed with permission, but a family is never billed directly for the gap.

Why does D.C.'s early intervention system look different from most states'?

The Office of the State Superintendent of Education (OSSE) runs Strong Start — the same office that oversees D.C. public and public charter K-12 schools — while most states assign Part C to a health or human-services department and hand the child to a separate education agency only at age 3.

The District's early-intervention mandate also sits in local law, D.C. Public Law 1-2-119, layered on top of the federal IDEA Part C requirement. Because one office runs both the birth-to-3 program and the school system a child enters afterward, a family's case history may carry forward more directly at the age-3 transition than in a state where Part C and the school system are separate agencies with separate intake systems — though the child still needs a new Part B evaluation, since eligibility for the two programs is not decided the same way.

What happens at age 3, and what if the family moves before then?

At age 3, Strong Start ends, and a child found eligible for continued support moves to Part B of IDEA, administered through the local school system under an Individualized Education Program (IEP) instead of the family-centered IFSP that governed services before the birthday 4Ref 4U.S. Department of Education, Office of Special Education Programs (2024).IDEA Part C: Early Learning and Early Childhood.Describes the transition from Part C (birth to 3) services toward Part B preschool special education at age 3.5Ref 5U.S. Department of Education, Office of Special Education Programs (2024).About IDEA.Describes Part B of IDEA, including the IEP and the FAPE guarantee that begins at age 3..

This shift — sometimes described as ifsp vs iep — trades a plan built around the family's routines for one built around specific, measurable goals tied to the classroom. A transition planning meeting is meant to happen well before the third birthday so the family isn't facing a gap in services while the new evaluation is underway. The table below summarizes the change:

A family who relocates before age 3 does not carry D.C. eligibility across state lines. Early intervention in Delaware, early intervention in Hawaii, early intervention in Idaho, early intervention in Illinois, and early intervention in Indiana each run their own intake and eligibility review under the same federal Part C floor, so submitting a new referral in the new jurisdiction promptly is the fastest way to avoid a gap in services.