Child development

How Early Intervention Works in Tennessee

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TEIS is one of the few state early-intervention systems run out of a disability-services agency rather than a health or education department, a change Tennessee made in 2020 after years under its Department of Education. This guide covers eligibility, referral, cost, and what changes when a Tennessee child turns three.

Last updated: July 2026

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What Is TEIS, and Which Agency Runs It Now?

Tennessee's Early Intervention System, TEIS, is the state's Part C program, the federally required system connecting children from birth to age three with developmental delays to evaluation and services 1. Since July 1, 2020, TEIS has been run by the Tennessee Department of Intellectual and Developmental Disabilities (DIDD), which took over as the state's Part C lead agency from the Department of Education.

That handoff was not a full break: nine TEIS positions still sit within the Department of Education specifically to handle child-find responsibilities, meaning identifying and referring children who may need services, and to manage the transition into pre-K and K-12 special education at age three. A Tennessee family may therefore interact with either agency depending on the child's age and stage in the process, even though DIDD holds overall responsibility for TEIS today. That kind of lead-agency change is not unique to Tennessee nationally, but it is relatively unusual: most states run Part C through a health or education department rather than a disability-services agency, so DIDD's role is one of the more distinctive features of how Tennessee organizes early intervention.

Does a Child Need an Autism Diagnosis First?

No. TEIS evaluates for developmental delay against its own eligibility standard, and federal guidance is explicit that early intervention does not require a completed autism evaluation, or any other diagnosis, first 2. A toddler flagged for limited eye contact, delayed language, or a loss of a previously used skill can be referred to TEIS the same week a parent, grandparent, or pediatrician notices it.

That matters in practice because a full autism diagnostic evaluation in Tennessee, as in most states, can take months to schedule, particularly outside the state's larger metro areas. TEIS evaluations run on a separate, faster track set by federal law: the team assesses the child's current functioning directly, and eligibility rests on measured delay rather than on a diagnostic label that may not exist yet. Families do not need a specific label in mind when they call; describing what is different about how the child communicates, plays, or responds is enough for TEIS staff to determine whether a referral for evaluation makes sense.

How Does a Family Refer a Child, and What Happens Next?

A parent can refer a child to TEIS directly, and so can a pediatrician, childcare provider, or relative, with no physician's referral required first 3. TEIS then has 45 calendar days from that referral to complete a multidisciplinary evaluation and, if the child qualifies, hold the meeting that produces an Individualized Family Service Plan, or IFSP 4.

The IFSP documents the child's present levels of development, the family's own priorities for daily routines, and the specific services, frequency, and setting for each one, typically home or childcare rather than a clinic. 45 days is a federal outer limit, not a target, and applies to every TEIS referral in the state regardless of which region handles it. Once written, the IFSP is not static: TEIS is required to review it at least every six months and complete a full reassessment annually, so the specific services, hours, and goals can change as a toddler's needs change over the roughly three years TEIS covers a family.

What Does TEIS Cost a Family?

TEIS provides evaluation and eligible services to Tennessee families at no cost, regardless of household income or insurance status. There is no sliding fee scale for a family to work through and no bill generated for services written into an IFSP.

The state funds TEIS through a combination of federal Part C dollars and state appropriations, and where a child has Medicaid or private insurance, billing happens between the state and the payer rather than the family. That no-cost structure is a state policy choice; federal law itself only requires evaluation and service coordination to be free, and leaves other services to each state's own rules on family cost. Families should still expect some paperwork, mainly to document income for federal reporting purposes and to confirm any Medicaid or private insurance a child already has, even though none of that paperwork translates into an actual bill for the family.

What Services Can a TEIS Plan Include?

An IFSP through TEIS can include speech-language therapy, occupational therapy, physical therapy, special instruction, and family training, chosen based on what the evaluation finds. For children with social-communication concerns, a speech-language pathologist frequently leads both the evaluation and much of the ongoing therapy, since that work is within their defined scope of practice 5.

TEIS, like every Part C program, is required to deliver services in natural environments, meaning a child's home or childcare setting rather than a therapy office, whenever that is appropriate for the family's routine. Tennessee's mix of dense urban counties around Nashville, Memphis, and Knoxville alongside large rural stretches of the state means how that requirement plays out in practice can look different depending on where a family lives. The professionals who staff a TEIS evaluation are drawn from both DIDD-contracted providers and, where child-find or school transition is involved, staff connected to the Department of Education, reflecting the split responsibility between the two agencies.

What Happens When a Tennessee Child Turns Three?

TEIS ends at age three, and eligibility shifts from Part C to Part B of IDEA, delivered through the local school district as a preschool special-education program 6. Because Tennessee kept child-find and transition staff inside the Department of Education even after moving TEIS to DIDD, the same office that eventually manages a child's preschool IEP has some visibility into the case before the birthday arrives.

How an IFSP becomes an IEP is still its own formal process, with its own evaluation, and Tennessee is required to hold a transition meeting and have a decision in place by the third birthday. Families comparing Tennessee with another state should know the federal clock is identical everywhere, even though the lead agency and rules are not: early intervention in Iowa, early intervention in Kansas, early intervention in Kentucky, early intervention in Louisiana, and early intervention in Maine all run on the same Part C foundation with their own local details.

Common questions

TEIS stands for Tennessee's Early Intervention System, the state's federally required Part C program serving children from birth to age three with a developmental delay or a diagnosed condition likely to cause one. It has been run by the Department of Intellectual and Developmental Disabilities since 2020, after years under the Department of Education.

No. A parent can refer a child directly, and so can a pediatrician, grandparent, or childcare provider, but no one's approval is required first. Contacting TEIS starts the 45-day evaluation clock the same day, whether or not any diagnosis has been made.

No. Evaluation and eligible services under TEIS are provided at no cost to Tennessee families, regardless of income or insurance status. The state handles any billing to Medicaid or private insurance directly, and families are not sent a bill for services written into their child's IFSP.

The Department of Intellectual and Developmental Disabilities has been TEIS's lead agency since July 1, 2020. The Department of Education still keeps a small number of staff working on child-find and the transition into preschool special education, so a family may deal with either agency depending on the child's age.

TEIS ends, and eligibility shifts to Part B of IDEA, delivered through the local school district as a preschool special-education program rather than a state-run system. Tennessee is required to hold a transition meeting and have a decision in place by the third birthday so services do not lapse.

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When to push TEIS for faster action

  • —Loss of words, gestures, or social behaviors the child previously had, at any age, which warrants prompt re-evaluation, not a wait-and-see approach.
  • —No evaluation has been scheduled more than 45 days after a referral to TEIS was made.
  • —No transition meeting has happened as a child's third birthday approaches and TEIS eligibility is about to end.

This page explains how Tennessee's public TEIS system works. It is not a developmental evaluation of any individual child and does not replace guidance from the child's IFSP team, pediatrician, or a qualified evaluator.

References

  1. 1.Early Childhood Technical Assistance Center (federally funded) (2024). Part C of IDEA. ECTA Center. link ✓That every state must designate a Part C lead agency running early intervention for infants and toddlers with developmental delays, applied here to Tennessee's TEIS/DIDD structure.
  2. 2.Centers for Disease Control and Prevention (2024). Accessing Services for Autism Spectrum Disorder. CDC — Autism Spectrum Disorder (ASD). linkThat families can access early intervention without waiting for a completed autism diagnosis, applied to TEIS's eligibility process.
  3. 3.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 ✓Parent-facing guidance that self-referral to Part C does not require a physician's referral, applied to TEIS's referral process.
  4. 4.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 ✓The federal 45-day evaluation timeline and IFSP process under Part C regulations, applied to TEIS's evaluation and IFSP steps.
  5. 5.American Speech-Language-Hearing Association (2024). Autism (Practice Portal). ASHA Practice Portal — Clinical Topics. link ✓The speech-language pathologist's role in evaluating and treating social-communication skills, applied to the services a TEIS IFSP can include.
  6. 6.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 ✓The Part C to Part B transition concept at age three, applied to TEIS's transition to a preschool IEP.

6 sources, numbered by first appearance. General health information, not medical advice. AI-assisted editorial content — citations link their sources. Editorial policy

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