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'Early Start' 101: Here's How Families Can Access Early Intervention Services for Younger Kids

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A collection of kids' toys sits on a beige and blue table beside a white wall.
A small table and chair with children's toys in Reyna Balladares' home in San Francisco on Feb. 26, 2024. (Kathryn Styer-Martínez/KQED)

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In California, babies and toddlers with developmental delays are entitled to receive a host of early intervention services to enhance their ability to sit, walk, talk or feed themselves. The services include physical therapy, speech therapy, occupational therapy or even equipment that helps young children maintain or improve certain skills. Parents and caregivers can also receive counseling and training to support their child’s needs.

State and federal law guarantee early intervention services through a program called Early Start because they help young children reach their potential and reduce the need for special education services when they enter school.

Getting the services as early as possible is crucial for these children, experts say because their brains are the most adaptable during the first three years of life. The services should ideally be provided in the child’s home, daycare or other “natural environments” because young children learn best when they’re in familiar surroundings.

But advocates tell KQED they’re seeing growing geographic and economic disparities in who gets early intervention services in their natural environment — that is, these services aren’t being made equally available to all kids.

So, if you’re worried your child may have a developmental delay or have already encountered issues while trying to access these kinds of services for your family, here’s what you need to know about navigating the state’s Early Start system.

How do I get started with securing Early Start services for my kid?

A pediatrician, parent or even daycare provider can contact their local regional center to ask for early intervention services through Early Start.

Regional centers are nonprofit agencies that contract with the California Department of Developmental Services (DDS) to:

  • Evaluate a child for a developmental delay or disability.
  • Determine if the child is eligible for early intervention services.
  • Arrange for those services.

Medi-Cal, the state’s Medicare program, covers developmental screenings during wellness checks for children at 9 months, 18 months and 30 months of age. The screening uses a standardized set of questions to see if a child’s motor, cognitive, social and emotional development are on track for their age. However, data shows that the developmental screening rates for young children in Medi-Cal are very low.

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If you suspect your child isn’t meeting his or her developmental milestones, don’t be afraid to ask about any concerns you have. Reyna Balladares, a foster parent profiled in our story about early intervention, says that when she noticed her foster child was slow to begin walking and talking, doctors told her that what was happening with the girl was normal. A specialist eventually evaluated the toddler and determined that she, in fact, needed physical therapy, speech-language therapy, occupational therapy and feeding therapy.

“You have to be very conscious if something different is going on with the child,” Balladares says, “and we have to advocate for [them].”

Who’s eligible for Early Start?

A child under 3 years old is qualified for early intervention services through Early Start (PDF) if they’re diagnosed as being at risk for developmental delays or if they have a developmental delay “of at least 25%” that affects their:

  • Cognitive development (thinking and learning).
  • Speech development.
  • Physical and motor development, including their vision and hearing.
  • Social and emotional development.
  • Adaptive development (everyday living skills like eating or dressing).

How much does Early Start cost?

There is no charge for regional centers to evaluate for a developmental delay, determine a child’s eligibility and arrange for early intervention services.

However, they are “technically funders of last resort,” according to a report by the California Budget and Policy Center. This means regional centers will only pay for services that are not covered by Medi-Cal or private insurance plans or while families wait for their insurance plan or Medi-Cal to approve the service.

What are the rights of parents and caregivers for accessing Early Start services for a child?

After being referred, regional centers have up to 45 days to evaluate the child, determine if they’re eligible for early intervention services, and propose an Individualized Family Service Plan (IFSP) that lays out the services that the child needs.

Mariah Martinez, a care coordinator manager with the San Francisco-based nonprofit Support for Families of Children With Disabilities, suggests filling out the referral form (which you can find on each regional center’s website) and emailing it to the regional center, so you can begin documenting the process from the start.

“Once the regional center emails you back with the confirmation that they received it, then that’s when the timeline begins,” she says.

If the process then goes beyond 45 days, caregivers can contact their caseload manager or the officer of the day at the regional center to get an update on the status of their case, Martinez says.

What if I’m not getting timely services?

As frustrating as it sounds, parents and caregivers often have to call their regional center coordinator repeatedly. “Keep pushing to move the process along,” Martinez says. She also suggests reaching out to their child’s pediatrician or medical social worker, a family resource center (there are more than two dozen of these located throughout neighborhoods in San Francisco, for example) or advocacy groups like Support for Families of Children With Disabilities to assist in communicating with their service coordinator.

“We try our best to get families connected to them,” she says. “And for the majority of time, I believe we’re pretty successful at getting them some sort of update regarding their case or if there’s anything else that the regional center needs from them. That way, the process goes a little bit smoother for them.”

Also, the First 5 Association of California offers a “Help Me Grow” program in each of the state’s 58 counties to help identify a family’s child development needs.

What if I disagree with the service plan? Or if my child was denied Early Start services?

The DDS suggests first talking with your service coordinator or asking the leadership of the regional center to review and reconsider their decision.

The next step after this could be seeking mediation or a due process hearing with the Office of Administrative Hearings. Martinez recommends “getting everything written down” so families will have documentation of their attempts to get services.

Martinez says it’s a good idea to seek legal advice from the Office of Clients’ Rights Advocacy before filing an appeal or complaint with the state. The OCRA has an attorney or advocate assigned to each regional center and is run by Disability Rights California.

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