Early Intervention Services
Service Description | Referral | Family Choice
Eligibility | Child & Family Characteristics | Family Participation
Early Intervention is an integrated developmental service available to the families of children from birth up to the third birthday, for whom there are developmental concerns due to identified disabilities, or whose typical development is at risk due to certain birth or environmental circumstances.
The Massachusetts Department of Public Health has the responsibility for administering and overseeing the statewide system of Early Intervention services, for certifying programs and coordinating funding sources, and for carrying out monitoring and technical assistance activities. There are many certified community-based programs serving all cities and towns in the Commonwealth. Each Early Intervention program is certified to provide services for a specified group of cities and towns, called a catchment area.
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 evaluation/assessment process, development of the Individualized Family Service Plan (IFSP) 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 addition, Early Intervention programs may contract with consultants in areas such as nutrition, adaptive equipment, and behavior management.
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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 45 days of referral, a meeting to plan for 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:
Telephone numbers (work and home)
Date of Birth
Other physicians/agencies/services involved
Reason for referral
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Each city and town in the Commonwealth has at least one Early Intervention program that provides services to its eligible residents. Families should be referred to the Early Intervention program certified for the catchment area in which they live.
Some of the larger catchment areas in the state have more than one certified Early Intervention program. When making a referral, families should be given the names of all the programs in the catchment area in which they reside. This Guide lists all programs serving a specific catchment area together. Parents may want to find out more about each program before having an eligibility evaluation. Since a family may only enroll in one Early Intervention program at a time, a parent must make a choice prior to having a child evaluated for eligibility. Once a program is chosen, the child will be evaluated; if the child is eligible and if the family elects to receive services, an Individualized Family Service Plan (IFSP) meeting will be held within 45 days after the choice was made. Early Intervention programs are responsible for providing individualized services to families as outlined in the IFSP. Occasionally this means that services may be provided outside the catchment area where the family resides.
Special note for families residing within the City of Boston and its environs: The Boston area, with the exception of Charlestown and East Boston, is considered to be one catchment area (this includes: Allston, Brighton, Brookline, Dorchester, Hyde Park, Jamaica Plain, Mattapan, Roslindale, Roxbury, and West Roxbury). Families who live in Boston may choose any of the programs listed on page 18 of this Guide, but many families choose the program closest to their home because of the close ties they may have and the connections that the specific Early Intervention program has with other neighborhood services.
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Children, from birth to age three and living in Massachusetts, may receive a multidisciplinary team evaluation by a certified Early Intervention Program, to determine if they are eligible to receive Early Intervention services, based on the eligibility criteria set by the Department of Public Health. Eligible children may receive EI services for as long as they meet eligibility criteria, up to but not on their third birthday.
Eligibility for Early Intervention is determined through an evaluation by a multidisciplinary team exercising sound clinical judgment and using a developmental inventory tool approved by the Massachusetts Department of Public Health. Instruments approved by the Department of Public Health for establishing eligibility, as of 7/1/2005, are: the Early Intervention Developmental Profile (“Michigan”) and the Battelle Developmental Inventory-2 (“BDI-2”).
Effective January 1, 2012, eligibility for all children referred to the Massachusetts Early Intervention System will be determined utilizing the BDI-2. A child will need to exhibit a delay of 1.5 standard deviations below the mean to be eligible for early intervention based on established delay.
I. A child is considered eligible for Early Intervention when there is an established risk or established developmental delay:
- The child has a diagnosed medical condition with a relatively well known expectation for delay which may included any of these diagnoses:
- neurological, metabolic, or genetic disorder,
- chromosomal anomaly,
- medical or other disabling condition with documented expectation of developmental delay,
- vision loss not corrected by medical intervention or prosthesis or
- permanent hearing loss of any degree, or
- The child exhibits a delay of 30%, as measured by an approved instrument yielding age equivalent scores, in one or more areas of development, including cognitive development, physical development, communication development, social/emotional development or adaptive development, or
- The child’s development is 1.5 standard deviation below the norm, as measured by an approved instrument yielding standard deviation scores, in one or more areas of development, including cognitive development, physical development, communication development, social/emotional development, or adaptive development.
- The child has questionable quality of developmental skills and functioning based on the informed clinical opinion of a multi-disciplinary team. A child found to be eligible based on the category of “clinical judgment” can receive services up to 6 months. For services to continue after this period, eligibility must be determined based on diagnosis, developmental delay or other risk factors.
II. A child is considered eligible for Early Intervention when there is a risk for developmental delays or disorders due to four or more of the following risk factors being present:
- Birth weight less than 1200 grams (2 pounds 10 ½ ounces)
- 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 for age, or weight for height, below 5th percentile; weight for age dropped more than two major centiles in 3 months (child under 12 months of age) or in 6 months (child 12-36 months of age)
- Chronic feeding difficulties
- Insecure attachment/interactional difficulties
- Blood lead levels measured at 5 mg/dl
- Suspected Central Nervous System abnormality
- Multiple trauma or losses
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- 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, clothing or shelter, including homelessness
- Open or confirmed protective service investigation, including child is in foster care
- Substance abuse in the home
- Domestic violence in the home
Family members are encouraged to be active participants in every component of Early Intervention service delivery. On an individual level, family members are involved in determining and participating in services for their child and family. On the program level, families are encouraged to advise and participate in the development and monitoring of policies, procedures and practices. Family members may choose to participate in these advisory functions as part of a group or as individuals.
To ensure comprehensive family participation, all members of the EI service team share responsibility for providing an environment in which such participation can occur. Early Intervention programs provide multiple and varied opportunities for family participation that ensure responsiveness to the diverse needs and interests of the families in the service population and enhance the collaborative nature of service delivery.
Family Involvement across the broad Early Intervention System is a core value of the Massachusetts EI system. The Early Intervention Parent Leadership Project (EIPLP), a parent-run project of the Department of Public Health, supports families to get involved and develop lifelong leadership and advocacy skills. For more information, contact the EIPLP at 877-353-4757 or visit their website at www.eiplp.org.
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For additional information on Early Intervention services, please contact the Massachusetts Department of Public Health, Early Intervention services at 617-624-6060 or call Family TIES of Massachusetts, the statewide information, resource, referral and support network for families.
Family TIES can be reached at 1-800-905-TIES (8437).
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