For parents & clinicians
How to Get Early Intervention Services (No Doctor Referral Needed)
The short answerIn the United States, you can contact your state or territory's early intervention (Part C) program yourself. A doctor's referral is not required to ask for an evaluation, and your child does not need a medical diagnosis before you make that request. Eligibility depends on an evaluation of your child's skills or, in some cases, existing records that show your child qualifies. Publicly funded programs provide services free or at reduced cost for eligible children, though eligibility rules and service fees vary by state. Requesting an evaluation starts the process; it does not guarantee that your child will qualify. [1] [2] [7] [14]
Key takeaways
- You can call early intervention directly. CDC states that if your doctor cannot connect you, you can reach out yourself; a doctor's referral is not necessary. [1]
- Who you contact depends on your child's age. For a child under 3, start with Part C early intervention. At age 3 and older, request a preschool special education evaluation through the local public school district, even if your child does not attend that school. [1] [3] [10]
- Evaluation and assessment have no parent fees under federal Part C rules. Child find, evaluation and assessment, service coordination, and certain IFSP administrative activities must be carried out at public expense. States may adopt a system of payments for services; inability to pay cannot delay or deny services under the regulation. [4]
- There is a federal 45-day timeline from referral to complete screening (if used), initial evaluation and assessments, and the first IFSP meeting for eligible children. Exceptions apply for documented exceptional family circumstances or lack of consent despite repeated, documented attempts. The detailed rules appear below. [5] [6]
- Eligibility is not the same as a medical diagnosis. Part C looks at developmental delay or certain diagnosed conditions that make delay likely; state criteria differ. Screening at the pediatrician's office and an autism diagnosis are separate processes. [1] [7] [11] [13]
- If your child loses skills, contact their healthcare provider promptly. You can also contact early intervention while the medical evaluation is underway. [11]
If you're looking into how to get early intervention, you may be unsure where to start. Perhaps your child is using fewer words than you expected, finding a movement difficult, or interacting differently from other children. This guide explains who to call, what happens after you ask for an evaluation, and how to find out about eligibility and costs.
Both views include the full guide. Clinician view adds assessment and research details.
What “early intervention” means in the U.S.
In everyday conversation, “early intervention” can mean any help a young child receives. In U.S. policy, Early Intervention usually means the public Part C program under the Individuals with Disabilities Education Act (IDEA): services and supports for infants and toddlers with developmental delays and disabilities, and for their families. [1] [3]
CDC describes early intervention as including speech therapy, physical therapy, occupational therapy, and other services based on the needs of the child and family. Programs exist in every state and territory. [1]
Under federal rules, Part C generally serves children under age 3 who need early intervention because they:
- have a developmental delay in one or more areas (cognitive; physical, including vision and hearing; communication; social or emotional; or adaptive), as measured by appropriate instruments and procedures; or
- have a diagnosed physical or mental condition with a high probability of resulting in developmental delay (examples in the regulation include chromosomal abnormalities, sensory impairments, and certain other conditions). [7]
States set the specific criteria used to measure developmental delay, and some also choose to serve infants and toddlers considered “at risk.” Children with similar concerns may therefore receive different eligibility decisions in different states. Your local program can explain the criteria that apply to your child. [1] [7]
An early intervention evaluation answers a program eligibility question. It is not automatically the same as:
- a developmental screening questionnaire at a well-child visit,
- a medical diagnosis (for example, autism), or
- a full specialty clinic workup. [11] [13]
You can pursue an early intervention evaluation while your child's healthcare provider looks into medical or developmental concerns.
If you're trying to understand a concern about communication or social development, Early Signs of Autism in Toddlers: What the Research Says and Speech Delay vs. Autism: How Clinicians Tell the Difference explain what clinicians look for. Our guide to Why Well-Child Visits Are More Than a Checkup can help you prepare to discuss concerns with your child's healthcare provider.
Ages 0–3 and what changes at age 3
Birth to age 3: Part C early intervention
If your child is under age 3, CDC advises calling your state or territory's early intervention program and saying you have concerns about your child's development and would like an evaluation for early intervention eligibility. [1]
Age 3 and older: school-district Child Find / Part B
If your child is age 3 or older, CDC and USAGov advise contacting a local public elementary school or school district to request an evaluation for preschool special education (or age-appropriate special education for an older child). You can do this even if your child does not attend public school. If the person who answers is unfamiliar with preschool special education, ask for the school or district special education director. [1] [3]
Under Part B Child Find rules, states must identify, locate, and evaluate children with disabilities who may need special education and related services, including children who attend private schools. A request is not a guarantee of an Individualized Education Program (IEP) or funding for every therapy; ask the district how it determines eligibility and services. [10]
Some states offer an option to continue Part C past age 3 for certain children who were already receiving Part C and are eligible for preschool services. Ask your coordinator whether your state offers this option and whether your child qualifies. [7] [9]
For toddlers already receiving Part C, planning for the move to preschool services begins before the third birthday. In general, when a toddler may be eligible for Part B preschool services, the lead agency notifies the state and local education agencies. With family approval, it holds a transition conference at least 90 days before the third birthday. If everyone involved agrees, the conference can take place earlier, up to 9 months before the birthday. A transition plan must be included in the IFSP on a similar timeline. [9]
If your child is referred fewer than 45 days before turning 3 and may qualify for Part B, the Part C agency refers them to education agencies with your consent; it is not required to complete a Part C evaluation, assessment, or initial IFSP meeting. Tell the program your child's birthday when you call so it can explain the next steps. [9]
How to find and contact your program
- Use CDC's state and territory contact list. Select your state or territory for the program's contact information. Each program has its own name (for example, Early Steps, Birth to Three, Babies Can't Wait, Early Start). [2]
- Say clearly what you want. CDC's suggested wording for under age 3: “I have concerns about my child's development and I would like to have my child evaluated to find out if he/she is eligible for early intervention services.” [1]
- You do not need to wait for a doctor's appointment to make that call. Keep your child's healthcare provider informed so they can also address hearing, vision, lost skills, and any need for specialty referrals. [1] [11]
- Ask for Parent Training and Information Center (PTI) help if the process feels confusing. USAGov notes that Parent Training and Information Centers provide information and services for children and young adults from birth to age 26 and their families. The Center for Parent Information and Resources maintains a Find Your Parent Center directory. [3] [12]
Keep a note of when you called, who you spoke with, and when you should expect to hear back.
What to expect: evaluation, eligibility, and the IFSP
From a concern to the next step
Have a developmental concern? You can ask for an evaluation without first obtaining a doctor's referral or a medical diagnosis. A request does not guarantee eligibility or services.
Under 3 · Part C early intervention
Part C: what the 45-day timeline covers
Generally, within 45 days after the agency or early-intervention provider receives the referral: screening if used, initial evaluation, initial assessments, and the initial IFSP meeting for an eligible child. This is not a 45-day deadline to begin all services.
Contact your state or territory's program
Request an early-intervention eligibility evaluation. Ask when your referral was received.
Find your Part C contactConsent before evaluation
The program needs parental consent before screening, if used, and before the child's evaluation and assessments.
Evaluation and eligibility decision
The program determines eligibility under state Part C rules. Qualifying records can sometimes establish eligibility without a new evaluation; assessments are still required.
Eligible
Assessments + initial IFSP meeting
Identify strengths, needs and supports; develop the Individualized Family Service Plan with the family. Assessments can overlap evaluation. Family-directed assessment is voluntary for each participating family member.
Then: consented services
After the IFSP is explained and informed written consent is given, each consented service must begin as soon as possible.
Not eligible
Ask about reasons, options and support
Ask for a written explanation. Keep healthcare follow-up going and ask when re-referral makes sense. A Parent Center can help explain options and procedural safeguards.
Find your Parent Center
Age 3 or older · School district / Part B Child Find
Request a school-district evaluation
Contact your local public school or district, even if your child is not enrolled there. Ask about preschool or age-appropriate special education evaluation. A request does not guarantee an IEP or funding for every therapy.
The school pathway has its own rules. The Part C timeline and cost notes here describe Part C, not school evaluation deadlines or fees.
- Timeline exceptions:
- The 45-day rule does not apply during documented exceptional family circumstances that make the child or parent unavailable, or when consent has not been given despite documented, repeated attempts to obtain it. Complete the steps as soon as possible once those circumstances end or consent is obtained.
- Around the third birthday:
- Some states allow certain children already receiving Part C and eligible for preschool services to continue Part C past age 3. Ask about local options. If referral occurs fewer than 45 days before age 3 and the child may qualify for Part B, the Part C agency refers to education agencies with parental consent and is not required to complete a Part C evaluation, assessment or initial IFSP meeting.
- Part C costs:
- Evaluation, assessment, child find and service coordination have no parent fees. Service fees depend on state policy. Inability to pay must not delay or deny services; if the family meets the state's definition of inability to pay, all Part C services must be provided at no cost.
A U.S. referral guide—not a diagnostic tool. Start with the age route, then follow the labeled next steps. Eligibility and services depend on the applicable program's rules; medical follow-up can continue alongside this process.
Sources: CDC [1] [2]; IDEA Part C [4] [5] [6] [7] [8] [9] [14]; Child Find [10]; Parent Center directory [12].
Referral starts a clock
Under federal Part C rules, once the lead agency or early intervention service provider receives the referral, the following must generally be completed within 45 days: any screening the state elects to use (with parent consent), the initial evaluation, the initial assessments of the child and family, and the initial IFSP meeting for an eligible child. [5] [6]
The 45-day timeline does not apply during periods when:
- the child or parent is unavailable because of exceptional family circumstances documented in the child's early intervention records; or
- the parent has not provided consent for screening (if applicable), evaluation, or the initial child assessment despite documented, repeated attempts to obtain consent. [5]
When those circumstances end or consent is obtained, the work must be completed as soon as possible. An interim IFSP may be developed when appropriate. [5]
Parental consent
Parental consent is required before screening procedures used to decide whether a child is suspected of having a disability, before evaluations and assessments of the child, and before early intervention services are provided. Parents may accept or decline individual services and may decline a service later without jeopardizing other Part C services. [8] [6]
Evaluation vs. assessment (plain language)
In Part C, the initial evaluation determines whether your child is eligible. Qualified professionals consider your account of your child's history, developmental information, and records, rather than relying on a single test. Sometimes existing medical or other records establish eligibility without a new evaluation; assessments are still required. Assessments identify an eligible child's strengths, needs, and appropriate supports. A family-directed assessment also explores your family's resources, priorities, and concerns, and participation is voluntary for each family member. [14]
Unless clearly not feasible, the child's evaluation and assessments must be in the child's native language, and family assessments in the participating family members' native language. Tell the team the languages your child uses and ask how interpretation and appropriate assessment will be arranged. [14]
If your child is eligible: the IFSP
If your child is eligible, you and the team develop an Individualized Family Service Plan (IFSP) together. This written plan is discussed at the initial IFSP meeting, which must take place within the same 45-day period described above. [6]
Your IFSP should describe your child's current development and set measurable outcomes, including how the team will check progress. It should spell out which services your child will receive, how often and where they will take place, projected start dates, any payment arrangements, and who your service coordinator is. With your agreement, it also includes your family's resources, priorities, and concerns. The plan includes steps for the eventual transition out of Part C. Services must take place in your child's natural environment to the maximum extent appropriate; the plan must explain any exceptions. [15]
The IFSP contents must be fully explained, and informed written consent must be obtained before early intervention services listed in the IFSP begin. Each consented service must be provided as soon as possible after that consent. [6]
IFSPs are reviewed at least every six months (or more often if needed or if the family requests), with an annual meeting to evaluate and revise the plan as appropriate. Meetings should be at times and places convenient for the family and in the family's native language or other mode of communication, unless it is clearly not feasible. [6]
If your child is not eligible
If your child does not qualify, ask for a written explanation of which areas were assessed and how the team applied your state's criteria. You can keep tracking development with your child's healthcare provider and ask when another referral would make sense if concerns grow. At age 3, you can request a school-district evaluation under Child Find. A Parent Center can help you understand the next steps and your procedural rights in your state. [3] [10] [12]
Rights and costs: what federal rules actually say
To understand what your family might pay, it helps to separate the evaluation process from the services your child may receive afterward.
Functions that must be at public expense (no fees to parents) under 34 CFR § 303.521(b) include:
- implementing child find requirements;
- evaluation and assessment (and related evaluation/assessment functions);
- service coordination;
- administrative and coordinative activities related to developing, reviewing, and evaluating IFSPs (and interim IFSPs) and to procedural safeguards and other statewide system components listed in the regulation. [4]
For services, states may adopt a written system of payments, which can include sliding-scale fees or other family contributions. The policy must define ability and inability to pay and ensure that inability to pay will not result in a delay or denial of services. If your family meets your state's definition of inability to pay, your child must receive all Part C services at no cost. Families also must not be charged more than the actual cost of a service after other payment sources are accounted for. [4]
CDC's plain-language summary is that publicly funded programs provide services free or at reduced cost for eligible children, and that each state has its own rules about eligibility and services. [1] [2]
Ask your program to explain any costs before services begin. Request its written system-of-payments policy and ask what is billed to public or private insurance, what parental consent is required for insurance use, and what happens if you decline to share income information. Parents who disagree with a fee or an ability-to-pay determination can use the procedures described in the regulation, including mediation, due process, a state complaint, or other state procedures. [4] [8]
In some states that mandate free appropriate public education (FAPE) for infants and toddlers, or that use Part B funds to serve children under 3, services that are part of FAPE for that child cannot be charged to parents under the Part C fee rules. Whether that applies depends on your state. [4]
What if you are waitlisted, delayed, or stuck?
Federal rules set a 45-day timeline for evaluation, assessment, and the initial IFSP meeting after referral, and they require that consented services begin as soon as possible. [5] [6] The AAP describes regional differences in access and long waits for desired services. If you are waiting, ask which step is delayed and what the program is doing to move it forward. [11]
Keep a record of the answers you receive as you follow up:
- Confirm that your referral was received and ask for the date that starts the 45-day clock.
- Ask whether an interim IFSP is appropriate if exceptional circumstances apply. [5]
- Put concerns in writing (email or letter): what you observe, when it started, and what you are requesting.
- Keep in touch with your child's healthcare provider about hearing, vision, lost skills, and specialty referrals while the Part C process continues. The AAP recommends timely referral for diagnostic evaluation and early intervention or school services, depending on age, when a child is identified as at risk for autism. A child with developmental delay should be referred for early intervention or school services whether or not they have an autism diagnosis. [11]
- Contact a Parent Training and Information Center for help understanding the process and your family's rights. [3] [12]
- Ask your IFSP team what barriers are causing delay and what temporary supports exist.
Wait times vary by locality and service type, so ask your program about the timeline for your child.
Support while you wait
While you're waiting for an evaluation or an IFSP meeting, you can keep supporting your child in familiar, everyday ways:
- Keep notes and short videos of strengths and concerns across home, childcare, and family settings.
- Follow through on hearing or vision checks your child's clinician recommends.
- Keep communication and play low-pressure. Our guide on speech delay versus autism includes everyday communication ideas to try while you wait for a speech-language or other evaluation. These suggestions do not replace an individualized treatment plan.
If your child stops using words, gestures, or social skills they previously used regularly, contact your child's healthcare provider promptly. The AAP states that medical evaluation of lost milestones is indicated. You can still contact early intervention at the same time. [11]
Screening, diagnosis, and eligibility
Swipe or scroll to see all columns
| Process | What it is for | What it is not |
|---|---|---|
| Developmental or autism screening (often at well-child visits) | Flags whether a closer look is needed | Not a diagnosis; not Part C eligibility by itself [11] [13] |
| Medical / specialty diagnosis | Explains a condition (for example, autism) using history and behavior | Not required before you can request a Part C evaluation [1] [11] |
| Part C eligibility evaluation | Decides whether the child qualifies for early intervention under state Part C rules | Not a full substitute for every medical question [1] [7] |
The AAP recommends autism-specific screening at 18- and 24-month visits and cautions that pediatricians cannot assume early intervention programs will carry out that screening. Keep discussing development at your child's healthcare visits while the Part C process continues. [11]
Questions to ask your provider and the early intervention program
Clinician view: referral practices and documentation
Additional detail for clinicians. Parent-facing rights, cost, and safety guidance above apply in either view.
- Do not make Part C contingent on specialty diagnosis. CDC's public guidance allows families to self-refer; eligibility is based on evaluation of skills. Facilitate connection even when the diagnostic workup is incomplete. [1]
- Refer in parallel. AAP guidance indicates that once a child is at risk for ASD by screening or surveillance, timely referral for clinical diagnostic evaluation and early intervention or school services (by age) is indicated. Children with developmental delay with or without an ASD diagnosis should be referred to early intervention or school services. Primary care should help families navigate both developmental assessment and diagnostic evaluation. [11]
- Document the concern and the handoff. Note parent observations, screening results, lost skills, hearing/vision status, languages spoken at home, date of Part C or LEA referral, and the agency contact. Tracking after a positive screen matters; AAP discusses barriers and follow-up after screen-positive results. [11]
- Do not assume Part C will cover autism-specific screening. AAP states pediatricians cannot assume early intervention systems will screen participants for ASD at recommended ages; continue practice-based surveillance and screening. [11]
- Know the fee distinction when counseling families. Evaluation, assessment, child find, and service coordination are no-fee functions under § 303.521(b); service fees, if any, follow the state's system of payments with inability-to-pay protections. Avoid telling families “all EI is free” or “EI always costs money.” [4]
- Discuss transition before age 3. Ask families whether Part C has scheduled transition planning, keeping the notification and conference timelines in § 303.209 in mind. [9]
- Explain how Part C eligibility differs from DSM diagnosis. Help families understand what an eligibility decision tells them and which developmental or medical questions may still need follow-up. [7] [11]
Evidence note: This article summarizes federal regulations and federal plain-language guidance. State eligibility thresholds, insurance billing practices, and local wait times are not comprehensively surveyed here.
Frequently asked questions
Do I need a doctor's referral to get early intervention?
No. CDC states that if your doctor is not able to connect you, you can reach out yourself, and that a doctor's referral is not necessary. [1]
Does my child need an autism diagnosis (or any diagnosis) first?
No. CDC says eligibility for early intervention services is based on an evaluation of your child's skills and abilities. A diagnosed condition that makes developmental delay likely is one federal eligibility pathway, but it is not the only one, and you can request evaluation based on developmental concerns. [1] [7]
Are early intervention services free?
Evaluation, assessment, child find, and service coordination must be provided at public expense with no fees to parents under federal Part C regulations. Services may be free or reduced-cost depending on your state's system of payments; inability to pay cannot delay or deny services under those rules. Ask your program for its written policy. [1] [4]
How long does the evaluation take?
Federal Part C rules generally require that screening (if used), initial evaluation and assessments, and, for an eligible child, the initial IFSP meeting be completed within 45 days of referral, with limited exceptions for documented exceptional family circumstances or lack of parental consent despite repeated attempts. [5] [6]
What if my child is 3 or older?
What is an IFSP?
An Individualized Family Service Plan is the written plan for an eligible infant or toddler and family under Part C. Parents must receive a full explanation and give informed written consent before services in the IFSP begin. [6]
What if we are found not eligible or services are delayed?
Ask for a written explanation and the next steps available to your family. Continue follow-up with your child's healthcare provider, and ask about another referral if concerns increase. A Parent Center can help you understand your options; at age 3, you can also request a school-district evaluation through Child Find. If the process is delayed, confirm when your referral was received and ask whether an interim IFSP is appropriate. [3] [5] [10] [12]
The bottom line
If you're concerned about your child's development, you can ask for an evaluation before you know what is causing the concern. For a child under 3, call your state's Part C program; for a child age 3 or older, contact the local school district.
When you call, explain what you've noticed and ask what happens next, when to expect a response, and how any service fees are handled. Keep your child's healthcare provider involved, especially if your child has lost skills or has hearing, vision, or other medical concerns. You do not need to have all the answers before you ask for help.
Sources
- Centers for Disease Control and Prevention. Early Intervention. Learn the Signs. Act Early. Updated February 16, 2026. CDC. ↩
- Centers for Disease Control and Prevention. Early Intervention Contact Information. Learn the Signs. Act Early. Updated February 16, 2026. CDC. ↩
- USAGov. Early intervention and special education services for children. Last updated April 1, 2026. USA.gov. ↩
- Electronic Code of Federal Regulations. 34 CFR § 303.521: System of payments and fees. eCFR. ↩
- Electronic Code of Federal Regulations. 34 CFR § 303.310: Post-referral timeline (45 days). eCFR. ↩
- Electronic Code of Federal Regulations. 34 CFR § 303.342: Procedures for IFSP development, review, and evaluation. eCFR. ↩
- Electronic Code of Federal Regulations. 34 CFR § 303.21: Infant or toddler with a disability. eCFR. ↩
- Electronic Code of Federal Regulations. 34 CFR § 303.420: Parental consent and ability to decline services. eCFR. ↩
- Electronic Code of Federal Regulations. 34 CFR § 303.209: Transition to preschool and other programs. eCFR. ↩
- Electronic Code of Federal Regulations. 34 CFR § 300.111: Child find. eCFR. ↩
- Hyman SL, Levy SE, Myers SM; Council on Children With Disabilities, Section on Developmental and Behavioral Pediatrics. Identification, Evaluation, and Management of Children With Autism Spectrum Disorder. Pediatrics. 2020;145(1):e20193447. DOI: 10.1542/peds.2019-3447 · PubMed · Full text, University of Washington copy. ↩
- Center for Parent Information and Resources. Find Your Parent Center. Parent Center Hub. ↩
- Centers for Disease Control and Prevention. Screening for Autism Spectrum Disorder. CDC. ↩
- Electronic Code of Federal Regulations. 34 CFR § 303.321: Evaluation of the child and assessment of the child and family. eCFR. ↩
- Electronic Code of Federal Regulations. 34 CFR § 303.344: Content of an IFSP. eCFR. ↩
Medical and editorial disclaimer
This article is educational information, not medical advice, a screening tool, or a diagnosis. It summarizes publicly available federal guidance and regulations and selected professional literature; it is not a comprehensive systematic review of early intervention research, and it does not replace advice from your child's healthcare provider or your state early intervention or special education program. Laws and state procedures can change; verify current contacts and policies with your state program. Pediatric Research Review summarizes published research and authoritative guidance; we do not conduct the studies or administer the programs described here. This article was prepared by the Pediatric Research Review Editorial Team and has not been clinically or medically reviewed. Sources checked November 6, 2026.
