Early Intervention

Early intervention provides services for infants and toddlers, birth to three, who have a developmental disability and/or delay and their families. Children are considered to be developmentally delayed when they have a 25% chronological age delay in development or a deviation below the standard for their age in one or more developmental areas.

The child may also be considered developmentally delayed if he or she has a physical or mental condition such as Downs Syndrome that is known to cause delay in development, or a hearing or vision impairment which meets certain criteria. The developmental areas considered in assessing these conditions include the following:

Functional areas of development

• Cognitive
• Physical
• Visual
• Hearing
• Communication
• Social or emotional
• Adaptive

Medical conditions affecting development

• Chromosomal abnormalities
• Congenital central nervous system defects
• Cerebral palsy
• Health impairment such as autism, epilepsy, and other chronic or acute degenerative health problems
• Orthopedic impairment
• Microcephaly

Early Diagnosis

Research indicates that early diagnosis and access to services can reduce the intensity of service required later in a child’s life and prevent involvement in special education for some children.

Services for children birth to three years of age diagnosed with developmental delays via the IDEA (Individual’s w/ Disabilities Education Act) are an entitlement. Currently school districts may provide services for eligible children or purchase these services through community-based organizations on a voluntary basis.

Legislation was passed in 2006, which requires all Washington school districts to partner with early intervention service providers to provide service to children birth to three by no later than fall 2009.

A major issue in this area is the early identification of delays and subsequent access to appropriate services. Research indicates that early diagnosis and access to services can reduce the intensity of service required later in a child’s life and prevent involvement in special education for some children. The existence of a system that assures access to developmental screening for all children birth-three is critical to the achievement of this goal.

The medical community acknowledges the importance of developmental screening. They have established recommendations for physicians regarding screening methodologies, parent involvement, referral and interface with community providers, cultural competency, and follow-up care. They acknowledge barriers, such as physician training, time requirements and inadequate reimbursement. They also recognize that the dynamic nature of child development requires developmental screening to be ongoing and occur at regular intervals over the course of the child’s early years.

Local issues that impact early identification efforts include currency of physician training in developmental screening and the fact that the traditional well-baby examination does not go into enough depth to truly identify any but the most apparent developmental concerns. Accurate and recurrent developmental screening in the context of the child’s medical home is critical to a successful prevention and early intervention system.

There are also a number of community-based settings in which children encounter health and early childhood professionals where developmental screenings can and do occur. Public Health Department efforts, such as Kids Get Care, Children with Special Health Care Needs, and the Child Health Care program, focus on the healthy development of children.  They make training, education, consultation and screening services available.

Child Care Resource and Referral and the King County Developmental Disabilities Division are partnering to provide training and support services to enhance early childhood providers abilities to screen for developmental delays, work with parents around developmental issues, and make referrals to appropriate resources. Some early intervention service providers also provide screening and consultation services in these settings. Sufficient resources are an issue in each of these areas. An increased capacity to provide screening and related support services in numerous community based settings is critical to success.

There are 65,000 children birth to three years of age in King County, and it is estimated that up to 2.2% or nearly 2,000 annually, experience developmental disabilities. In King County, the average age of identification of developmental delays is 1.8 years. Federal funding performance guidelines for early identification say the average age should be 1 year.^[1]

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