What Happens After an Early Intervention Referral
The short answer
An early intervention referral begins a structured process to evaluate whether your child has a developmental delay or disability and would benefit from therapeutic services. The evaluation is free, and services are available in every state for children from birth to age 3 under Part C of the Individuals with Disabilities Education Act (IDEA). Being referred does not mean something is wrong; it means someone wants to make sure your child has every opportunity to reach their potential.
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By Age
What to expect by age
Babies can be referred to early intervention at any age, and infants who were born prematurely, had a NICU stay, or have a diagnosed condition are often referred before they leave the hospital. At this age, services typically focus on supporting feeding, parent-child bonding, and early motor development. The evaluation process is play-based and observational; no one will put your tiny baby through stressful testing.
If your pediatrician, you, or another caregiver has concerns about how your baby is developing, a referral can be made at any time. After the referral, your state's early intervention program must complete an evaluation within 45 days. The evaluation team typically includes professionals from multiple disciplines who assess motor skills, communication, cognitive development, and social-emotional functioning. You will be an active participant in the process and your input about your baby's abilities is essential.
At this age, evaluations often focus on motor milestones like sitting, crawling, and reaching, as well as communication skills like babbling and responding to sounds. If your child qualifies, an Individualized Family Service Plan (IFSP) is created, which outlines specific goals and the services your child will receive. Services are delivered in your child's natural environment, which usually means a therapist comes to your home or daycare.
Referrals during the toddler years often relate to speech and language delays, motor delays, or behavioral concerns. The evaluation process is the same regardless of age: free, comprehensive, and family-centered. If your child is found eligible, services may include speech therapy, occupational therapy, physical therapy, developmental instruction, or a combination. Early intervention has been shown to significantly improve outcomes, especially when started before age 2.
Early intervention services under Part C are available until your child's third birthday. If your child is referred close to age 3, the evaluation and service process is the same but the team will also begin planning for the transition to Part B services through your local school district, if needed. This transition planning ensures there is no gap in support for your child.
What Should You Do?
When to take action
- You feel anxious or emotional after receiving a referral, which is a completely understandable reaction even when the referral is routine
- The evaluation process takes several weeks from referral to first appointment, which is typical given scheduling and the 45-day timeline
- Your child performs differently during the evaluation than they do at home, which evaluators account for by also gathering your observations
- Your child qualifies for services in some areas but not others, which is common and reflects their unique developmental profile
- You have concerns about your child's development but have not yet received a referral and want to request one
- More than 45 days have passed since the referral and you have not been contacted for an evaluation
- You disagree with the evaluation results and want to understand your right to request a re-evaluation or independent assessment
- You need help understanding the IFSP or the services being recommended for your child
- Your child is approaching their third birthday and has not yet been evaluated despite a referral, as the window for Part C services closes at age 3
- Your child is showing significant regression in previously acquired skills such as losing words, stopping walking, or withdrawing socially
Sources
Related Resources
Trust your instincts. If something feels wrong, reach out to your pediatrician.
Worrying about your baby means you care. That is a good thing.
Related Medical Concerns
My Baby's Head Shape Looks Abnormal
Many babies develop temporary head shape irregularities that are completely normal. A cone-shaped head from vaginal delivery reshapes within days. Mild positional flattening (plagiocephaly) from sleeping on the back is very common and usually improves with repositioning and tummy time. However, head shape changes involving ridges, a persistently bulging fontanelle, or rapid head growth changes should be evaluated to rule out craniosynostosis.
Achondroplasia (Dwarfism) in Babies
Achondroplasia is the most common form of short-limbed dwarfism, affecting about 1 in 15,000 to 40,000 births. It is caused by a mutation in the FGFR3 gene and is usually apparent at birth with characteristic features including short limbs, a larger head, and a prominent forehead. Intelligence is normal. With monitoring for specific complications and supportive care, children with achondroplasia lead full, active, and independent lives.
Adenoid Hypertrophy and Breathing
Adenoids are lymphoid tissue located behind the nose that help fight infection in young children. When adenoids become enlarged (adenoid hypertrophy), they can block the nasal airway, causing chronic mouth breathing, snoring, nasal speech, and sleep-disordered breathing. Enlarged adenoids are most common between ages 2-7 and are a leading cause of obstructive sleep apnea in young children. Treatment ranges from watchful waiting and nasal steroids to surgical removal (adenoidectomy) if breathing or sleep is significantly affected.
How to Advocate for Your Child's Needs
You know your child better than anyone, and your observations matter. If you feel something is not right with your child's development or health, you have every right to ask questions, request evaluations, and seek second opinions. Advocating for your child is not being difficult - it is being a good parent.
Air Quality and Baby Health
Babies and young children are more vulnerable to air pollution than adults because they breathe faster, their lungs are still developing, and they spend more time close to the ground where some pollutants concentrate. The EPA recommends keeping babies indoors when the Air Quality Index (AQI) exceeds 100 (orange level). During wildfire smoke events, keep windows closed, use air purifiers with HEPA filters, and monitor your child for coughing, wheezing, or difficulty breathing. Long-term exposure to air pollution can affect lung development.
Altitude Sickness in Babies
Babies and toddlers can experience altitude sickness when traveling above 5,000-8,000 feet (1,500-2,500 meters). Symptoms are harder to recognize in infants because they cannot describe how they feel. Watch for unusual fussiness, poor feeding, disrupted sleep, vomiting, and fast breathing. Gradual ascent is the best prevention. Most pediatricians recommend avoiding sleeping at very high altitudes (above 8,000 feet) with infants when possible, and descending immediately if symptoms appear.