UPDATE: NC’s Early Intervention for Children Birth to 3 in Limbo

By Sumera Syed

North Carolina’s early intervention program – NC Infant Toddler Program—is in a state of flux as the N.C. Department of Health Human Services works to manage funding and staffing reductions mandated in the 2013 Budget.1 With early intervention in the news, it’s a good time to review the topic.

  • What is Early Intervention?
  • Why is Early Intervention an Important Birth to Eight Strategy?
  • How Does Early Intervention Work in NC?
  • What is the Need in NC?


What is Early Intervention?
Early intervention provides supports and services to young children with developmental delays or disabilities or with established conditions that are likely to result in delay.

Under the Individuals with Disabilities Education Act (IDEA), states are required to provide early intervention services to ensure the earliest possible identification, diagnosis and treatment of children under age three with serious chronic illnesses, developmental disabilities and developmental delays. States must ensure that early intervention services are available to every eligible infant or toddler.

In North Carolina, the program is called the NC Infant Toddler Program. Children are eligible if they:

Have a documented delay in one or more of the following areas:

  • Cognitive Development
  • Physical Development, including fine and gross motor function
  • Communication Development
  • Social-Emotional Development
  • Adaptive Development.

Are diagnosed with a physical or mental condition which has a high probability of resulting in developmental delay (e.g., Autism, congenital anomalies, etc.)2

Once children turn three they are served by the Department of Public Instruction. These services are also mandated by different sections of IDEA.

Why is Early Intervention an Important Birth through Eight Strategy?
Because 80% of critical brain development happens in the first three years of life, intervening early makes a significant impact on children’s outcomes. Early intervention helps many children develop skills at a level equal to their peers by age three and has been shown to positively impact outcomes across developmental domains, including language and communication, cognitive development, and social and emotional development.3

In North Carolina, 70% of children participating in the NC Infant Toddler Program make “greater than expected improvements” and more than half who are diagnosed with a problem eventually catch up with their peers, according to the NC Division of Public Health.4

The state also benefits financially from providing early intervention services. “Studies have found a number of long-term cost savings in terms of decreased grade repetition, reduced special education spending, enhanced productivity, lower welfare costs, increased tax revenues and lower juvenile justice costs,” according to the National Early Childhood Technical Assistance Center.5

How Does Early Intervention for Children Birth to 3 Work in North Carolina?
Currently in North Carolina, early intervention services are delivered through a statewide network of 16 regional Child Developmental Services Agencies (CDSA).

Children are referred to a CDSA by concerned parents, hospitals, physicians and other health care providers, child care programs, social services agencies and other public and private agencies. The CDSA then determines if the child is eligible for services based on standardized measures of child health and development, interviews and discussions with families, and observations of the child.

Families are eligible regardless of income, and do not pay for evaluation or referrals. Other services are based on a sliding fee scale. Each eligible child and family has an Early Intervention Service Coordinator to work with them. This person works with the family to write and carry out an Individualized Family Service Plan (IFSP). The plan outlines the services to be provided and is reviewed every six months.

What is the Need in North Carolina?
Research indicates that as many as 13% of children from birth to age three have delays that would make them eligible for early intervention.6 In North Carolina, that would translate to almost 49,000 children.7 Currently, the NC Infant and Toddler Program serves almost 20,000 children in the state.

In 2013, the General Assembly reduced funding for CDSA’s by $8 million. An additional $10 million reduction is scheduled for Fiscal Year 2014-15 along with the elimination of 160 staff positions.8 DHHS had planned to close three Child Developmental Services Agencies and contract with East Carolina University for those services.9 Late last month, the University notified DHHS that it would not expand its service area, creating uncertainty for how the Department will ensure all children are able to access early intervention services.

UPDATE MAY 23, 2014: Governor McCrory’s budget would allow the Department of Health and Human Services to determine how to manage the budget reductions legislated by the General Assembly for FY 2014-15. It would rescind the requirement that the Department eliminate 160 positions.

 

 

Resources

Endnotes

  1. THE JOINT CONFERENCE COMMITTEE REPORT ON THE CONTINUATION, EXPANSION, AND CAPITAL BUDGETS, Senate Bill 402. Raleigh: North Carolina General Assembly, 21 July 2013. Pdf.
  2. New Eligibility Definition for the NC Infant Toddler Program. Raleigh: NC Department of Health and Human Services, 1 July 2006. Pdf.
  3. The Outcomes of Early Intervention for Infants and Toddlers with Disabilities and Their Families. Issue brief. Chapel Hill: National Early Childhood Technical Assistance Center, 2011. Print.
  4. Ryan, Kevin, and MPH. Implementation Update: Reductions to Children’s Developmental Services Agencies. Raleigh: Department of Health and Human Services, 12 Mar. 2014. Pdf.
  5. Diefendorf, Martha, MRP, and Susan Goode, MLS, PT. The Long Term Economic Benefits of High Quality Early Childhood Intervention Programs. Rep. Chapel Hill: National Early Childhood Technical Assistance Center, 2005. Print.
  6. The Importance of Early Intervention for Infants and Toddlers with Disabilities and Their Families The Importance of Early Intervention for Infants and Toddlers with Disabilities and Their Families. Issue brief. Chapel Hill: National Early Childhood Technical Assistance Center, 2011. Print.
  7. State Baby Facts: North Carolina. Issue brief. Washington, DC: Zero to Three, 2013. Print.
  8. THE JOINT CONFERENCE COMMITTEE REPORT ON THE CONTINUATION, EXPANSION, AND CAPITAL BUDGETS, Senate Bill 402. Raleigh: North Carolina General Assembly, 21 July 2013. Pdf.
  9. Ruiz, Andrew. “DHHS to Close 3 Offices, Affects Special Needs Toddlers.” – WNCT. 3 Mar. 2014. Web. 21 May 2014.