about Early Intervention

A system of care. A community of support.

Early intervention is a term that describes a wide range of services available to children, age birth to three, who have disabilities or developmental delays. A federal law, the Individuals with Disabilities Education Act (IDEA) Part C, mandates early intervention services and establishes the guidelines for eligibility and service delivery. Early intervention services may include home visits, family training, counseling, special instruction and therapy. These “early intervention” services are designed to help families help their infant or toddler reach his/her developmental potential.

woman and baby play with toy


Infants and children with mild-to-profound hearing loss who are identified in the first 6 months of life and provided with immediate and appropriate intervention have significantly better outcomes than later-identified infants and children in vocabulary development, receptive and expressive language, syntax, speech production, and social-emotional development. Children enrolled in early intervention within the first year of life have also been shown to have language development within the normal range of development at 5 years of age.

Joint Committee on Infant Hearing, Year 2007 Position Statement. American Academy of Pediatrics. p. 90. http://pediatrics.aappublications.org/content/120/4/898.full.pdf+html

Federal guidelines mandate that once any degree of hearing loss is determined, children should be referred to early intervention within 7 days of confirmation of hearing loss (CFR §303.303 (a)(2)(i)).   Early intervention services should begin as soon as possible after diagnosis of hearing loss but no later than 6 months of age. For those children who are identified after birth but during their early childhood years (birth – 3, due to acquired or late identified hearing loss), early intervention services should begin as soon as possible after a diagnosis of hearing loss but no later than 3 months after the diagnosis has been made.

Most often either the audiologist or pediatrician makes the referral to early intervention, however any health care provider who has knowledge of the child’s diagnosed hearing loss should ensure the child and family have been referred for early intervention services. According to CFR §303.303(c)(1-8)primary referral sources include:

  • Hospitals, including prenatal and postnatal care facilities;
  • Physicians;
  • Parents, including parents of infants and toddlers;
  • Child care programs and early learning programs;
  • Schools;
  • Public health facilities;
  • Other public health or social service agencies;
  • Other clinics and health care providers;

All EHDI providers have the responsibility to ensure children in their care who have been diagnosed with any degree of hearing loss (unilateral, mild, moderate, severe, profound, auditory neuropathy/auditory dysynchrony) are referred for early intervention services to ensure these children have access to a range of services and support to help them achieve their full developmental potential. Further, families benefit greatly when EHDI providers serve to connect them with a full range of services and support so that they may be able to make informed decisions on behalf of their child and family.

Early Intervention in Texas

Texas provides a comprehensive system of services for families of infants and toddlers who have a hearing loss. Two state agencies, the Department of Assistive and Rehabilitative Services Division for Early Childhood Intervention (DARS-ECI) and the Texas Education Agency (TEA) have outlined a plan to ensure that a full range of early intervention services are available throughout all areas of Texas.

DARS-ECI is the state’s lead agency for early childhood intervention (ECI) services and provides oversight to local ECI programs that assist families. Local ECI programs work with deaf education programs within local education agencies (school districts), Regional Day School Programs for the Deaf (RDSPDs) and the Texas School for the Deaf (TSD) so that specialized services, specific to children with hearing loss, are available to families. This collaborative relationship between local ECI and deaf education programs ensures that children and families have access to the array of early intervention services and support as well as a specialized early intervention service provider who is a teacher of the deaf/hard of hearing trained in early intervention.

These specialized services, as defined by state guidelines, are known as auditory impairment (AI) services. AI services for infants and toddlers ages birth to 3 are often referred to as deaf education early intervention or parent-infant services. Deaf education early intervention services focus on helping babies develop speech, language and social skills by supporting families as they begin to explore questions regarding their child’s communication and development.

In Texas, children who are suspected (received a “refer for diagnostics” on an outpatient screen) or have a diagnosed hearing loss are to be referred to ECI within the federal timelines (7days). Local ECI and deaf education providers partner directly with the family to initiate the evaluation process in order to determine eligibility and from there develop an individualized family service plan (IFSP). The Department of State Health Services’ (DSHS) TEHDI Program, DARS-ECI and TEA have outlined the referral protocol that takes the family through the initial screen all the way through coordinated early intervention services.

Where families live determines which local ECI and which deaf education early intervention programs provide services in their area. Local ECIs, local school districts and RDSPDs all have different names that may be reflective of a geographic area or a host agency/school district such as Central Plains Center ECI, Lewisville ISD or Abilene RDSPD. Local ECIs may partner with one or more local school district and/or RDSPD, and the same may be true for RDSPDs and local school districts as their geographical boundaries are rarely the same.

To find an ECI program in your area, go to the ECI Program Search. You may make a referral through the TEHDI MIS or you may contact the local ECI program directly to make a referral. You may also call the DARS Inquiries Line at 1-800-628-5115 or send an email message to dars.inquiries@dars.state.tx.us. For those who are deaf or hard of hearing, please use the relay option of your choice or dial 7-1-1 to connect with Relay Texas when contacting DARS.

In the past, there has often been a lack of timely referral for diagnosis of and intervention for infants and toddlers with suspected hearing loss. Texas has made great strides to reach out to EHDI providers to make them aware of the EHDI service delivery system, which includes early intervention, and to help EHDI providers share information with families about the benefits of early intervention for their deaf or hard of hearing child and family. The Texas EHDI statewide campaign seeks to further this effort by empowering you as an EHDI provider to ensure all families have access to early intervention services so that their child may reach his/her developmental potential. Together we are…

A system of care. A community of support.