Children, from birth to age three and living in Massachusetts, may receive a multidisciplinary team evaluation by a certified Early Intervention Program, to determine if they are eligible to receive Early Intervention services, based on the eligibility criteria set by the Department of Public Health. Eligible children may receive EI services for as long as they meet eligibility criteria, up to but not on their third birthday.

Eligibility for Early Intervention is determined through an evaluation by a multidisciplinary team exercising sound clinical judgment and using a developmental inventory tool approved by the Massachusetts Department of Public Health. Instruments approved by the Department of Public Health for establishing eligibility, as of 7/1/2005, are: the Early Intervention Developmental Profile (“Michigan”) and the Battelle Developmental Inventory-2 (“BDI-2”).

Effective January 1, 2012, eligibility for all children referred to the Massachusetts Early Intervention System will be determined utilizing the BDI-2. A child will need to exhibit a delay of 1.5 standard deviations below the mean to be eligible for early intervention based on established delay.

  1. A child is considered eligible for Early Intervention when there is an established risk or established developmental delay:
    • The child has a diagnosed medical condition with a relatively well known expectation for delay which may included any of these diagnoses:
      • neurological, metabolic, or genetic disorder,
      • chromosomal anomaly,
      • medical or other disabling condition with documented expectation of developmental delay,
      • vision loss not corrected by medical intervention or prosthesis or
      • permanent hearing loss of any degree, or
    • The child exhibits a delay of 30%, as measured by an approved instrument yielding age equivalent scores, in one or more areas of development, including cognitive development, physical development, communication development, social/emotional development or adaptive development, or
    • The child’s development is 1.5 standard deviation below the norm, as measured by an approved instrument yielding standard deviation scores, in one or more areas of development, including cognitive development, physical development, communication development, social/emotional development, or adaptive development.
    • The child has questionable quality of developmental skills and functioning based on the informed clinical opinion of a multi-disciplinary team. A child found to be eligible based on the category of “clinical judgment” can receive services up to 6 months. For services to continue after this period, eligibility must be determined based on diagnosis, developmental delay or other risk factors.
  2. A child is considered eligible for Early Intervention when there is a risk for developmental delays or disorders due to four or more of the following risk factors being present:

Child Characteristics

  • Birth weight less than 1200 grams (2 pounds 10 ½ ounces)
  • Gestational age less than 32 weeks
  • NICU admission more than 5 days
  • Apgar less than 5 @ 5 minutes
  • Total hospital stay more than 25 days in 6 months
  • Diagnosis of Intrauterine Growth Retardation (IUGR) or Small for Gestational Age (SGA)
  • Weight for age, or weight for height, below 5th percentile; weight for age dropped more than two major centiles in 3 months (child under 12 months of age) or in 6 months (child 12-36 months of age)
  • Chronic feeding difficulties
  • Insecure attachment/interactional difficulties
  • Blood lead levels measured at 5 mg/dl
  • Suspected Central Nervous System abnormality
  • Multiple trauma or losses

Family Characteristics

  • Maternal age at child’s birth less than 17 or maternal history of 3 or more births before age 20
  • Maternal education less than or equal to 10 years
  • Parental chronic illness or disability affecting care-giving ability
  • Family lacking social supports
  • Inadequate food, clothing or shelter, including homelessness
  • Open or confirmed protective service investigation, including child is in foster care
  • Substance abuse in the home
  • Domestic violence in the home

How Can a Child and Family Become Involved?

Anyone (a parent, doctor, caregiver, teacher, or friend) can make a referral by calling 1-800-905-TIES and asking for a listing of certified Early Intervention Programs serving a particular city or town. Referrals are made directly to a certified program.

What Happens After a Referral?

An EI team will conduct a developmental evaluation with the child and family to determine eligibility. This evaluation/assessment will focus on specific areas of child development, including areas related to cognitive, language, motor, social, emotional, behavioral, and self-help skills.

If the child is eligible, an Individualized Family Service Plan (IFSP) is written based on the individual needs of the child and family. The development of the IFSP begins within 45 days of referral.

Family Choice

Each city and town in the Commonwealth has at least one Early Intervention program that provides services to its eligible residents. Families should be referred to the Early Intervention program certified for the catchment area in which they live.

Some areas in the state have more than one certified Early Intervention program. Upon referral to a program, parents are notified of the names of the other programs serving that catchment area and have the opportunity to talk with the other programs before having an eligibility evaluation. Once a program is chosen, the child will be evaluated; if the child is eligible and if the family elects to receive services, an Individualized Family Service Plan (IFSP) will be developed within 45 days after the choice was made.

Special Note for Families Residing Within the City of Boston and Its Environs

The Boston area, with the exception of Charlestown, Beacon Hill and East Boston, is considered to be one catchment area (this includes: Allston, Brighton, Brookline, Dorchester, Hyde Park, Jamaica Plain, Mattapan, Roslindale, Roxbury, and West Roxbury). Families who live in Boston may choose any of the programs, but many families choose the program closest to their home and neighborhood.

This information is provided by the Early Intervention Program within the Department of Public Health.