For many parents, developmental concerns don’t arrive all at once. They build slowly—delay in walking, difficulty with balance, fewer words than expected. You might tell yourself to wait and see, but sometimes that quiet inner voice keeps nudging you to look a little closer.
If your gut is nudging you to pay attention, don’t ignore it. Calling your local Early Childhood Intervention (ECI) provider is an excellent first step, says Catherine Carlton, chief of staff at My Health My Resources of Tarrant County (MHMR), a nonprofit that offers community-based child and family services. Carlton knows that feeling firsthand. Her own son needed physical therapy to strengthen his legs, and he qualified for ECI services.
“It’s overwhelming. I mean, when you need help and rely on a system to help you, it is overwhelming and stressful and hard and scary and alone and all those adjectives. But what I found is that ECI provided that support and connection for me to understand the system, to get my son what he needed, to support not just me but my family. They were our cheerleaders. They were our supporters. They were our providers,” she says.
If you’re concerned about a developmental delay, Early Childhood Intervention could be exactly what your child needs. Here’s what to know.
What Is the Texas ECI Program?
Early Childhood Intervention is a statewide program that offers services such as speech, occupational, feeding and developmental therapies to children ages 3 and younger. Little ones receive these services in their natural learning environment—whether that’s home, in a child care setting or even a grandparent’s house, says Anisha Philips, senior director of ECI at MHMR Tarrant.
Who Qualifies for Early Childhood Intervention Services?
Children don’t need to have a special needs diagnosis to receive ECI services. They qualify if they meet one of three criteria:
Medical diagnoses:
They have a medical diagnosis that’s likely to cause a developmental delay, such as cerebral palsy, epilepsy, Down syndrome or spina bifida. (Parents can use the ECI Qualifying Diagnosis Search Tool.)
Sensory impairments:
They are deaf, hard of hearing, blind or visually impaired, as defined by the Texas Education Agency.
Developmental delays:
They have a delay of at least 25% in one or more areas of social/emotional, adaptive, communicative, motor or cognitive development or 33% in expressive language development.
Once a child qualifies, services continue until developmental goals are met or they transition out of the program at age 3, explains Dr. Tracy Harrington, a licensed psychologist in the Developmental Psychology department at Cook Children’s. Nationally, the Centers for Disease Control and Prevention estimates that about 1 in 6 children has a developmental delay or disability, making a need for early support more common than many parents realize.
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When Should You Call About Developmental Concerns?
Your pediatrician is an important partner. Well-child visits in the first few years include developmental screenings, and doctors track progress in communication, movement and social skills. But parents don’t need to wait for a provider to raise concerns; you know your child best.
“Mom to mom, I would say, call,” Carlton says. “Calling and everything being OK is a good situation, but calling and there is a need? You want to do that sooner rather than later, so that you can get connected to the team.”
The brain develops at a rapid rate in the first few years, and research shows that early intervention is key to bridging the gap when there’s a developmental delay. As children age, the gaps continue to expand and the delays can get more profound if not addressed, Harrington says.
While every child develops at their own pace, these signs may warrant a closer look:
By 12 Months
Your 12-month-old doesn’t crawl, use gestures like waving or shaking their head, show interest in peek-a-boo, babble or sit steadily. Other things to watch for include not being able to stand when supported or eating solid foods.
By 1–2 Years
Your 1- to 2-year-old doesn’t speak or use two-word sentences, know the function of common household objects, imitate actions or words or follow one-step instructions. Not walking or developing a heel-toe walking pattern could be other red flags.
By 2–3 Years
Your 2- to 3-year-old has difficulty with the stairs, drools or has unclear speech, can’t communicate in short phrases, doesn’t understand simple instructions or has extreme difficulty separating from a primary caregiver. Other warning signs at this age relate to play: your child can’t build a tower of more than four blocks, doesn’t engage in pretend play or has little interest in other children.
How to Request an ECI Evaluation in Texas
If you’re concerned about your child’s development, you—or your pediatrician, a family member, or other caregiver—can request an evaluation. You’ll fill out a referral form, which includes basic contact information and a description of your concerns. You can find this form on your local ECI provider’s website. To find the program that serves your area, visit hhs.texas.gov and search “ECI Program Search,” where you can look up services by city, county or zip code.
Once a referral is submitted, the ECI provider has 45 calendar days to complete an evaluation and write the Individualized Family Service Plan (IFSP). Within a few days, someone from your local program will reach out to schedule a first visit.
What Happens During the First Visit?
During this first visit, which typically lasts about two hours and often takes place in your home. During the visit, specialists conduct a comprehensive assessment that looks at all areas of development and ask detailed questions about your child’s history, daily routines, strengths and your family’s priorities.
If your child does not qualify, ECI providers often connect families to additional community resources and may schedule a follow-up evaluation in several months, says Amy Spawn, CEO of The Warren Center in Dallas. “We will check back in with the family in three months or six months and see how the child is doing. If the parents have concerns again, we’ll have them come back in and do another evaluation,” she says. “We want to make sure that those families have a lifeline to us.”
What Is an Individualized Family Service Plan (IFSP)?
If your child does qualify, you’ll work with your team to write an IFSP. This plan is developed based on the unique needs of your child and family, and it includes goals you set together, what services are needed, how often they’ll be provided and who will be providing them.
It will also include information like your service coordinator’s name, a description of your child’s strengths and needs, an explanation of how the team will measure your kiddo’s progress and any services your child needs that aren’t provided by ECI.
Once you sign the IFSP, the planned services must begin within 28 calendar days.
What Do ECI Services Look Like at Home?
Depending on your child’s needs, services may include speech therapy, occupational therapy, physical therapy, feeding support, nutrition counseling, social work or specialized skills training.
One of the distinguishing features of ECI is its family-centered approach. Providers coach caregivers on strategies and techniques that fit naturally into daily routines. With Carlton’s son, that looked like creativity on the living room floor.
“Our physical therapist—we always called her the MacGyver of physical therapy—would say, ‘OK, grab that couch cushion. Grab that pot. Let’s take that spoon,’” Carlton says. The therapy activity was based on whatever was within arm’s reach while they were playing together.
For other children, it might mean playing with certain toys during bathtime to help with motor skills, practicing saying certain words on the drive to the grocery store or incorporating feeding techniques at mealtimes.
Providers will observe and document your child’s progress at each visit and adjust strategies as needed. The IFSP is reviewed every six months and eligibility is reassessed annually, though adjustments can be made at any time.
How Much Does the Texas ECI Program Cost?
The referral, evaluation and assessment, case management, IFSP development and any translation or interpreter services needed are provided to Texas families at no cost. When it comes to the services your child receives, you can either use your child’s public or private insurance or pay the Family Cost Share—a sliding scale based on your income and family size after allowable deductions. ECI staff will help you determine your monthly maximum charge.
What Happens When Your Child Turns 3?
Transition planning typically begins the child is between 27 and 33 months old, Philips says. Because ECI services end at age 3, families work with their team to explore next steps.
The most common plan is connecting you to your local school district for Early Childhood Special Education. The district must complete any additional evaluations and determine eligibility before the child’s third birthday. If eligible, the child will receive an Individualized Education Plan (IEP). Other options include charter schools, private therapy, child care or Head Start.
Whatever path families choose, Spawn says, providers work to ensure the transition feels smooth and supported. “We make sure that transition happens seamlessly for parents,” she says.
Over Age 3? How to Request a Free School Evaluation
Early Childhood Intervention services end at age 3, but support doesn’t stop there. If you have concerns about a child who is older, you can contact your local public school district and request a free evaluation. You do not need a doctor’s referral, and your child does not have to be enrolled in the district to request an evaluation.
If eligible, your child may receive services through an Individualized Education Plan (IEP), which can include speech therapy, occupational therapy, behavioral support or classroom accommodations.
Texas ECI Providers in DFW
The following are Early Childhood Intervention programs in the DFW area that work in association with Texas Health and Human Services:
LifePath Systems
1515 Heritage Drive, McKinney, Texas
972/562-0331
lifepathsystems.org
Metrocare Services
3230 Remond Drive, Dallas, Texas
214/331-0109
metrocareservices.org
MHMR of Tarrant County / ECI of North Central Texas
3840 Hulen St., Suite 602, Fort Worth, Texas
817/335-3022
mhmrtc.org
The Warren Center, Inc.
320 Custer Road, Richardson, Texas
972/490-9055
thewarrencenter.org
The Bottom Line
- If you’re worried about developmental delays, calling your local ECI provider is a proactive first step.
- The Texas ECI program offers free evaluations and family-centered services for children under 3.
- Early support can make a meaningful difference — and reassurance is valuable, too.
