6.5: The Referral Process
- Page ID
- 232038
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\(\newcommand{\avec}{\mathbf a}\) \(\newcommand{\bvec}{\mathbf b}\) \(\newcommand{\cvec}{\mathbf c}\) \(\newcommand{\dvec}{\mathbf d}\) \(\newcommand{\dtil}{\widetilde{\mathbf d}}\) \(\newcommand{\evec}{\mathbf e}\) \(\newcommand{\fvec}{\mathbf f}\) \(\newcommand{\nvec}{\mathbf n}\) \(\newcommand{\pvec}{\mathbf p}\) \(\newcommand{\qvec}{\mathbf q}\) \(\newcommand{\svec}{\mathbf s}\) \(\newcommand{\tvec}{\mathbf t}\) \(\newcommand{\uvec}{\mathbf u}\) \(\newcommand{\vvec}{\mathbf v}\) \(\newcommand{\wvec}{\mathbf w}\) \(\newcommand{\xvec}{\mathbf x}\) \(\newcommand{\yvec}{\mathbf y}\) \(\newcommand{\zvec}{\mathbf z}\) \(\newcommand{\rvec}{\mathbf r}\) \(\newcommand{\mvec}{\mathbf m}\) \(\newcommand{\zerovec}{\mathbf 0}\) \(\newcommand{\onevec}{\mathbf 1}\) \(\newcommand{\real}{\mathbb R}\) \(\newcommand{\twovec}[2]{\left[\begin{array}{r}#1 \\ #2 \end{array}\right]}\) \(\newcommand{\ctwovec}[2]{\left[\begin{array}{c}#1 \\ #2 \end{array}\right]}\) \(\newcommand{\threevec}[3]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \end{array}\right]}\) \(\newcommand{\cthreevec}[3]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \end{array}\right]}\) \(\newcommand{\fourvec}[4]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}\) \(\newcommand{\cfourvec}[4]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}\) \(\newcommand{\fivevec}[5]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}\) \(\newcommand{\cfivevec}[5]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}\) \(\newcommand{\mattwo}[4]{\left[\begin{array}{rr}#1 \amp #2 \\ #3 \amp #4 \\ \end{array}\right]}\) \(\newcommand{\laspan}[1]{\text{Span}\{#1\}}\) \(\newcommand{\bcal}{\cal B}\) \(\newcommand{\ccal}{\cal C}\) \(\newcommand{\scal}{\cal S}\) \(\newcommand{\wcal}{\cal W}\) \(\newcommand{\ecal}{\cal E}\) \(\newcommand{\coords}[2]{\left\{#1\right\}_{#2}}\) \(\newcommand{\gray}[1]{\color{gray}{#1}}\) \(\newcommand{\lgray}[1]{\color{lightgray}{#1}}\) \(\newcommand{\rank}{\operatorname{rank}}\) \(\newcommand{\row}{\text{Row}}\) \(\newcommand{\col}{\text{Col}}\) \(\renewcommand{\row}{\text{Row}}\) \(\newcommand{\nul}{\text{Nul}}\) \(\newcommand{\var}{\text{Var}}\) \(\newcommand{\corr}{\text{corr}}\) \(\newcommand{\len}[1]{\left|#1\right|}\) \(\newcommand{\bbar}{\overline{\bvec}}\) \(\newcommand{\bhat}{\widehat{\bvec}}\) \(\newcommand{\bperp}{\bvec^\perp}\) \(\newcommand{\xhat}{\widehat{\xvec}}\) \(\newcommand{\vhat}{\widehat{\vvec}}\) \(\newcommand{\uhat}{\widehat{\uvec}}\) \(\newcommand{\what}{\widehat{\wvec}}\) \(\newcommand{\Sighat}{\widehat{\Sigma}}\) \(\newcommand{\lt}{<}\) \(\newcommand{\gt}{>}\) \(\newcommand{\amp}{&}\) \(\definecolor{fillinmathshade}{gray}{0.9}\)- Differentiate between the referral, evaluation, and service planning processes for children under age 3 (IFSP) and those age 3 and older (IEP).
- Explain the structure and purpose of an IFSP and an IEP, including how goals are set, services are delivered, and transitions are planned to meet children's developmental and educational needs.
What is a Referral?
A referral is the formal process of requesting a developmental evaluation or specialized assessment when there are concerns about a child’s growth, learning, or behavior. The goal of the referral process is to ensure that children with potential developmental delays or disabilities are identified early and connected to appropriate services. Early identification and intervention can significantly improve developmental outcomes, especially when support is provided during critical periods of growth.
Referrals may be prompted by observations from parents, teachers, childcare providers, or healthcare professionals who notice that a child is not meeting developmental milestones or is struggling in ways that differ from same-age peers. The referral process acts as a gateway to further evaluation and, when needed, access to services such as speech therapy, physical therapy, or special education support.
Because developmental concerns can arise at any age, referral processes are designed differently for infants and toddlers (birth to age 3) and for preschool- and school-aged children (age 3 and older). The following sections describe how referrals are made and managed in each age group.
Referral Process for Children Under Age 3
The referral process begins with identifying developmental concerns arising from various sources. Parents may notice delays in their child’s milestones, pediatricians may identify potential developmental issues during routine checkups, or childcare professionals may observe atypical behaviors or skills. Practitioners often use standardized developmental screening tools, such as the Ages and Stages Questionnaire (ASQ), to determine if further evaluation is needed (Centers for Disease Control and Prevention [CDC], n.d.). Once concerns are identified, the child is referred to the state’s early intervention system. Referrals can be made by anyone familiar with the child’s development, including parents, healthcare providers, or teachers/caregivers, and parents can also contact their state’s early intervention office directly. By law, referrals must be addressed promptly, with contact initiated within seven calendar days (Shonkoff & Meisels, 2000).
Following the referral, the child undergoes a comprehensive, multidisciplinary evaluation to determine eligibility for services. This evaluation assesses areas such as communication, motor, cognitive, social-emotional, and adaptive skills. Eligibility criteria vary by state but typically include children with significant developmental delays or a diagnosed condition that increases the risk of delays (Quire et al., 1996). If the child is deemed eligible, an IFSP is developed within 45 days of the referral. An Individualized Family Service Plan (IFSP) is a family-centered plan designed to support children under the age of three who have developmental delays or disabilities. This plan outlines specific goals for the child’s development, the services required (e.g., physical or speech therapy), and how and where these services will be provided. The IFSP is reviewed every six months and updated annually to ensure it continues to meet the child’s and family’s needs.
Figure \(\PageIndex{1}\). IFSP Process. from Genevieve Howard.
The IFSP process focuses on delivering early intervention services in natural environments, such as the home or childcare setting. It is governed by Part C of the Individuals with Disabilities Education Act (IDEA). As the child approaches their third birthday, the IFSP team collaborates to develop a transition plan. This plan ensures a seamless shift to preschool services, which may involve an evaluation for eligibility under an Individualized Education Program (IEP) governed by Part B of IDEA.
Referral Process for Children Over Age 3
For children aged three and older, the referral process transitions to the school district and focuses on developing an Individualized Education Program (IEP). This process ensures that children continue to receive support for developmental or educational challenges within the school-based setting.
Concerns about a child’s development or learning may arise from various sources, including parents, preschool teachers, or healthcare providers. Parents or caregivers can initiate a referral by contacting their local school district’s special education department or the Child Find program, a federally mandated initiative that helps identify children with disabilities. Upon receiving a referral, the school district must respond within a specific timeframe, which typically ranges from 10 to 15 days, depending on state regulations. Parental consent is required to proceed with the evaluation.
The evaluation process involves a multidisciplinary team conducting assessments in all areas of suspected need, such as communication, motor, cognitive, or social-emotional skills. The evaluation must be completed within 60 days of receiving parental consent. Eligibility for an IEP is determined based on whether the child meets criteria under one of IDEA’s recognized disability categories, such as developmental delay or speech/language impairment (Marston, 2018).
If eligible, an IEP team—including parents, teachers, and specialists—collaborates to develop the plan. The IEP outlines measurable goals, necessary accommodations, and the services the child will receive, such as speech therapy or occupational therapy. Services are typically provided in the least restrictive environment (LRE), such as an inclusive preschool classroom. The IEP is reviewed annually to monitor progress, and reevaluations occur at least every three years to ensure the plan remains appropriate.
Figure \(\PageIndex{1}\). IEP Process for Parents. from A Day in Our Shoes with Lisa Lightner.
References, Contributors and Attributions
Centers for Disease Control and Prevention (CDC). (n.d.). Developmental disability basics. https://www.cdc.gov/child-development/about/developmental-disability-basics.html
Marston, J. (2018). Child observation and assessment: Linking theory to practice. Sage.
Quire, M., Nickel, R., & Eisert, D. (1996). Early intervention strategies for young children. Journal of Early Childhood Development, 12(4), 45-52.
Shonkoff, J. P., & Meisels, S. J. (2000). Handbook of early childhood intervention (2nd ed.). Cambridge University Press.