Note: This post is tailored to families in Washington State, but the general process is similar elsewhere.
I encourage all parents and teachers to do developmental monitoring: from time to time check out a developmental checklist to be sure your child is on track. And read developmental newsletters for ideas on how to support well-rounded development. Or, you can check out the Washington Early Learning and Development Guidelines which are an amazing resource for children birth through grade 3, where each developmental level includes ways to support your child’s development, differences in development and guidelines for when/how to seek intervention services.
About 1 in 6 children has a developmental or behavioral issue, such as autism, ADHD, dyslexia, and developmental delays. Only 30% of those concerns would be detected just through the monitoring process. Early intervention from birth to age 3 can help children learn important skills, and getting support and services for children age 3 and up can have a huge benefit for their schooling.
If you are wondering if your child might have autism or ADHD or developmental delays, start with a screening tool. The results might help to reassure you that your child is actually developing normally or they could validate that seeking further assessment and testing would be beneficial. The ASQ – Ages and Stages questionnaire is one of the best available tools for overall development, and you can complete it yourself in about 15 minutes. The ASQ-SE screens for social-emotional development, and can help to identify possible autism signs. (Learn more about using the ASQ and ASQ-SE and understanding your child’s ASQ results.)
For Washington state residents: you can complete the ASQ and ASQ-SE online and a child development specialist from Within Reach will contact you with the results within a week and discuss those results with you. Oregon offers an online ASQ and ASQ-SE here that appear to be open to anyone – you will see the results when you complete the screening.
Talk with a Professional
A helpful second step is to talk to your child’s doctor or their teacher or childcare provider about your concerns, and share the results of the screening. Here is a tip sheet for talking with a doctor about your concerns.
Your child’s doctor may offer a referral to a specialist, such as a child neurologist or a child psychologist. You could also ask for a written referral for testing, using this form.
You can also directly contact your state’s early childhood system to request a free Child Find Evaluation to find out if your child qualifies for intervention services. You do not need a doctor’s referral to make this call.
Evaluation – for Children under 3
The Individuals with Disabilities Education Act, or IDEA (specifically in Part C) guarantees your child a right to a free developmental evaluation. Some people call it “birth to three services,” “early intervention,” or “Part C services”. If your child qualifies for intervention, services can be billed to insurance, or offered on a sliding scale. You will not be denied services if you can’t pay for them.
In Washington, evaluations are provided through ESIT – Early Support for Infants and Toddlers. (Info for Outside Washington.) Each county has a lead agency that processes referrals and schedules evaluations. All the agencies are listed here. To learn which agency serves your location, you can call the Help Me Grow Washington Hotline at 1-800-322-2588.This statewide, toll-free number offers help in English, Spanish and other languages.
The evaluation process uses standardized tools and observations to evaluate a child’s development in 5 areas: physical, cognitive, social-emotional, communication, adaptive / self-care, and sensory processing skills. The evaluator uses natural situations to look at these skills as a child plays, stacks blocks, draws, etc.
If the evaluation shows your child is eligible for services (eligibility criteria here), they may develop an IFSP – Individualized Family Service Plan – and you will be referred for early intervention services, such as physical therapy, occupational therapy, speech therapy, hearing or vision services. In most cases, services are provided in the home or in a child-care setting.
Learn more about IFSP and Early Intervention, and even more about IFSP.
Evaluations for Children age 3 – 5
In Washington, “Child Find” evaluations are offered through your school district. They are free but you must request them.
You can call your school district coordinator* and say: “I have concerns about my child’s development and I would like to have my child evaluated through the school system for preschool special education services. Can you help me or let me speak with someone who can?” Write down who you speak to, the date, and what was said; you might need this information later.
At some point, you will need to submit a written request for evaluation. Some parents start with that. A sample letter to request evaluation is available on PAVE’s website, or the state offers a referral form. (Learn more about how to make the request for an evaluation.)
From the time of request the school has 25 school days to decide whether to evaluate, then 35 school days to complete the evaluation. Make sure you keep a record of when you started the process. (Learn more about the referral and evaluation process.)
The evaluation might look like academic tests, questionnaires, informal observations of the child and parent interviews. They may measure: communication skills, hearing and vision, motor skills, social skills, academic skills, thinking and reasoning. (Learn more about evaluation.)
IDEA describes 14 disability categories. If your child meets the criteria under one of those categories, they are eligible for an Individualized Education Program (IEP). Learn more about developing an initial IEP. (Tips for preparing for your IEP meeting.)
If they don’t meet IDEA eligibility, but they have a disability that impacts a “major life activity” they can have a section 504 plan for accommodations which enable equitable access. (If they are found not eligible, learn what to do.)
Children with identified disabilities can receive free special education and related services at preschools run by the local public-school district or through Head Start or ECEAP. (Learn more about preschool placement.) Related services might include speech therapy, occupational therapy, mental health counseling or special transportation, etc.
If your child is older than 5:
Contact the public school that your child attends or that they would assigned to (if they are homeschooled or attending private school). From there, the process is much as described above.
Most specialized education is provided by special educators who “push in” with support in the general education classroom. (The IDEA requires education in the Least Restrictive Environment (LRE) to the greatest extent possible with typically developing peers.) Some children do not thrive in typical classrooms, and may receive “pull out” instruction in a specialized setting.
Families that homeschool or attend private school, have the option to receive some services from the public school system, even if they are not attending full-time. Learn more about private school Equitable Services plan.
In order to access publicly funded early intervention services and special education, you will only need to complete the free evaluations described above.
It is also possible to have a formal evaluation by a child psychologist or psychiatrist, a occupational therapist or speech/language pathologist, clinic specializing in autism, ADHD, etc. This may lead to a more detailed report about your child’s diagnosis and how you can support them, or it may make you eligible for additional services that could be covered by insurance, or may make your child eligible for medications. These diagnostic evaluations may be covered by your insurance or might require paying out of pocket, and can be expensive, so be sure you check about costs and coverage.
If you’re looking for a provider for a diagnosis, seek recommendations of knowledgeable professionals in your area from:
- Support groups (for example, Autism Speaks has a national directory of providers;
- People who have children or other family members with the condition
- Governmental resources (for example, the Autism Guidebook for WA)
- Your primary care provider or other health care professionals
- Early intervention or special education providers
- If you’re feeling uncertain about having your child tested, or you’re wondering “do they have a problem or are they just quirky?” check out my post on deciding whether to have your child tested.
- For a basic understanding of what autism is, and what the signs are, check out my Autism 101 post.
- If you notice your child runs from one thing to another to another, read my post on the Race Car Brain.
- Ages and Stages has a helpful overview of screening, and links to resources for supporting your child’s development: https://agesandstages.com/7-screening-questions-with-dr-jane-squires/.
- ARC of King County has some great resource lists for families with developmental challenges: https://arcofkingcounty.org/resource-guide/special-education/overview.html I highly recommend their Overview of Children’s Services..
*How to Contact Your School District
For children age 3 to 5, you’ll reach out to the special ed team in your child’s school district. Here’s info for all the districts in the state. k12.wa.us/sites/default/files/public/specialed/resourcelibrary/SpEdDirectory.pdf
Here are contacts for district’s on Seattle’s Eastside. (I teach for the Bellevue College Parent Education Program so these are the resources I refer to.) If their websites said what agency provides evaluations for ages birth to 3, I list that after the website URL. (If the Early Intervention provider is not listed, call Help Me Grow Washington Hotline at 1-800-322-2588.)
- Bellevue: https://bsd405.org/services/special-education/childfind/ Kindering.
- Issaquah: https://www.isd411.org/programs-services/special-education/childfind. Kindering, Encompass, and CTC.
- Kent: https://www.kent.k12.wa.us/Page/3871. Community Health Access Program
- Mercer Island: https://www.mercerislandschools.org/Page/15251
- Renton: https://meadowcrest.rentonschools.us/our-school/child-find
- Lake WA School District (Kirkland / Redmond / Sammamish: https://www.lwsd.org/programs-and-services/special-services/child-find Kindering and Wonderland.
- Riverview School District (Carnation / Duvall) – https://www.rsd407.org/childfind. Encompass.
- Snoqualmie Valley https://www.svsd410.org/Page/645. The school district does evaluations for birth to 3 as well.
- Tahoma School District (Maple Valley). https://www.tahomasd.us/departments/special_services/early_childhood_services/school_readiness/tahoma_resources?msclkid=ee81ddf8d01111ec87845ab4e173bb8c
To refer your child for Kindering services, call (425) 653-4300 or submit an online referral form here. Kindering provides helpful information about their telehealth evaluations.