Child Eligibility

Any child from birth to the age of 36 months can be evaluated for eligibility for First Steps services. After evaluation, a child qualifies for continuing services if they meet the criteria under one of the following conditions:

Developmental Delay
A child qualifies based on a developmental delay if he or she is determined to have a 25% delay in one domain or a 20% delay in two or more domains. “Domain” refers to any of cognitive, communication, physical, social-emotional, or adaptive development.

Medical Diagnosis of High Probability of Developmental Delay
A child with any of the following medical diagnoses that would result in a high probability of a developmental delay:

  • Chromosomal abnormality/genetic disorder
  • Neurological disorder
  • Congenital malformation
  • Sensory impairments (including vision and hearing)
  • Severe toxic exposure (including prenatal)
  • Low birth weight (less than 1500 grams)
  • Neurological abnormalities in the newborn period


The Costs Involved

First Steps staff works with families to ensure the lowest cost possible for services. Evaluations are offered at no cost to families and the standard evaluation covers all of the domains listed above. Additionally, your Service Coordinator is free of charge and helps connect families with agencies and clarify the whole process. Finally, First Steps provides services with co-payments based on the family’s income. Many of our families pay no co-pay.


Services Offered

Each First Steps family is provided a team of specialists (called providers or therapists) who work with parents and their children. Each team is different, depending on the child’s needs. Your Service Coordinator will help to identify specialists who are appropriate in your situation.

The following lists the specialists available to First Steps families and briefly describes each area of service. A printable version (PDF) of this list is also available.

Assistive Technology (AT)
Assistive Technology includes materials or equipment that can help the child improve what he or she can do. These devices are limited and need special approval from the State. Orthotics are not available through First Steps.

Audiology and Audiological Services
Audiology is concerned with the child’s hearing. It involves assessing hearing and looking for reasons when there is hearing loss. Audiologists may recommend special techniques or equipment to assist in communication. Audiological equipment may need special authorization from the State.

Developmental Therapy (DT)
Specialists in this area understand child development, learning, and behavior. They are educators who help develop and teach you ways to encourage the child to make progress. Developmental therapists can also work closely with other specialists to help form a plan that fits into the family’s daily schedule.

Health Services
Providers of health services help with special services like tracheotomy care, tube feedings, or changes of dressing during times that other First Steps services are being provided.

Medical Services
First Steps asks each enrolled child to have a primary medical home, or a primary care physician. This individual will coordinate medical services and evaluations. While First Steps is not responsible for regular well-being care, physicians might be contacted to supply services like testing and consultations that are related to deciding whether a child is eligible for First Steps.

Nursing supports other services. A nurse might make sure that a child’s medical needs are addressed properly in the plan of service. A nurse is responsible for addressing the child’s health and might provide short-term care to prevent and improve health problems.

Nutrition addresses eating habits and feeding skills. Nutritionists can help with special diets and menus, food selection, and special feeding issues. They can help parents look at how their child’s growth is affected by eating and at how to work with concerns like reactions to food textures or food density.

Occupational Therapy (OT)
When a child faces unique challenges with daily living skills, occupational therapy helps to develop skills that will improve the child’s ability to function. An occupational therapist will look at coordination of movement, feeding, dressing, and fine motor skill such as playing with small toys and tasks that require using a crayon. The occupational therapist might recommend or design special equipment or activities that will help the child with daily living.

Physical Therapy (PT)
Physical therapy helps a child improve the use of bones, muscles, joints, and nerves. The physical therapist will help plan a therapeutic exercise program, work with parents on how best to handle and position their child, and may recommend or make special equipment that can increase the child’s ability to move.

Psychological Services
Psychological services focuses on learning and on social and emotional development. The psychologist can assess a child and help with managing the child’s behavior.They work with problems in living situations that can affect a child and might develop a program that can include counseling, parent training, and educational programs.

Social Work
Social work is concerned with supporting families and helping them to deal with difficulties that might interfere with the family’s ability to participate in early intervention. Social workers provide family counseling, work with parent groups, and link families to other community resources and supports.

Speech/Language Pathology (SLP)
Speech and language pathology focuses on a child’s communication skills and on difficulties with speech or language. This specialty looks at what the child understands and how he or she communicates. Speech therapists will work with the child to improve language and communication skills. They might work with parents to develop alternative ways to communicate, such as through sign language or through pictures and other devices. Speech pathologists may also work with how the child uses his or her mouth for feeding and for making sounds.

Transportation can assist with the costs of travel that might be necessary for a child to receive First Steps services. This include transportation for assessments and evaluations. It may include reimbursement to the family or to a private or public transportation provider.

Vision services focus on identifying vision impairments, delays, or abilities that affect a child’s development. This might lead to referral for professional treatment and could include an “orientation and mobility specialist” who would work with parents and their child to help with getting around safely and independently. First Steps does not pay for eye glasses.


Provider Agencies

First Steps connects families to state-approved provider agencies that offer the services outlined above. Each county has a specific set of providers that serves that county.

To see which providers are available in your county, see the Clusters H & J Provider Agency List (PDF).



Is your child on track for his or her age? Use the downloadable developmental checklist to evaluate your child.

Do you think your child may have a developmental delay? Contact First Steps staff by calling 866-644-2454 to find out what steps you can take next.



September 2017 Announcements:


Designed for parents of children and youth with special health care needs and the professionals who serve them, this Heart To Heart conference offers a big variety of topics in general and breakout sessions.  Families and Self-Advocates are FREE.  8:00-3:30 includes breakfast and lunch.  30+ Service Providers Exhibiting

More information and registration:

Conference Flier attached HERE: FamilyVoicesConferenceFlyer


Useful Resources for Parents

A Family’s Guide through Procedural Safeguards (PDF)
American Academy of Pediatrics
Ball State University – Speech, Language, and Hearing Clinic.
Born Learning
CDC – Child Development
Early Childhood Meeting Place
eXtension – Child Care
Family Rights Brochure
Family Voices Indiana
Healthy Families Indiana
IIDC – Resource Center for Autism
Indiana Association for Child Care Resource & Referral
Indiana Association for the Education of Young Children
Indiana Bureau of Child Care
Indiana Child Care Health Consultant Program
Indiana Department of Health
Indiana Family and Social Services Administration
Indiana Institute on Disability and Community
Indiana School for the Blind & Visually Impaired
Indiana School for the Deaf
KidHeath – Your Child’s Growth
MedlinePlus – Child Development
Mental Health America of Indiana
Midwest Orthotics
MUMS National Parent-to-Parent Network
Prevail Prosthetics & Orthotics
Prevent Child Abuse Indiana
Rush County Parenting Council
St. Joseph Institute for the Deaf – Indianapolis
Zero To Three