Early Start is California’s early intervention program for babies and toddlers from birth to 36 months. Under the Early Start program, California regional centers and some school districts evaluate a referred child within 45 days and provide services at no cost to eligible families. A child qualifies with a 25% delay in one area of development, an established risk condition, or a high-risk combination of factors. You do not need an autism diagnosis to make a referral.
Quick answer
Early Start program California: Early Start is the state’s early intervention system for children under 3 who have a developmental delay or a risk condition. Anyone can refer a child to the local regional center. Within 45 days, the team evaluates the child and, if eligible, writes an Individualized Family Service Plan (IFSP) with services built into daily routines.
Last checked: November 10, 2026. This is general information, not legal or medical advice.
Who runs the Early Start program California families use?
Early Start is California’s version of federal Part C of the Individuals with Disabilities Education Act (IDEA). The Department of Developmental Services (DDS) is the lead agency and works with the California Department of Education.
Locally, the work is split three ways:
- Regional centers serve most children, including toddlers with delays linked to autism.
- School districts or county offices of education (LEAs) serve children whose only needs come from vision, hearing or severe orthopedic impairments (solely low-incidence disabilities).
- Family Resource Centers funded by Early Start offer parent-to-parent support, information and referral to every family.
For a toddler with possible autism, the regional center is the usual door.
Who qualifies for Early Start?
A child under 3 qualifies through one of three paths, decided after evaluation and assessment. Since June 30, 2022, the delay threshold is 25% in at least one area.
- Developmental delay: a 25% delay in cognitive, physical (including vision and hearing), expressive communication, receptive communication, social or emotional, or adaptive skills.
- Established risk: a condition with a known cause and a high probability of delay, such as Down syndrome or cerebral palsy.
- High risk: two or more biomedical risk factors identified by a professional. Examples include birth before 32 weeks, low birth weight, or breathing support for over 48 hours in the first 28 days.
For a toddler with suspected autism, the delay path is the usual route, through communication or social-emotional skills. The Disability Rights California guide to Early Start eligibility lists all six areas and the high-risk factors.
Signs that are worth a referral
You don’t need to be sure. A concern about how your child talks, understands, plays, moves or connects with people is enough to call. Our checklist of early signs of autism in toddlers lists what to watch for by age.
How do you refer a child to Early Start?
Anyone can refer a child: a parent, a doctor, a child care provider or another professional. A phone call or short letter to your regional center describing your concern is enough. Professionals who spot a possible delay must refer within seven days. You can also call the Early Start BabyLine at 800-515-BABY (800-515-2229) to find your local contacts.
- Find your regional center by county and ask for Early Start intake.
- Describe your concern. Give your child’s age and what you have noticed.
- Sign consent. Evaluation can’t start until you give written consent, so return forms quickly.
Our guide on how to apply for regional center services walks through intake step by step. The regional center intake checklist lists the documents to bring.
What happens in the 45 days after a referral?
Within 45 days of receiving the referral, the regional center or school district must evaluate your child and decide on eligibility. If your child qualifies, the team writes the IFSP within the same window. The center can extend the timeline only in exceptional circumstances, at the family’s request, or while it waits for written consent.
- Service coordinator: one person guides your family and arranges services.
- Evaluation: specialists assess all developmental areas.
- IFSP meeting: you and the team agree on outcomes for your child and family, and the services to reach them.
- Reviews: the IFSP is reviewed every 6 months and fully evaluated at least once a year.
What services does Early Start provide?
Services depend on your child’s assessed needs and your family’s priorities. Services are delivered in the child’s natural environment, which means home, child care or community settings, within daily routines like meals, play and bath time.
- Speech and language services, occupational therapy and physical therapy
- Child development (infant development) services
- Family training, counseling, psychological and social work services
- Vision, audiology, nursing, nutrition and assistive technology
- Medical services for diagnosis and evaluation only
Behavioral services are also used for some toddlers. ASC doesn’t favor one approach; our Options Policy on choosing therapies explains why families should weigh each option for their own child.
Does Early Start cost anything?
Early Start services are provided at no cost to eligible families. Evaluation, eligibility and service coordination are free. However, regional centers are funders of last resort, so the family’s health coverage is used first.
- Private insurance: required for medical therapies, including speech, occupational and physical therapy and behavioral services.
- Medi-Cal: used for covered services when your child has it.
- Regional center funds: pay for IFSP services that no other source covers.
Ask your service coordinator who pays for each service before you sign the IFSP. If your health plan pays part of an IFSP service, the regional center must pay the copay, coinsurance or deductible when no other third party is liable (Welfare and Institutions Code 4659.1).
What happens when your child turns 3?
Early Start ends at the third birthday. The service coordinator holds a transition conference at least 90 days, and up to 6 months, before your child turns 3. If your child qualifies for special education, the school district must have an IEP in place by the third birthday.
Children aged 3 and 4 can also be provisionally eligible for regional center services. It needs significant limits in two major life activities and lasts until age 5. Our guide to the Early Start transition at age 3 covers the steps month by month.
| Question | Early Start (0 to 3) | Regional center (3+) | School district (3+) |
|---|---|---|---|
| Law | Federal IDEA Part C; state Early Intervention Services Act | Lanterman Act | Federal IDEA Part B; California Education Code |
| Who qualifies | 25% delay, established risk or high risk | Substantial disability from autism and other listed conditions; provisional at ages 3 and 4 | Child needs special education in one of the eligibility categories |
| Plan | IFSP | IPP (Individual Program Plan) | IEP |
| Where services happen | Home and daily routines | Home and community | Preschool or school settings |
| Cost to family | No cost; insurance used first | No cost for most services; insurance used first | Free public education |
For the rules after 3, see who qualifies for regional center services with autism.
Frequently asked questions
Does my child need an autism diagnosis for Early Start?
No. Early Start eligibility is based on a delay, an established risk condition or high risk, not on a diagnosis. A toddler can qualify through a communication or social-emotional delay before any autism evaluation.
What is the Early Start BabyLine?
The BabyLine is the statewide Early Start information number: 800-515-BABY (800-515-2229). It helps families find their local regional center, school program and Family Resource Center. You can also call your regional center directly.
Is Early Start the same as Head Start?
No. Early Start is early intervention for children under 3 with delays or risk conditions, run through regional centers and school districts. Head Start and Early Head Start are separate federally funded child development programs with their own eligibility rules.
Do we need to be US citizens to apply?
Regional center intake is free. Westside Regional Center, for example, states that intake is provided to everyone regardless of citizenship status. Ask your own regional center if you are unsure.
Next step
If you have a concern, call your regional center’s Early Start intake line this week. For the bigger picture of diagnosis, regional centers and school, see our guide to autism services in California. The official program page is the DDS Early Start page.
Call the Autism Society of California information line at 1-800-869-7069, or connect with parents near you through Autism Society affiliates in California.