This resource helps primary care providers (PCPs) communicate effectively with families of children who are deaf or hard of hearing (DHH) as they navigate the referral process to early intervention (EI) programs in their state/territory, including the Individuals with Disabilities Education Act (IDEA) Part C program.

The first three years of life are a critical window for brain development, with rapid growth of language, including auditory and/or visual language pathways. This is why timely screening, diagnosis, and referral into EI for children who are DHH is important. Even short delays in diagnosis or intervention can affect a child’s long term language acquisition, impacting cognitive, social-emotional, and academic outcomes.

How to Use this Resource:

  • Integrate tips from this resource into well-child visits and to support care coordination
  • Use communication prompts as a family engagement tool
  • Promote education among clinical staff and with medical students/trainees
  • Share with your practice patient/family navigators to support EI referral

Did you know?

The Early Hearing Detection and Intervention (EHDI) system of services refers to families, providers, services, and programs that work together to support children and families. EHDI system partners collectively work to achieve the EHDI national benchmarks which include: 1 month: Newborn hearing screening (before hospital discharge or by 1 month of age);  3 months: Diagnosis of hearing status; 6 months: Enrollment in EI.

Want to learn more about newborn hearing screening and the EHDI system?  View the resource linked below.

View


Partnering with Early Intervention Programs

EI is a core part of the EHDI system, and is critical to support optimal development, including language acquisition for DHH children. For children identified as DHH following newborn hearing screening, referral to the EI system should occur as soon as possible after diagnosis, and EI services should begin no later than six months of age if the child is found eligible for services.* PCPs and their practice teams are key collaborators with EI systems and are encouraged to actively engage with EI providers to ensure continuity of care and optimal outcomes. A referral to EI needs to be made immediately once a child is diagnosed as DHH.

PCPs and their practices can incorporate the tips below to support families through the EI referral process.  

  • Know your state/territory EI system: Understand eligibility criteria, available services, referral processes, and data sharing opportunities. Visit the Early Childhood Technical Assistance Center to learn more and/or connect with your state/territory EHDI program for resources. Note that different states/territories may have different names for their IDEA Part C EI programs.
  • Serve as a trusted connection between families and EI providers: PCPs and their practice teams can reinforce the importance of timely intervention and continuity of care.
  • Know and connect with your state/territory EHDI program: Your state/territory EHDI program is an important source of information about EI, family based organizations, and opportunities to engage in bidirectional data sharing across the EHDI system. State/territory EHDI programs have information or links specifically designed for parents of DHH children.
  • Familiarize yourself and your practice team with EI services specifically for DHH children: Services are determined based on the individual needs of the child and family.  Common services though include speech and language therapy, Deaf coaches, American Sign Language (ASL) coaching and family ASL programs, audiology, developmental therapy, and family coaching. Children with additional diagnoses and needs may also benefit from physical therapy, occupational therapy, and/or other types of services through EI. Social work and nursing support may also be offered as part of EI.
  • Engage in bidirectional information sharing with consent: PCPs and their practice teams can work with EI teams to share medical records, diagnostic results, and developmental updates. Note that Family Educational Rights and Privacy Act (FERPA) and Health Insurance Portability and Accountability Act (HIPAA) consent may be needed to engage in information sharing.
  • Engage in care planning: Participate in Individualized Family Service Plan (IFSP) meetings or provide input to guide the development of the IFSP.

Myth Busters

  

“EI means something is wrong with my baby.” → False. EI provides support that helps babies grow and thrive and helps families by giving them tools to support their child’s learning. EI is not about labeling or fixing.

“EI is too expensive for my family.” → Let’s learn more. Each state/territory determines their own policies on funding EI services.  In some states, EI services are provided free of charge. Other states use a sliding fee scale based on a family’s needs or bill insurance, including Medicaid for EI services. EI teams can help families understand any expenses.

“EI will replace what I do as a parent.” → False. EI providers coach and partner with families, building on what parents already do well.

“My child is too young to be alone with an EI therapist.” → Let’s learn more. Family-centered practices is the foundation of EI.  EI providers coach the family to support their infant or toddlers development and learning.

“Families are not ready for EI, so we will wait until they adjust to the diagnosis" → False. All families deserve access to information and many report that they wished they had received information sooner while honoring their experiences

“We can wait to start services later if needed.” → False. Starting early gives children the best chance to develop strong communication/language skills. EI services are also time limited (up to 3 years of age), and delaying could result in missed service opportunities.

“EI is not needed until the baby is talking.” → False. EI should start as early as possible to ensure the child has access to communication/language. All communication/language opportunities should be shared with families, including listening and spoken language as well as visual language.

“Families do not want to have the therapist in their home/families do not want to travel to an early intervention center, so it is not worth it to refer them to EI” → Let’s learn more. All EI looks to put families at ease and can provide therapy with the family present in a comfortable  environment. That could be their home, a local library or community center, a child care center, or even a park.


Conversation Prompts: Suggestions for Engaging in Discussion about EI With Families

Framing EI as an essential opportunity to support child development for families / caregivers can help reduce delays and facilitate family/caregiver buy-in. For many families, their DHH child is the first DHH individual they have met so EI providers can help empower families with the knowledge to understand and support their child. 

Here are some conversation prompts PCPs can use when discussing EI with families/caregivers:

“EI is essential to the development of your baby. EI helps babies build strong communication and language skills during the most important window for brain development by teaching parents strategies for communicating with a DHH child.”

“Starting EI as early as possible helps your child meet key developmental milestones in language, social-emotional skills, and learning by teaching you strategies to support their unique needs.”

“EI can help your child reach important developmental milestones and give you tools and strategies to support their growth at home and in daily routines.”

“The EI evaluation is not a commitment for hours of therapy. The evaluation does not require enrollment in services.”

“The EI evaluation provides useful information and increases access to resources and supports, if needed.”

“EI services are often provided at no cost or on a sliding scale, and sessions are designed to fit into your family’s schedule and your preferred location, such as your home or your child’s child care setting.”

“Connecting with other families can often be helpful in navigating EI. Would you like me to connect you with your local Hands and Voices chapter?”

Additional Resources for Providers

Providers seeking more information about EHDI benchmarks, EI programs, and/or other referral supports such as family-based organizations can:

For questions and/or technical assistance, please contact the EHDI Provider Education Center. 


This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $300,000 with 0% financed with nongovernmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS or the U.S. Government

Last Updated

11/02/2026

Source

American Academy of Pediatrics