Early Childhood Disabilities and

Special Education
BY KRISTINE SLENTZ, PHD, Western Washington University, Bellingham

The earliest years of life are full of rapid changes and transitions. Young children are all precious, especially
to their caregivers, regardless of challenges to health, learning, and/or development that are common prior
to school entry. Parents and early childhood teachers are usually the first to notice when infants, toddlers,
and preschoolers are not developing and learning as expected. Parents and teachers are also in the best
position to provide additional support and special care when it is needed. There is not always a clear
difference, however, between the usual ups and downs of the early childhood years and developmental
problems that indicate a need for special services.
Infants and toddlers generally acquire developmental milestones in a typical sequence, but no two
develop at exactly the same rate or following the same patterns. Caregivers often wonder how to tell the
difference between a child’s unique timetable and a developmental problem. For example, most infants
crawl before they walk, but some do not. A few take their first steps at 8 months and others not until 15
months. Many infants begin to use words around their first birthday, but others begin talking much later.
Parents and other caregivers often understand toddler speech that sounds like gibberish to strangers.
All preschool children are learning to get along socially, to share and take turns and use inside voices,
but some are unusually shy or overly aggressive. Both teachers and parents are familiar with common
troublesome behaviors such as interrupting, refusing, tantrumming, hitting, and biting. Most young
children quickly learn to replace problem behaviors with socially appropriate ones. Others persist in defiant
or inappropriate behavior that has a negative effect on peer and adult relationships. These examples
clearly illustrate the vast amount of variation among typically developing children. The hard questions
teachers and caregivers sometimes face include: At what point does an individual difference in the rate,
sequence, or pattern of early development indicate a problem? When do the common problems of early childhood
become serious enough to require special services?

WHAT IS A DISABILITY?
The concept of disability has many definitions and components, all of which sort children into two groups:
those who have disabilities and those who do not. In reality, applying the concept of disability to early
development can be confusing. Some children receive disability diagnoses as newborns, although
developmental and learning problems may not become evident for some time. Conversely, parents and
teachers often have concerns about the development and learning ability of some children long before a
disability is identified.

Definitions
Dictionary definitions for ‘‘disability’’ include words such as incapacity, disadvantage, and handicap, and
indicate that disability has a negative effect on health, development, and/or learning. Medical definitions
include diagnoses such as Down syndrome, cerebral palsy, Fragile X syndrome, traumatic brain injury, and
spina bifida. Such labels refer to specific conditions that compromise a child’s ability to interact, move,
grow, and/or learn at expected rates and in typical sequences. This handout addresses early disabilities
and special education services that address early developmental and learning needs in very young children.

IDEA 2004
A federal law entitled Individuals with Disabilities Education Improvement Act (IDEA 2004) provides eligible
children, starting at age 3, the right to special education services in U.S. public schools. Preschool children
ages 3 to 5 are served under Part B of IDEA, which addresses assessment, individualized programs, and
placements for 3- to 21-year-olds. Some states also provide special education services to infants and toddlers

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under Part C of the same law. IDEA identifies specific N Move with symmetry, balance, and coordination in
disability categories such as orthopedic and other health increasingly upright postures such as sitting, crawling,
impairments, specific learning disabilities, autism, blindness walking
and deafness, and mental retardation. Each state defines N Chew and swallow a variety of solid foods
disability to reflect health, learning, and developmental N Use sounds and gestures to communicate; combine
problems that can be addressed by special education. To consonant and vowel sounds to make words
be eligible for special education services, a child must
have a disability that meets the state’s definition for at
least one of the IDEA categories and must also need 12 Months to 3 Years
special services. By the time children are 3 years old, they typically
Infants, toddlers, and preschoolers are most often have learned the basic skills necessary for independ-
eligible under the broad disability category of devel- ent movement, communication, and social inter-
opmental delay because eligibility criteria for a more action. Disabilities identified during this period
specific disability category tend to be unreliable or involve conditions that interfere with talking, walking,
inappropriate for very young children. State definitions relating to peers, and using hands. Referrals for
vary somewhat, but in general a developmental delay is special services may be appropriate for 3-year-olds
considered to be significant disruption in the process of who do not:
early development that is likely to have a negative effect on
school performance. Temporary disruptions (such as N Use motor skills in play (running, climbing, jumping)
illness, moving, or emotional upset) and minor departures N Use fingers and hands to draw, build block structures,
(such as walking, talking, or completing toilet training later play with small toys
than usual) are usually resolved quickly with no lasting
N Play near and with peers; begin pretend play
impact. A developmental delay, on the other hand, carries
N Continue to increase vocabulary and combine words
long term implications and the need for special care and
into increasingly longer sentences
support. Developmental delay does not necessarily mean a
N Use eating utensils, undress and dress themselves,
global delay, but is found in one or more of the major areas
use the toilet
of development, including physical, cognitive, commun-
N Learn simple concepts (hot/cold; up/down; in/out;
ication, social–emotional, or adaptive development.
big/little)
N Match a variety of actions to appropriate objects in
WHEN SHOULD CAREGIVERS MAKE REFERRALS?
play (hugging stuffed toys, turning pages of books,
All young children are growing and learning new things
putting hat on head, stacking blocks)
each day. We expect to see changes in what very young
children know and are able to do from one week to the
next. For this reason, identification of disabilities involves
comparisons between each child and his or her peers, as 3 to 5 Years
well as monitoring changes in growth and development During the preschool years children combine and
over time. Caregivers need to be familiar with expected coordinate a number of fundamental skills to become
ranges of development in order to know when a child adept at communicating, moving about, socializing, and
might be showing signs of a significant delay or disability. learning new information. Referrals may be in order for
6-year-olds who do not:
Birth to 12 Months
Newborn infants have small repertoires of simple N Participate in groups; attend to adult leading groups of
behaviors such as looking, sucking, turning eyes and children
heads, waving arms and legs, cooing, and crying. Most N Engage in cooperative and imaginative play with peers
disabilities that are identified during infancy involve N Ask and answer simple questions; consistently use full
conditions that have a pervasive effect on health, basic sentences
movement, sight, and/or hearing. Serious disabilities are N Use balanced and coordinated motor skills in physical
often identified at birth or during first year well-baby play
checks. Infants should be referred for evaluation if, by N Show understanding of print concepts (‘‘reading’’
their first birthdays, they do not: signs, logos, familiar books; ‘‘writing’’ notes, lists,
labels)
N Develop consistent sleep/wake patterns and routines N Demonstrate beginning knowledge of letters and
N Calm when familiar caregivers hold, cuddle, and talk numbers
soothingly N Eat, dress, and toilet independently

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N Use present, past, and future tenses of primary eligibility for special services. Comprehensive evaluations
language; use descriptive words (adjectives and generally involve a very careful and detailed assessment
adverbs) of the skills a child has in each area of development, and
are often conducted by a multidisciplinary team of
It is important to consider the child’s learning professionals.
experiences when determining if preschoolers are truly
having difficulty with these skills. A child who has never Birth to 3 Services
been to preschool and has mild delays in some of these Early intervention services for infants and toddlers with
preacademic skills may only need exposure to these special needs, including eligibility evaluations, are
types of tasks to ‘‘catch up’’ with normally developing provided by school districts in some states, and by
peers. health and human service agencies in other states.
Once a child is determined to be eligible under Part C
IDENTIFYING DISABILITIES IN EARLY CHILDHOOD of IDEA, further assessment focuses on identifying the
It’s important to identify developmental delays and functional skills that very young children need to
disabilities in early childhood because young children participate in daily routines and family life, such as
must be determined eligible to receive services under eating, sleeping, moving about, interacting, and playing.
IDEA legislation. Young children have no time to lose Therapists, psychologists, and early interventionists
when they need special services, and research suggests may participate on assessment teams for birth to
that earlier initiation of services is associated with 3-year-olds, and parents also are considered to be
improved outcomes. The process for determining the important members of assessment teams. The team
presence of a disability is fairly consistent for children also discusses family priorities, concerns, and resources
from birth to school age. for the child being assessed. An Individualized Family
Service Plan (IFSP) combines family priorities with child
Early Identification and Screening assessment results to determine unique and relevant
Unless a medical diagnosis is made at birth or during a outcomes for each family. Services for eligible infants
well-child visit, the first step in identifying a young child’s and toddlers are provided in ‘‘natural environments’’
disability is a concern raised by someone familiar with such as children’s homes, neighborhood play groups,
the child. Usually a parent, preschool teacher, or other child-care settings, parks, libraries, or other places
caregiver becomes worried about a young child’s where families participate with infants and toddlers
development or learning because they have noticed without disabilities.
delays in the skills listed on the previous pages.
Pediatricians and child-care providers are often the first Preschool Services, Ages 3 to 5
to receive referrals from parents, discuss concerns, and Local school districts are responsible for providing
begin the process of identification. preschool special education services, including com-
The first assessment is usually a brief screening to prehensive evaluations. Children ages 3 through 5 are
determine if more comprehensive assessment is war- usually scheduled for an evaluation at the school by a
ranted. Screening assessments involve evaluating a few multidisciplinary team of professionals. The evaluation
key skills in each of the major areas of development: team may include therapists, psychologists, and
physical, cognitive, communication, social–emotional, educators who participate in a detailed assessment.
and adaptive. Pediatricians routinely conduct devel- All the assessment results are combined to determine
opmental screenings during well-child visits, and publicly if the child meets eligibility requirements and needs
funded early education programs such as Head Start also special education. If the child is eligible, an
screen children annually. In many communities, schools, Individualized Education Program (IEP) is designed
public health departments, and other agencies also that contains goals and objectives for each child.
provide early childhood screening clinics. Results of Preschoolers who are eligible for special education are
screening assessments indicate which children seem to usually served in preschool classrooms in the
be developing as expected, and also identify those for local school district, or community-based preschool
whom a comprehensive assessment is need to determine programs that enroll children with and without
if there are significant delays or disabilities. disabilities.

Comprehensive Evaluation and Services THE ROLE OF PARENTS AND TEACHERS

If screening results indicate a potential disability, a Parents and early childhood teachers often worry that
comprehensive evaluation is conducted to determine the the needs of young children with disabilities can only be
nature and severity of the problem and establish a child’s met by special therapeutic, medical, and educational

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professionals. Specialized instruction and therapies are REFERENCE
important components of special education but, first and Individuals with Disabilities Education Improvement Act.
foremost, young children thrive in settings with familiar 20 U.S.C. 1 1400–1485 (2005).
adults who know them and provide loving care. Parents
and other caregivers of children with suspected or RECOMMENDED RESOURCES
identified disabilities may find confidence in the following For Parents
guidelines: Children’s Disability Information: http://www.
childrensdisabilities.info
N Make referrals when you have a persistent concern
about children in your care. Early identification of Practical information and many links to other sites,
disabilities is strongly associated with positive out- including sites on specific disabilities.
comes. PACER Center: http://www.pacer.org
N Trust what you know about individual children and
Information for parents on advocacy, disability,
share with the evaluation team. Your area of
IDEA, services, and resources, birth–21.
expertise is the unique knowledge of children in
Parents Helping Parents: http://www.php.com
your care.
N Keep in mind that a disability diagnosis does not Guidance, support, and services designed and deliv-
change the child in any fundamental way, but it may ered from parents of children with special needs.
change how you think about the child. Remember, the
child is still the same child. For Early Educators
N Continue to participate with the child in familiar Division for Early Childhood: http://www.dec-sped.org
caregiving routines and activities. Consistency is an
important foundation for learning in early childhood. Early childhood division of the Council for
N Keep the child involved in neighborhood and com- Exceptional Children (CEC), an international profes-
munity-based services if at all possible. Children with sional organization for early childhood special
disabilities often thrive with peers in familiar early education and early intervention, with many
resources supporting inclusion of children with
childhood settings, especially with the additional
disabilities in early childhood programs.
support of special services.
National Association for the Education of Young
N Work with special services personnel to embed IEP
Children: http://www.naeyc.org
and IFSP goals, objectives, and outcomes into
ongoing routines and activities at home and in Professional organization dedicated to the well-
preschool classrooms. Individual goals, objectives, being of all young children ages birth to 8 years,
and outcomes are most meaningful when children also with resources on inclusion.
can use the skills in home, school, and community Zero to Three: http://www.zerotothree.org
activities.
N Expect to learn about a lot of new information, A wealth of practical and educational resources
acronyms, agencies, personnel, and teaching strat- specific to infants, toddlers, their families, and
egies. Many parents and early educators become professionals who serve them.
experts about the disabilities of their own children.
N Realize that referral, assessment, eligibility evalu- Kristine Slentz, PhD, is a Professor of Special Education at
ation, and diagnosis can be a very emotional process Western Washington University in Bellingham, WA and has
for parents. Early educators provide an invaluable a particular interest in early childhood assessment and cross-
service to parents by listening, being involved in the cultural work with young children and their families.
process, and offering personal support when parents
E 2010 National Association of School Psychologists, 4340 East West Highway, Suite 402,
need it. Bethesda, MD 20814—(301) 657-0270

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