"I was a nervous wreck when Early Head Start recommended that my toddler get an evaluation. I was scared of what the results would be. But the program held my hand every step of the way. And now she's getting the help she really needs. Thank you, Head Start!" – Head Start parent

This chapter describes the referral and evaluation process. You support families and their children through what is often an unfamiliar, and maybe scary, referral process. You coordinate with the IDEA Parts C and B local agencies to provide timely and effective referrals and to complete the evaluations.

Key Ideas

• You work with local agencies that provide services under the IDEA. These agencies handle evaluations and decide if a child qualifies for special services.
• You help:
  • Make referrals quickly and correctly.
  • Ensure families understand each step of the process.
  • Clarify what staff and families need to do after the evaluation.
  • Make sure children get the help they need — whether or not they qualify for IDEA services.
• Your program must support:
  • Children who qualify for IDEA services.
  • Children who don’t qualify but still need extra help.
  • Children who are waiting for an eligibility decision.
• Programs must act quickly when screening results or other information show a child may need help.
• Part C and Part B have different rules for who qualifies, how long the process takes, and what services are offered.
• Families are partners in the process. Keep them involved and informed.
• Respect each family’s experiences, backgrounds, and language throughout the referral and evaluation process.
• Your program should have a written agreement with local Part C and Part B agencies. This outlines how referrals and evaluations will be handled.
• A coordinated approach is key. This helps make sure every child and family can fully participate in the program while waiting for or receiving services.

What is the referral and evaluation process in Head Start programs?

Child screenings and assessments, 45 CFR §1302.33 details the referral and evaluation process. The Performance Standards require programs to promptly address needs the that screening results and other information reveal. The needs or concerns might be related to an area of development, or they may be medical or dental in nature.

Parents and families must consent to a referral and evaluation. If they don't consent, the program can document the discussion and family’s choice to put in the child's file. A program must always partner with the child’s parents, family, and the relevant local agency to support families through the evaluation process.

You refer the child with suspected disabilities or delays to the local agency responsible for implementing IDEA. That agency evaluates the child and determines if they are eligible for IDEA services.

Who is responsible for implementing IDEA?

Different agencies are responsible for providing services under the IDEA, depending on the child’s age:

• Part C (Birth to Age 3):
  The state lead agency is responsible for early intervention services. This agency varies by state and may be a health department, education department, or another public agency.
• Part B (Ages 3 to 21):
  For young children ages 3 to 5, IDEA Part B Section 619 applies. If the school district has a 619 coordinator, this person leads the formal evaluation process. They work with your program and the family to make sure everything is done correctly. In some communities, the LEA may also serve as the Part C agency, but often it is a different organization. If that’s the case, your program must have a separate agreement with each agency.

What if a child doesn’t qualify for IDEA services?

If a child’s evaluation results do not qualify them for IDEA services:

• The program must consult with a mental health or child development professional to see if the child still has a significant delay.
• If so, the program must work with the family to find other services and supports. These may be covered by:
  • The child’s health insurance
  • Section 504 of the Rehabilitation Act
  • The program’s own budget if no other funding is available

What are programs required to do?

• Under Additional Services for Children with Disabilities, 45 CFR §1302 Subpart F, programs must make sure children with disabilities:
  • Receive all services they need
  • Can fully participate in all program activities
• While a child is being evaluated for IDEA services, the program must provide individualized services and supports.
• Under Eligibility, Recruitment, Selection, Enrollment, and Attendance, 45 CFR §1302 Subpart A, programs cannot expel or unenroll children because of behavior concerns.
• If a child does not already have an IFSP (Individualized Family Service Plan) or IEP (Individualized Education Program), the program must:
  • Work with the family and a mental health consultant
  • Consider a referral to the local Part C or Part B agency

Timelines to Know

• Programs must complete screenings within:
  • 45 days of the child’s first home visit or school day
  • 30 days for programs operating fewer than 90 days
• After a referral:
  • Part B must complete evaluations within 60 days
  • Part C must complete evaluations within 45 days

Protecting Children’s Privacy

Head Start programs must protect the privacy of every child and family they serve. This includes how programs collect, store, share, and manage child records. Protections for the Privacy of Child Records, 45 CFR §1303 Subpart C outlines the rules. 

Key privacy practices include:

• Confidentiality: Only authorized staff and relevant agencies may access a child’s records.
• Parental rights: Families must be informed of their rights to view, request changes to, or receive copies of their child’s records.
• Secure storage: Programs must store records in a way that protects them from unauthorized access.
• Informed consent: Before sharing information with outside agencies, programs must get written permission from the child’s parent or guardian.
• Transparency: Families should know who has access to their child’s information and how they will use it. 

Respecting privacy builds trust with families and ensures that sensitive information is handled with care and professionalism.

What is your role with families during referral and evaluation?

As a DSC, you ensure families understand each step in the process, tell them what they need to know, and prepare them to make decisions. You also debrief with families after any meetings. Talk through what you learned, discuss the next steps, and prepare questions for the next meeting. If they need translation or interpretation services, you may need to coordinate this with your program leadership team or community partners.

In some states, Head Start staff may participate in this meeting as the general education representative. You may want to include the child's teacher as part of the team. In other states, staff can't attend unless family members invite them. Most families want Head Start staff to join them. Families may not know that they can invite Head Start staff or other specialists, so check on your state’s laws.

Planning for Partnerships

Your program works closely with Parts C and B local agencies to support children with disabilities and their families. Together, the team:

• Clarifies roles and responsibilities for everyone involved in evaluations, eligibility decisions, and IFSP or IEP meetings. This helps ensure each partner understands their part in the process.
• Follows clear timelines to keep evaluations, meetings, and services on schedule.
• Maintains consistent communication with families. Using tools like phone calls, emails, video chats, and social media helps keep everyone informed — especially nonresidential parents or other key family members.
• Plans ahead for challenges, such as scheduling conflicts or difficulty reaching family members.
• Agrees on steps to support families through any obstacles.
• Protects the confidentiality of children’s records by following privacy laws and using secure systems.
• Engages all key family members in decision-making. Family engagement staff can help you identify who should be involved and how to include them effectively.

This coordinated approach ensures that your program and its partners work as one team to provide strong, family-centered support.

What is your role in helping families understand the process?

Families often have many questions when their child is being evaluated for services. They may feel unsure about the results, worry about their child being labeled, or believe common myths about disabilities. Some families may feel social pressures or have negative views about disabilities. Families might worry about how this could affect their child’s future.

You and your team can help by listening, answering questions, and offering support. This process can feel new and even scary for families, so it’s important to guide them with care and respect.

What Families Need to Know

As the disability services coordinator, you play a key role in helping families understand what’s happening. Here are some important points to share:

• The evaluation process takes time. It can take up to 45 days for infants and toddlers, and 60 days for preschoolers..
• It may feel like a long wait. Let families know this is normal. You can also check in with the local IDEA agency to make sure things are moving forward.
• Your program may have an MOU with the agency. This agreement explains the timelines and what to do if someone misses a deadline.
• Children don’t have to wait for support. While waiting for results, your program can still provide individualized support to help the child participate in daily activities.

How can you help families prepare for an IFSP or IEP meeting?

1. Describe who will be there and why. Briefly explain the purpose of the meeting. Describe the assessments your program used with the child. Discuss the evaluations the specialists completed on the child. If possible, give the names of the participants and their responsibilities.
2. If parents and families want, rehearse questions or comments they might want to make. Also, ask if there are points they would like you or other program staff to make.
3. Help families gather and present information about their child. They can make a "My Child" book that includes previous reports from specialists and teachers. It can include photos, videos, and work samples that show what the child can do and how they learn.
4. Review the meeting's physical setup with your program staff, the IDEA agency, and the parents and family. A round table where the family sits next to familiar Head Start staff sends a message: "We want you to be our partner. We will advocate together for your child." A room with a long table where everyone sits far apart and where eye contact is difficult conveys a different message.
5. Tell parents and family how long the meeting will take.
6. Explain their right to appeal a decision.
7. Refer families to the Parent Training and Information Center (PTIC) in their state for support in the IFSP or IEP process and understanding their rights under the IDEA.

What is your role with other program staff during referral and evaluation?

The waiting period for determination of IDEA services is valuable learning time for a child. You must provide individualized support during the interim period. Typically, you coordinate with the child's family, education staff, mental health consultant, and others to develop a Child Action Plan (CAP). It may include teaching strategies and ways to modify the learning environment for the interim. If the evaluation determines the child is not eligible for IDEA services, your program may decide to keep the CAP and update it as needed.

During the interim period, you also may need to coordinate with the health services manager. If your program referred children with special health concerns to the IDEA agency because of suspected disabilities, they may need a CAP to specify their interim services. The health team can help you and the education staff ensure that children engage in learning activities.

To learn more about how to individualize support while awaiting IDEA determination for a child, refer to Standards in Action: Interim Services for Children with Disabilities or Suspected Delays.

Your program's management team also works with you during the referral and evaluation process. Accurate and timely recordkeeping is necessary. Your program must develop a system to track referrals and services and to monitor treatment plans. If your program is small, you might be able to do this by hand, but it's more efficient to use an online tracking system. If you and program management decide to purchase new software, the cost of the tracking system will have to be included into the program budget, along with any training costs. Whether tracking is done by hand or online, confidentiality is required to maintain secure records. See Appendix C for a sample tracking sheet.

The Evaluation: Determining Eligibility for IDEA Services

Depending on the child’s age, the early intervention or special education partners complete a diagnostic evaluation. The partners collaborate with qualified professionals in speech and language, cognitive, hearing, vision, psychology, and physical development. The evaluation team considers all the data your program provides, including screening results, child assessments, child health records, and information from the family.

After specialists complete their evaluations, the team gathers to determine whether the child is eligible for services. 

Eligibility criteria differ under Part C and Part B. Eligibility and Service Delivery Policies: Differences Between IDEA Part C and IDEA Part B compares the legislation. It's important for you to know where the differences lie.

Part C Eligibility

Under Part C, an eligible infant or toddler has one of the following:

• A delay in cognitive, physical (including vision and hearing), communication, social, emotional, or adaptive development
• A diagnosed physical or mental condition that has a high probability of resulting in developmental delay
• Is “at risk” for a substantial developmental delay if they don’t receive early intervention services, due to biological or environmental factors

Each state determines the percentage of delay that establishes eligibility for a developmental delay. The state establishes the list of physical or mental conditions that have a high probability of resulting in developmental delay. States also determine whether they will add a service eligibility category for at-risk infants and toddlers.

If an infant or toddler is eligible for IDEA services, the local agency team starts writing an IFSP. It specifies the early intervention services the young child and family will receive and where they will get services. The law requires children receive the services in natural environments in the context of routines and activities that are part of the child and family's daily life. The natural environment can be a family's home, as in a home-based program, or a group care setting.

Part B Eligibility

For children and youth ages 3 to 21, IDEA Part B lists 14 eligible categories for types of disabilities:

• Autism
• Deaf blindness
• Deafness
• Developmental delay
• Emotional disturbance
• Hearing impairment
• Intellectual disability
• Multiple disabilities
• Orthopedic impairment
• Other health impairment
• Specific learning disability
• Speech or language impairment
• Traumatic brain injury
• Visual impairment (including blindness)

The federal definitions help states define who is eligible for free, appropriate public education under IDEA. The law allows states to decide whether they include the term "developmental delay" in their definition of a child with a disability and for what age range. Some states are more stringent about the use of the term developmental delay. How your state defines developmental delay affects how your LEA uses the term. This affects who in your program qualifies for services under IDEA Part B. Learn about your state's laws, as well as the federal law.

If a child age 3 or older is eligible for IDEA services, the LEA prepares an IEP that specifies the learning goals, the special education services the child will receive, and where the LEA will provide the services. The law requires that the child be placed in the LRE. This means, when possible, the child is in a learning environment with children without disabilities and engages in activities with supports and services as needed.

Supports for Children Who Are Not Eligible for IDEA Services

Your program must continue to provide interventions and individualized supports to children who received a diagnostic evaluation but are not eligible to receive IDEA services. Programs are also required to support their families. As the DSC, you work with your team and the child's family to update or develop a CAP. The family may also explore eligibility under Section 504 of the Rehabilitation Act.

There are important distinctions:

• A CAP is an internal Head Start plan, sometimes called a Child Services Plan. It details how to help the family while they wait to learn if their child is eligible for IDEA services. Writing down the plan can help, but it is not required. A mental health consultant, educators, and other staff can help you write the plan. Include families; their input will strengthen the plan. The CAP can be short-term or long-term if a child does not have a disability but still needs support.
• Only the LEA can determine eligibility for a 504 Plan. If a child is not eligible to receive IDEA services but would benefit from more supports, a 504 Plan might apply. The law does not require a written plan or family participation in decision-making. School districts handle 504 plans differently. Many districts do not write them for preschool children. A 504 Plan does not include funding.

School districts handle Section 504 plans differently. Many districts do not write Section 504 plans for preschoolers with disabilities. Find out about the policies in your school district so you can guide parents and family.

When IDEA deems a child ineligible for its services but needing support, weigh the options with the family. Your program may have already prepared a CAP for interim services during the evaluation process.

• Ask the family if they want the school district to explore a Section 504 Plan for their child. Your input, along with that of specialists, other staff, and the mental health consultant, can help a family decide.
• Parents and family must consent to release medical records or other information to help support eligibility for a Section 504 Plan.
• If the district determines the child is eligible under Section 504, the 504 Plan may replace the CAP. However, Head Start staff should continue to provide individualized supports, especially if the 504 Plan lacks specific strategies.
• If the child does not qualify under Section 504, the CAP can continue as a long-term support plan within your program.

Through ongoing assessment and recordkeeping, your team may decide to refer a child again later.

Your program has options to develop plans for children who need support but don't qualify for IDEA services. Tailor the Section 504 Plan or CAP for the individual child. A one-size-fits-all approach does not work!

Review this infographic to help you choose the correct plan for children who do and don't qualify for IDEA. It captures the steps from when concerns are identified to when the final plan is in place.

Payment System

IDEA funding for Part B and Part C services vary. It’s important to understand the differences.

Part B: Free Appropriate Public Education (FAPE)

Part B entitles children ages 3 and older who qualify for special education to FAPE, which means:

• Families do not pay for IDEA services.
• Public agencies provide and monitor services.
• Services must meet the standards of the  State Educational Agency (SEA).
• Services include appropriate early childhood, elementary, or secondary education.
• Services must align with the child’s  IEP.

Part C: Family Cost Participation

Part C services are not automatically free. Instead, each state must develop a system of payments that outlines:

• What services are free (e.g., evaluations, service coordination, IFSP development).
• What services may be billed to public benefits (e.g., Medicaid) or private insurance?
• Whether families may be charged fees for certain services (e.g., therapy), often based on a sliding fee scale.

States must:

• Inform families of their rights and responsibilities.
• Obtain written consent before using insurance or charging fees.
• Ensure that inability to pay does not delay or deny services.

If a Child Is Not Eligible for IDEA Services

If a child has a significant delay but does not qualify for IDEA services:

• Programs must still partner with families to find appropriate services and supports.
• The child’s health insurance may cover some costs.
• Programs may use Head Start funds to provide supports when no other funding is available.

Examples of program-funded supports include:

• Purchasing assistive devices
• Hiring a part-time classroom aide
• Providing individualized strategies to help the child fully participate in classroom activities

This ensures that all children, regardless of eligibility, receive the support they need to thrive in the Head Start program.

People Who Can Help You

• Family service manager and staff
• Health managers and staff
• Education managers, coaches, education staff, and home visitors
• Management team
• Mental health consultant
• Child development professional
• Early intervention providers
• Special education providers

Questions to Ask Your Team

Referral Process

• How does our program handle referrals for evaluation?
• What steps do we take before deciding to refer a child?
• How do we refer a child who has special health needs?
• Who is responsible for making the referral?
• How do we involve parents and family members in the referral process?

Family Communication and Support

• How do we explain the IDEA evaluation and eligibility process to families?
• What do we do to support families throughout the process?
• Do we provide interpreters or translators when needed for meetings with early intervention or special education teams?

Program Reflection

• What parts of our referral and evaluation process are working well?
• What challenges have we faced? How can we improve?

Additional Support Plans

• If a child qualifies for a Section 504 Plan, do we have clear steps and procedures in place?
• Do our internal CAPs meet each child’s needs effectively?

Tracking and Monitoring

• Is our tracking system for referrals and services accurate and easy to use?
• Do we need to make any changes to improve it?
• How often does a representative from the Head Start program attend evaluation meetings or IEP or IFSP meetings? How do we select that person? How do we prepare both the program representative and the parents and family for meetings?

Tips to Ensure a Smooth Referral and Evaluation Process

As a DSC, you are the team leader for any evaluation follow-up. You coordinate the people in the process and remove barriers and challenges at each step.

• Maintain accurate and thorough records. Know where children are in the process. Have referred children seen the appropriate specialists? Are their families on board? How long before you learn whether the child qualifies for IDEA services? If they do not qualify, what is next?
• Make sure the team meets deadlines. Ensure everyone is aware of the legal timelines.
• Support parents and family to be the primary advocates for their child. Help them prepare for the IFSP or IEP meeting. Remind them to identify their child's strengths.
• Facilitate communication. Communicate regularly with staff, partners, and families. This will help you resolve issues that slow down the process or add confusion.
• Work with the health manager. A child with special health concerns should first see a healthcare provider. If needed, they will then be referred to the local IDEA agency.
• Debrief with stakeholders. Find out what could be done better.
• Stay current on legislation. Tell your early intervention and special education partners about changes in federal or state laws that may affect referrals and services.
• Work with your program managers to review and update MOUs. Ensure they reflect effective processes and address any concerns from partners.

See Appendix C for a child tracking sheet. For a detailed list of tasks related to referral and evaluation, refer to Appendix D.

Scenario: Supporting Leroy Through the Evaluation Process

Leroy is a 4-year-old in the Lakeside Head Start program. His screening results, along with comments from his parents and teachers, show some concerns about his development. He may have delays in language and thinking skills. Hillary, the Head Start disability services coordinator, refers him to the local education agency (LEA) for an evaluation to see if he qualifies for preschool special education under IDEA.

Team Meeting and Observations

Samantha, the school district’s parent coordinator, sets up a meeting. She meets Leroy’s mother, a school psychologist, and the Head Start team. During the meeting:

• Leroy’s mother and teachers share their concerns.
• The psychologist gathers input from the bus driver and nutritionist, who say Leroy doesn’t talk much.
• Teachers say Leroy struggles to follow two-step directions, stay focused, and manage his emotions.

The psychologist explains that she will use a play-based assessment as part of the evaluation. Samantha describes the rest of the process and asks Leroy’s mother how she wants to be involved. Hillary explains that Lakeside includes children with and without disabilities in the same classroom and supports all children. This reassures Leroy’s mother, who already uses some of the program’s family services. Leroy’s father can’t attend the meeting, so the team writes notes for him.

Classroom Observation

The team agrees that the evaluation team should observe Leroy during a classroom activity. They want to see him in a familiar setting where he feels comfortable. On observation day:

• Hillary, Leroy’s mother, and the psychologist watch him together.
• Hillary checks in with the mother to confirm her observations and takes notes.
• The LEA team also completes other evaluations to assess Leroy’s speech and development.

Providing Support While Waiting

It takes time to determine if Leroy qualifies for IDEA services. While they wait, Hillary makes sure Leroy still gets support. She works with the mental health consultant and education staff to create strategies that help Leroy fully participate in classroom activities.

Eligibility Meeting and Family Involvement

Both of Leroy’s parents attend the meeting to review the evaluation results. The school district and Head Start staff:

• Involve the parents in the discussion.
• Ask for their questions and observations.
• Make sure they understand the information.
• Assure them that their goals for Leroy will be part of any special education plan.

By the end of the meeting, Leroy’s parents feel confident that the team will include them in decisions and work together to support their child.