ECI in Texas: How Early Childhood Intervention Works, and How Private Therapy Fits Alongside It

The short answer: Early Childhood Intervention (ECI) is Texas's statewide program for children from birth to 36 months who have a developmental delay, a disability, or a medical diagnosis that can affect development. Any parent can refer their own child. The evaluation is free, and ongoing services are billed on a sliding scale based on family size and income. No family is turned away because they can't pay. ECI ends at your child's third birthday, when support can move to your school district. Many families also start private speech, occupational or ABA therapy alongside ECI, because the two do different jobs.

If you're reading this because something about your toddler's development has you wondering, you're in the right place. Noticing is the first step, and you don't need a diagnosis, a doctor's referral, or certainty to ask for help in Texas.

What is ECI?

ECI is run by Texas Health and Human Services (HHS) through local ECI programs across the state. It's part of the federal Individuals with Disabilities Education Act (IDEA), which requires every state to offer early intervention for infants and toddlers. In Texas, that program is ECI.

ECI providers work with your child and family where you already spend your days: at home, at child care, or out in the community. A big part of ECI is coaching parents and caregivers on how to build your child's skills into everyday routines like meals, bath time and play.

Who qualifies for ECI in Texas?

Your child can qualify if they are under 36 months old, live in Texas, and meet one of these criteria:

• A developmental delay of at least 25% in one or more areas: communication, motor skills, social-emotional, adaptive and self-help, or thinking and learning (cognition).
• A delay of at least 33% in expressive language, if that is the only area of delay.
• A medically diagnosed condition that's likely to cause a developmental delay.
• A hearing or vision impairment, as defined by the Texas Education Agency.

ECI doesn't diagnose autism. If you're wondering about autism, ECI can still evaluate your child's development, and a diagnosis would come separately from a physician or psychologist.

How do I refer my child to ECI?

You can refer your own child. You don't need a pediatrician's referral, although doctors, child care providers and others can refer too.

• Find your local program using the HHS ECI program search at citysearch.hhsc.state.tx.us. Search by your city or ZIP code.
• Or call the HHS Office of the Ombudsman at 877-787-8999 and select option 3.

Under federal law, the evaluation, assessment and first planning meeting for an eligible child must happen within 45 days of the referral. That planning meeting produces an Individualized Family Service Plan (IFSP), which sets your goals and services.

What does ECI cost?

These parts of ECI are free to every family: the evaluation and assessment, case management, developing your IFSP, and translation or interpreter services.

For ongoing services, Texas uses a Family Cost Share: a sliding-fee scale based on your family size and income, after allowable deductions. You can also authorize ECI to bill your child's private insurance or Medicaid. Texas HHS is clear on one point: no child or family will be turned away because of an inability to pay.

ECI and private therapy: why many families use both

ECI and private therapy aren't competitors. They're built for different jobs, and families can use both at the same time.

What ECI is built for

• Ages: birth to 36 months.
• Where: your home, child care, or the community.
• Approach: coaching parents and caregivers to weave new skills into daily routines.
• How often: set in your IFSP.
• Cost: free evaluation; ongoing services on a sliding scale.
• At age 3: ECI ends and support moves to your school district.

What private center-based therapy adds

• Ages: toddlers through the school years, with no handoff at 3.
• Where: a center with therapy rooms, gyms and classroom spaces.
• Approach: direct therapy with your child, plus parent coaching.
• How often: set by your child's plan, from a few sessions a week to intensive ABA.
• ABA therapy: available; Texas insurance usually requires an autism diagnosis to cover it.
• Cost: usually billed to private insurance or TRICARE.

Families often add private therapy when they want more hours than ECI provides, when their child needs a specific kind of support like ABA, or when they want one team that can stay with their child past age 3. Starting private therapy doesn't mean leaving ECI. Many families keep both and ask the two teams to share notes.

What happens when my child turns 3?

ECI ends on your child's third birthday. Before then, ECI helps you plan the next step:

• A transition conference is held at least 90 days, and up to 9 months, before your child turns 3. You, your ECI team and, with your consent, your school district meet to talk about what comes next.
• Your school district evaluates your child for Early Childhood Special Education (ECSE). In Texas, the meeting where eligibility and services are decided is called an ARD meeting (Admission, Review and Dismissal). It produces an Individualized Education Program (IEP).
• If your child has received ECI services for at least 90 days before turning 3 and ECI has notified the district, the evaluation, ARD meeting and IEP should be in place by your child's third birthday.

School services focus on what your child needs to learn and take part at school. Many families keep private therapy going alongside ECSE for support outside the school day. Our half-day school-readiness program is built for that in-between stage, when a child is heading toward a classroom but still needs one-on-one support.

Where to start in Dallas–Fort Worth and Houston

If you're in north Texas or the Houston area and want to explore private therapy alongside ECI, these are our Texas centers:

• Keller: ABA, speech therapy, occupational therapy and school readiness, near Davis Boulevard and Keller Parkway. Families come from Keller, North Richland Hills, Watauga, Colleyville and north Fort Worth.
• Southlake: ABA, speech therapy, occupational therapy and school readiness, near Davis Boulevard and Southlake Boulevard. Families come from Southlake, Trophy Club, Grapevine and Bedford.
• Denton: ABA therapy on Fort Worth Drive, close to Corinth, Argyle, Sanger and Aubrey.
• Missouri City: ABA therapy and school readiness in Riverstone, close to Sugar Land, Stafford and southwest Houston.

In Texas we accept Aetna, BCBS of Texas, TRICARE, UnitedHealthcare and United Behavioral Health, and we check your benefits before your child's first visit. Learn more about how insurance covers ABA.

Common questions

Can I refer my own child to ECI, or do I need a doctor?

You can refer your own child. Use the HHS ECI program search or call 877-787-8999 and select option 3.

Can my child get ECI and private therapy at the same time?

Yes. They serve different purposes, and many Texas families use both. Ask both teams to share goals so your child gets one consistent message.

Does ECI provide ABA therapy?

ECI focuses on developmental support and parent coaching in everyday settings. ABA therapy is usually provided by private providers and, in Texas, insurance typically requires an autism diagnosis to cover it.

What if my child is already close to 3?

You can still refer. If your child turns 3 soon, ask about the school district's Early Childhood Special Education evaluation, and consider starting private therapy so support doesn't pause during the handoff.

Sources: Texas Health and Human Services, Early Childhood Intervention Services and Family Cost Share; Texas Education Agency, guidance on the ECI-to-school transition; IDEA Part C regulations.