First Steps

last updated: Jan 2025

Indiana's First Steps System provides early intervention services for families who have infants and toddlers with developmental delays or who have a diagnosed condition that has a high probability of resulting in a developmental delay in the future. Services are coordinated to give qualifying children the widest possible array of early intervention resources.

Who is Eligible for First Steps Early Intervention Services?

A child (birth to third birthday) is eligible for First Steps services if he/she demonstrates a 20% delay or -1.5 standard deviation in function in two areas of development (called domains) or a 25% delay or -2.0 standard deviation in function in one area of development. The developmental domains are cognitive, physical (fine motor, gross motor, hearing, vision), communication, social or emotional, and adaptive development. A child may also be eligible because of a high probability of developmental delay. Conditions that would indicate such a condition may include chromosomal abnormalities or genetic disorders, neurological disorders, congenital malformations, low birth weight or severe toxic exposure, sensory impairments, and neurological abnormality in the newborn period. Additional information about eligibility can be found here: https://www.in.gov/fssa/firststeps/parents/how-to-get-help.

What Services are Available?

Services children may receive through Indiana’s First Steps System include:

Assistive Technology Services
Audiology Services
Family Education
Health Services
Medical Services (for diagnostic purposes only)
Nursing Services
Nutrition Services
Occupational Therapy
Other Services
Physical Therapy
Psychological Services
Service Coordination
Special Instruction (formerly “Developmental Therapy”)
Speech Language Pathology
Social Work Services
Transportation
Vision Services

Starting First Steps Services

Parents with concerns about their child’s development may call their local First Steps System Point of Entry office (found here: https://www.in.gov/fssa/firststeps/first-steps-offices/), explain their concerns, and ask to have their child evaluated. Anyone can refer a child to First Steps, including: family, friends, a service provider, or the child’s physician. Visit https://www.in.gov/fssa/firststeps/parents/steps-to-first-steps/ to view the intake process.

Cost Of First Steps Services

Families whose household income is at or above 250% of the federal poverty guidelines are subject to a shared system of payment for First Steps services. Indiana’s sliding scale fee program is called First Steps Cost Participation. Families may request that expenses related to the medical and personal care of a family member be considered in the calculation of the family income and co-payment amount. Such expenses may include health insurance copayments and premiums, prescriptions and hospital expenses. Co- payments are charged for most First Steps services. There are several services, however, for which a co-pay will not be charged. These include an evaluation, development of an Individual Family Service Plan (IFSP), service coordination, and procedural safeguards.
Any questions about co-pays and services can be answered by First Steps Intake or Service Coordination staff.

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Programs and systems change often. It is important to ensure that you are using the most current information. Please check https://www.inf2f.org/fact-sheets.html for the most recent edition.

This fact sheet was 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 $96,750 with 89% percent financed with nongovernmental sources. The contents are those of INF2F and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. For more information, please visit HRSA.gov.