Early Steps is Florida's early intervention program for children from birth to 36 months. Whether your child can enroll depends on eligibility rules written by the Florida Department of Health. The rules mention "1.5 standard deviations" and "informed clinical opinion," which can sound confusing when you are worried about your toddler. This guide explains each route into Early Steps in plain English, using the Early Steps Policy Handbook updated 14 October 2026.
What are the ways a child can qualify for Early Steps?
Policy 3.1.1 says a child under 3 is eligible if they meet one of these criteria:
- An established condition (Policy 3.1.2): a diagnosed condition known to affect development.
- A developmental delay (Policy 3.1.3): measured by testing and the team's professional judgment.
- An at-risk condition (Policy 3.1.5): a physical or mental condition known to create a risk of delay. This route gives a limited set of services.
Section 391.308(3), Florida Statutes, lists a wider menu of possible criteria, but it applies them only "if specific funding is provided, and the associated applicable eligibility criteria are identified, in the General Appropriations Act." The handbook is where the criteria actually in use are written down, so that is what this guide follows.
Does an autism diagnosis qualify my child automatically?
Autism spectrum disorder is on the list of established conditions, along with genetic and metabolic disorders, neurological disorders, severe attachment disorder, sensory impairment (vision or hearing), and infants who weighed less than 1,200 grams at birth. A child with an established condition does not need to show a measured delay.
The paperwork matters. Most established conditions need "a written confirmation from a licensed physician of the diagnosis." For autism and severe attachment disorder, the handbook also accepts confirmation from "a healthcare practitioner acting within his/her scope of practice" (Policy 3.1.2 B). The written confirmation must be in your child's Early Steps record. If your child is diagnosed, bring a copy of the report. Our article on autism diagnosis and Early Steps eligibility goes into more detail.
What do the 1.5 and 2.0 standard deviation rules mean?
For a child without an established condition, Policy 3.1.3 A is the key rule. A child is eligible when they have "a developmental delay as measured by appropriate diagnostic instruments and procedures and informed clinical opinion that exceeds:
1. 1.5 standard deviations below the mean in two or more developmental domains, or
2. 2.0 standard deviations below the mean in one or more developmental domains."
A standard deviation is a measure of how spread out scores are. Standardized developmental tests compare your child's skills with a large group of children the same age. The "mean" is the average score. A score 1.5 standard deviations below the mean means your child's skills in that area are well below what most children their age show. A score 2.0 standard deviations below means a larger gap.
As a rough guide, on tests that report a standard score with an average of 100 and a standard deviation of 15, 1.5 standard deviations below the mean is about 77.5, and 2.0 below is 70. Not every test uses that scale, so ask the evaluator how your child's scores compare with the cut-offs.
| Route | Size of delay | How many areas |
|---|---|---|
| Policy 3.1.3 A.1 | More than 1.5 standard deviations below the mean | Two or more domains |
| Policy 3.1.3 A.2 | More than 2.0 standard deviations below the mean | One or more domains |
Which areas of development are tested?
Policy 3.1.3 B lists five developmental domains:
- Cognitive: thinking, learning and problem solving.
- Physical, including vision and hearing: gross and fine motor skills and health.
- Communication: understanding and using sounds, gestures and words.
- Social or emotional: playing and relating to other people.
- Adaptive: self-help skills such as feeding, dressing and toileting.
Any Early Steps evaluation must find your child's developmental status in each of these areas (Policy 3.5.2), and at least two people from two or more separate disciplines must be involved (Policy 3.4.8). For many autistic toddlers, the communication and social or emotional domains show the clearest differences, but the team looks at all five.
What is "informed clinical opinion"?
Test scores are not the whole picture. Informed clinical opinion is the evaluation team's professional judgment, based on observation, your description of daily life, records and other information. Policy 3.1.3 D says it "may be used to establish a child's eligibility for Early Steps even when an evaluation instrument does not indicate eligibility." It works only in one direction: the handbook adds that "in no event may informed clinical opinion be used to deny a child's eligibility for Early Steps when scores on the evaluation instrument(s) meet Early Steps eligibility criteria."
Policy 3.1.4 also says no single procedure can be the only basis for the decision. The process must include your child's history (including an interview with you), their level of functioning in each area, information from others who know your child when needed, and a review of records. Your observations count, so come ready to describe what you see at home.
Can recent records be used instead of new testing?
Yes, in some cases. Policy 3.1.3 C says your child's "medical and other records may be used to establish eligibility based on developmental delay without conducting an evaluation" if the records show your child meets Florida's criteria and "Are from within the past 90 days." Policy 3.5.1 similarly says a new evaluation is not needed if your child "Has had an evaluation within the past 90 days" using an accepted tool.
If your child had a developmental evaluation in the last three months, from a hospital, a developmental pediatrician or a private therapist, bring it. It may save time. Note that a standard score is still required as part of the process when eligibility is based on delay or on records (Policy 3.1.6).
What does the at-risk route give my child?
A child with "a physical or mental condition known to create a risk of developmental delay" can be eligible on an at-risk basis, confirmed in writing by a licensed physician (Policy 3.1.5). Services for this group are narrower: individualized family support planning, service coordination, developmental surveillance and family support. If a delay appears later, the team can review eligibility.
What if my child is found not eligible?
- You must receive a copy of the evaluation results (Policy 3.1.10).
- Early Steps must give you prior written notice, including your right to dispute the decision (Policy 3.5.4). Section 391.308(4)(b) also requires written information on the right to appeal.
- You can ask Early Steps how to re-refer if new concerns come up, and you can pursue a private evaluation.
Eligibility based on a delay is not permanent either. Continuing eligibility is re-determined at the annual IFSP review (Policy 3.1.11). Families moving to Florida from another state must meet Florida's criteria, even if the child was served in another state's program (Policy 3.1.7).
Next steps
Anyone can refer a child to Early Steps, including parents, by calling 1-800-218-0001 or using the online referral at floridaearlysteps.com. Our Early Steps guide explains the program as a whole, and the 45-day timeline shows what happens after you call.
Early Steps and private ABA are separate. If your toddler has an autism diagnosis, or you are seeking one, Hope Center can talk with you about ABA, parent training and how to coordinate goals with your IFSP. We have no waitlist and offer a free insurance benefits check. Contact us or call 561-337-8865.