Philadelphia Children Experience Delays in Early Intervention Access

The Struggles of Early Intervention in Philadelphia

When Kimberly Halevy’s son, Joshua, was three years old, she started hearing from his preschool that he was acting out. He rarely participated in circle time and had trouble playing with other kids. At first, Halevy thought getting him the support he needed would be straightforward. However, she now describes the effort to get her child support through Philadelphia’s federally mandated, publicly funded early intervention system as exhausting.

Though state evaluators found Joshua should receive multiple forms of therapy each week, it took months for any services to begin. Then, once providers contacted her, she said it became a “guessing game” whether her son would receive the home-based occupational therapy and specialized instruction he qualified for every week.

“I kept being mad at myself for not pushing,” Halevy said. “But now I realize that it’s just the program.”

Across Philadelphia, young kids like Joshua are waiting months and sometimes years for early intervention services that they are legally entitled to, according to families, therapy providers, and advocates. Federal law states a child must receive services as soon as possible after an evaluation team completes their Individualized Education Program (IEP). Pennsylvania has interpreted that to mean 14 days. But one provider said the list she can access of children waiting for speech therapy — one of several early intervention services — is sometimes more than 2,000 families long.

The Role of Elwyn in Philadelphia’s Early Intervention System

Early intervention providers are under strain nationwide, with not enough funding or staffing to meet the need. But in Philadelphia — home to 16% of the state’s early intervention population — one player is largely responsible for the system: a 170-year-old nonprofit called Elwyn that the state pays to manage the publicly funded program.

As Philly’s early intervention system struggles to meet the needs of all kids, some providers and advocates say neither Elwyn nor the state officials who oversee the program are doing enough to ensure kids get services on time.

In response to questions, Elwyn President and CEO Charles McLister said the organization works quickly to assess children and provide them with services. “For the vast majority of cases, services are provided within the defined window,” said McLister. But he acknowledged that there can be delays due to family communication, transportation, scheduling, and severe staffing shortages across the sector.

Erin James, press secretary at the Pennsylvania Department of Education, said in a statement that the department stays in close contact with Elwyn throughout the year “to remind them of their legal obligations.” James did not respond to questions about service delays for Philadelphia families. But she said that early intervention programs often lack resources. “Current funding levels for EI [early intervention] services are not sufficient because the population of students who qualify for EI services has been increasing for years,” James said.

Delays and Disparities in Access

In Philadelphia, the program’s delays are a key reason many of the city’s most vulnerable kids fall behind before they even start kindergarten, advocates say. Data from early intervention program reports the state publishes shows Philly children in early intervention programs lag behind their peers elsewhere in key growth areas, like developing social emotional skills.

“The whole idea of having to wait more than the required time is really putting kids at a disadvantage,” said Inella Ray, director of parent advocacy and engagement at the advocacy organization Children First. “Because when kids don’t have the support that they need, in today’s current education or environment, they get pushed out.”

Parents face delays accessing early intervention services. Early intervention is part of the landmark Individuals with Disabilities Education Act, which dictates that all children with disabilities must have access to a free and appropriate public education. Though each state creates and manages its own program, all kids through age 5 who are identified as having a developmental delay or disability are eligible.

In Pennsylvania, the Department of Education oversees local early intervention programs for preschool-age kids. In almost every county, families get connected with services through an intermediary unit, a kind of regional education service agency. But in Philadelphia, things work differently. The state pays Elwyn a combination of state and federal dollars to administer the city’s preschool early intervention program, along with a much smaller program in Chester. Last fiscal year, its contract was worth around $90 million.

Challenges in Implementation

Elwyn is in charge of assessing children, developing their IEPs, and subcontracting with a network of providers for services they qualify for. When Halevy’s kids’ preschool said her son needed an aide, the preschool owner gave Halevy advice: phone Elwyn. So she did, and she was relieved when the organization told her they could fit Joshua in to begin his evaluation later that week.

That was July 2024. She hoped Joshua would have services in time to be back at preschool by the following September. But soon, Halevy said she began hitting roadblocks.

In August, she said she didn’t hear much from Elwyn. Like other early intervention programs statewide, Elwyn often takes a two-week service break at the end of summer — one of many scheduled break periods during the year.

But then when she did hear back that September, she learned Elwyn wouldn’t consider providing a 1-to-1 aide without observing Joshua in his educational environment. But the preschool said he couldn’t return to class unless he had someone there to specifically support him.

At the end of September, when evaluators wrote Joshua’s initial IEP, they documented that they discussed adding an aide to assist Joshua at preschool. But they wrote that because they could not observe Joshua in his educational environment, they did not have enough information to support that recommendation. “[T]he family is in a difficult position,” the team wrote on the IEP, which Chalkbeat has reviewed.

Joshua’s IEP states that he should receive occupational therapy and specialized instruction each week. The law requires services to begin within 14 days. But more than a month after, Joshua still wasn’t receiving services, Halevy said.

Long-Term Impacts and Calls for Change

The state requires early intervention programs to report data on how kids progress in certain areas, like social emotional learning and acquiring new skills. State program reports show that for the last five years of data, children in Elwyn’s Philadelphia program have been less likely to progress in all three growth categories compared with the state average.

Margie Wakelin, a senior attorney at the Pennsylvania-based Education Law Center, said her team has assisted more than 80 Philadelphia families in the last year whose kids’ education was disrupted at least in part because they couldn’t access appropriate services from Elwyn. The vast majority of those children, she said, were Black and Brown kids affected by poverty.

Some families hire attorneys to help them access the services they’re entitled to, or get pro bono representation from organizations like the Education Law Center. Many who win their cases get compensatory education, often in the form of money the family can use to pay for services after the case is over.

But that doesn’t make up for lost time as children quickly age out of early intervention. Research shows that children’s brains develop more rapidly between birth to 5 than any other time of their life. Many families, Wakelin said, have also had their children suspended from preschool or made to only attend partial days because of their disabilities.

“It’s such a critical period for kids to have access to high quality education,” said Wakelin. A system that identifies children as needing services but doesn’t follow through, she added, is “really failing our kids.”

Funding and Equity Concerns

These and other challenges aren’t unique to Philadelphia families. But preschool operators and early intervention providers say there are particular and longstanding problems in Philly.

Two years ago, Sharon Neilson, former director of the Woodland Academy Child Development Center in West Philadelphia, was part of a group pushing to bring attention to problems in the city’s early intervention program. Council members held a hearing about parents’ challenges accessing services, and Neilson and other providers met with Elwyn.

At the time, Neilson said, she was hopeful that things would improve. But since then, she said, “we’ve actually seen it get worse.”

Neilson, who now works as support staff at Woodland Academy, said of the 22 children enrolled at the preschool, about four currently receive services from Elwyn, and three more are going through the process of getting evaluated.

The preschool helps families navigate the process, in part because submitting required paperwork and scheduling evaluations can create additional barriers, she said. But even with additional help, in her experience it still usually takes months for kids to be evaluated and services to begin, she said.

“I think that’s the saddest thing for me,” Neilson said. “The families are very frustrated because they don’t know what to do — they just know that they need help for their child, but it’s just very hard to navigate.”

Officials say a lack of resources is largely to blame. Over the past decade, the number of preschool-age children in Pennsylvania receiving early intervention services has grown by a third, and funding hasn’t kept up.

Pennsylvania Department of Education spokesperson Erin James said that is why Gov. Josh Shapiro proposed increasing funding for preschool early intervention by $14.5 million in the state budget. However, months past the budget deadline, lawmakers remain at an impasse over the budget and early education providers are further strained.

One provider who contracts with Elwyn said concerning inequities exist in Elwyn’s program. (Chalkbeat is not naming the provider due to her fears of retaliation from Elwyn.) It’s an accepted norm, the provider said, that kids in nicer neighborhoods get picked up for service much faster than those in poorer neighborhoods.

“There’s an access and equity issue across the board,” said the provider. “And that’s exacerbated by the shortage of providers.”

Asked about those access and equity concerns, McLister said that to address some related challenges, this year Elwyn is implementing more targeted training for staff and plans to develop a family resource center. He said the organization has also employed internal speech language pathologists to assign to high-priority cases.

When families reach out to Elwyn, McLister said staff provide them with documentation and verbal explanations of how the process works to ensure families understand their rights, next steps, and how to give consent for evaluations.

The organization also periodically notifies providers of historically underserved ZIP codes to encourage providers to serve kids equitably across the city, and includes provisions in its contracts meant to “promote fairness and accountability.” McLister said Elwyn places subcontractors on corrective action plans if the organization “detects patterns of non-acceptance that disproportionately impacts underserved areas.”

As for Halevy, she says her family has gotten relatively lucky. They were able to get Joshua started on an evaluation quickly. And she’s been able to get new therapists when others stop showing up.

But her family’s biggest piece of luck, she said, is that her husband recently got a new job with better health insurance. She plans to use that to get some of the services her kids need. That means she no longer will completely rely on Elwyn.

She just wishes she could erase the months of waiting and worrying about why Joshua’s services took so long to start.

“Basically, what happened is we fell through the cracks,” she said.