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Challenges and Opportunities for Early Intervention Systems: Lessons Learned from a State Advocacy Landscape Analysis

Explore key challenges facing Early Intervention (EI) systems, including workforce shortages, funding gaps, and access barriers, alongside policy and advocacy strategies to strengthen services for infants, toddlers, and families.

May 29, 2026

Early Intervention (EI) provides critical services to infants and toddlers with or at risk of developmental delays or disabilities. Research shows that getting children the right support early makes a real difference in their development and saves money in the long run. But across the country, too many families are running into barriers that make it hard to access these services in a timely manner.

One chronic issue plaguing EI systems is that the advocates and organizations working to improve them are stretched too thin. Too few people are working on EI policy, and they often lack the shared infrastructure—tools, networks, and resources—needed to accelerate change and improve outcomes.

To better understand the predominant issues facing EI systems across the country, and to assess what states are doing to address these challenges, Start Early conducted a landscape analysis across 17 states. We reviewed federal and state policy, research, and reports, and we talked directly with early childhood advocates, providers, and family leaders. The following report captures what we learned, including: the core challenges states are facing, key policy levers to drive change, effective advocacy strategies, and what states are doing to increase advocacy capacity. These findings are intended to support federal, state, and local systems leaders and advocates who are working to drive improvements within the EI system.

Key Findings

  • States across the country share common challenges: (1) workforce shortages; (2) inadequate funding and rates; (3) waiting lists, service delays, and inconsistent access; (4) barriers to family and parent advocacy; (5) challenges to system reform and governance; and (6) gaps in data and research.
  • We identified a core set of policy levers to strengthen the EI system: (1) cost modeling and provider rate reform; (2) Medicaid optimization and billing reform; (3) eligibility expansion; (4) service delivery model improvements; and (5) cross-system collaboration.
  • States are using a range of effective advocacy strategies: These include (1) coalition building and cross-sector partnerships; (2) authentic provider and family advocacy; (3) administrative advocacy; (4) legislative education and relationship building; (5) strategic communication; (6) individual family advocacy; and (7) data- and research-driven advocacy.
  • Advocacy capacity is one of the field’s greatest unmet needs: In most states, too few advocates are focused on EI, and even fewer have the policy expertise to drive sustained change. States are working to simultaneously build a deeper bench of advocates and ensure authentic family and provider voice is part of all advocacy efforts.
  • EI reform requires structural change and sustained advocacy capacity: Our landscape analysis outlined an urgent but achievable path forward. Through coordinated action, adequate investment, and authentic engagement of those most impacted, states can create a stronger EI system.

Start Early supports leaders to build advocacy capacity to address these key challenges and opportunities for Early Intervention. Access more information and support through Together for Young Children with Disabilities campaign and the Early Childhood Disability State Advocate Collective or email Start Early Consulting directly at Consulting@StartEarly.org.

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Publications & Resources

Challenges and Opportunities for Early Intervention Systems: Lessons Learned from a State Advocacy Landscape Analysis

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This report examines core challenges, policy levers, and advocacy strategies within the Early Intervention state policy landscape. It offers examples of what’s working and thoughts on increasing EI advocacy capacity.

Download Challenges and Opportunities for Early Intervention Systems: Lessons Learned from a State Advocacy Landscape Analysis

Challenges and Opportunities Early Intervention Systems: Executive Summary

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High-level summary of our State Advocacy Landscape Analysis.

Download Challenges and Opportunities Early Intervention Systems: Executive Summary

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