Start with what works for every child: warm relationships, predictable routines and play. Then add a few targeted tools, like picture schedules, more ways to communicate and steady teamwork with the family and specialists. In Massachusetts, licensed programs must also make reasonable accommodations and name a staff liaison for each child with a disability.

By our editors · Facts checked October 7, 2026. This guide is general information, not medical advice.

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Disclosure: Treehouse Learning Center, which runs childcare and therapy programs in Massachusetts, publishes KidBrief. Our directory lists every licensed program, and we always label ours. Some links may be affiliate links: if you buy through them, we may earn a commission at no extra cost to you. How we make money.

The short version

  • An IFSP covers kids under 3 through Early Intervention. An IEP covers kids 3 and up through the school district.
  • State licensing rules require written accommodations, made with the family, and a named liaison for each child with a disability.
  • Visual schedules, first-then boards and AAC help many kids. AAC does not stop children from learning to talk.
  • Children with identified special needs get a written progress report every three months.
  • You don’t diagnose. You observe, document and loop in the family.
A teacher sits at a table with a young boy and gestures as they look at his workbook together
Photo: Ronald Felton / Unsplash

IFSP vs. IEP: what’s the difference?

Both plans come from IDEA, the federal special education law. Part C covers infants and toddlers through age 2; Part B covers ages 3 through 21. You don’t write these plans, but you help make them work every day.

IFSPIEP
AgesBirth to 33 and up (preschool special education serves 3 to 5)
Run byLocal EI program, overseen by the Department of Public HealthPublic school district, under DESE
Where services happenNatural settings: home, child care, communityHome, child care or public school, as the IEP team decides
Cost to familiesNo out-of-pocket costFree

Per the state IFSP handbook, the first IFSP is written within 45 days of referral and reviewed at least every six months. EI ends the day before the third birthday, after a transition conference at least 90 days earlier. Anyone can refer a child to EI, but state rules require parent consent before your program contacts outside providers, so the usual move is to encourage the family to call. For the school-age version of this paperwork, see IEP vs. 504 plan.

Where do you fit on the team?

The family leads. Around them: EI providers or district staff, often a speech-language pathologist (SLP), occupational therapist (OT) or physical therapist (PT), plus the pediatrician. The IFSP handbook lists the child care provider as a team member, and 606 CMR 7.04 says that, with parent permission, your program helps develop and review the child’s plan. In practice:

  • Ask the family which two or three goals matter most in your room.
  • Ask a visiting therapist to model one strategy during a routine you run daily, like snack.
  • Agree on shared words, signs or pictures across home, therapy and class.

Classroom supports that actually work

Visual schedules and first-then boards

Pictures help kids who struggle with spoken directions. A daily picture schedule shows what’s next. A first-then board pairs a task with something the child enjoys: first shoes, then outside. Point as you speak and give a heads-up before changes. HeadStart.gov offers free printable visuals for routines, play areas, rules and feelings.

AAC: pictures, signs and speech devices

AAC is any way of communicating besides speech: gestures, signs, picture boards, tablet apps and speech-generating devices. ASHA says research shows AAC does not stop people from talking and can support speech. Keep the child’s board or device within reach all day, including outdoors and at meals. Touch the symbols as you talk, wait longer than feels natural, and honor every attempt.

Sensory needs

Some kids are overwhelmed by noise or textures; others crave movement. Offer a quiet corner, warn kids before loud events like fire drills, offer a tool or glove for messy play, and build in movement breaks. Ask the child’s OT for specific strategies, and never force contact with a texture.

Peer buddies

Show classmates how to invite a friend to play, wait for an answer and use the friend’s picture board. Pair a child with a buddy for transitions, and plan small groups that include strong language models.

Teach inside the routines you already run

Embedded learning opportunities are short, planned teaching moments inside ordinary routines, each aimed at one goal. HeadStart.gov suggests an activity matrix: goals down the side, daily routines across the top. If the goal is asking for things, snack becomes practice: hold up two choices and wait for a word, sign or picture. Need more ideas? Try our play-based lesson ideas.

Child not joining in? HeadStart.gov lists modifications to try: adjust the environment, adapt materials, simplify the activity, use the child’s interests, or add adult or peer support. For hitting, biting or defiance, see our classroom behavior guide.

Working with families

  • Ask what works at home before you try something new.
  • Share a win before you share a concern.
  • Get written permission before talking with outside specialists, as state rules require.
  • Document new concerns and raise significant problems with the family right away, per 606 CMR 7.06. Don’t diagnose. Suggest the pediatrician and an evaluation through EI (under 3) or the district (3 and up). Our script for talking to parents about a development concern helps.

The legal basics of inclusion

ADA. The Americans with Disabilities Act covers nearly all private child care programs, whatever their size; programs run by religious organizations are exempt. According to the U.S. Department of Justice, programs must assess each child individually, make reasonable policy changes unless that would fundamentally alter the program, and not charge extra for required accommodations.

Massachusetts licensing. Under 606 CMR 7.04, a program must make reasonable accommodations for a child with a disability, list them in writing with parent input and name at least one educator as liaison. If an accommodation isn’t reasonable, the program must tell the parent in writing within 30 days.

Inclusion as a value. The DEC and NAEYC joint position statement defines quality inclusion by access, participation and supports, and DESE’s inclusion policy backs inclusive, high-quality programs for young children with disabilities.

Documentation that helps the team

  • The child’s record must include any IFSP or IEP and its periodic reviews, per 606 CMR 7.04.
  • Progress reports are due every three months for kids with identified special needs, versus every six months for most toddlers and preschoolers, under 606 CMR 7.06. Offer parents a meeting, and give specialists a chance to contribute.
  • Write what the child did and said, during which routine and with what support. Skip guesses about causes.
  • Keep a simple goal grid: date, routine, goal, what happened, support used. It becomes ready-made notes for team meetings.

For children who need extra support

Many kids won’t have a plan yet, and some are waiting on an evaluation. Every strategy here works without a diagnosis. Know the early signs of autism and ADHD so you can describe what you see, not label it.

Go slow with dual language learners: Massachusetts EEC guidance notes many go through a silent period, listening more than speaking, which can look like a delay. Share observations from several settings and ask how the child communicates at home. The CDC’s free milestone checklists, covering 2 months to 5 years, give you and the family shared language. More on our inclusive care hub.

Common questions

Do I need a diagnosis before I use these strategies?

No. Visual supports, extra wait time and peer buddies are good teaching for any child. If you’re concerned, document what you see, talk with the family and suggest they speak with the pediatrician.

Can a program turn away a child because of autism?

Not because of a diagnosis alone. The ADA requires an individual assessment, and Massachusetts rules require reasonable accommodations written with the family. A program that finds an accommodation unreasonable must explain that in writing within 30 days.

Will pictures or a speech device keep a child from talking?

No. ASHA reports that research shows AAC does not stop speech or slow language growth. Kids who use AAC can also learn to read and write.

What happens when a child with an IFSP turns 3?

EI ends the day before the third birthday, after a transition conference held at least 90 days earlier, per the IFSP handbook. The district decides whether the child qualifies for an IEP. With the family’s permission, share your observations with the district team.

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