ECI, School Services and ABA Therapy in Texas: How They Fit Together

If you are worried about how your young child is developing, you may hear about several kinds of help in Texas: Early Childhood Intervention (ECI), special education through your school district, and ABA therapy. Each one has its own rules about age, eligibility and who pays. Knowing how they fit together helps you move faster and avoid gaps.

This guide explains each program, how families combine them, and how to start ABA therapy with BH Field from our Round Rock office, wherever you live in Texas.

Key takeaway: ECI serves children from birth to 36 months and does not require a diagnosis to refer. School districts serve eligible children from age 3. ABA therapy is a separate, insurance-funded service for children with autism. They are not either-or, and many families use more than one.

Early Childhood Intervention (ECI)

Texas's early intervention program, under Part C of the federal Individuals with Disabilities Education Act (IDEA), is Early Childhood Intervention (ECI), run by the Texas Health and Human Services Commission (HHSC). It supports families of children from birth to 36 months with developmental delays, disabilities or certain medical diagnoses.

What families should know, from HHSC's referral page and the ECI Parent Handbook:

• No diagnosis is needed to refer. A referral can be based on a family's concern or a professional's judgment. A medical diagnosis or a confirmed developmental delay is not required, and children can be referred as soon as a delay is suspected.
• Anyone can refer. Parents, doctors, child care providers and others can make a referral.
• Finding your local program. Each ECI program serves specific ZIP codes. Search by ZIP code, county or city on the HHSC site, or call the HHS Office of the Ombudsman at 1-877-787-8999 (choose your language, then option 3).
• A plan within 45 days. If your child is eligible, ECI writes an Individualized Family Service Plan (IFSP) with you within 45 days of the referral.
• Cost. Evaluations, assessments and case management are provided at no cost. Some families pay a monthly fee for certain services, based on a sliding scale, and ECI may bill Medicaid or private insurance with your permission. No one is refused services because of an inability to pay.
• Leaving ECI at 3. All children leave ECI by their third birthday. Transition planning starts after age 2, and at least 90 days before the third birthday your service coordinator will offer to set up meetings with the programs you are considering, such as your school district.

School services: Early Childhood Special Education from age 3

Texas school districts and charter schools provide Early Childhood Special Education (ECSE) for eligible children ages 3 through 5 (TEA parent guide). For a child coming from ECI, the evaluation, the ARD (Admission, Review and Dismissal) meeting and the Individualized Education Program (IEP) are meant to be completed by the third birthday.

If your child was never in ECI, you can still ask. Parents have the right to request a special education evaluation for a child who is at least 3 years old at any time (TEA guide for ages 3-5).

School services focus on what your child needs to learn and take part in school, and they are written into the IEP.

Where ABA therapy fits

ABA (applied behavior analysis) therapy is a separate service from ECI and school special education. It is usually paid for by health insurance or Medicaid, and it typically requires an autism diagnosis and insurance authorization. In Texas:

• State-regulated group health plans must cover autism treatment, including ABA, for children diagnosed before age 10, under Texas Insurance Code § 1355.015. Self-funded employer plans are generally exempt from state mandates.
• Texas Medicaid has covered ABA for members 20 and younger since February 1, 2022 (TMHP). HHSC's ABA guide for families also lists ECI among the Medicaid services available to children with autism.

Behavior analysts in Texas are licensed by the Texas Department of Licensing and Regulation (TDLR).

How families combine them

• Under 3, still waiting on a diagnosis. Refer to ECI now. You do not need to wait for an autism evaluation.
• Under 3, with an autism diagnosis. Your child can receive ECI services and also start ABA therapy if insurance authorizes it. Share the IFSP with your BCBA, and let your ECI service coordinator know about ABA, so goals line up.
• Turning 3. As your child leaves ECI, the school district can evaluate them for ECSE. ABA therapy can continue alongside school services.
• School age. The IEP covers your child's education. ABA therapy, when medically necessary and authorized, works on goals at home, at school and in the community.

With your permission, we are happy to coordinate with your child's ECI team or school.

How to start ABA therapy with BH Field in Texas

BH Field is now open in Texas. Our office is at 2631 Gattis School Rd, Suite 220, Round Rock, TX 78664, and we serve families across the whole state.

We do not have a clinic in Texas yet, so here is how services work:

• Direct ABA therapy is delivered in person by a Registered Behavior Technician (RBT) at your home or at your child's school.
• Telehealth is used for assessments, BCBA supervision and parent training. It is not used for your child's direct therapy sessions.
• Our team is bilingual in English and Spanish.

What intake looks like

Our intake has nine stages, and it usually takes 2 to 16 weeks from first contact to first session:

1. You complete the questionnaire.
2. We contact you within 24 hours.
3. You send your documents. This part is yours, and it sets the pace of everything after it.
4. We build your intake package in 1 to 3 business days, including verifying your benefits.
5. Insurance approves the assessment, in 1 day to 4 weeks.
6. Your BCBA assesses your child and writes the report, in 1 to 2 weeks.
7. Clinical review, in 2 to 4 business days.
8. Insurance approves treatment, in 1 day to 4 weeks.
9. We match your team, in 1 business day to 4 weeks.

The two insurance approvals and therapist matching drive that range. Matching depends on your schedule flexibility, any language or therapist-gender preference, and your location, since in-home services need an RBT who covers your area. If we cannot staff your case quickly, we will tell you honestly rather than leave you wondering.

What to have ready

• Your child's autism diagnosis report
• Both sides of every insurance card your child has
• Your child's IFSP or IEP, if they have one

No diagnosis yet? ECI (under 3) or your school district (3 and older) can be a good first step while you arrange an evaluation, and you are welcome to call us with questions in the meantime.

Reach us at (877) 438-1265 or info@bhfield.com.

Next steps

• See how we serve families statewide on our Texas page.
• Start ABA therapy and we will contact you within 24 hours.
• Use the ABA intake checklist to gather your documents.
• Learn how we check your coverage on our insurance verification page.