| This story was originally published by Illinois Answers Project
The bus stop had become one of the scariest places for Stephanie Jimenez. So had her apartment complex’s parking lot, driveways and any busy street.
Her then-2-year-old daughter Lia wasn’t talking and struggled with sensory processing. She had meltdowns when Jimenez tried to hold her hand, and she would often sprint away without regard to her own safety the moment she stepped outside. At its worst, the family put Lia in a harness with a leash.
Though there was never an accident, the threat of one was everywhere.
Then, Jimenez started working part-time as a parent liaison for Early Intervention. The little-known, publicly funded program provides therapies to infants and toddlers up to age 3 who are experiencing developmental delays or disabilities. The temporary support can help these children reach important milestones and initiate therapies that they might continue receiving throughout their childhood.
Not long after starting her job, Jimenez asked a colleague, “Can I talk to you about my daughter?” Lia was soon evaluated through Early Intervention, and qualified for speech and occupational therapies.
Jimenez immediately requested telehealth, rather than in-person sessions, for Lia. The girl’s third birthday was approaching, and Jimenez had heard accounts of children waiting months to receive in-person services. Early Intervention therapies stop once a child turns 3.
Research shows the first three years of a child’s life are a narrow and critical period for brain development. Studies analyzing the outcomes of Early Intervention found it can change a child’s developmental trajectory, and may even reduce the need for special education later.
The telehealth sessions proved challenging — Jimenez often found herself chasing after Lia with her phone’s camera during therapy — but they worked with the family’s schedule, and got results for Lia. Following the therapist’s guidance, Lia now holds onto one part of her “stuffie” when walking outside, while Jimenez or her husband holds onto the other.
Still, Jimenez said she has a “mixed” relationship with virtual therapy. She accepted it because it was what was available.
“We don’t have the luxury anymore of waiting,” she said.
In recent years, the percentage of Illinois families waiting for Early Intervention has doubled. The Illinois Answers Project identified dozens of families who have waited long periods for services — some as many as six to 17 months. The U.S. Department of Education has found the state has failed to meet its targets for providing timely therapies.
The delays are largely due to more children entering the program even as therapists continue to leave, citing low pay and poor benefits. Black children are more likely to face these delays, as are children who live in rural areas.
The state has started to embrace telehealth for Early Intervention, and it has become widespread among providers. Yet it has done little to improve wait times or fix the shortage of therapists. A disparity has also emerged: Virtual therapy is more likely to be provided in Chicago’s poorest ZIP codes than other areas of the state.
There’s also a growing gulf between how providers and families view virtual visits. Many providers are enthusiastic about them because they feel they improve the quality of the therapies, while also reducing professional burnout and unpaid costs. Yet parents frequently state their strong preference for in-person care.
These challenges come at a time when Early Intervention is set to be housed under the new Illinois Department of Early Childhood starting July 1. Spokespersons for both the Illinois Department of Early Childhood (IDEC) and Illinois Department of Human Services (IDHS) declined to make leadership of either agency available for interviews for this story.
An IDHS spokesperson said in a statement that Early Intervention is “designed to strengthen families’ ability to support their child’s development, and that work can be effectively delivered through multiple approaches, including in-person and Live Video Visits (LVV).”
“While there is still significant work to do,” an IDEC spokesperson said in a statement, “there has been recent progress and investments to build on.” This includes adding 21 new Early Intervention related jobs to the department by 2027 as well as some previous rate and cost of living increases for certain providers.
Jimenez, who helped co-found the group Illinois Families for Early Intervention, is among the advocates who say Early Intervention needs significantly more state funding. The key to improving Early Intervention, according to experts, advocates and consultants, is to pay therapists a higher wage. Illinois has significantly lower provider rates than other states.
In the state budget legislators passed on June 1, Gov. JB Pritzker allocated an additional $15 million in state funding for Early Intervention for fiscal year 2027. But this is a fraction of the $40 million advocates wanted. And it still likely won’t be enough to bring Illinois’ reimbursement to that of other comparable states. That would require about $150 million annually, according to consultants hired by the state.
State officials declined to say if any of the new 2027 funding will go toward providers’ salaries.
Advocates, parents and providers fear the Early Intervention delays will continue to get worse if providers aren’t incentivized to stay.
“Time’s against us,” Jimenez said. “Waitlists steal the time.”
Long wait times persist
At her 2-year check-up, Kaleb Taylor’s daughter wasn’t yet talking, prompting her pediatrician to refer her to Early Intervention. But seven months later, the little girl had yet to even be evaluated.
After leaving voicemails for months, Taylor, a Chicago tenants-rights organizer, found an address for the service coordinator’s office. He showed up one morning, slipping through security as other employees entered the office building.
The staff was initially alarmed, Taylor recalled. Once he explained why he was there, they acknowledged that his daughter shouldn’t have waited so long for an evaluation. She received one not long after his office visit.
But it was too late. Taylor’s daughter, who was eventually diagnosed with autism, only received a couple months of Early Intervention therapy before she aged out.
It’s become a familiar story for many families, some of whom have experienced even longer delays. Illinois Answers reviewed dozens of complaints filed with IDHS’s Bureau of Early Intervention in which parents said their children experienced wait times of 6 months, 9 months and more than a year.
Early Intervention requires children to be evaluated within 45 days of being referred to the program. Once a plan is developed, therapies must start within 30 days after the parents consent to the service plan. For nearly a decade, the U.S. Department of Education has found Illinois’ program has failed to meet its requirements.
In 2024 and 2025, parents filed 50 complaints to the Bureau of Early Intervention. Of the 40 complaints made in 2025, 26 were deemed as “founded” by IDHS. Nearly all related to some type of service delay.
The wait times hovered around a median of 82 days after the required time frames, an Illinois Answers’ analysis found. According to one complaint, a family waited 17 months for therapy. Other parents complained about being forced to find private providers. One family wrote that they paid more than $6,000 for 44 sessions with a private provider.
Wait times have only gotten worse, according to the most recent state data. In 2018, virtually no families were waiting to receive their initial evaluation, assessment or the creation of their service plan. By 2024, close to 8% of families had not received an evaluation within the required 45 days.
Between 2018 and 2022, the percentage of families experiencing service delays hovered around 5%. But by May 2024, when more than 24,000 children had active service plans, nearly 9% of families were experiencing delays.
With current wait times, child development specialist Stacey Isrow said she “absolutely” sees the impact of delays on her clients. For children younger than 36 months, even one or two months of a delay, while on a waitlist, can lead to a child “struggling for quite a while.”
“If a child’s been sitting on a waitlist, those delays are exacerbated, become more involved in the behavior of a child,” Isrow said. “You’re no longer looking at a speech delay. You’re looking at a speech delay from a child that’s very angry.”
Waiting more than a month for therapy, one Illinois parent emailed their baby’s service coordinator in May 2024, asking for an update. Their then-6-month-old son had a heart defect and other health issues. Much of his development was closer to that of a 3-month-old, according to a complaint his parent filed with the state.
“There are no occupational therapists with in-person availability at this time,” the service coordinator wrote back to the parent. “Would you be interested in starting video services while I [continue] searching for someone who can come in-person?”
‘It’s frustrating to not feel valued’
The long wait times are a product of more children qualifying for Early Intervention while the number of therapists has declined.
From 2018 to 2022, nearly 500 Early Intervention therapists left the program each year. While many providers entered the program, the total workforce declined about 6.6% during that time frame. Providers often cite low pay and hidden costs as reasons for leaving, according to a 2024 report prepared for IDHS by the consulting firm Afton Partners.
Many Early Intervention therapists are independent contractors. They don’t receive any benefits and are only paid for the hours they spend providing therapy to children. This doesn’t account for travel to families’ homes or any administrative responsibilities, such as filing paperwork or billing insurance companies.
Providers don’t get paid sick days or reimbursement for mileage. Transportation costs can be exorbitant. If a family cancels a session, the therapist isn’t paid.
It’s not like this in other states. In Indiana, speech language pathologists have an hourly rate of $118, compared to $85 in Illinois. New Jersey reimburses therapists 50% when clients miss appointments. Missouri offers mileage reimbursement and travel incentives.
“For the level of importance of our job and our education and all of the verbalization of how important we are, it doesn’t feel like it,” said Lisa Wister, an Oak Park occupational therapist.
“I do the work because it’s really important to me,” she said. “I’ve been in (occupational therapy) for over 20 years, but … it’s frustrating to not feel valued. And compensation is one of the ways you feel valued.”
Nationally, Early Intervention occupational therapists have an average base salary of $57,885, which is 30% less than if they worked in a school and 38% less than if they worked in a hospital, according to another 2024 report.
Full-time, independent Early Intervention providers have a median annual revenue of $70,709, according to the consultant reports. This is “substantially lower” than earnings for similar roles in Illinois. A speech language pathologist working in the state, for example, has a median income of $87,910 before taxes.
In a May 2026 survey of 230 therapists conducted by the Illinois EI Grassroots Alliance, 40% said they are considering leaving the industry if changes are not made in the next year. A majority of respondents were independent contractors, many of whom have been in the field for more than 15 years. About 19% said they would plan to only offer telehealth services in the next year if conditions remain the same.
Early Intervention began using telehealth due to the onset of the COVID-19 pandemic. In 2022, the state officially approved it as a permanent form of therapy. It’s become widespread since then.
Illinois Answers interviewed a dozen therapists for this story. Many of the providers across different disciplines used live video visits to varying degrees. Several told Illinois Answers telehealth helps cut down on travel costs, reduces cancellations and can ease scheduling. Some said it allows them to work with families in areas they wouldn’t have driven to previously.
“Personally, this changed my life,” said Rhonda Levie, an Early Intervention social worker.
Driving “all over the place” in DuPage County was contributing to her burnout.
Full-time therapists who used telehealth were not completing more appointments than therapists visiting families’ homes, according to the consultants’ report. Instead, they’re using the time in-person providers spend traveling on administrative work, such as billing and scheduling appointments.
Virtual services, the consultants also found, have at times been pitched as “solution to EI access in rural areas, where there are fewer providers and it takes long for providers to travel to families.”
Yet, according to the report, children in rural areas are less likely to receive services virtually than the state average. It’s in part because parents prefer in-person visits.
In a family focus group, the consultants found that many had “experienced (live video visit) services, often because this was their only option.”
Parents mixed on telehealth — and disparities persist
When virtual speech therapy was offered to Erika Reffett’s son Noah, who has cerebral palsy, she acquiesced.
Reffett, who was living in Joliet at the time, said Noah was supposed to receive two speech therapy sessions a week, but was only getting one due to a provider shortage.
Early Intervention offered to have a therapist fill the other speech therapy sessions virtually. Reffett agreed, and to her surprise, it was “really helpful.” She and Noah developed a closer relationship with that therapist than the one coming to their home.
“I was willing to take whatever I could get,” she said. “And it ended up working beautifully.”
Reffett was one of the few parents who told Illinois Answers they had a positive experience with virtual therapy. Nearly all described difficulties with managing these therapies.
It’s not clear if one mode of therapy produces better outcomes than the other. The state doesn’t track data in a way that allows for comparison for how children fare with virtual or in-person therapies.
In a 2025 report, IDHS found that between 2018 and 2023, the percentage of children in Early Intervention who showed significant improvements in certain skills or were demonstrating age-appropriate developmental levels by the time they exited had declined. Illinois officials attributed the slippage to factors such as the impact of the pandemic, service delays and families’ preference for in-person services when virtual is the only option available.
A speech language pathologist who works for a Quad Cities school district told Illinois Answers that she had concerns about the quality of virtual services when her own son needed speech therapy.
She felt it was essential for the provider to be there in person in order to listen to her son swallow, examine his mouth and study the way he chews. She didn’t think an expert could “effectively get that from a video.”
The family waited about eight months for in-person therapy before turning to private services. The mother said she “definitely” thinks that her son, now age 2, would be much farther along in his feeding development if he had received in-person therapy immediately.
Federal rules require families be included in developing their child’s service plan, including the “method of delivering the early intervention services.” State statute also makes clear that Illinois parents have the final decision to accept or decline these services, specifically the option between in person or telehealth. Parents will also not face any penalties for declining certain modes of therapies.
Illinois Answers reviewed several complaints parents filed with IDHS’s Bureau of Early Intervention in which they described experiencing service delays because they did not want virtual therapies.
Families in the poorest areas are more likely to receive virtual services, even though most prefer in-person therapy, the Afton consultants found. Those living in ZIP codes with the highest percentages of children in poverty are twice as likely to receive services virtually than the state average. These “deep poverty” areas are concentrated in some of Chicago’s majority-Black neighborhoods such as Auburn Gresham, West Garfield Park, South Austin and South Deering.
A Bronzeville mother who identifies as Black, Puerto Rican and Pakistani said she waited about eight months for her son to be evaluated and was never given the option of in-person therapies, only virtual. She said she felt “beggars can’t be choosers,” even though it became clear the boy struggles with telehealth.
“Your average speech therapist looks like (YouTube star) Ms. Rachel with blonde hair,” the Bronzeville mother said. “They’re going to feel more comfortable going to Lakeview. They’re going to feel more comfortable going to Rogers Park. They’re going to feel more comfortable going to wherever that is, not a predominantly Black and brown neighborhood.”
Early Intervention service delays are disproportionately affecting Black and Latino children, with families of color also reporting “disparities in their experiences with EI, such as having providers who share their language or cultural background,” according to the consultants’ report.
Interpreters, translators and bilingual providers, the consultants also found, “were growing increasingly frustrated with the EI payment system and often took on significant amounts of unpaid work to support non-English speaking families.”
Eleanor Grano, of Riverside, has been adamant about having bilingual speech and developmental therapists for her 20-month-old son Cinco. She said she had to wait five months for a bilingual speech therapist.
“[Early Intervention] is all about coming into your house and recreating the natural setting for the child,” she said, “but they’re bringing in people who don’t even speak his language.”
Advocates say budget increase is not enough
The recommendations to improve Early Intervention have been clear: Advocates say the program desperately needs more money.
According to the consultant’s 2024 report, Illinois would need to increase providers’ pay by an average of 95% to fully cover their costs and time and to reach parity with other states that have similar costs of living. Gov. JB Pritzker’s 2024 budget gave a 10% rate increase for therapists and service coordinators. Some providers have received cost-of-living adjustments or rate increases in the last four of seven fiscal years, state officials said.
Illinois is in the midst of a massive overhaul of all of its early childhood services. Pritzker has stated that the Smart Start plan, which was launched in 2023 to expand access to preschool and other early childhood services, is intended to make Illinois the best place in the country to raise young children.
This summer, the new Illinois Department of Early Childhood will oversee Early Intervention as well as other programs and divisions housed in the Illinois Department of Human Services and the Department of Childhood and Family Services.
Overall, Early Intervention has a budget of about $275 million. In his 2027 budget, Pritzker added $15 million — not the $40 million advocates asked for — to “support timely services for families,” bringing the state’s contribution from the general revenue fund to nearly $177 million. Of the remainder, $20 million is from the federal program IDEA Part C and the rest accounts for Medicaid reimbursement, according to an IDEC spokesperson.
It’s unclear if this increase in funding will go toward providers’ salaries.
An IDEC spokeswoman referred all of Illinois Answers’ questions to IDHS. An IDHS spokeswoman said “IDEC anticipates the funding will be utilized across several areas, including increasing provider capacity and reducing barriers and administrative burdens for families.”
Sarah Ziemba, a founding member of IL EI Grassroots Alliance, told Illinois Answers that in a meeting this spring with IDEC leadership, the officials could not commit to using any of the additional funding for provider raises.
At an Illinois House Appropriations Committee hearing in March, lawmakers asked IDEC Secretary Teresa Ramos whether the money would go to providers.
“We’re still evaluating that,” Ramos told lawmakers. “I’m happy to circle back when we know more.”
At April’s Illinois Interagency Council on Early Intervention meeting, IDEC Director of Special Projects Aaron Beswick said the updates are “things that families and providers don’t always see, necessarily, but you’ll absolutely feel.”
It includes, he said, improving data collection, oversight, billing and payment systems and the dispute resolution process for parents.
Yet advocates such as Karen Berman, a managing director for the Illinois policy team at the early childhood advocacy group Start Early, said she’s glad to see a budget increase, but it falls “far short” of what’s needed to change the number of families waiting for services due to provider shortages.
“You still don’t have enough solutions to negate the fact that you have to pay them a higher wage,” she said.
This article first appeared on Illinois Answers Project and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.
