Early Childhood Takes Root (1990–2009)

Welcome to Panel 4, “Early Intervention Expands.”

By 1990, the legal foundation for disability services was established. Children had the right to education. Early intervention programs were growing. But the final decade of the twentieth century and the first years of the twenty-first brought something new: scientific proof of why early intervention matters so much.

Let me take you back to July 26, 1990. President George H.W. Bush stood on the White House lawn and signed the Americans with Disabilities Act, the ADA. Surrounded by thousands of disability rights advocates, he declared, “Let the shameful wall of exclusion finally come tumbling down.”

The ADA was revolutionary. IDEA had guaranteed education, but the ADA addressed everything else: employment, public places, transportation, telecommunications. It said that excluding people with disabilities from restaurants, stores, jobs, buses, from everyday life, was discrimination, illegal discrimination.

Think about what this meant for families with young children with disabilities. Your child would grow up in a world with curb cuts, accessible playgrounds, automatic doors. A world where businesses could not refuse service because someone had a disability. A world where accessibility was expected, not exceptional.

But even more important than the physical changes, the ramps and accessible parking, was the cultural shift. The ADA declared that people with disabilities belong in community life. Full stop.

Now, while lawyers were working on civil rights, scientists were making discoveries that would change everything we understood about child development.

In the 1990s, new brain imaging technology allowed researchers to watch children’s brains develop in real time. And what they discovered was astonishing.

The first three years of life are not just important, they are foundational. During those years, a child’s brain forms seven hundred to one thousand new neural connections every single second. Early experiences literally shape brain architecture. Positive interactions, responsive caregiving, appropriate stimulation, these build the neural pathways children need for learning, relationships, self regulation, everything.

And here is the critical finding. Early intervention during these years can change developmental trajectories. Brain scans showed measurable differences between children who received early therapy and support and those who did not. Studies proved that investing in early intervention saved money later. Every dollar spent on early services prevented multiple dollars in later special education, healthcare, and social costs.

This research transformed early intervention from “it seems like a good idea” to “this is scientifically proven to work, and timing is critical.”

Organizations like United Services for Children were at the forefront of implementing this research. Services increasingly focused on the birth to three period, when the brain is most plastic and responsive to intervention. Therapists learned about neurodevelopment and adapted their approaches accordingly.

Services expanded dramatically during this period. Missouri First Steps grew, reaching more families across the state. More therapists trained in early intervention. The approach became truly family centered, not just treating children but coaching parents, providing services in homes and childcare settings, addressing family priorities alongside developmental goals.

Early intervention became multidisciplinary. Speech therapists, occupational therapists, physical therapists, special educators worked together as teams. They recognized that development is interconnected. You cannot separate motor skills from communication or social development from sensory processing.

Technology brought new possibilities too. The 1990s and 2000s saw innovations in assistive technology. Children who could not speak could use communication devices. Computers became accessible through touch screens and adapted keyboards. Mobility equipment improved. These were not just gadgets. They were tools that let children participate in ways previously impossible.

Think about a child who cannot speak but can use a speech generating device to tell their parents they love them, or ask for their favorite snack, or answer a question in preschool. Technology did not fix the disability. It removed barriers that had prevented participation.

During this period, Congress reauthorized IDEA multiple times, each time strengthening requirements. The 1997 reauthorization emphasized inclusion in general education. The 2004 reauthorization focused on outcomes, not just access to services but actual learning and achievement.

The inclusion movement gained momentum. Research consistently showed that children with disabilities made better progress when educated alongside typically developing peers. Non disabled children benefited too, learning that diversity is normal and developing empathy and patience.

Yet implementation was uneven. Some districts embraced inclusion. Others maintained segregated programs. Advocates continued to push. True inclusion means not just physical presence but meaningful participation with appropriate supports.

Early childhood programs increasingly embraced inclusion. Preschools learned to support children with diverse needs. Organizations like United Services for Children partnered with community childcare centers, providing consultation and support so children with disabilities could attend typical preschools alongside their neighbors.

Family centered practice became standard during this era. Research confirmed what families had long known. Parents are the experts on their children. Intervention works best when embedded in daily routines. Family well being affects child outcomes. Professionals should coach families, not simply treat children.

This required significant changes in how therapists worked. Instead of providing therapy while parents watched, therapists taught parents strategies they could use throughout the day. Instead of clinic appointments, services moved into homes and community settings, where children actually live and learn.

For United Services for Children and similar organizations, this period brought tremendous growth. Services expanded beyond therapy alone to include comprehensive early intervention, evaluation, family support, care coordination, assistive technology, and community inclusion consultation. Staff specialized in early childhood. Partnerships multiplied with Missouri First Steps, school districts, childcare providers, and medical professionals.

By 2009, the transformation was remarkable. A baby born with Down syndrome in St. Charles County would:

• Be identified early through screening
• Receive evaluation to determine needs
• Get coordinated services through Missouri First Steps
• Have therapists working with the family in their home
• Access assistive technology if beneficial
• Attend an inclusive preschool with appropriate supports
• Transition smoothly to school services at age three

This comprehensive system did not exist twenty years earlier. It was built through research, advocacy, policy refinement, professional development, and organizational commitment.

As you reflect on this panel, consider how scientific research strengthened the case for early intervention, how technology expanded possibilities, and how family centered practice reshaped the therapist’s role.

Most importantly, consider what it means that by 2009, comprehensive early intervention had become the standard rather than the exception. This transformation, from charity based services in the 1960s to evidence based systems in the 2000s, represents one of the great public health achievements of our time.

The systems built during this era remain the foundation of early intervention today. When United Services provides services, when Missouri First Steps coordinates care, when families receive support in their homes, we are living in the world this era created.