Kentucky First Steps ABA for Toddlers: What Families Need to Know
In short: Kentucky First Steps is the state's early intervention program for children under 3 with developmental delays or disabilities, including autism. It can cover ABA therapy when deemed medically necessary, and families pay nothing out-of-pocket. Our free service, Start with ABA, can match you with a vetted BCBA-led provider who accepts First Steps.
Key takeaways
- Kentucky First Steps provides early intervention services, including ABA therapy, for eligible toddlers under 3.
- Services are free for families, funded by state and federal dollars, and do not require private insurance.
- ABA must be prescribed by a doctor and deemed medically necessary to be covered through First Steps.
- Eligibility is based on a multidisciplinary evaluation showing a 25% delay or a diagnosed condition like autism.
What Is Kentucky First Steps?
Kentucky First Steps is the state's early intervention system under Part C of the federal Individuals with Disabilities Education Act (IDEA). It serves families with children from birth to age 3 who have developmental delays or a diagnosed condition that is likely to result in a delay, such as autism spectrum disorder (ASD). The program is administered by the Kentucky Cabinet for Health and Family Services and works through local providers across all 120 counties.
The goal of First Steps is to support families in helping their child reach developmental milestones. Services are provided in the child's natural environment-typically the home, daycare, or community settings-and are designed to be family-centered. For toddlers with autism, this can include applied behavior analysis (ABA) therapy, which is an evidence-based approach to teaching communication, social, and adaptive skills while reducing challenging behaviors.
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How ABA Therapy Works Through First Steps
ABA therapy through First Steps is not automatically provided; it must be recommended by a physician and determined medically necessary through the Individualized Family Service Plan (IFSP) process. Here is how it typically unfolds:
Referral and Evaluation
If you suspect your toddler has autism or a developmental delay, you can refer your child to First Steps directly. You do not need a doctor's referral, though many families start with their pediatrician. After referral, a service coordinator will guide you through a multidisciplinary evaluation at no cost. This evaluation assesses your child's skills in areas like communication, motor skills, problem-solving, and social-emotional development.
Eligibility for ABA
To qualify for ABA therapy, your child must meet one of these criteria:
- A diagnosed condition such as autism that carries a high probability of developmental delay.
- A 25% delay in one or more developmental areas, as measured by standardized tools.
If eligible, the IFSP team-including you, the service coordinator, and therapists-will develop a plan. ABA therapy goals will be specific, measurable, and tied to your child's needs, such as increasing eye contact, following simple instructions, or reducing tantrums.
Who Provides ABA?
First Steps contracts with local agencies and individual providers. ABA services must be delivered by a Board Certified Behavior Analyst (BCBA) or a supervised registered behavior technician (RBT). The BCBA designs the treatment plan, trains parents, and oversees implementation. Because ABA is intensive (often 10-25 hours per week), providers may work with your family in multiple sessions each week.
Costs and Insurance: What You Pay
One of the biggest advantages of First Steps is that services are free for eligible families. There are no co-pays, deductibles, or out-of-pocket costs. The program is funded through a combination of federal grant money, state funds, and Medicaid. If your child has private insurance, First Steps may bill that insurance, but you will not be charged for any remaining balance. This includes ABA therapy, which is covered under Kentucky's Medicaid program for children with autism.
For families without insurance, First Steps covers all services directly. This makes it an accessible option for many families who might otherwise struggle to afford ABA therapy, which can cost thousands of dollars per month without coverage.
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How to Get Started with First Steps for ABA
Here is a step-by-step guide to accessing ABA through Kentucky First Steps:
- Contact First Steps: Call the statewide intake line at 1-800-442-0087 or visit the Kentucky First Steps website to find your local point of entry.
- Request an evaluation: Share your concerns about your child's development. A service coordinator will schedule a free multidisciplinary evaluation within 45 days.
- Attend the IFSP meeting: If your child qualifies, you will meet with the team to create a plan. Specifically request ABA therapy if it is not already suggested.
- Choose a provider: First Steps will share a list of approved ABA providers in your area. You can also use our free matching service, Start with ABA, to get connected with a vetted BCBA-led provider who accepts First Steps.
- Begin services: Once the provider is selected, they will start working with your family, often within a few weeks.
Remember, you are an equal member of the IFSP team. You have the right to decline or request changes to services.
What to Expect from ABA Therapy for Toddlers
ABA for toddlers looks different than for older children. Sessions are play-based, short (often 1-2 hours), and involve heavy parent training. The BCBA will teach you strategies to encourage communication and reduce challenging behaviors in daily routines like mealtime, bath time, and play. Goals might include:
- Requesting a preferred toy using a word, sign, or picture.
- Making eye contact when spoken to.
- Following simple one-step directions.
- Tolerating transitions between activities.
Progress is tracked daily, and the BCBA adjusts the plan every few weeks based on data. You will also receive regular coaching on how to generalize skills across settings.
Common Mistakes to Avoid
Navigating early intervention can be confusing. Here are pitfalls to watch out for:
- Waiting for a formal diagnosis: You do not need an autism diagnosis to start First Steps. If your child has a delay, they may still qualify for ABA or other therapies.
- Not asking for ABA specifically: Some IFSP teams may not mention ABA unless you request it. Be proactive and ask if ABA is appropriate for your child.
- Assuming insurance won't cover it: First Steps covers ABA regardless of your insurance status. Do not let cost concerns stop you from seeking help.
- Delaying enrollment: Early intervention is most effective before age 3. Once your child turns 3, they transition out of First Steps into school-based services, which may not offer the same intensity of ABA.
Transitioning Out of First Steps
As your child approaches age 3, the IFSP team will plan the transition to preschool special education services through your local school district. This is called the transition conference, held at least 90 days before the third birthday. At that meeting, you can discuss whether ABA will continue through the school system or if you will need to seek private insurance or Medicaid coverage. Our free service can help you find a BCBA-led provider for ongoing ABA if needed.
How Start with ABA Can Help
At Start with ABA, we offer a free matching service to connect families with vetted, BCBA-led ABA providers. When you contact us, we ask about your child's age, diagnosis, location, and insurance (including First Steps). We then share a shortlist of providers who have experience with early intervention and accept First Steps. This saves you time and ensures you work with a qualified professional. There is no cost or obligation-we are here to help you navigate the process.
If you are ready to start, call us or visit our website. We can also answer questions about ABA, First Steps, and how to advocate for your child during the IFSP process.