In 2026, we are taking a closer look at the Office of Childhood (OOC) by exploring different programs that work together to strengthen children and families, and the professionals that support them. In this year’s newsletter series, we will spend each month highlighting different OOC programs. OOC is composed of many unique and connected parts, and each plays an important role. Together, all these programs are part of a larger system that supports families statewide. Our intent is to show how OOC programs fit together to create a better understanding of the work.

As part of our yearlong journey through the Office of Childhood (OOC), this month we are highlighting Early Intervention First Steps.

First Steps is Missouri’s Early Intervention system for infants and toddlers, birth to age three, who have delayed development or diagnosed conditions that are associated with developmental disabilities. First Steps is a voluntary program that provides families the tools they need to enhance their child's development, learning, and participation in family and community life.

First Steps operates statewide through local System Points of Entry (SPOEs). A child may be referred to First Steps by a parent or other primary referral source such as a physician, child care provider, or parent educator. View the full list of who can make a referral to First Steps and information on how to refer. 

To be eligible for services, a child must be between the ages of birth and 36 months and have a diagnosed physical or mental condition associated with developmental disabilities, or a high probability of resulting in a developmental delay or disability, or children who have a developmental delay. Read more about First Steps eligibility criteria.

Children found eligible for First Steps have an Individualized Family Service Plan (IFSP) that reflects the family’s concerns, priorities, and resources regarding the development of their infant or toddler. Missouri First Steps uses an educational, routines‑based model meaning services occur in the child’s natural environments and families lead goal‑setting with support from their IFSP team, rather than receiving clinic‑style direct therapy. Services are delivered via a teaming model in which professionals collaborate across disciplines to meet the needs of each family.

All early intervention services, including service coordination, are delivered by individuals who meet DESE’s qualifications. 

The First Steps program is funded through five sources including state general revenue, federal grant funds, public insurance (MO HealthNet/Medicaid), private insurance, and family cost participation fees. Family fees are assed based on a sliding scale with participation fees ranging from $5 to $100 per month that covers all First Steps services. Fees may also be adjusted based on certain criteria. Learn more about the First Steps System of Payments policy. 

To learn more about the Missouri First Steps program, visit the First Steps website or contact an Early Intervention team member.