Maryland Infants and Toddlers Program vs. Private Autism Day Centers: A Family’s Guide

If your toddler is missing milestones or a screening raised concerns, you may be hearing about the Maryland Infants and Toddlers Program for the first time, along with private autism day programs. They are different kinds of support, and many families use one, the other or both at different times. This guide explains how the Maryland Infants and Toddlers Program (MITP) works, how it compares with a private program and how families can make the two fit together. It is general education and does not replace advice from your child’s care team.

Key Takeaways

• The Maryland Infants and Toddlers Program serves eligible children from birth to age 3, and services are free to eligible families.
• You do not need an autism diagnosis to make a referral. Anyone, including a parent, can refer a child.
• MITP services are built around an Individualized Family Service Plan (IFSP) and usually happen in everyday settings such as your home.
• A private autism day program offers structured, planned practice with peers. Insurers generally look for a clinical autism diagnosis before authorizing ABA.
• Many families combine the two. With your written permission, both teams can share goals so routines stay consistent.
• An M-CHAT-R/F screening result is not a diagnosis. It signals whether a full evaluation may help.

MITP vs. Private Autism Day Programs at a Glance

Use this table to scan common differences. Programs vary, so treat it as a starting point for questions, not a rating.

Feature	Maryland Infants and Toddlers Program	Private autism day program
Ages served	Birth to age 3, with an Extended IFSP option in Maryland for some children	Varies by program; many serve toddlers and preschoolers
Cost to families	Free to eligible families	Usually billed to insurance, Maryland Medicaid or private pay; coverage varies by plan
Diagnosis needed?	No. Eligibility comes from an evaluation of development	Insurers generally look for a clinical autism diagnosis before authorizing ABA
Where services happen	Natural environments, such as home, childcare or community settings	Usually at the program, sometimes combined with home or community sessions
Plan	Individualized Family Service Plan (IFSP)	Individualized treatment plan, often overseen by a BCBA
Main focus	Coaching caregivers and supporting development within daily routines	Structured, planned practice of communication, social and daily living skills
Weekly time	Set in the IFSP for each child	Set through a clinical assessment, treatment plan and what the plan authorizes

What Is the Maryland Infants and Toddlers Program?

The Maryland Infants and Toddlers Program is the state’s early intervention system for young children with developmental delays or disabilities. It runs through a local program in every Maryland county and Baltimore City. According to the program, services are free and family-centered, and assessments and visits can take place at home, in the community or virtually, depending on your family’s needs.

Early signs that lead families to ask questions can include differences in joint attention, pointing and play, or a toddler who is slower to talk. If you are unsure whether a delay in speech is part of a broader picture, our guide to speech delay vs. autism red flags may help you organize what you are seeing.

Program Eligibility Requirements

Eligibility rests on your child’s development, not your family’s income. A child under 3 who lives in Maryland may qualify through (Pathfinders for Autism):

• A delay of 25% or more in at least one area of development: cognitive, communication, physical, social-emotional or adaptive.
• Atypical development or behavior that is likely to lead to a delay, even without a measurable 25% delay.
• A diagnosed physical or mental condition that has a high probability of resulting in a delay.

A medium- or high-risk M-CHAT-R/F score is a screening result, not a formal autism diagnosis. You can make a referral based on a screening result or simply on your own concerns.

Free Family-Centered Services

Once a child is found eligible, the local program and your family write an Individualized Family Service Plan, or IFSP. The plan lists outcomes built around your family’s priorities and daily routines, because you know your child best. Depending on your child’s needs, services can include speech-language therapy, occupational and physical therapy, special instruction and family training. Each family also has a service coordinator who helps keep everything connected.

Federal early intervention rules call for services to be provided, to the extent appropriate, in natural environments, meaning the everyday settings where a child would usually spend time, such as home or childcare (34 CFR 303.126). That is why many MITP visits focus on coaching caregivers during real routines like meals, play and bath time.

Does Your Child Qualify for MITP?

Many parents ask whether their child qualifies for the Maryland Infants and Toddlers Program. The three eligibility pathways are listed under Program Eligibility Requirements above. A referral simply starts the process. Qualified personnel make the actual determination through a free evaluation, so you do not need to wait for certainty before reaching out.

Developmental Delay Threshold

The delay pathway uses one concrete number: a delay of at least 25% in one or more developmental areas. Your child does not need delays everywhere. One area can be enough. Evaluators look at:

• Cognitive: how your child learns, explores and solves problems.
• Communication: understanding words and gestures and expressing needs.
• Physical: fine motor, gross motor, vision and hearing.
• Social-emotional: connecting with people and managing feelings.
• Adaptive: everyday self-help skills such as eating and dressing.

If your child does not show a measurable 25% gap, atypical development or behavior can still be considered. Your observations as a parent are part of the evaluation.

Diagnosed Conditions That Qualify

Some children arrive with a diagnosis already in hand, such as a genetic condition or a hearing loss found at birth. For these children, a diagnosed condition with a high probability of causing delay can open a separate path to eligibility, even without a measurable delay. A diagnosis alone does not automatically decide eligibility; qualified personnel make an individualized determination. Autism is often identified later, so many autistic toddlers qualify through the delay or atypical-development pathways instead.

If you are also pursuing a clinical diagnosis, a comprehensive autism evaluation may use well-established tools, and our guide to preparing for an ADOS-2 evaluation explains one common part of that process.

Referral Versus Eligibility

A referral opens the door, but it is not the same as eligibility. Anyone, including you, your pediatrician or your childcare provider, can refer a child under 3. With your consent, the local program then evaluates your child’s development. An autism diagnosis by itself does not decide MITP eligibility; the evaluation does.

How to Make a Referral to MITP (Step by Step)

The referral process is often simpler than families expect, and you do not need a physician’s approval to start.

1. Refer your child. Submit a referral through the Maryland Infants and Toddlers online referral system, or find the contact information for your county’s local program on the MITP referral page. Parents, doctors and childcare providers can all make a referral.
2. Free evaluation. With your consent, qualified professionals evaluate your child’s development, using your input along with their own observations and assessments.
3. Eligibility determination. The team decides whether your child meets one of the eligibility pathways.
4. IFSP meeting. If your child is eligible, you and the team write the IFSP. Under federal rules, the evaluation, assessment and initial IFSP meeting are to be completed within 45 days of the referral (34 CFR 303.310).

How Often MITP Services Happen

There is no single statewide number of visits. Your child’s IFSP sets the frequency, length and method of each service based on your child’s outcomes (34 CFR 303.342). Many visits take place at home or in community settings, where providers observe routines, practice strategies with you and leave ideas to use between visits. If you feel your child needs more support, ask your service coordinator how services are reviewed and whether the plan can change. Parent coaching outside the program can also help families build calmer, more predictable routines at home.

The Extended IFSP Option: Services Through Age 4

In Maryland, a third birthday does not always mean early intervention ends. Families of children who are found eligible for preschool special education may be able to choose an Extended IFSP, which can continue early intervention services until the beginning of the school year following the fourth birthday, instead of moving straight to an IEP (COMAR 13A.13.01.07). Ask your service coordinator whether this option applies to your child.

Question	What to know	Your next step
Who can choose it?	Children found eligible for preschool special education who were receiving early intervention services	Ask your service coordinator before the transition meeting
How long can services last?	Until the beginning of the school year following the fourth birthday	Confirm the timeline for your child in writing
What is included?	Year-round, family-centered services with school-readiness goals such as early language, literacy and numeracy	Review the updated IFSP together
Can we switch to an IEP later?	Yes. Families can move to an IEP, but ask how that choice affects the IFSP	Ask your local program how to make the change

What Blue Sails’ Early-Intervention Autism Program Provides

Blue Sails Counseling and Consulting is a private provider and is not part of the Maryland Infants and Toddlers Program. Our early-intervention autism program is for children ages 2 to 6, with full-day and half-day options. It is a clinical program, distinct from general childcare. ABA therapy is planned with BCBA oversight and delivered with support from Registered Behavior Technicians. Enrollment depends on a clinical assessment, an individualized treatment plan, program fit and any payer requirements. Program options and locations vary, so ask intake what is available for your family.

Depending on your child’s plan, families can ask about speech-language therapy, occupational and sensory therapy, parent coaching and training and psychiatry when clinically appropriate. A structured program day can include circle time with visual supports, snack, transitions and planned practice with peers. Everyday skills such as toilet training and feeding routines and the kindergarten readiness skills many families work on before school can be part of the plan.

You can contact intake before your child has a diagnosis. Ask which records, referrals or medical orders your child’s services and insurance plan require.

Why Some Private Programs Recommend More Weekly Hours

Families comparing options often notice that a private program may recommend many more hours each week than an MITP plan includes. The two systems are built differently. MITP centers on coaching caregivers within daily routines, while a clinical ABA program typically sets weekly hours through an assessment and treatment plan.

Research on how many hours of intervention young autistic children need is still developing, and findings are mixed. More hours do not automatically mean more progress, and the right amount depends on your child’s needs, energy, other therapies and family life. Ask any program how it decides on hours, how progress is measured and how often the plan is reviewed.

Consistency Across Settings

Whatever the number of hours, consistency tends to matter. Skills are easier to practice when the same cues, visual supports and routines show up at home, in childcare and in therapy. A plan that both your family and your child’s Providers can follow every day is often more useful than a schedule that is hard to sustain.

Home Visits vs. a Structured Program Day

MITP visits usually happen where your child already spends time. A provider may join a meal or playtime, show you a strategy and help you practice it. The main benefit is that skills are built into your real routines.

A structured program day adds routines such as circle time, snack and transitions with other children, with adults supporting each child’s goals. Our guide to an autism early intervention day program vs. traditional daycare walks through what a program day can look like, and our comparison of program-based ABA vs. in-home ABA covers the trade-offs between settings. Neither is right for every child.

MITP Is Free, So What Does a Private Program Cost?

No Family Charge

Cost worries should not keep you from making a referral. MITP services are free to eligible families, and eligibility does not depend on income. Services for children from birth to age 3 can address communication, thinking and learning, social-emotional growth, self-help skills and motor skills.

How Private Programs Are Paid For

Private program costs vary widely by program, hours and coverage. Many families use health insurance, and some use Maryland Medicaid or private pay. Ask each program for a written estimate, what your plan covers and what your share may be. Our insurance and billing page explains how Blue Sails works with insurance, and Blue Sails accepts TRICARE. Families weighing a free Infants and Toddlers Program evaluation against private testing can compare payer rules in our guide to autism testing and ABA funding in Maryland.

Will Insurance Cover a Private Autism Program?

Coverage depends more on your plan than on the program. In Maryland, many state-regulated health plans must cover medically necessary habilitative services, including ABA, for children younger than 19 who have an autism diagnosis. Federal employee plans, military coverage and self-funded employer plans are generally outside that state mandate, so check your plan documents (Pathfinders for Autism). Maryland Medicaid covers medically necessary ABA for members under 21 (Maryland Department of Health).

Insurers pay for qualifying services, not attendance alone. Before you start, confirm medical-necessity rules, prior authorization and whether the program’s clinicians are in network. Because insurers generally want a clinical diagnosis, families often look at how a medical autism diagnosis differs from school IEP eligibility when planning next steps.

Can You Combine MITP With a Private Program?

In many cases, yes. Families commonly ask whether enrolling in a private program affects MITP. A few points to keep in mind:

• MITP decides eligibility through its own evaluation. Enrolling in a private program does not automatically qualify or disqualify your child.
• Your IFSP governs MITP services, which usually take place in natural settings such as home.
• A private program is not automatically an MITP provider. Your local program decides how its services are delivered, and arrangements vary by county.
• MITP services remain free, while private program costs are separate.

How to Blend MITP and Private Program Services

Blending the two can work well when both teams pull toward the same outcomes. Start with your child’s IFSP outcomes, since they reflect your family’s priorities. With your written consent, you can share them with the private program so both teams reinforce the same skills rather than competing goals.

• Ask your MITP service coordinator to help clarify roles so services do not overlap.
• Choose a few skills that matter at home and practice them during meals, play or bedtime.
• Ask each team which strategies carry over, and request a joint conversation if progress looks different across settings.
• Use IFSP reviews to check that the plan still fits your child and your family’s week.

Parenting a young child through evaluations and new services can be a lot. Support for parents of neurodivergent children can help you care for yourself and your family along the way.

Turning 3: IEP, Extended IFSP, or a Private Program?

Transition planning with your school system begins at least 90 days before your child’s third birthday (34 CFR 303.209). MITP eligibility does not carry over automatically. Families usually weigh three possibilities:

• An IEP: with your consent, the school system evaluates your child, decides eligibility for preschool special education and develops an IEP if your child qualifies.
• An Extended IFSP: eligible families may continue early intervention until the beginning of the school year following the fourth birthday.
• A private program: a clinical program can be used alongside either plan, depending on your child’s needs and coverage.

Our guide to medical autism diagnosis vs. Maryland school IEP eligibility explains why a diagnosis and school eligibility are separate decisions. For the step-by-step school side, see our guide to moving from early intervention to a Maryland public school IEP.

MITP, a Private Program, or Both: How to Decide

There is no single right answer. These questions can help you talk it through with your child’s pediatrician and care team:

• Is your child under 3? If so, a referral to MITP costs nothing and can start right away, even while you wait for other appointments.
• Does your child need more structured, peer-based practice than home visits provide?
• Does your child have a clinical autism diagnosis, or is an evaluation still pending?
• What does your insurance cover, and what fits your family’s schedule and energy?
• Who will help keep goals consistent if you use more than one service?

You can revisit the choice as your child grows. For more on this age group, see our page on support for toddlers and preschoolers and our autism and early intervention guide.

Official Sources and Where to Get Help

Use these resources to confirm eligibility rules, make a referral or find your county program:

• Maryland Infants and Toddlers Program (mditp.org): the statewide program home.
• MITP referral page: online referral and contact information for each local program.
• Maryland Department of Health: Infants and Toddlers Program: program overview.
• Maryland Autism Waiver: a Medicaid waiver for eligible autistic children and youth who have an IFSP or IEP. The Maryland Department of Health notes there is a waitlist; you can call the Autism Waiver registry at 866-417-3480.
• Pathfinders for Autism: a Maryland nonprofit with guides on early intervention and insurance.

How Blue Sails Can Help

Blue Sails offers autism services for young children and their families, including autism evaluations, ABA therapy with BCBA oversight, an early-intervention autism program, speech and occupational therapy, parent training, and psychiatry when clinically appropriate. When you are ready, request an appointment and intake can talk through clinical fit, current availability and what your insurance requires. If your child is under 3, you can also refer to MITP at the same time.

If you are worried about your child’s or your own immediate safety, call 911, go to the nearest ER, or call or text 988.

Frequently Asked Questions

What Should I Do While Waiting for a Diagnosis or Evaluation Appointment?

If your child is under 3, you can refer to the Maryland Infants and Toddlers Program right away; you do not need a diagnosis. In the meantime, keep notes on what you notice, share them with your child’s pediatrician and ask about services that can start before a diagnosis.

Can My Child Receive MITP Services and Attend a Private Program at the Same Time?

Often, yes. MITP services follow your child’s IFSP and usually happen at home or in community settings, while a private program follows its own treatment plan. With your written permission, the two teams can share goals so routines stay consistent.

Is the Maryland Infants and Toddlers Program Really Free?

Yes. Services are free to eligible families, and eligibility depends on your child’s development, not your income. A private program is a separate service with its own costs, which may be covered by insurance depending on your plan.

What Credentials Should a Private Program’s BCBAs and RBTs Hold?

A Board Certified Behavior Analyst (BCBA) holds certification from the Behavior Analyst Certification Board, and Registered Behavior Technicians (RBTs) work under a BCBA’s supervision. Ask any program who oversees your child’s plan, how staff are supervised and whether clinicians are licensed in Maryland where required.

How Quickly Can My Child Start a Private Program After an Autism Diagnosis?

Start timing depends on any assessments still needed, insurance authorization and current openings. Intake can explain the next steps, scheduling options and paperwork for your family.