Early intervention in India: DEICs, RBSK and where to find free help

The years before school are when children learn to understand and use language, move, play with others and manage a day’s routines, and when parents work out what helps their own child. Help that starts then gives the child practice at what is hard and the adults strategies sooner, so the family is not starting from nothing when nursery admissions begin.

Indian guidance is clear about timing. The Indian Academy of Paediatrics (IAP) guidelines on global developmental delay (2022) say early intervention should start as soon as the delay is recognised, without waiting for a formal diagnosis, and IAP’s 2017 autism consensus says a definitive diagnosis is not needed first. IAP also recommends screening all children at 9–12 months, 18–24 months and school entry, checking vision and hearing in every child with a suspected delay, and referring on if a child loses skills.

Keep three steps apart: screening says whether to look further, diagnosis is a clinical assessment by qualified professionals, and certification is a separate statutory process under the RPwD Act. Intervention need not wait for the last two. This guide is information, not medical advice; Special Minds does not screen, assess or diagnose, and the paediatrician is the right first call.

Rashtriya Bal Swasthya Karyakram (RBSK), now RBSK 2.0 on the National Health Mission’s site, is the government’s child health screening and early intervention programme. It covers children from birth to 18 for the ‘4 Ds’: defects at birth, deficiencies, diseases and developmental delays, including disabilities, and treatment for the conditions it identifies is free, including surgery at tertiary level. The 2026 guidelines list 38 numbered items, among them Down syndrome, global developmental delay, language delay, autism, ADHD and specific learning disorders; the 2013 guidelines listed 30, and the NHM web page says 32.

RBSK does not screen every child. The guidelines set out where it reaches children and what follows:

• Newborns at public health facilities up to six weeks old, and at home through ASHA workers’ newborn care.
• Children from six weeks to six years at Anganwadi centres, at least twice a year.
• Pupils in Classes 1 to 12 in government and government-aided schools, at least once a year.
• Children found to need help are referred on, including to the District Early Intervention Centre.
• Under RBSK 2.0 a digital health card is generated for each child screened; keep it with the child’s records.

Private schools are not among the listed platforms, though the 2026 document says, as an aim, that no child should be left out. A child in a private school or at home can still be seen: parents can take a child to a DEIC themselves, and the paediatrician can refer.

A DEIC is a centre at the district hospital that confirms diagnoses, manages children, gives therapy and links families to specialist hospital care. The 2014 DEIC guidelines focus on children up to six and allow referral or parent self-referral; any child under six with a neuro-motor problem, for example, can get therapy there. That design also assigns learning disabilities and ADHD at six to nine to the DEIC, and the 2026 RBSK guidelines describe DEICs as caring for children from birth to 18. All services are meant to be free. The 2014 core services are:

• Medical and dental care.
• Occupational therapy and physiotherapy.
• Psychological assessment and counselling, including parent training and behaviour modification.
• Audiology and speech-language therapy.
• Vision services, including for retinopathy of prematurity.
• Cognition services, special education and psycho-social support.
• Lab tests, nutrition and social support.
• Transport reimbursement for specialist hospital care, and referral and coordination between services.

The 2026 staffing table includes a paediatrician, a physiotherapist or occupational therapist, an audiologist and speech therapist, a psychologist, an optometrist and an early interventionist who also works as special educator and social worker. The 2014 design lists disability certificates as a supplementary service arranged with the disability board; ask whether yours does this.

Government policy is to set up a DEIC at district hospital level across the country, but there is no current official count of how many are working. Do not assume your district has a functioning centre, or that it offers every service listed. In the large cities, where the district hospital is one of several government hospitals, finding the right door can take a phone call or two.

Ask the paediatrician whether there is a DEIC in your district and whether they would refer, or call the paediatrics department at the district hospital. If your child attends an Anganwadi centre or a government school, ask about the RBSK referral. When you get through, these questions save a wasted trip:

• Is the DEIC running now, and which therapies are available at the moment?
• Can a parent bring a child directly, or is a referral letter needed?
• What should we bring: reports, the immunisation card, any RBSK health card?
• Is there a wait for the first assessment, and for therapy after it?
• Can the hearing and vision checks be done there?
• Will the therapists give us activities to do at home between sessions?
• If a service is not available, where do you refer children instead?

There are 22 Cross-Disability Early Intervention Centres (CDEICs) for children up to six, run under DEPwD, the central government’s department for persons with disabilities, at national institutes and composite regional centres. They include NIEPID in Secunderabad, NIEPMD in Chennai, AYJNISHD in Mumbai and PDUNIPPD in Delhi, and composite regional centres such as Davanagere, Nellore, Ahmedabad and Kozhikode.

Expect fees. NIEPID and NIEPMD charge for services, and NIEPID gives concessions on a white ration card or an income certificate; at AYJNISHD most assessments are free, but some tests and therapy carry fees. Services and charges change, so call before you travel and ask what is offered at your child’s age.

Not every regional centre is listed as a CDEIC, so ask each what it offers children under six. NIEPID and NIEPMD also run family cottages, where parents stay for up to a week for training.

The National Trust, set up under the National Trust Act 1999, covers four conditions only: autism, cerebral palsy, intellectual disability and multiple disabilities. Its Disha scheme offers early intervention and school readiness from birth to ten: day care of at least four hours a day on at least 21 days a month, in batches of 20, with a special educator or early intervention therapist, a physiotherapist or occupational therapist, a counsellor, a caregiver and an aya. Seats are split equally between low-income families and paid places.

For the Trust to fund a place, the child needs a UDID card, or a UDID enrolment number with a certificate, and enrolment in Niramaya. The Trust’s 2025-26 Citizens’ Charter says no new Disha projects are being sanctioned and no applications accepted; that concerns new centres run by registered organisations, and existing centres continue, with vacant seats listed on nationaltrust.nic.in, where the current position should be checked.

Niramaya, the Trust’s health insurance, pays on reimbursement only, up to a yearly limit, for outpatient care, medicines and tests, corrective surgery, hospital stays, ongoing therapies within a sub-limit, dental care, AYUSH and transport, with no age bar and treatment at any hospital; the policy year ends on 31 March. The 2025-26 Charter sets new enrolment at two hundred and fifty rupees a year for BPL families and five hundred for others, and renewal at fifty and two hundred and fifty. It is free for a person whose legal guardian is not a natural parent, and in the North-Eastern states.

Niramaya requires a UDID card for one of the four conditions, and accepts an enrolment number with a certificate only for children under seven; the UDID card and disability certificate for a child explains how to apply.

Families often combine services: an assessment and some therapy through a DEIC or a national institute, private sessions with a speech-language pathologist or occupational therapist nearer home, and daily practice in between. IAP’s 2024 consensus describes a multidisciplinary team, including a developmental therapist, physiotherapist, occupational therapist, speech therapist and clinical psychologist, led by a developmental paediatrician or paediatrician, at a child development centre or a DEIC.

Check registration. Under the RCI Act, audiologists and speech therapists, clinical psychologists and special teachers must be registered with the Rehabilitation Council of India to practise, and RCI’s online register lets families check a name before the first session.

The therapists set the targets; the hours between sessions decide how much carries into daily life. A special educator at home works on the same targets during meals, play and routines, keeps a short record for the therapists and shows the household what to do; special educator or therapist: who does what draws the line between the roles. Special Minds introduces vetted special educators at home in Mumbai, Delhi NCR, Bengaluru, Hyderabad, Chennai, Kolkata, Pune and Ahmedabad, and does not provide speech therapy, occupational therapy or physiotherapy.

None of this replaces a clinician’s advice, and the therapists will refine it once they know your child. These are things any family can begin this week, while waiting for a first appointment:

• Keep the day predictable and show it with pictures; visual schedules at home explains how to make one.
• Talk through what you are doing together in short phrases, and wait a few seconds for your child to respond before filling the silence.
• Follow your child’s lead in play for a few minutes each day, joining in with what already interests them.
• Keep speaking the languages of the home; advice to drop one is not supported by the evidence, as speech delay in a bilingual home explains.
• Follow IAP’s screen-time advice: no screens under two apart from video calls with family far away, and at most an hour a day, supervised, between two and five.
• Ask for a hearing and vision check if neither has been done.
• Keep dated notes or short phone videos of what your child does and says, to show the clinician.
• Agree the same few words for the same things across the household, so grandparents and whoever helps at home say them the same way; a shared daily routine makes this easier.

Start a file too: every report, the immunisation card, any RBSK health card and dated notes from each appointment. Keep it ready for school admission, a DEIC or national institute visit, and any disability certificate application.