Early Supports & Services

Intellectual & Developmental Disabilities

Early Supports and Services (ESS) is at the heart of the comprehensive services we offer for children between birth and age three and their families. Providing family-directed, individualized supports, our offerings encompass Early Supports and Services, Autism Protocol Services and a number of other relevant services.

Autism Protocol Services

Autism Protocol services build upon the Early Supports and Services provided through a child’s IFSP (Individual Family Support Plan). These additional services include, but are not limited to, consultation and supports designed to help families identify and implement behavioral and sensory strategies that are known to assist children who have Autism to achieve their optimum potential.

In Home Supports

For children that live at home with their family and are supported on the IHS waiver, we offer the following services: Personal care: which includes assistance and skills training with basic daily living skills, such as communication, socialization, health and personal safety, and physical functioning.

Children’s Services

The Moore Center oversees more than 650 families, featuring family-oriented services customized to best meet the needs of the child. The Children’s Service Department oversees the provision of Early Supports and Services (ESS) in the greater Manchester area, which serves children under three who have an established condition, developmental delay, or are at risk of a substantial delay.  Service providers in ESS act as the contact point for families, offering resources and service coordination.

How do I know if my child is eligible?

To determine eligibility please visit our Start Here page.

What is Early Supports & Services?

Early Supports and Services (ESS) is designed to help children under age three to get a good start in life, especially when there are concerns about developmental delays. In New Hampshire, ESS is available to eligible children and their families in the time between the child’s birth and his or her third birthday. 

These resources include a developmental evaluation, therapeutic interventions and instruction, guidance, referral to community resources, coordination of services, and transition assistance to available community supports and services upon the child’s third birthday or when a child is no longer eligible for ESS.

Families who are eligible for services from the ESS program are assigned a Case Manager. The Case Manager coordinates all aspects of a child’s program and is a family’s contact person within the program.  Oversight is provided for many aspects of the child’s program including: scheduling for assessments, Individualized Family Support Plan meetings, and consultations. Case Managers also provide families information on available community resources that would be beneficial to a child’s development such as activities and educational information

The Moore Center’s professional team of licensed and experienced pediatric speech/language pathologists, pediatric physical therapists, pediatric occupational therapists, early childhood educators and family liaisons works in tandem with families, providing a multi-disciplinary approach to ensure the best possible outcome for the child.  The Moore Center’s credentialed ESS staff provides family support and education and also has knowledge of additional community resources that can be of assistance to families.

Developmental Milestones

The future of our society is largely dependent on how diligently we work to ensure the health, safety and well-being of the next generation. Studies have proven time and time again that by taking proactive steps to provide children with the early building blocks they need to grow and thrive, we are making an investment in our future workers and citizens.
The ESS staff works with families to support their children’s progression through Developmental Milestones, respecting families’ values, needs, cultures and priorities in the natural settings of homes and childcare facilities.

At 7 months, many children are able to:

  • Turn head when name is called 
  • Smile back at another person 
  • Respond to sound with sounds 
  • Enjoy social play (such as peek-a-boo)

At 1 year (12 months), many children are able to:

  • Use simple gestures (waving “bye-bye”) 
  • Make sounds such as “ma” and “da” 
  • Imitate actions in their play (clap when you clap)

At 1 1/2 years (18 months), many children are able to:

  • Do simple pretend play (“talk” on a toy phone) 
  • Point to interesting objects 
  • Look at object when you point at it and tell them to “look!” 
  • Use several single words unprompted

At 2 years (24 months), many children are able to:

  • Use 2 to 4 word phrases 
  • Follow simple instructions 
  • Become more interested in other children 
  • Point to object or picture when named 

At 3 years (36 months), many children are able to:

  • Show affection for playmates 
  • Use 4 to 5 word sentences 
  • Imitate adults and playmates (run when other children run) 
  • Play make-believe with dolls, animals, and people (“feed a teddy bear”)

PRIDE is a small discretionary fund available to assist families in emergency situations like the need for food, fuel or utilities. It can also be used for some therapies that are not covered under Medicaid and trainings.

Staff and Family Support Advisory Council members review each request. A maximum of $300.00 may be approved in a one-year period if funding allows.


Respitality is the “gift of time.” It provides caregivers the opportunity to spend one night at a hotel of their choice (from a list of participating hotels). A one-time coordination fee is required and a vendor will arrange the hotel accommodations. There may be a waiting period depending on where you want to stay.

Additional Questions About ESS

Q: How do I start?
A: Anyone can make a referral to ESS, including parents, pediatricians, relatives, and child care providers. Parents who have concerns or questions about their child’s development often make referrals. Initial calls should be made to our ESS Intake Coordinator at 603-206-2714.

Q: Do I need a referral from my pediatrician?
A: No, not for the initial Intake appointment. Parents may self refer by calling us directly. If, after the Intake, a parent wishes to proceed with the evaluation, Early Supports and Services (ESS) will ask the parent to sign a permission form asking the child’s pediatrician to order the evaluation.

Q: How do I know whether my child is eligible?
A: The Intake Coordinator schedules an eligibility evaluation at a mutually convenient time. It usually takes place in the family’s home, where the child is most comfortable. The evaluation team includes at least two professionals in fields related to early childhood development and care such as physical therapy, occupational therapy, early childhood education, special education, and speech therapy.

To be determined eligible for ESS in New Hampshire, children must meet one of these specific categories:  established conditiona developmental delay of 33% (physical, cognitive, communication, social/emotional or adaptive development), at risk for substantial developmental delay (in five or more documented conditions or circumstances) or atypical behavior.

Q: What happens next if my child is eligible for services?
A: The family, the ESS providers, and anyone else the family wishes to include develop an Individualized Family Support Plan (IFSP). It reflects the family’s and child’s strengths, needs, and priorities, as identified by them, as well as those identified by the evaluation team. The plan defines goals and the activities and supports that will be provided to reach them. Supports and services include instruction and therapeutic services that are intended to improve the family’s ability to understand and enhance the child’s development.

Q: If my child is eligible, where will services be provided?
A: Services are provided in a natural setting such as the child’s home or child care. Parent education is at the heart of ESS, so, whenever it is possible, we prefer to have the parent(s) present when services are provided. This allows the parents to learn strategies to carry over activities throughout the child’s daily life. After every visit, progress notes, along with any suggested activities for the week, are written up and a copy is given to parents.

Q: How many providers will be working with my child?
A: A child eligible for the program will have a primary therapist or educator who will work with him or her across all areas of development. A child’s primary provider will call in other therapists or educators as consultants as necessary to be sure all of a child’s developmental needs are met. Having one consistent provider allows children to feel comfortable with and form a solid relationship with him or her. We believe this approach results in ESS services being provided in a seamless, efficient, and comfortable manner for the whole family.

Q: If ESS services are available from birth to age three, does that mean my child will automatically receive services until his/her third birthday?
A: Not necessarily.  Once eligibility for the program is determined and an Individual Family Support Plan (IFSP) is developed, the child’s ESS provider(s) regularly check the progress made on the goals described in it.

If it is determined that services are no longer needed, families and staff make a decision together. Families are encouraged to call ESS at any time before their child turns three if other developmental concerns come up that may warrant further evaluation.

Q: ESS is available to eligible children until their third birthday. What happens when my child turns three?
A: Each child who enters ESS receives service coordination, which includes help with transitioning him or her into the school system or other community settings seamlessly.

Q: Can I afford this service for my child?
A: ESS is  funded through state and federal funds, Medicaid and private health insurance, as well as other community resources. No child will be declined services because of the family’s lack of financial resources.

Q: Are there other services available to my family if we are receiving ESS?
A: Yes. The Moore Center’s ESS services include information, referral, and some financial assistance for disability-related expenses or respite care. If your child is diagnosed with autism spectrum disorder he or she is also eligible for Autism Protocol Services.

These additional services include, but are not limited to, consultation and supports designed to help families identify and implement behavioral and sensory strategies that are known to assist children who have Autism to achieve their optimum potential.

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