After a Brooklyn toddler with autism failed to receive many of the therapies she was entitled to, two city agencies refused to provide makeup services to help her catch up, according to a federal lawsuit filed on Tuesday against the city’s health and education departments.
The case revolves around a child, referred to by her initials R.A., who exhibits limited speech skills and cognitive delays. She was eligible for a variety of therapies through Early Intervention, a program designed to offer services to children with various developmental delays from birth to age 3. At just 2 years old, R.A. was entitled to receive occupational, speech, and behavioral therapies. However, the suit claims that she only received limited sessions of behavioral therapy during her seven months in the Early Intervention program, with none of the occupational and speech therapies provided.
When R.A. turned 3 last year, the Department of Health and Mental Hygiene, which operates Early Intervention for city residents, refused to grant makeup services for the therapies since she had “aged out” of the program. This transition left her without the critical support she needed, putting her and her family in a precarious position. R.A. now attends a special education preschool, but the Education Department, responsible for overseeing special education plans for school-age children, has also declined to provide additional therapies to compensate for what she missed during Early Intervention.
The family finds themselves “caught between two systems,” said Betty Baez Melo, the director of the early childhood education project at Advocates for Children, which is spearheading the lawsuit alongside Morrison & Foerster LLP. “Neither agency is taking accountability in order to provide the child with the services that she didn’t receive.” This sentiment echoes a widespread frustration among families navigating the bureaucracies of health and education services, particularly when their children’s needs are not being met.
The lawsuit contends that R.A. has a right to “compensatory services” under federal law to make up for lost therapy sessions. The family had previously attempted to secure these compensatory services from the Health Department through an administrative law judge but was met with resistance. Advocates for Children is also involved in a separate federal lawsuit against the Education Department, aiming to expedite makeup services for school-age children who have missed out on critical therapies.
Experts emphasize that receiving therapies early in life is essential for young children with disabilities or delays, as their brains are still rapidly developing. Early intervention can significantly reduce the need for more extensive—and costly—special education services later on, making it crucial that children like R.A. receive the therapies they need without interruption.
Although the lawsuit focuses on R.A., Baez Melo believes it holds implications for numerous families in similar situations. According to an audit released by the state comptroller earlier this year, approximately 58% of children eligible for Early Intervention did not receive all of the services they were entitled to between July 2018 and February 2022. This period coincided with the onset of the pandemic, during which the number of children receiving services plummeted, and providers scrambled to adapt by offering therapies remotely.
R.A.’s mother, a 29-year-old identified in the lawsuit as B.A., resides in East New York. She describes the journey to secure services for her daughter as a distressing experience, filled with obstacles and frustrations. B.A. suspected early on that her daughter might have a disability, as R.A. struggled with making eye contact, often repeated questions instead of answering them, had difficulty sitting still, and was resistant to touching or eating soft foods.
The family hoped that Early Intervention services could help address some of these challenges. Initially, the city offered teletherapy, which posed significant difficulties for the family. R.A. has trouble sitting still, and B.A.’s limited English proficiency made it harder to follow a therapist’s instructions for delivering services to her daughter.
While R.A. did receive some behavioral therapy known as Applied Behavioral Analysis (ABA), it never reached the 20 hours a week she was supposed to receive, according to court documents. Furthermore, she did not receive any of her required speech or occupational therapy sessions, which are crucial for her development.
Many families throughout the city face similar struggles in securing providers, a challenge that is particularly acute in certain neighborhoods. As an immigrant from Bangladesh, B.A. also questioned whether language barriers affected how seriously the service coordinator took her concerns.
“I didn’t do anything wrong — we started everything on time, but I couldn’t help my daughter,” B.A. said in Bengali during an interview that was interpreted by her sister. “She needs a lot of help besides what the [Education Department] provides.” The weight of her words reflects the anguish and determination of countless parents who are trying to navigate a complex system that often fails to deliver the support their children desperately need.
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