Regional Variations in Early Intervention Utilization for Children with Developmental Delay

Abstract

We tested whether state-level variations in early intervention program (EI) participation were consistent with rates of key risk factors for early developmental delay. Based on the results of prior studies, we focused on child poverty and low birth weight as risk factors, included state threshold for EI eligibility by category (classified as broad/moderate or narrow), and aggregated the states into regions. Bivariate analyses were done in SPSS 15.0. All data were for 2009. Results were tested against data for prior years to ascertain whether findings for 2009 were anomalous. Nationally, 2.67 % of the age-eligible population was served in EI (range among states, 1.24-6.51 %). Variation in EI participation was significant at the regional level. Early intervention participation was lowest in the south and highest in the northeast (p < 0.01). Regional variations in low birth weight (p < 0.01) and child poverty (p < 0.01) were also significant. Both were highest in the south. While EI participation varied significantly by state eligibility standards, this factor did not entirely explain variance in utilization. Results for 2009 were representative of multi-year trend data. National EI utilization rates consistently lagged behind need as identified in epidemiologic studies from multiple sources. The results strongly suggest that there is a significant population of infants and toddlers who need but do not receive EI services, especially in the south.

Utilisation of early intervention services in young children with hypoplastic left heart syndrome

“…Although early intervention services are mandated by Part C of the Individuals with Disabilities Education Act in the United States of America, there is wide variability in interpretation and eligibility by state. 14,17 There are important limitations to this study, the most significant of which is that we relied on parent reports of use of early intervention services. Parents may not have distinguished between an evaluation and actual therapy.…”

“…13 Administration of early intervention and interpretation of Individuals with Disabilities Education Act Part C vary widely by state. 14,15 Typically, therapeutic efforts to support development are offered to children aged 0-3 years. If support is still needed after age 3 years, children enter early education services with a focus on school readiness.…”

Patterns and predictors of childcare subsidies for children with and without special needs

“…However, the proportion of young children served under IDEA represents only 2.8% to 5.9% of children in this age group. This is well below the 13% to 15% estimated to have eligible disabilities and delays, signaling that many children in need of services do not receive them under this federal program (Boyle et al, 2011; Grant & Isakson, 2013; Hebbeler, Spiker, & Kahn, 2012; Rosenberg et al, 2008). There has long been concern that children with special needs are under-identified, but even among those children with identified needs, approximately one-third receive no services (Peterson et al, 2011).…”

“…Given these considerations, we opted for the SD approach. Thus, we sought to capture children identified under the law via criterion 1 above, but being mindful of persistent under-identification of eligible children (e.g., Boyle et al, 2011; Grant & Isakson, 2013; Hebbeler, Spiker, & Kahn, 2012), we also sought to include those children likely to be eligible under federal and state laws, given the information available in the ECLS-B, via criteria 2 and 3.…”

EPICE cohort: 2-year neurodevelopmental outcomes after very preterm birth

“…Health outcomes such as infant mortality3 vary quite dramatically among states. There is also regional variability in access to perinatal health services and postdischarge support like early intervention 4. These differences are often explained away by pointing to the differing sociodemographic makeup of states and regions.…”