Regional Variations in Early Intervention Utilization for Children with Developmental Delay
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Regional Variations in Early Intervention Utilization for Children with Developmental Delay Roy Grant • Elizabeth A. Isakson
Published online: 24 August 2012 Ó Springer Science+Business Media, LLC 2012
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. R. Grant (&) Children’s Health Fund, 215 West 125th Street, Suite 301, New York, NY 10027, USA e-mail: [email protected] E. A. Isakson National Center for Children in Poverty, Columbia University Mailman School of Public Health, New York, NY, USA e-mail: [email protected]
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Keywords Early intervention Developmental delay Infant Early childhood Policy Abbreviations EI Early intervention also known as IDEA part C IDEA Individuals with disability education act 2004 IFSP Individual family service plan NEILS National early intervention longitudinal study CSHCN Children with special health care needs SPSS A software program used for data analysis ANOVA A data analytic method to determine variance between groups
Introduction The early intervention program (EI) was established by federal law in 1986 and subsequently reauthorized as Part C of the Individuals with Disabilities Education Act (IDEA). It is intended to promote the earliest possible identification and intervention for developmental delay and to reduce or prevent later costly special service needs. The population served is infants and toddlers birth through 35 months of age [1]. Participation by states is optional; however, by 1994 every state and the District of Columbia had implemented a statewide EI Program. Referred children receive a multidisciplinary developmental evaluation and, if found eligible
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