Rates of early intervention services in very preterm children with developmental disabilities at age 2 years.
OBJECTIVE
Preterm birth is increasing in prevalence and long-term follow-up studies have documented high rates of neurosensory, intellectual, academic and behavioural disabilities. The importance of early intervention (EI) is well recognised but significant barriers to receiving EI exist in the community. This study explores the association of levels of disability at age 2 years with EI services and social risk in a large cohort of very preterm children.


METHODS
This was a cohort study of 236 very preterm (gestational age < 30 weeks or birthweight < 1250 g) infants recruited at birth. Children were assessed comprehensively at age 2 years, and EI and social risk data were gathered via parental questionnaire. Disability levels were assigned as none, mild, or moderate to severe. The relationships of disability level to EI services and social risk were determined.


RESULTS
Of the initial cohort, data from 227 (97%) were available at age 2 years. Overall, 50.7% (115/227) of children had some disability. A significant difference was present (P < 0.001) between the rates of EI and disability, with only 27.9% of children with a mild disability receiving EI services compared with 51.1% of children with a moderate to severe disability. After adjustment for level of disability, those of higher social risk were less likely to receive EI services (odds ratio 0.25; 95% confidence interval 0.11-0.56; P = 001).


CONCLUSIONS
Currently available follow-up, referral and EI services underserve the most vulnerable children in our community, those with a combination of biological and social risk factors for developmental disabilities.
Roberts
Gehan
G
Victorian Infant Brain Study Group, Murdoch Children's Research Institute, University of Melbourne, Melbourne, Victoria, Australia. gehan.roberts@rch.org.au
Howard
Kelly
K
Spittle
Alicia J
AJ
Brown
Nisha C
NC
Anderson
Peter J
PJ
Doyle
Lex W
LW
D002662:Child Health Services / Q000706:statistics & numerical data*; D002675:Child, Preschool; D015331:Cohort Studies; D002658:Developmental Disabilities / Q000175:diagnosis / Q000628:therapy; D019988:Children with Disabilities / Q000706:statistics & numerical data*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development; D016017:Odds Ratio; D047928:Premature Birth; D018570:Risk Assessment; D012923:Social Class; D011795:Surveys and Questionnaires