Regional variations in early intervention utilization for children with developmental delay.
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.
Children's Health Fund, 215 West 125th Street, New York, NY 10027, USA. rgrant@chfund.org
Roy
R
Grant
Elizabeth A
EA
Isakson
D000293:Adolescent; D000704:Analysis of Variance; D002648:Child; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000453:epidemiology / Q000628:therapy*; D018479:Early Intervention, Educational / Q000706:statistics & numerical data*; D004608:Eligibility Determination / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight; D008297:Male; D011159:Population Surveillance; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology