Are We Missing a Vulnerable Population in Early Intervention?

Abstract

Infants with low birth weight (LBW ≤ 2,500 g) are at high risk for developmental delays, including cognitive impairments. Retrospective studies have shown that these children often have learning and/or behavioral difficulties at school age. Early evaluation and enrollment in early intervention (EI) programs may reduce the impact of these difficulties; however, many children who would benefit from such programs may not receive EI services. This study provides information on 279 children born LBW and includes information on developmental capability and EI enrollment. Results indicate that children born LBW in EI services had lower overall developmental standard scores than those not in EI. However, it is concerning that almost an equal number of children across all categories of birth weight are not in services.

Early Intervention Referral Outcomes for Children at Increased Risk of Experiencing Developmental Delays

“…Unfortunately, this national pattern of under-enrollment also holds true for infants with complicated early medical histories that place them at increased risk of experiencing developmental delays, including those born LBW (Barfield et al, 2008;Blasco, Guy, Saxton & Duvall, 2017;Litt & Perrin, 2014). State-specific research has shown that barriers to successful EI enrollment for LBW infants include lack of a formal referral tracking process and poor communication between referring providers and EI programs (Little, Kamholz, Corwin, Barrero-Castillero, & Wang, 2015).…”

“…Furthermore, recommendations for improving EI referral outcomes for preterm and LBW infants include faxing referrals directly to EI programs rather than simply providing the family with a phone number (Jimenez, et al, 2014) and following up on referral outcomes (Little, et al, 2015). Limited data from previous research suggests some children born LBW may not be in services due to be difficulty connecting with the program or not being found eligible upon evaluation (Blasco et al, 2017). Though under-enrollment of LBW children in EI services is well documented, there is little research examining why this is the case.…”

“…Children born LBW are at-risk for developmental delays and would likely benefit from early intervention (EI) services. While several research studies have shown that children born LBW are under-enrolled in EI services (Atkins, Duvall, Dolata, Blasco, & Saxton, 2017;Blasco et al, 2017;Hebbeler et al, 2007;Litt & Perrin, 2014;Tang et al, 2012), there has been no systematic investigation regarding why this is the case. Based on clinical experience, many EI referrals placed by physicians are not ultimately successful (i.e., do not result in a child being evaluated and/or reviewed for eligibility by the program and enrolled in services), for unknown reasons.…”

“…delays, yet are under-enrolled in EI nationally (Barfield et al, 2008;Blasco, Guy, Saxton & Duvall, 2017;Litt & Perrin, 2014). Litt and Perrin (2014) have not been referred to the program previously, or have been referred in the past but the referral did not result in evaluation and/or services through the program.…”

“…Additional research completed using the same dataset (Blasco & Saxton, 2009) investigated EI enrollment across birth weight categories (i.e., LBW ≤ 2,500 grams, VLBW ≤ 1,500 grams, ELBW ≤ 1,000 grams, Blasco et al, 2017). The authors found children born VLBW or ELBW were more likely to be enrolled in EI than children with heavier birth weights.…”