Expenditures for Early Intervention Services

Abstract

What does it cost to provide early intervention services? Data collected as part of the National Early Intervention Longitudinal Study were used to determine expenditures for infants, toddlers, and their families receiving services through Part C programs. The study found that the national average total expenditure for early intervention services in the late 1990s was $15 740 and the average monthly expenditure was $916. Both the total expenditure and the monthly expenditure differed for children with different reasons for eligibility for early intervention services. The expenditures for children with diagnosed conditions and developmental delays were higher than those for children with only communication delays or risk conditions, although there was substantial variation in monthly expenditure within each of the 4 categories. Expenditures also varied as a function of children's health with the highest average monthly expenditure for children in poor or fair health. The findings illustrate the kinds of questions that can be addressed with expenditure data and underscore the need for the regular collection of expenditure data at the state and national levels. Careful examination of outcomes experienced by children with various conditions who receive special collections of services at various costs will allow resources for early intervention to be allocated more equitably and efficiently.

Characterizing and Predicting Outcomes of Communication Delays in Infants and Toddlers: Implications for Clinical Practice

“…Yet, issues arise in allotting scarce EI resources (U.S. Department of Labor, 2011;Hebbeler, Levin, Perez, Lam, & Chambers, 2009). For children with identifiable medical conditions such as Down syndrome or deafness, EI services are generally mandated.…”

“…In an ideal world, perhaps children with risk factors about whom parents were concerned could receive intervention in the first year of life, and if they did, their developmental trajectories might be significantly altered in a positive direction. But EI is expensive (Hebbeler et al, 2009), SLPs are in short supply in many areas of the country ( U.S. Department of Labor, 2011), and the evidence that this scenario is valid is currently absent, as is the evidence as to what would constitute an efficacious treatment. Several research groups (summarized by Zwaigenbaum et al, 2009) studying the development of this population are experimenting with offering training to parents to maximize at-risk infants' opportunities for social-communicative development, but the results of this research have not yet been published.…”

The Cost of Serving Infants and Toddlers Under Part C

“…The overall average spending per month per child and family for early intervention services was $916. However, the average monthly expenditure ranged from $549 for children with a risk condition to $1103 for children with a diagnosed condition (Hebbeler, Levin, Perez, Lam, & Chambers, 2009). The NEILS also identified striking variations in expenditures within each of the 4 disability-related categories as well as between them.…”

“…The only comparable data is from the NEILS. Hebbeler et al (2009) reported that the average time for children in early intervention was 17.2 months for a total cost of $18,492.53 (in 2009 dollars) for the period of eligibility. The NEILS data were based on the actual number of months each child received services under Part C. Whereas, because of time constraints, we had to presume that each child enrolled would continue to receive Part C services until their third birthday.…”

“…One example of the use of guesstimation in the current study was the use of a federally approved department indirect rate as a proxy for being unable to conduct the exhaustive study that would be required to arrive at exact administrative overhead cost. This process is similar to the "imputation procedures performed to obtain the best estimate of the expenditure history of each child," as described in the NEILS (Hebbeler et al, 2009). …”