The Impact of Race on Participation in Part C Early Intervention Services

Abstract

Objective To quantify racial differences in receipt of early intervention (EI) services among children ages birth to three. Methods We conducted multivariable analyses of a nationally representative sample of children eligible for EI services using data from the Early Child Longitudinal Study, Birth Cohort. Birthweight <1000 grams, genetic and medical conditions associated with developmental delay, or low scores on a standardized measure of developmental performance defined EI eligibility. Receipt of EI services was ascertained from parent self-report. The effect of race on receipt of EI services was examined in main effect models and models stratified by EI qualifying condition, which was defined as either established medical condition or developmental delay in the absence of an underlying medical diagnosis. Results At 9 months of age, among the 1000 children eligible for EI services, 9% of children received services; there were no Black-white racial differences in receipt of services. At 24 months of age, among the 1000 children eligible for EI services, 12% received services; Black children were 5 times less likely to receive services than white children (aOR 0.19; 95% CI 0.09, 0.39). In models stratified by qualifying condition, Black children who qualified for services at 24 months based on developmental delay alone were less likely to receive services (aOR 0.09; 95% CI 0.02, 0.39); there were no differences by race among children who qualified based on established medical conditions (aOR 0.56; 95% CI 0.18, 1.72). Conclusions Racial disparities in EI service receipt, which were not present during infancy, emerged as children became toddlers. These disparities were found most consistently among children who qualified for services based on developmental delay alone.

Early Intervention Before Autism Diagnosis in Children Referred to a Regional Autism Clinic

“…This varies from previous reports of race and insurance type impacting access to early intervention and is an encouraging finding. 11,12 We found that children referred for diagnostic ASD evaluation were receiving a mixture of both federally funded programing and privately obtained therapies. Among our sample, almost 70% of children received services under the Individuals with Disabilities Education Act (Part C and Part B).…”

“…For example, black children at 24 months of age are 5 times less likely to receive early intervention services than white children. 11 Furthermore, utilization of Part C services has also been reported as higher among children with Medicaid. 12 Despite such disparities, recent outcome reports have shown that 71% of all Part C Infant and Toddler Program participants less than 3 years of age have greater than expected growth in knowledge and skills, and 52% of these participants exit the early intervention program with development within age-appropriate limits.…”

Parental Preferences for Early Intervention Programming Examined Using Best–Worst Scaling Methodology

“…Parents from ethnic minority backgrounds may report different levels of interest in interventions that focus on building parenting skills when compared to parents of Caucasian background (Calzada et al 2012), and perhaps because of this, they are less likely to engage in parenting programs (Sanders and Kirby 2012). Racial disparities also exist within other early intervention programs for children with developmental delays (Feinberg et al 2011). Identifying parental preference that may vary across racial/ethnic groups can help understand how certain components of early childhood programs may influence racial/ ethnic minority groups' participation.…”

Missed Opportunities in the Referral of High-Risk Infants to Early Intervention

“…17,25,26 Wang et al 20 reported higher EI enrollment among children with birth weights ,1000 g who were receiving public insurance. Results from our regression analyses also showed that EI referrals were positively associated with public insurance.…”