Does the persistence of development delay predict receipt of early intervention services?

Abstract

Objective: To examine how the persistence of infants' and toddlers' developmental delays affects their access to early intervention services (EI).

Methods: Using the Early Childhood Longitudinal Study, Birth cohort (ECLS-B), we examined receipt of EI at 24 months for each category of developmental change. Development delay was measured at 9 and 24 months and categorized as none (ie, within 1 SD below the mean), mild (ie, between 1 and 1.5 SD below the mean), and moderate/severe (more than 1.5 SD below the mean). Changes in the subjects' developmental skills between 9 and 24 months were calculated. For children with a delay at either time point, adjusted logistic regression models estimated the likelihood of receiving EI at 24 months.

Results: Use of EI varied across severity, type, and timing of developmental delay. Among the children with a cognitive delay, those with delays at 9 and 24 months were significantly more likely to receive EI at 24 months than peers whose delays improved, emerged, or worsened. Among the children with a motor delay, those with regression from normal to moderate/severe were significantly more likely to receive services than children with persistent delays (adjusted odds ratio 2.7, 95% confidence interval 1.1-6.6).

Conclusions: Except for children whose motor skills regress substantially, children with dynamic developmental delays are less likely than their peers with persistent delays to receive EI. This finding suggests the need for improved understanding of developmental surveillance, referral, and use of EI services.