Social and Functional Characteristics of Receipt and Service Use Intensity of Core Early Intervention Services

Abstract

Objective: Describe children's diagnostic, social, and functional characteristics associated with the use of core early intervention (EI) services.

Methods: The sample included infants and toddlers (N = 2045) discharged from an urban EI program (2014-2016). Adjusted logit models estimated the marginal effects and 95% confidence intervals (CIs) of receipt of any of the 4 core EI services, controlling for the child's developmental condition type, race and ethnicity, primary language, sex, insurance type, age at referral, and functional performance at EI entry. Adjusted median regression estimated EI core service intensity controlling for child characteristics.

Results: The median per-child EI service intensity was less than 3 h/mo (median, 2.7; interquartile range, 2.1-3.5). Children whose primary language was English were 6% more likely to receive occupational therapy (marginal effect = 0.063; 95% CI, 0.010-0.115). Compared to infants, 1- to 2-year-old children were less likely to receive physical therapy and occupational therapy but more likely to receive speech therapy. Compared to infants, 1-year-olds received more intensive speech therapy (β = 0.42; 95% CI, 0.10-0.70), and 2-year-olds received less intensive occupational therapy (β = -0.70; 95% CI, -1.35 to -0.10). Children's functional performance at EI entry was significantly associated with the receipt and intensity of EI services.

Conclusions: Many EI-enrolled children received low-intensity services, a result that was associated with the primary language of the caregiver and the child's age and functional status. Results suggest the need for interventions to improve service delivery for vulnerable EI subgroups.

Keywords: early intervention; functional performance; service use; therapy.

Figure 1.

Conceptual Framework for the Study of Early Intervention Utilization (Adapted from Aday and Andersen)