Identifying Infants and Toddlers at High Risk for Persistent Delays.

OBJECTIVES: Little is known about the extent to which a developmental delay identified in infancy persists into early childhood. This study examined the persistence of developmental delays in a large nationally representative sample of infants and toddlers who did not receive early intervention. METHODS: In a sample (n ≈ 8700) derived from the early childhood longitudinal study, birth cohort, we examined developmental changes between 9 and 24 months. Motor and cognitive delays were categorized as none, mild, and moderate/severe. Adjusted ordinal logistic regression models estimated the likelihood of worse developmental delay at 24 months. RESULTS: About 24 % of children had a cognitive delay and 27 % had a motor delay at either 9- or 24-months. About 77 % of children with mild and 70 % of children with moderate/severe cognitive or motor developmental delay at 9-months had no delay at 24-months. Children with mild cognitive delay at 9-months had 2.4 times the odds of having worse cognitive function at 24-months compared to children with no cognitive delay at 9 months. Children with moderate/severe cognitive delay at 9-months had three times the odds of having worse cognitive abilities at 24-months than children who had no cognitive delay at 9-months. Similar results were found for motor skills. CONCLUSIONS: Developmental delays in infants are changeable, often resolving without treatment. This work provides knowledge about baseline trajectories of infants without and without cognitive and motor delays. It documents the proportion of children's delays that are likely to be outgrown without EI and the rate at which typically-developing infants are likely to display developmental delays at 2-years of age.

Computing theoretical rates of part C eligibility based on developmental delays.

Part C early intervention is a nationwide program that serves infants and toddlers who have developmental delays. This article presents a methodology for computing a theoretical estimate of the proportion of children who are likely to be eligible for Part C services based on delays in any of the 5 developmental domains (cognitive, motor, communication, social-emotional and adaptive) that are assessed to determine eligibility. Rates of developmental delays were estimated from a multivariate normal cumulative distribution function. This approach calculates theoretical rates of occurrence for conditions that are defined in terms of standard deviations from the mean on several variables that are approximately normally distributed. Evidence is presented to suggest that the procedures described produce accurate estimates of rates of child developmental delays. The methodology used in this study provides a useful tool for computing theoretical rates of occurrence of developmental delays that make children candidates for early intervention.

Part C early intervention for infants and toddlers: percentage eligible versus served.

OBJECTIVE: Part C early intervention is a nationwide program that serves infants and toddlers who have developmental delays. Previous research has revealed that large numbers of candidates for Part C services do not receive early intervention. Current eligibility criteria for Part C services vary from state to state. This article compares estimates of the percentage of children who are likely to be eligible for early intervention in each state and Washington, DC, with the proportion of children who are served in each of those jurisdictions. METHODS: Data for this study were obtained from the Early Childhood Longitudinal Survey-Birth Cohort. Using these data, we computed the proportion of children who would be eligible based on the numerical eligibility definitions currently in use across the United States. RESULTS: This study revealed the proportion of infants and toddlers likely to be eligible for Part C services ranges from 2% to 78% across the United States. The proportion of children enrolled in Part C ranges from 1.48% to 6.96%. CONCLUSIONS: This research documented substantial variability in the proportion of children who are likely to be eligible for Part C services. Most states have adopted eligibility definitions that make many more children candidates for Part C early intervention than they serve. However, current rates of enrollment are insufficient to serve all children with delays that fall under 2 SDs below the mean on any of the 5 developmental domains that are required to be evaluated by Part C regulations.

Prevalence of developmental delays and participation in early intervention services for young children.

OBJECTIVES: The objective of this study was to use a nationally representative longitudinal sample of children born in the United States in 2001 to estimate rates of eligibility for Part C early intervention, to estimate rates of access to services for developmental delays, and to examine factors that are associated with access to services. METHODS: Data for this study were collected as part of the Early Childhood Longitudinal Study, Birth Cohort, which obtained data from participants when children were 9 and 24 months of age. Descriptive analyses were used to generate national estimates of the prevalence of developmental delays that would make children eligible for Part C services and rates of participation in early intervention services. Logistic regression analyses were conducted to examine whether child developmental delay, race, insurance availability, and poverty status were associated with the probability of receiving services. RESULTS: Results indicated that approximately 13% of children in the sample had developmental delays that would make them eligible for Part C early intervention. At 24 months, only 10% of children with delays received services. Children with developmental delays were more likely to receive services than those who do not have delays; black children were less likely to receive services than children from other ethnic and racial groups. CONCLUSIONS: The prevalence of developmental delays that make children eligible for Part C services is much higher than previously thought. Moreover, the majority of children who are eligible for Part C services are not receiving services for their developmental problems. Strategies need to be developed to monitor patterns of enrollment in early intervention services and reach out to more minority children, particularly black children.