The impact of race on participation in part C early intervention services.

Abstract

To quantify racial differences in receipt of early intervention (EI) services among children ages birth to 3 years. Multivariable analyses of a nationally representative sample of children eligible for EI services using data from the Early Child Longitudinal Study, Birth Cohort was conducted. Birth weight <1000 g, 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. 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 (adjusted odds ratio [aOR] 0.19; 95% confidence interval [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). 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.