Background
Methods and declarations
Study design and population
Ethics approval and consent to participate
EI care variables
Explanatory variables
Data analysis
Results
Characteristics of study cohort
Not Referred (n = 11,964) | Referred, but not Receiving EI (n = 2024) | Referred and Received IFSP (n = 722) | |
---|---|---|---|
Condition Type | |||
Developmental Delay (DD) | 97.5 | 90.5 | 87.7 |
Diagnosed Condition (DC) | 2.5 | 9.5 | 12.3 |
Condition Severity Group | |||
No Condition | 89.5 | 74.8 | 70.6 |
Mild | 6.8 | 10.9 | 10.2 |
Moderate | 2.0 | 9.0 | 11.0 |
Severe | 1.6 | 5.4 | 8.2 |
Birthweight by Category | |||
Less than 1.5 kg | 0.5 | 3.6 | 3.46 |
1.5 kg to 2.5 kg | 4.8 | 8.3 | 8.45 |
Greater than 2.5 kg | 94.7 | 88.1 | 88.1 |
Child’s Age | |||
Less than 12-Months | 59.4 | 58.9 | 62.0 |
12–24 Months | 21.0 | 23.3 | 28.7 |
Greater than 24 Months | 19.6 | 17.8 | 9.3 |
Family Income (annually) | |||
Less than $19,999 | 93.8 | 94.6 | 91.8 |
Greater than $20,000 | 6.2 | 5.4 | 8.2 |
Race/Ethnicity | |||
White, non-Hispanic | 15.0 | 14.4 | 14.5 |
Black, non-Hispanic | 12.8 | 11.2 | 9.3 |
Hispanic | 69.0 | 70.4 | 73.7 |
Other, non-Hispanic | 3.2 | 4.0 | 2.5 |
Primary LanguageA | |||
English | – | – | 55.0 |
Other | – | – | 45.0 |
Child’s sex, Female | 51.0 | 37.8 | 36.7 |
Insurance Type, Medicaid and CHP + A | – | – | 87.7 |
Characteristic | % (n) |
---|---|
Type of EI Services Received (n = 571)A | |
Physical Therapy | 21.4 (122) |
Occupational Therapy | 17.3 (99) |
Speech and Language Pathology | 74.4 (425) |
Developmental Intervention | 49.4 (282) |
Number of EI Services Received (n = 571) | |
One Service | 18.2 (104) |
Two Services | 35.2 (201) |
Three or more Services | 46.6 (266) |
Mean (SD) | |
Child Outcome Survey (COS) score at EI entry (n = 448)B | |
Positive Social Emotional Skills | 4.6 (1.8) |
Acquiring and Using Knowledge and Skills | 3.7 (1.5) |
Taking Appropriate Action to Meet Needs | 4.3 (1.7) |
Aim 1. Characteristics of EI-referral gaps
Independent Variables | Referred Only | Referred and Received IFSP |
---|---|---|
Diagnosed ConditionA | -0.046* | −0.015 |
[− 0.087, − 0.005] | [− 0.030, 0.001] | |
Condition Severity Group | ||
No Condition | ref | ref |
Mild | 0.098*** | 0.024** |
[0.070, 0.127] | [0.008, 0.040] | |
Moderate | 0.388*** | 0.154*** |
[0.314, 0.461] | [0.095, 0.213] | |
Severe | 0.334*** | 0.156*** |
[0.249, 0.420] | [0.088, 0.223] | |
Birthweight by Category | ||
Less than 1.5 kg | ref | ref |
1.5 kg to 2.5 kg | −0.176*** | − 0.000 |
[−0.276, − 0.077] | [− 0.036, 0.036] | |
Greater than 2.5 kg | − 0.269*** | − 0.021 |
[− 0.365, − 0.174] | [− 0.054, 0.012] | |
Child’s Age | ||
Less than 12-Months | ref | ref |
12–24 Months | 0.023** | 0.014** |
[0.006, 0.041] | [0.004, 0.025] | |
Greater than 24-Months | −0.042*** | −0.031*** |
[−0.058, − 0.025] | [− 0.039, − 0.023] | |
Family Income (annually) | ||
Greater than $20,000 | − 0.009 | 0.011 |
[−0.034, 0.017] | [−0.004, 0.027] | |
Race/Ethnicity | ||
White, non-Hispanic | ref | ref |
Black, non-Hispanic | −0.029* | −0.012 |
[−0.054, − 0.004] | [− 0.025, 0.002] | |
Hispanic | 0.017 | 0.006 |
[−0.002, 0.037] | [−0.005, 0.017] | |
Other, non-Hispanic | 0.019 | −0.015 |
[−0.024, 0.061] | [−0.035, 0.004] | |
Child’s sex, Female | −0.078*** | − 0.020*** |
[−0.091, − 0.065] | [− 0.027, − 0.012] |
Aim 2. Characteristics of EI access gaps
Aim 3. Characteristics of EI service type gaps
Independent Variables | Marginal Effects of any PT | Marginal Effects of any OT | Marginal Effects of any ST | Marginal Effects of any DI |
---|---|---|---|---|
Had a Diagnosis | 0.225*** | 0.214*** | 0.084 | 0.224** |
[0.104, 0.347] | [0.091, 0.337] | [−0.030, 0.197] | [0.088, 0.360] | |
Birthweight by Category | ||||
Less than 1.5 kg | ref | ref | ref | ref |
1.5 kg to 2.5 kg | 0.177* | −0.056 | −0.210 | − 0.010 |
[0.026, 0.328] | [−0.260, 0.148] | [−0.463, 0.044] | [− 0.331, 0.311] | |
Greater than 2.5 kg | 0.135** | − 0.014 | −0.102 | − 0.121 |
[0.041, 0.228] | [−0.194, 0.167] | [− 0.318, 0.115] | [− 0.406, 0.164] | |
Child’s Age | ||||
Less than 12-Months | ref | ref | ref | ref |
12–24 Months | − 0.024 | −0.037 | − 0.080 | − 0.114* |
[− 0.096, 0.048] | [− 0.111, 0.036] | [− 0.179, 0.018] | [− 0.213, − 0.016] | |
Greater than 24-Months | 0.013 | 0.045 | 0.034 | − 0.234** |
[−0.112, 0.138] | [− 0.103, 0.192] | [− 0.103, 0.170] | [− 0.400, − 0.068] | |
Family Income (annually) | ||||
Greater than $20,000 | − 0.136*** | − 0.104* | − 0.078 | 0.057 |
[− 0.201, − 0.071] | [− 0.197, − 0.011] | [− 0.230, 0.075] | [− 0.092, 0.207] | |
Race/Ethnicity | ||||
White, non-Hispanic | ref | ref | ref | ref |
Black, non-Hispanic | 0.034 | −0.003 | 0.045 | 0.041 |
[−0.125, 0.193] | [−0.157, 0.152] | [− 0.142, 0.232] | [− 0.156, 0.239] | |
Hispanic | 0.001 | −0.037 | − 0.004 | − 0.097 |
[− 0.097, 0.099] | [− 0.144, 0.071] | [− 0.126, 0.118] | [− 0.243, 0.048] | |
Other, non-Hispanic | 0.056 | − 0.093 | − 0.036 | − 0.047 |
[− 0.141, 0.253] | [− 0.357, 0.172] | [− 0.339, 0.267] | [− 0.332, 0.238] | |
Child’s sex, Female | 0.028 | − 0.054 | − 0.026 | − 0.006 |
[− 0.040, 0.096] | [− 0.121, 0.014] | [− 0.112, 0.060] | [− 0.100, 0.087] | |
Primary Language, English | 0.013 | 0.017 | − 0.028 | 0.049 |
[− 0.062, 0.088] | [− 0.062, 0.097] | [− 0.121, 0.064] | [− 0.053, 0.151] | |
Insurance Type, Medicaid and CHP+ | − 0.067 | 0.007 | 0.039 | 0.157* |
[−0.186, 0.053] | [−0.109, 0.122] | [− 0.111, 0.188] | [0.005, 0.309] | |
Entry Child Outcome Summary Sub-ScalesB | ||||
Positive Social Emotional Skills | 0.054*** | −0.002 | −0.017 | − 0.073*** |
[0.026, 0.082] | [−0.032, 0.028] | [−0.055, 0.020] | [− 0.112, − 0.034] | |
Acquiring and Using Knowledge and Skills | 0.039** | 0.009 | −0.049* | 0.032 |
[0.010, 0.068] | [−0.021, 0.039] | [−0.086, − 0.011] | [−0.009, 0.072] | |
Taking Appropriate Action to Meet Needs | −0.095*** | −0.051*** | 0.058*** | 0.033 |
[−0.125, − 0.066] | [− 0.078, − 0.025] | [0.027, 0.090] | [−0.003, 0.068] |
Marginal Effects of Number of Services (Compared to other Service Groups) | |||
---|---|---|---|
Independent Variables | One Service | Two Services | Three or More Services |
Had a Diagnosis | −0.143*** | − 0.176*** | 0.319*** |
[−0.194, − 0.092] | [− 0.257, − 0.095] | [0.199, 0.440] | |
Birthweight by Category | |||
Less than 1.5 kg | ref | ref | ref |
1.5 kg to 2.5 kg | −0.025 | − 0.018 | 0.043 |
[−0.201, 0.151] | [−0.132, 0.096] | [− 0.247, 0.332] | |
Greater than 2.5 kg | 0.001 | 0.000 | −0.001 |
[−0.161, 0.162] | [−0.099, 0.099] | [− 0.262, 0.260] | |
Child’s Age | |||
Less than 12-Months | ref | ref | ref |
12–24 Months | 0.078* | 0.044* | −0.122* |
[0.006, 0.151] | [0.009, 0.078] | [−0.226, − 0.019] | |
Greater than 24-Months | 0.073 | 0.042 | −0.114 |
[− 0.052, 0.197] | [−0.010, 0.093] | [− 0.288, 0.060] | |
Family Income (annually) | |||
Greater than $20,000 | −0.054 | − 0.044 | 0.098 |
[−0.134, 0.025] | [−0.124, 0.036] | [− 0.060, 0.257] | |
Race/Ethnicity | |||
White, non-Hispanic | ref | ref | ref |
Black, non-Hispanic | − 0.021 | − 0.024 | 0.045 |
[−0.111, 0.069] | [− 0.127, 0.079] | [− 0.148, 0.238] | |
Hispanic | 0.061 | 0.046 | −0.107 |
[−0.015, 0.137] | [− 0.022, 0.114] | [− 0.249, 0.035] | |
Other, non-Hispanic | 0.084 | 0.056 | −0.140 |
[−0.037, 0.205] | [−0.019, 0.132] | [− 0.331, 0.051] | |
Child’s sex, Female | − 0.003 | − 0.002 | 0.005 |
[−0.061, 0.054] | [− 0.039, 0.034] | [− 0.089, 0.100] | |
Primary Language, English | − 0.016 | − 0.010 | 0.026 |
[−0.079, 0.047] | [− 0.049, 0.029] | [− 0.075, 0.128] | |
Insurance Type, Medicaid and CHP+ | − 0.040 | − 0.021 | 0.061 |
[−0.166, 0.086] | [− 0.074, 0.032] | [− 0.118, 0.239] | |
Child Outcomes Summary Sub-ScalesB | |||
Positive Social Emotional Skills | 0.027* | 0.017* | −0.044* |
[0.002, 0.053] | [0.001, 0.033] | [−0.084, − 0.004] | |
Acquiring and Using Knowledge and Skills | −0.008 | − 0.005 | 0.013 |
[−0.032, 0.016] | [−0.020, 0.010] | [− 0.026, 0.052] | |
Taking Appropriate Action to Meet Needs | −0.007 | − 0.004 | 0.012 |
[−0.029, 0.014] | [−0.018, 0.009] | [− 0.023, 0.047] |