The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #64975

Roy Grant, The Children's Health Fund, 317 East 64th Street, New York, NY 10021, 212-535-9400, rgrant@chfund.org, Molly Nozyce, PhD, Pediatric Neurodevelopment, Jacobi Medical Center, 1400 Pelham Parkway South, Bronx, NY 10467, and Alexandra H. Gordon, MA, Department of Psychology, Ferkauf / Yeshiva University, 1300 Morris Park Avenue, Bronx, NY 10467.

The Early Intervention Program (“EI”) is an entitlement providing screening, evaluation and services for infants and toddlers (birth-36 months old) with developmental delay. Data are presented from a descriptive study intended to clarify the developmental status of children referred by their primary pediatrician for EI services, and the contributory medical conditions that affect them. The setting was a tertiary care hospital in New York City. Developmental status was established using the Bayley Scales of Infant Development Mental Development Index (MDI). Contributory medical conditions were coded as: birth weight<1000 grams; genetic or inborn metabolic disorder; congenital organ anomaly; primary neurologic disorder; or infectious disease like meningitis. Data are drawn from 575 consecutive EI eligibility assessments performed over a three year period. We found 57% have a serious contributory medical condition. Mean MDI=64 (~2 standard deviations below the mean). To control for possible sampling bias because of the tertiary care setting, results for a subset of the tertiary care patients were compared with those for a sample of identically referred, comparably evaluated, and demographically similar patients from a community hospital. Within this comparison, we found the following: the degree of cognitive delay is comparable, mean MDI=65 in the community sample compared with 67 in the tertiary care subset. Overall prevalence of contributory medical conditions is lower in the community sample (28% compared with 45%, p<.05). For patients <18 months, medical involvement is comparable (75% compared with 70%). Policy and programmatic implications for EI are discussed.

Learning Objectives:

• Participants will become more aware of the nature medical conditions that affect infants and young toddlers with delayed development. Participants will become aware of the importance of integrating developmental services with medical services.

Keywords: Infant Health, Children With Special Needs

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.