Community-based lead exposure screening and intervention for children with disabilities

In 2007, Lead Safe D.C., a primary prevention program on childhood lead poisoning in Washington D.C., created a new branch of its screening and intervention program aimed at serving families of children with disabilities. The new program component was conducted in partnership with Health Services for Children with Disabilities, a full-spectrum health plan and facility for the families of special-needs children.

The program quickly identified a wide spectrum of socio-economic, cultural and health-related factors that negatively impact the ability of targeted families to cope with environmental hazards. Standardized interviews of clients revealed that many families were unaware of the risks presented by environmental health hazards or had misconceptions about the nature of the threats posed. Also, irregular schedules and intensive health management issues related to their child's disability presented unique challenges for families in adopting preventive approaches to environmental hazards.

The program identified five critical elements in providing screening to these families including: 1.) on-site clinical assessment of the child, 2.) on-site environmental testing, 3. ongoing consultation, 4.) partnership with city government referral agencies including housing, health, enforcement environmental departments and 5.) access to social-assistance related services.

Lastly, this paper explores the Lead Safe D.C. collaboration with HSC as a model for integrating environmental screening with services already being offered to special needs families. Investigators concluded that the challenges are substantive and that environmental interventions for target families must be specially-designed to account for these issues.