Correlates of Early Intervention Program Participation in the 50 States and the District of Columbia

The Early Intervention Program (EI) is an entitlement to evaluation and intervention for infants and toddlers (birth-36 months) with developmental delay. National data show 32% of EI-enrolled children were born at low birthweight (LBW).The efficacy of early intervention to improve outcomes is established for children with developmental delay including those born at LBW. In response to fiscal pressures, some states have made cuts to their EI program. This study tested the hypothesis that EI Programs in individual states meet the needs of high-risk infants, and cutting EI Programs could have negative long-term implications. We developed a state-level data base using publicly available data (for 2007) indicating EI participation and various risk factors for developmental delay (child poverty rate as a proxy for psychosocial risk, and biomedical markers including LBW, special healthcare needs, and diagnosed autism rates). We found that risk factors associated with developmental delay were not significantly associated with state rates of EI participation (U.S. rate=2.52%; range, 1.19% to 6.94%). States with higher percentages of uninsured children had lower EI participation rates (p<0.05), indicating problems in safety nets for children with disabilities. Census Bureau region was significantly associated with EI participation rates (p<0.01). In the south, EI participation rate was lowest (mean=2.13%), and LBW (mean=9.5%) and child poverty rates (mean=20.8%) highest. In the northeast, EI participation rate was highest (mean=3.93%) and LBW (mean=7.8%) and child poverty rates (mean=13.8%) lowest. We conclude that EI Programs did not consistently reach high-risk infants and toddlers in all states, with significant regional variations.