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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
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Birth characteristics associated with early intervention referral, evaluation for eligibility, and program

Karen M Clements1, Wanda D Barfield, Milton Kotelchuck

  • 1Bureau of Family and Community Health, Massachusetts Department of Public Health, Boston, Massachusetts 02108, USA. karen.clements@state.ma.us

Maternal and Child Health Journal
|May 20, 2006
PubMed

Insights

Early Intervention (EI) services in Massachusetts successfully referred and evaluated most at-risk infants. Birth characteristics like low birthweight significantly predicted EI referral, with most referred infants deemed eligible for services.

Area of Science:

  • Pediatric Health
  • Public Health Policy
  • Developmental Pediatrics

Background:

  • The Individual with Disabilities Education Act mandates Early Intervention (EI) services for infants and toddlers with developmental delays.
  • Assessing referral, evaluation, and eligibility rates is crucial for understanding service access for at-risk infants.

Purpose of the Study:

  • To determine the percentage of high-risk infants referred to Massachusetts EI services within one year of birth.
  • To identify specific birth characteristics that predict referral, evaluation, and eligibility for EI services.

Main Methods:

  • Utilized the Pregnancy to Early Life Longitudinal (PELL) data system, linking birth certificate, hospital discharge, and EI program data for 219,037 infants born between 1998-2000.
  • Employed multivariate logistic regressions to identify independent infant predictors of referral, evaluation, and eligibility.

Main Results:

  • 6.8% of infants were referred to EI within one year; referral rates were high (88%) for infants with multiple birth risks.
  • Low birthweight (<1500g) strongly predicted referral; triplet birth was the strongest predictor of evaluation.
  • 88% of referred infants were evaluated, and 85% were found eligible for services.

Conclusions:

  • Early Intervention referral and evaluation rates are high for at-risk infants in Massachusetts.
  • Birth characteristics beyond the state's high-risk definition, such as specific birthweights, predict referral.
  • Linked population and program data are valuable for evaluating EI service delivery.
Abstract

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