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Using the Race Model Inequality to Quantify Behavioral Multisensory Integration Effects
Published on: May 10, 2019
The impact of race on participation in part C early intervention services
Emily Feinberg1, Michael Silverstein, Sara Donahue
1From the *Department of Pediatrics, Boston University School of Medicine, Boston Medical Center, Boston, MA; Departments of †Community Health Sciences and ‡Biostatistics, Boston University School of Public Health, Boston, MA.
Insights
Racial disparities in early intervention (EI) services emerge in toddlerhood, with Black children less likely to receive care. These differences are most pronounced for developmental delay, not established medical conditions.
Area of Science:
- Pediatrics
- Public Health
- Health Disparities
Background:
- Early intervention (EI) services are crucial for children's development.
- Understanding racial disparities in EI service access is vital for equitable healthcare.
Purpose of the Study:
- To quantify racial differences in the receipt of early intervention (EI) services for children aged 0–3 years.
- To investigate how these disparities vary based on the qualifying condition for EI services.
Main Methods:
- Analysis of a nationally representative sample of children eligible for EI services.
- Used data from the Early Child Longitudinal Study, Birth Cohort.
- Examined racial effects on EI service receipt using multivariable analyses, stratified by qualifying condition (established medical condition vs. developmental delay).
Main Results:
- No Black-White racial differences in EI service receipt were observed at 9 months of age.
- By 24 months, Black children were 5 times less likely than White children to receive EI services.
- Disparities were most significant for children qualifying due to developmental delay alone, with Black children being less likely to receive services.
Conclusions:
- Racial disparities in EI service receipt emerge between infancy and toddlerhood.
- These disparities are primarily driven by differences among children qualifying for services based on developmental delay.
- Ensuring equitable access to EI services for all children, particularly those with developmental delays, is critical.
Objective:
To quantify racial differences in receipt of early intervention (EI) services among children ages birth to 3 years.
Methods:
Multivariable analyses of a nationally representative sample of children eligible for EI services using data from the Early Child Longitudinal Study, Birth Cohort was conducted. Birth weight <1000 g, genetic and medical conditions associated with developmental delay, or low scores on a standardized measure of developmental performance defined EI eligibility. Receipt of EI services was ascertained from parent self-report. The effect of race on receipt of EI services was examined in main effect models and models stratified by EI qualifying condition, which was defined as either established medical condition or developmental delay in the absence of an underlying medical diagnosis.
Results:
At 9 months of age, among the 1000 children eligible for EI services, 9% of children received services; there were no black-white racial differences in receipt of services. At 24 months of age, among the 1000 children eligible for EI services, 12% received services; black children were 5 times less likely to receive services than white children (adjusted odds ratio [aOR] 0.19; 95% confidence interval [CI] 0.09, 0.39). In models stratified by qualifying condition, black children who qualified for services at 24 months based on developmental delay alone were less likely to receive services (aOR 0.09; 95% CI 0.02, 0.39); there were no differences by race among children who qualified based on established medical conditions (aOR 0.56; 95% CI 0.18, 1.72).
Conclusions:
Racial disparities in EI service receipt, which were not present during infancy, emerged as children became toddlers. These disparities were found most consistently among children who qualified for services based on developmental delay alone.
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