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Part C Early Intervention Enrollment in Low Birth Weight Infants At-Risk for Developmental Delays
Kristi L Atkins1, Susanne W Duvall2, Jill K Dolata2
1School of Medicine, Institute on Development & Disability, Oregon Health and Science University, 707 SW Gaines St., Portland, OR, 97239, USA. atkinskr@ohsu.edu.
Insights
Most low birth weight infants do not enroll in Part C Early Intervention (EI) services. Many infants who qualify for EI due to high-risk medical conditions are not receiving these crucial early developmental supports.
Area of Science:
- Pediatrics
- Developmental Pediatrics
- Public Health
Background:
- Part C Early Intervention (EI) services are critical for infants with developmental delays.
- Low birth weight (LBW) infants are at increased risk for developmental delays.
- Understanding enrollment patterns in EI for LBW infants is essential for optimizing early support.
Purpose of the Study:
- To investigate enrollment patterns in Part C EI for low birth weight (LBW) infants.
- To identify characteristics of LBW infants who qualify for but are not enrolled in EI.
- To examine factors influencing EI enrollment in this population.
Main Methods:
- Retrospective analysis of data from 165 LBW infants in a high-risk infant follow-up program.
- Data collection included developmental assessments, parent questionnaires (demographics, EI enrollment), and electronic medical records.
- Medical variables and qualifying conditions for EI were extracted.
Main Results:
- Over 71% of LBW infants were not enrolled in EI.
- Factors associated with EI enrollment included birth weight, gestational age, developmental scores, and insurance status.
- 42.1% of non-enrolled LBW infants in Oregon met criteria for high-probability developmental delay conditions.
Conclusions:
- Less than one-third of LBW infants were enrolled in EI at their initial high-risk follow-up visit.
- Infants with developmental delays and public insurance were more likely to be enrolled.
- A significant majority of LBW infants with identifiable medical risk factors for developmental delays were not enrolled in EI.
Abstract:
Objectives To investigate enrollment patterns in Part C Early Intervention (EI) for low birth weight (LBW) infants (≤2500 g). A secondary aim is to characterize LBW infants that are not enrolled in EI, but would qualify by meeting criteria for a condition associated with a "high-probability" for developmental delays (i.e., Intraventricular Hemorrhage grade III or higher, Apgar score of ≤5 at 5 min, and/or birth weight of ≤1200 g). Methods Data were gathered from 165 LBW infants participating in a high-risk infant follow-up program. Developmental assessment was completed. Basic demographic information and data regarding enrollment in EI were collected via parent questionnaire. Medical variables were extracted from each infant's electronic medical record. Results 71.5 % of LBW infants were not enrolled in EI. Factors influencing probability of EI enrollment included birth weight, gestational age, developmental test scores, and insurance status. Of the 107 infants living in Oregon who were not enrolled in EI, 42.1 % would qualify for services due to an early medical condition identified in Oregon as a condition associated with a "high-probability" for developmental delays. Conclusions Less than one third of LBW infants were enrolled in EI by their first visit to a high-risk infant follow-up program. Those infants demonstrating developmental delays and public insurance were more likely to be enrolled. The majority of infants who have readily identifiable medical risk factors that qualify them for EI were not enrolled. This study was limited by the constraints implicated by using a clinical sample.
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