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Disparities Affect Developmental Risk for Head Start Preschoolers
Karen Burkett1, Rita Pickler2, Katherine Bowers3
1Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States of America; United States of America.
Insights
Racial and ethnic disparities exist in identifying and treating developmental delays (DD) in Head Start (HStart) preschoolers. Early detection and intervention through primary care are crucial for diverse HStart children at risk for DD.
Area of Science:
- Early Childhood Education
- Pediatric Developmental Health
- Health Disparities Research
Background:
- Head Start (HStart) programs serve low-income preschoolers, providing essential early education and support services.
- Early identification of developmental delay or disability (DD) is critical for timely intervention and improved long-term outcomes.
- Existing research suggests potential racial and ethnic disparities in the identification and treatment of DD.
Purpose of the Study:
- To analyze Head Start (HStart) preschooler data based on the severity of developmental concerns.
- To examine socio-demographic factors contributing to racial and ethnic disparities in the early identification of developmental delay or disability (DD).
- To investigate referral and treatment patterns for HStart preschoolers with varying levels of developmental concerns.
Main Methods:
- Analysis of 2014-2015 Head Start (HStart) data from urban and suburban Midwestern centers.
- Descriptive statistics to determine the prevalence of developmental concerns and compare child characteristics.
- T-tests, chi-square tests, and multivariate logistic regression to compare groups and identify predictors of concern severity.
Main Results:
- Nearly one-third of HStart preschoolers exhibited developmental concerns, with 70% classified as mild-to-moderate risk and 30% as severe risk for DD.
- Few children, even those with severe concerns, were routinely referred for healthcare evaluation or received formal treatment via an Individualized Education Plan.
- Preschoolers with severe concerns in suburban and urban settings were less likely to be African American or Latinx, indicating potential under-identification and under-treatment in racially and ethnically diverse populations.
Conclusions:
- Disparities in the educational diagnosis of DD may reflect broader inequities in diagnosis and treatment for minority groups.
- Primary care settings are vital for the initial detection and management of DD.
- Primary care offers a critical opportunity to address the disproportionate risk of DD among diverse HStart preschoolers.
Purpose:
This paper presents an analysis of Head Start (HStart) preschooler data by severity of developmental concern, while considering socio-demographic and other factors that highlight racial and ethnic disparities in the early identification of developmental delay or disability (DD).
Design And Methods:
We conducted an analysis of 2014-2015 academic year data for preschool-aged children in HStart in both urban and suburban centers in a large Midwestern city. Descriptive statistics were used to determine the prevalence of developmental concerns and compare characteristics of children with mild-to-moderate versus severe developmental concerns; differences between groups were compared using t-tests and chi-square tests. Multivariate logistic regression was used to determine the independent effect of each predictor of concern severity.
Results:
Nearly one-third of HStart preschoolers were identified with developmental concern; 70% were mild-to-moderate risk for DD and the remaining severe risk. Neither group was routinely referred to healthcare for evaluation or treatment, and most of the severe risk group did not qualify nor receive treatment for DD with an Individualized Education Plan. Suburban and urban preschoolers with severe concern were less likely to be African American or Latinx, suggesting that racially and ethnically diverse preschoolers in HStart may be under-identified and under-treated.
Conclusions:
Lags in the educational diagnosis of DD may mirror the disparities in diagnosis and treatment of DD among minority groups. Primary care is the first line for detection and treatment of DD, and offers a unique opportunity to act for racially and ethnically diverse HStart preschoolers disproportionately at-risk for DD.
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