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Disparities Affect Developmental Risk for Head Start Preschoolers.

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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.

Keywords:
Developmental riskPreschoolersRacial/ethnic disparities

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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.