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Impacts of the Smart Beginnings Parenting Program on Early Childhood Special Education Evaluation and Service

Leah J Hunter1, Ashleigh I Aviles2, Elizabeth B Miller3

  • 1Department of Psychology (LJ Hunter and DS Shaw), University of Pittsburgh, Pittsburgh, Pa.

Academic Pediatrics
|April 6, 2025
PubMed

Insights

The Smart Beginnings (SB) parenting program reduced referrals for early intervention (EI) or early childhood special education (ECSE) services. This suggests SB may impact access to crucial developmental support for young children.

Area of Science:

  • Child Development
  • Public Health
  • Health Services Research

Background:

  • Parenting interventions' impact on healthcare access for early childhood services is understudied.
  • Smart Beginnings (SB) is a tiered intervention combining universal primary care parenting programs and targeted home visiting.
  • This study focuses on a low-income, predominantly Black/Latine sample.

Purpose of the Study:

  • To assess the effect of the Smart Beginnings (SB) parenting intervention on referrals to early intervention (EI) and early childhood special education (ECSE).
  • To examine the influence of SB on access to developmental services for young children in underserved populations.
  • To understand the relationship between early child behavior/language and EI/ECSE referrals.

Main Methods:

  • Utilized data from a randomized controlled trial (RCT) of SB in NYC and Pittsburgh.
  • Included 280 families (132 treatment, 148 control), diverse in race/ethnicity and language, all Medicaid-eligible.
  • Employed hierarchical logistic regressions to analyze factors predicting EI/ECSE evaluation and referral by age 4, based on 2-year-old child outcomes.

Main Results:

  • Lower expressive vocabulary and higher problem behaviors at age 2 predicted EI/ECSE evaluation and referrals by age 4.
  • Assignment to the Smart Beginnings (SB) intervention was associated with a reduced likelihood of referrals for EI/ECSE services following evaluation.
  • The intervention demonstrated a potential to moderate the pathway to formal developmental services.

Conclusions:

  • Children with early language and behavior challenges are more likely to receive EI/ECSE services.
  • The Smart Beginnings (SB) intervention appeared to decrease the likelihood of children being referred for these services.
  • Further research into predictors of EI/ECSE involvement is crucial for promoting equity in early care systems for marginalized groups.
Abstract

Keywords:
early childhood special educationearly interventionintervention

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