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Developmental needs of infants and toddlers who require lengthy hospitalization
H M Feldman1, D L Ploof, D Hofkosh
1University of Pittsburgh, School of Medicine, PA.
Insights
Many young children hospitalized long-term have developmental delays or risk factors, making them eligible for early intervention services. Hospitals should implement systems to identify and support these vulnerable children.
Area of Science:
- Pediatric Health
- Developmental Pediatrics
- Hospital Medicine
Background:
- Prolonged hospitalization in children under three is often linked to complex medical needs.
- Identifying developmental risks early is crucial for long-term child outcomes.
Purpose of the Study:
- To characterize children under 3 with lengthy hospital stays.
- To assess their eligibility for early intervention services under PL 99-457.
Main Methods:
- Medical record survey of 135 children hospitalized >30 days between 1990-1991.
- Analysis of demographic and medical characteristics.
- Evaluation of eligibility for early intervention based on handicaps, delays, and risk factors.
Main Results:
- Congenital anomalies were the leading cause of lengthy hospitalizations.
- 54% of children were eligible for early intervention due to biologic handicaps or developmental delays.
- An additional 36% qualified for developmental screening and monitoring based on risk factors.
Conclusions:
- Infants and toddlers requiring extended hospital stays exhibit a high prevalence of developmental disorders and risk factors.
- Hospitals should establish integrated systems for early identification, assessment, and intervention services.
- Proactive hospital-wide strategies are essential to address the needs of this high-risk pediatric population.
Objectives:
To describe demographic and medical characteristics of a sample of children younger than age 3 years who required lengthy hospitalization in a tertiary care hospital. To determine the proportion of children in the sample with biologic handicaps, developmental delays, or risk factors for developmental disorders who met eligibility criteria for early intervention services based on federal law PL 99-457 and state regulations.
Design:
Survey of medical records.
Setting:
Large, urban, tertiary care children's hospital.
Patients:
All 135 children younger than age 3 years hospitalized for more than 30 days during 1990 and 1991.
Interventions:
None.
Main Results:
The most prevalent cause of lengthy hospitalization was congenital anomaly followed by chronic and perinatal conditions; 38 patients (28%) required technology assistance at the time of discharge. Seventy-three children (54%) were eligible for early intervention services based on the presence of a biologic handicap or developmental delay. An additional 48 patients (36%) were eligible for developmental screening and periodic developmental monitoring on the basis of medical and social risk factors.
Conclusions:
Because of the high prevalence of developmental disorders and risk factors in infants and toddlers requiring lengthy hospitalizations, hospital-wide systems for identification, developmental assessment, and early intervention services should be designed and implemented.