The effect of state early intervention eligibility policy on participation among a cohort of young CSHCN.
The effect of state early intervention eligibility policy on participation among a cohort of young CSHCN.
复制标题
DOI：
10.1542/peds.2009-1255g
复制
发表时间：
2009-12-01
期刊：
影响因子：
8
通讯作者：
Hauser-Cram, Penny
中科院分区：
文献类型：
--
作者：
McManus, Beth;McCormick, Marie C;Hauser-Cram, Penny
目的：本研究的目的是描述一组父母报告的发育迟缓和残疾的幼儿在早期干预(EI)参与方面的状态差异。方法：数据来自2005-2006年全国特殊卫生保健需求儿童调查，以描述EI参与的状态差异。使用多水平模型估计儿童社会人口学和发展特征的相对贡献率，以及国家儿童教育资格政策对儿童教育参与率的影响。结果：各州儿童教育参与率为45.7%(23.1%-83.3%)。EI参与者不太可能是西班牙裔，生活在多种族家庭，贫穷，有发育迟缓，或有不那么严重的情况/迟缓。对于居住在EI资格标准更严格的州的儿童，预测获得EI的概率比那些标准宽松的儿童低(0.43比.52)。贫困影响了这种联系，调整后的贫困儿童(185%联邦贫困水平)接受EI的概率分别为0.18和0.36(P<；0.05)。在非贫困儿童中，那些生活在资格标准严格的州的儿童与生活在资格标准宽松的州的贫困儿童获得EI的可能性几乎一样(.33比.36；P<；.05)。结论：这项研究的结果显示，由于儿童和州项目的特点，参与EI的显著差异和未得到满足的需求。改善对弱势群体的发展服务需要解决这些差距的根源。
OBJECTIVE: This purpose of this study was to describe differences in early intervention (EI) participation according to state among a cohort of young children with parent-reported developmental delays and disabilities.METHODS: Data were obtained from the 2005-2006 National Survey of Children With Special Health Care Needs to describe state differences in EI participation. Multilevel modeling was used to estimate the relative contributions of child sociodemographic and developmental characteristics, and state EI eligibility policy on EI participation.RESULTS: The overall rate of EI participation was 45.7% (23.1%-83.3% across the states). EI participants were less likely to be Hispanic, live in a multiracial family, be poor, have a developmental delay, or have a less severe condition/delay. The predicted probability of receiving EI was lower for children who lived in states with more strict EI eligibility criteria than those with liberal criteria (.43 vs .52). Poverty influenced this association, with the adjusted probabilities of receiving EI for poor (185% federal poverty level) children being .18 and .36, respectively (P < .05). Among nonpoor children, those who lived in states with strict eligibility criteria were nearly as likely as poor children who lived in states with liberal eligibility criteria to receive EI (.33 vs .36; P < .05).CONCLUSIONS: The results of this study reveal marked disparities and unmet needs in EI participation as a function of both characteristics of the child and the state program. Improving developmental services for vulnerable populations requires addressing these sources of disparity.