Early Childhood

What’s Behind the Gaps in Early Intervention Services—And What It Means for K-12 Schools

By Evie Blad — October 10, 2023 3 min read
Close crop of the back of a pre-school girl's head showing her playing with foam puzzle pieces of shapes and numbers.
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Better demographic data about young children with disabilities who seek and receive federally funded early intervention services, such as physical therapy, could help policymakers address barriers to access.

That’s the conclusion of a new report by the Government Accountability Office, the nonpartisan federal watchdog agency, which analyzed states’ data from the 2021-22 school year.

The agency used the data, and related surveys of state officials to explore disparities in access to programs under Part C of the Individuals with Disabilities Education Act, through which states use federal funding to identify and treat infants and toddlers with disabilities and developmental delays and to support their families.

The aim is to begin a program of treatment and support, sometimes fully addressing concerns before a child enters the K-12 school system. Those services could include speech therapy for verbal delays, physical therapy for motor skill development, family training to address emotional development, or vision support. But a lack of qualified providers and staffing challenges mean many qualifying children don’t receive or struggle to access services, state officials told the GAO.

That gap matters to K-12 leaders, who benefit when students receives services early, said Allison Friedman-Krauss, an assistant research professor at Rutgers University’s National Institute for Early Education Research.

“These children are going to be entering your system,” she said. “The more Part C can give them a step up early on, the better prepared they will be when they walk in your doors for kindergarten.”

Federal data lacking

Forty-one states provided the GAO with data about every step of the early intervention pipeline: referral, evaluation, eligibility determination, and enrollment in services. In those states, 53 percent of children who were referred for Part C were ultimately enrolled in services.

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There are no federal data on the race and ethnicity of children who seek early intervention services, but statistics from the 16 states that track such information found “notable variation at different points in the enrollment process,” the report said. Those steps include referrals, evaluations, eligibility determinations, and actually being enrolled in services.

Among those 16 states, the portion of referred children who received an evaluation for services was as low as 59 percent of American Indian or Alaska Native children and as high as 86 percent of Asian children, a spread of 27 points.

Among children deemed eligible for services after an evaluation, the portion who actually enrolled ranged from a low of 91 percent of American Indian or Alaska Native to a high of 95 percent of Asian and white children, a 4-point range.

Gaps in services could represent factors like awareness of options among parents, a lack of early intervention staff who speak a student’s home language, or a variety of other factors, Friedman-Krauss said.

Another potential cause for disparities: States use different methods to determine whether children have developmental delays, some broader and some more narrow, the GAO found. Some states use qualitative measures. For example, Vermont evaluations call for an “observable and measurable developmental delay.” But other states use quantitative measures. In Illinois, for example, a child must show a “30 percent or greater delay in one or more developmental area.”

The U.S. Department of Education has sought to address such access gaps by asking Congress to require states to create equity plans that include data about racial and ethnic disparities of children who enroll in Title C services.

But that plan doesn’t call for demographic data about earlier steps in the process—such as referrals and evaluations—which may help paint a fuller picture of how unequal access is, the GAO report found.

The agency recommended that Congress empower federal officials to require states to collect demographic data on children at all steps in the Part C process: referral, evaluation, eligibility determination, and receiving services.

“When kids in need of services are identified late in the game or not at all, they miss out on critical support needed to meet their developmental milestones,” Jacqueline M. Nowicki, who leads education research at GAO, said on an Oct. 5 agency podcast. “And that makes it harder for them over the long term—academically, behaviorally, socially, and developmentally.”


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