Department of Health Systems, Management and Policy (ZS Richardson and BM McManus); Department of Occupational Therapy, College of Applied Health Sciences (MA Khetani), University of Illinois at Chicago.
Department of Occupational Therapy, College of Applied Health Sciences (MA Khetani), University of Illinois at Chicago.
Acad Pediatr. 2019 Sep-Oct;19(7):722-732. doi: 10.1016/j.acap.2019.02.004. Epub 2019 Feb 21.
Describe children's diagnostic, social, and functional characteristics associated with the use of core early intervention (EI) services.
The sample included infants and toddlers (N = 2045) discharged from an urban EI program (2014-2016). Adjusted logit models estimated the marginal effects and 95% confidence intervals (CIs) of receipt of any of the 4 core EI services, controlling for the child's developmental condition type, race and ethnicity, primary language, sex, insurance type, age at referral, and functional performance at EI entry. Adjusted median regression estimated EI core service intensity controlling for child characteristics.
The median per-child EI service intensity was less than 3 h/mo (median, 2.7; interquartile range, 2.1-3.5). Children whose primary language was English were 6% more likely to receive occupational therapy (marginal effect = 0.063; 95% CI, 0.010-0.115). Compared to infants, 1- to 2-year-old children were less likely to receive physical therapy and occupational therapy but more likely to receive speech therapy. Compared to infants, 1-year-olds received more intensive speech therapy (β = 0.42; 95% CI, 0.10-0.70), and 2-year-olds received less intensive occupational therapy (β = -0.70; 95% CI, -1.35 to -0.10). Children's functional performance at EI entry was significantly associated with the receipt and intensity of EI services.
Many EI-enrolled children received low-intensity services, a result that was associated with the primary language of the caregiver and the child's age and functional status. Results suggest the need for interventions to improve service delivery for vulnerable EI subgroups.
描述与核心早期干预（EI）服务使用相关的儿童诊断、社会和功能特征。
该样本包括从城市 EI 项目中出院的婴儿和幼儿（N=2045）（2014-2016 年）。调整后的对数模型估计了接收任何 4 种核心 EI 服务的边际效应和 95%置信区间（CI），控制了儿童的发育状况类型、种族和民族、主要语言、性别、保险类型、转诊年龄和 EI 进入时的功能表现。调整后的中位数回归估计了 EI 核心服务强度，控制了儿童特征。
每个儿童的 EI 服务强度中位数不足 3 小时/月（中位数，2.7；四分位距，2.1-3.5）。主要语言为英语的儿童接受职业治疗的可能性高 6%（边际效应=0.063；95%CI，0.010-0.115）。与婴儿相比，1-2 岁儿童接受物理治疗和职业治疗的可能性较小，但接受言语治疗的可能性较大。与婴儿相比，1 岁儿童接受的言语治疗强度更高（β=0.42；95%CI，0.10-0.70），2 岁儿童接受的职业治疗强度更低（β=-0.70；95%CI，-1.35 至-0.10）。儿童在 EI 进入时的功能表现与 EI 服务的接收和强度显著相关。
许多接受 EI 的儿童接受的服务强度较低，这一结果与照顾者的主要语言以及儿童的年龄和功能状况有关。结果表明，需要采取干预措施，改善弱势 EI 亚组的服务提供。
