Highlights
- •Nearly 1/3 of Head Start preschoolers were identified with concern for developmental delay or disability
- •None of those at-risk for developmental delay or disability were routinely referred for healthcare evaluation or treatment
- •African American and Latinx preschoolers were most at-risk for delayed identification and treatment for developmental delay
- •Primary care partnering with Head Start can speed early diagnosis for minority preschoolers at-risk for developmental delay
Abstract
Purpose
This paper presents an analysis of Head Start (HStart) preschooler data by severity
of developmental concern, while considering socio-demographic and other factors that
highlight racial and ethnic disparities in the early identification of developmental
delay or disability (DD).
Design and methods
We conducted an analysis of 2014–2015 academic year data for preschool-aged children
in HStart in both urban and suburban centers in a large Midwestern city. Descriptive
statistics were used to determine the prevalence of developmental concerns and compare
characteristics of children with mild-to-moderate versus severe developmental concerns;
differences between groups were compared using t-tests and chi-square tests. Multivariate logistic regression was used to determine
the independent effect of each predictor of concern severity.
Results
Nearly one-third of HStart preschoolers were identified with developmental concern;
70% were mild-to-moderate risk for DD and the remaining severe risk. Neither group
was routinely referred to healthcare for evaluation or treatment, and most of the
severe risk group did not qualify nor receive treatment for DD with an Individualized
Education Plan. Suburban and urban preschoolers with severe concern were less likely
to be African American or Latinx, suggesting that racially and ethnically diverse
preschoolers in HStart may be under-identified and under-treated.
Conclusions
Lags in the educational diagnosis of DD may mirror the disparities in diagnosis and
treatment of DD among minority groups. Primary care is the first line for detection
and treatment of DD, and offers a unique opportunity to act for racially and ethnically
diverse HStart preschoolers disproportionately at-risk for DD.
Keywords
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Article info
Publication history
Published online: July 15, 2020
Accepted:
June 21,
2020
Received in revised form:
May 16,
2020
Received:
November 9,
2019
Footnotes
☆This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
