Assessing the Effects of Early Intervention Services on Infants & Toddlers in the U.S. Child Welfare System

Background and Purpose: Children in the U.S. child welfare system (CWS) experience developmental delays and/or disabilities at substantially higher rates than children in the general population, but they are less likely to receive early intervention services. This is concerning given that early intervention (EI) services often have a positive impact on the developmental trajectories of delayed/disabled children, particularly when services are initiated during infancy or toddlerhood. However, these findings are based on research with general population, not child welfare, samples. We addresses this research gap by using data from the most recent national study of children in the U.S. CWS to explore the effects of EI services specifically on CWS-involved infants and toddlers.

Methods: Using data from the National Survey of Child and Adolescent Well-Being II on a sample of 0-2 year olds referred to the U.S. CWS for suspected maltreatment (n = 2,937), we calculate the weighted percentage likely to qualify for EI services, and the frequency with which those children received these services within an 18 month period of CWS involvement. Subpopulation analysis with weighted, ordinary least squares regression was used to explore whether receipt of EI services predicted improvement for those likely to qualify for EI on three developmental standardized instruments (i.e., Preschool Language Skills (PLS-3) which measures communication skills, the daily living skills domain of the Vineland Adaptive Behavior Scale, and the cognitive skills subscale of the Battelle Developmental Inventory (BDI)). Analyses controlled for scores on standardized measures at baseline as well as child welfare case characteristics and child/family socio-demographics.

Results: Twenty-four percent of 0-2 year olds reported to the U.S. CWS meet typical early intervention eligibility criteria, yet only a third (33.6%) of those children receive early intervention services at baseline and/or 18 months later. Receipt of EI services at baseline predicted lower standardized scores on language (B = -6.41, p < 0.01) and cognitive development (B = -5.82, p < 0.01) 18 months later, but not socio-emotional development (i.e., Vineland Daily Living Scale).

Conclusions & Implications: Many infants and toddlers entering the U.S. CWS qualify for EI services, yet they are not receiving these services. Interestingly, those who do, do not appear to benefit developmentally. This finding could suggest that EI is not constructive for infants and toddlers in the CWS, but more likely it reflects a tendency of the CWS to only pursue EI services for children with the most severe and/or degenerative conditions, who might lose skills or whose developmental progress may be slower than children in the CWS who were not identified as likely qualifying for EI. This interpretation highlights the importance of child welfare policies and practices that promote routine developmental assessments of maltreated infants and toddlers and universal referral of all qualifying children, as well as training caseworkers regarding the importance of referring all children with qualifying delays to EI, not just those whose developmental deficits are the most serious or readily visible.