Advertisement

An Intervention to Increase Detection of Developmental Delays in WIC Programs

Published:January 13, 2023DOI:https://doi.org/10.1016/j.acap.2023.01.003

      Abstract

      Background

      Low-income children are at risk for under-detection of developmental disabilities (DD). Women's Infants and Children's Special Supplemental Nutrition Program (WIC) clinics see low-income children regularly in early childhood and could be an important source of referrals to developmental services.

      Methods

      This was a site-randomized trial of an intervention to train WIC staff in early identification of DD's, using CDC's Learn the Signs Act Early (LTSAE) developmental monitoring materials. 7 county WIC agencies in Oregon enrolled; 4 intervention agencies and 3 control agencies. The intervention consisted of an on-site, half-day training regarding signs of developmental delays, use of LTSAE materials, and referral to EI/ECSE. Control sites received no training and continued their usual care and referral processes. Primary study outcome was number of children referred from WIC to EI/ECSE in control vs. experimental counties as well as % of referrals evaluated, using data obtained Oregon's EI/ECSE program. Data for 46 children referred to EI/ECSE were obtained.

      Results

      Overall, 3 of 4 intervention sites increased their referrals to EI/ECSE, and 0 of 3 control sites increased referrals. Total referrals in the intervention arm increased from 5 to 33 in the intervention arm, but decreased from 6 to 2 in the control arm. In the intervention arm, referrals increased for both boys and girls and for all ages.

      Conclusion

      This brief intervention with WIC staff led to short-term increases in EI referrals and evaluations. Such interventions may hold promise for reducing disparities.

      Abbreviations:

      DDs (Developmental disabilities), WIC (Special Supplemental Nutrition Program for Women, Infants, and Children), EI/ECSE (Part C Early Intervention/Early Childhood Special Education)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Academic Pediatrics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Dickerson AS
        • Rahbar MH
        • Pearson DA
        • et al.
        Autism spectrum disorder reporting in lower socioeconomic neighborhoods.
        Autism. 2016;
        • Gallegos A
        • Dudovitz R
        • Biely C
        • Chung PJ
        • Coker TR
        • Barnert E
        • Guerrero AD
        • Szilagyi PG
        • Nelson BB.
        Racial Disparities in Developmental Delay Diagnosis and Services Received in Early Childhood.
        Acad Pediatr. 2021 Sep-Oct; 21 (Epub 2021 May 19. PMID: 34020100; PMCID: PMC9169674): 1230-1238https://doi.org/10.1016/j.acap.2021.05.008
        • Clements KM
        • Barfield WD
        • Kotelchuck M
        • Wilber N.
        Maternal socio-economic and race/ethnic characteristics associated with early intervention participation.
        Maternal & Child Health Journal. 2008; 12: 708-717
        • Heidlage JK
        • Cunningham JE
        • Kaiser AP
        • et al.
        The effects of parent-implemented language interventions on child linguistic outcomes: A meta-analysis.
        Early Childhood Research Quarterly. 2020; 50: 6-23
        • Law J
        • Garrett Z
        • Nye C.
        The efficacy of treatment for children with developmental speech and language delay/disorder: A meta-analysis.
        Journal of Speech Language & Hearing Research. 2004; 47: 924-943
        • Roberts MY
        • Kaiser AP.
        The effectiveness of parent-implemented language interventions: A meta-analysis.
        American Journal of Speech-Language Pathology. 2011; 30: 180-199
      1. Weitlauf AS, McPheeters ML, Peters B, et al. AHRQ Comarative Effectiveness Review: Therapies for children with autism spectrum disorder: behavioral interventions update. http://effectivehealthcare.ahrq.gov/ehc/products/544/1945/autism-update-report-140806.pdf. Published 2014. Accessed June, 2021.

        • Downs MP
        • Yoshinaga-Itano C.
        The efficacy of early identification and intervention for children with hearing impairment.
        Pediatric Clinics of North America. 1999; 46: 79-87
      2. Individuals with Disabilities Education Act, 20 U.S.C. § 1400 (2004)

        • Adams RC
        • Tapia C
        Council on Children with Disabilities. Early intervention, IDEA Part C services, and the medical home: collaboration for best practice and best outcomes.
        Pediatrics. 2013; 132
        • Zuckerman KE
        • Chavez AE
        • Reeder JA.
        Decreasing disparities in child development assessment: identifying and discussing possible delays in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).
        J Dev Behav Pediatr. 2017; 38: 301-309
      3. Zuckerman KE, Chavez AE, Lindly OL, Regalado Murillo C, Reeder JA. Disparities in familiarity with developmental disabilities among low-income parents. under review.2018.

        • Sanders B.W.
        • Zuckerman K.E.
        • Ash J.S.
        • Kopstick A.J.
        • Gorman P.N.
        Early Intervention Referral Information, Transmission, and Sources-A Survey of State Part C Coordinators and Analysis of Referral Forms.
        J Dev Behav Pediatr. 2021;
        • Farmer J.E.
        • Falk L.W.
        • Clark M.J.
        • Mayfield W.A.
        • Green K.K.
        Developmental Monitoring and Referral for Low-Income Children Served by WIC: Program Development and Implementation Outcomes.
        Maternal and child health journal. 2021; : 1-12
      4. Centers for Disease Control and Prevention. Learn the signs. Act early. . http://www.cdc.gov/ncbddd/actearly/index.html. Accessed Web Page, 2013.

        • Guerrero Alma D.
        • et al.
        A WIC-based curriculum to enhance parent communication with healthcare providers.
        Journal of community health. 2013; 38: 958-964
        • Solgi M.
        • Feryn A.
        • Chavez A.E.
        • Wilson L.
        • King M.
        • Scholz J.
        • Fombonne E.
        • Zuckerman K.E.
        Parents' Concerns Are Associated with Early Intervention Evaluation and Eligibility Outcomes.
        Journal of Developmental & Behavioral Pediatrics. September 8, 2021; (- Volume - Issue -doi)https://doi.org/10.1097/DBP.0000000000001003
        • Cycyk LM
        • De Anda S
        • Ramsey KL
        • Sheppard BS
        • Zuckerman KE.
        Moving through the pipeline: Ethnic and linguistic disparities in special education from birth through age five.
        Educational Researcher. 2022; 51: 451-464https://doi.org/10.3102/0013189x221120262