An Intervention to Increase Detection of Developmental Delays in WIC Programs

Published:January 13, 2023DOI:



      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.


      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.


      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.


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


      DDs (Developmental disabilities), WIC (Special Supplemental Nutrition Program for Women, Infants, and Children), EI/ECSE (Part C Early Intervention/Early Childhood Special Education)
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