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Open Access Research article

Predictors of receiving therapy among very low birth weight 2-year olds eligible for Part C early intervention in Wisconsin

Beth Marie McManus1*, Stephanie Robert2, Aggie Albanese3, Mona Sadek-Badawi3 and Mari Palta3

Author Affiliations

1 Department of Health Systems, Management & Policy, Colorado School of Public Health, 13001 E. 17th Place, MS B117, Aurora, CO 80045, USA

2 Department of Social Work, University of Wisconsin-Madison, Madison, WI, USA

3 Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, USA

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BMC Pediatrics 2013, 13:106  doi:10.1186/1471-2431-13-106

Published: 11 July 2013

Abstract

Background

The Individuals with Disabilities Education Act (Part C) authorizes states to establish systems to provide early intervention services (e.g., therapy) for children at risk, with the incentive of federal financial support. This study examines family and neighborhood characteristics associated with currently utilizing physical, occupational, or speech therapy among very low birthweight (VLBW) 2-year-old children who meet Wisconsin eligibility requirements for early intervention services (EI) due to developmental delay.

Methods

This cross-sectional analysis used data from the Newborn Lung Project, a regional cohort study of VLBW infants hospitalized in Wisconsin’s newborn intensive care units during 2003–2004. We included the 176 children who were age two at follow-up, and met Wisconsin state eligibility requirements for EI based on developmental delay. Exact logistic regression was used to describe child and neighborhood socio-demographic correlates of parent-reported receipt of therapy.

Results

Among VLBW children with developmental delay, currently utilizing therapy was higher among children with Medicaid (aOR = 5.3, 95% CI: 1.3, 28.3) and concomitant developmental disability (aOR = 5.2, 95% CI: 2.1, 13.3) and lower for those living in a socially more disadvantaged neighborhood (aOR=0.48, 95% CI: 0.21, 0.98, per tertile).

Conclusions

Among a sample of VLBW 2-year olds with developmental delays who are EI-eligible in WI, 4 out of 5 were currently receiving therapy, per parent report. Participation in Medicaid positively influences therapy utilization. Children with developmental difficulties who live in socially disadvantaged neighborhoods are at highest risk for not receiving therapy.

Keywords:
Very low birth weight; Early intervention; Physical therapy; Neighborhood disadvantage