Service Delivery

Risk factors of children who exited from an early intervention program without an identified disability and returned with a developmental disability.

Giannoni et al. (2010) · Research in developmental disabilities 2010
★ The Verdict

Kids who leave early-intervention clean but carry quiet medical or family risks often return later—schedule follow-up screens before you close the file.

✓ Read this if BCBAs and service coordinators who discharge toddlers from Part C programs.
✗ Skip if Clinicians who only serve school-age youth with firm diagnoses.

01Research in Context

01

What this study did

The team looked at kids who left an early-intervention program with no label.

Months or years later these same kids came back and now had a developmental disability.

They checked birth, health, and family records to see what red flags were already there.

02

What they found

Most kids who returned had subtle signs at the first exit.

Low birth weight, slow growth, or mom’s mental-health notes were common.

The signs were not enough to qualify then, but they looked clear in hindsight.

03

How this fits with other research

Capio et al. (2013) show that piling family risks makes parents drop out of services.

Poppes et al. (2010) show that even after exit, medical risks can still bloom into disability.

Together they say: watch both child signals and family load; either can break the path.

Fairthorne et al. (2016) add that mom’s past psychiatric care doubles later autism-ID odds.

That fits the new finding that maternal mental-health notes often sat in the file long before the child returned.

04

Why it matters

You can build a safety-net list for every discharge.

Tick low birth weight, slow language, or any maternal mood flag.

If two or more boxes are checked, set an automatic re-screen at 9 and 18 months.

One extra phone call now can catch the kids who slide back later.

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Add a 9-month ‘risk flag’ calendar reminder for any child exiting with low birth weight, slow growth, or maternal mental-health history.

02At a glance

Intervention
not applicable
Design
other
Sample size
2439
Population
developmental delay, mixed clinical
Finding
not reported

03Original abstract

A retrospective cohort study was undertaken to identify risk factors for children at greatest risk of delayed diagnosis of developmental disability. Two thousand four hundred and thirty-nine children were selected for this study due to their participation in the California Early Start (ES) Program in 1998. Comparisons were made among children that had no break in services offered through the ES Program versus children that returned with a disability after exiting the ES Program. Factors examined include child's condition and qualifying risk factors, mother's demographic characteristics, family's risk factors, and risk scores developed for each county in which the family resided. Children with a delay in diagnosis of a disability have characteristics that fall outside the norm for the identification of a disability. It is not clear if this is related to age-specific manifestation to the appearance of a disability or to conditions difficult to diagnose.

Research in developmental disabilities, 2010 · doi:10.1016/j.ridd.2010.02.014