Developmental Status and Early Intervention Service Needs of Maltreated Children. Background to the Project

04/01/2008

Popular media coverage as well as many state legislative initiatives demonstrate that the nation has taken note of the important role of early developmental experiences during infancy and early childhood. Among young children, most at risk of developmental problems are those who experience child neglect and abuse. Children younger than three years of age are the most likely of all children to become involved with Child Welfare Services (Wulczyn et al., 2005). Those with medical or developmental conditions experience an even higher level of involvement with Child Welfare, including an increased likelihood of removal from parental care and a prolonged stay in foster care, compared to unaffected peers (Rosenberg & Robinson, 2004). A major opportunity to minimize or avoid developmental problems is missed when maltreated children do not receive services that could ameliorate these negative experiences.

As recognition of maltreated childrens developmental needs grew in scientific and policy circles, this missed opportunity began to be identified and addressed. The National Research Council and Institute of Medicine (2000) recommended that all children who are referred to a protective services agency for evaluation of suspected abuse or neglect be automatically referred for a developmental behavioral screening under Part C of the Individuals with Disabilities Education Act.  In 2003, the Child Abuse Prevention and Treatment Act (CAPTA) was enacted, requiring that states have a mechanism for the referral of maltreated children under the age of three to early intervention services funded by Part C of the Individuals with Disabilities Education Act (IDEA). Part C of the IDEA, which was reauthorized in 2004, contains a comparable provision supporting the CAPTA requirement. A document that accompanied the CAPTA legislation clarified that a referral and appropriate screening are mandated (House Report 108-779, 2004).

Under Part C of the Individuals With Disabilities Education Act (IDEA) of 1990, children needing services are to be identified, evaluated, and served, especially those children who are typically underrepresented (e.g., minority, low-income, inner city, Indian and rural populations) through an interagency, coordinated, multidisciplinary system of early intervention services. Eligibility for Part C services entitles children to services as deemed necessary in the evaluation and documented in the Individualized Family Service Plan (IFSP) that is developed by Part C service providers and parents at the time the time of enrollment. Physical therapy, occupational therapy, speech and language therapy, and services provided by a developmental specialist, are among the most common Part C services used.

Although many of these maltreated children may be candidates for early intervention services, there is reason to believe that only a small number are typically enrolled (Horwitz, Owens, & Simms, 2000; Robinson & Rosenberg, 2004). Despite legislative requirements, many child welfare agencies have not had an adequate referral mechanism for developmental services (Leslie et al., 2003). Moreover, child welfare workers often do not recognize developmental problems (Rosenberg, Smith, & Levinson, 2005). When children are referred, early interventionists may be unprepared to address the additional challenges inherent in working with maltreated children, their families, and child welfare systems (Vig, Chinitz, & Shulman, 2005). In some states, Child Welfare Services may have had a limited history of collaboration with Part C service providers. Child Welfare Service referrals are likely to challenge early intervention service conventions because this population of children and their families is likely to be different compared to children typically served under Part C (Harbison, Parnes, & Macomber, 2007).  They found that the children served by Part C differ most markedly from children served in Child Welfare Services; Early Head Start; and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).  Lower percentages of Part C children are poor, have mothers that did not graduate from high school, or live in single-parent families. Part C does not have an income eligibility requirement, which likely contributes to these distinctions (Harbison et al., 2007).

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