Fewer children in Colorado are getting services to address potential developmental problems early, increasing the likelihood that they will need more intensive support down the road.
Referrals to the state’s early intervention services for developmental delays were down last year, and nearly 20% fewer Colorado children received them in January 2021 compared to March 2020, according to the annual Kids Count report.
Programs enroll children up to age 2, and can include everything from physical and speech therapy to hearing aids and counseling for parents on how to manage children’s challenging behavior.
This matters because the sooner children begin receiving services, the more likely they are to return to a specific developmental track by the time they reach school, said Bill Jagger, vice president of early childhood and policy initiatives at Colorado Children’s Campaign. The brain forms most readily in the first three years of life, so it is possible to address developmental delays later, which usually require more intensive and expensive services, he said.
“The early years of life are this wonderful window,” he said.
Often, referrals come from well-child check-ups or when a teacher at a preschool or child care center notices that a child is struggling, but last year because of the pandemic, children were less likely to see them. Jagger said. According to the Kids Count report, one family in five skipped at least some scheduled well-child visit last year, where their children would normally be screened for developmental delays.
Parents can ask for a self-assessment if they are concerned about their children’s development, but most don’t know they have a choice.
“The declining referral is probably not because we have fewer children with developmental delays,” he said.
The American Academy of Pediatrics recommends that all children be screened for developmental delay at 9 months, 18 months and 2 1/2 years, and for autism at 2. When a screening shows that children are developing more slowly than expected, they are referred to the state’s early intervention program, which uses a team to determine whether They have delays, and whether it is severe enough to qualify for services.
Christy Scott, director of the Early Intervention Program at the Colorado Department of Human Services, said the number of children referred has increased substantially, but not in the given number. This is probably due to at least two factors: the state changed eligibility criteria, and it has been challenging to match families and providers who have a similar preference for personal or virtual services, she said.
“Some families don’t want to have services right now, or don’t want to get services through early intervention,” she said.
strict eligibility rules
In July 2020, the state tightened eligibility criteria for children to receive early intervention during the pandemic as a cost-saving measure, said Jennifer Levine, director of public policy for The Ark of Colorado. This automatically prevents children with less serious needs from receiving services, she said.
“Before the emergency rule changes, those kids will be covered,” she said.
Earlier, children who were 25% behind their peers could get services, but this has been increased to 33%. For example, a 2-year-old whose developmental skills were previously more similar to that of an 18-month-old would have qualified, but now the child must act at the 16-month level to qualify.
The two months “do not seem dramatically different, but the trajectory of early childhood development is very rapid,” said Jodi Litfin, a clinical child psychologist and deputy program officer at Rocky Mountain Human Services, who specializes in early childhood development for children in Denver. Provides intervention services.
Scott said there are no plans to change the eligibility cutoff again, despite the change in budget position. The state is working on creating and funding a “more resilient” Early Start program for children with less severe delays, so early intervention is focused on children with the greatest needs, she said. The new program is scheduled to start enrolling children in July 2022.
“If we’re able to bring these kids in, look at the needs of this child and this family, maybe we can connect them to the resources we already have,” she said.
While fewer children were served last year, the state deserves credit for continuing to work with families through virtual sessions, Jagger said. Early intervention largely depends on teaching parents exercises and strategies to support their child’s development, which can be done remotely, he said.
Litfin said the change in rules is one factor in the reduction in the number of children they serve, but there are also greater barriers for families to get the services they need. It’s not an easy process, even in normal times, she said, and some of the most vulnerable families aren’t participating in the numbers they did pre-pandemic: from low-income neighborhoods that had a newborn baby. -Care unit, or who speak a language other than English or Spanish.
“I think with all the stress that families were experiencing during the pandemic, it became even more challenging” to get help, she said.
Families participating in Denver needed more support during the pandemic than in previous years, as many were facing financial strain and trying to help older children learn from home while working with their younger children. were doing, Litfin said. Service coordinators help connect parents to resources for food and rental assistance, and some parents have found “respite care” to keep an eye on their older children during appointments, she said.
In Denver, the city was able to put some money toward setting up a program for children with less severe needs, called Early Step, which launched in April, Litfin said. She also received a grant to fund a “Family Navigator” that would direct caregiving families at Denver Health’s clinics toward early intervention, early stages, and other resources to support their children’s development, she said. said.
Litfin said that going forward, this type of partnership is going to become more important as families grapple with the effects of the pandemic.
“No one agency and certainly no one program can meet all needs,” she said.
need more help
If children’s needs are not recognized early, they may need more help when they reach school. Miranda B., associate chief of student equity and opportunity at Denver Public Schools. Kogan said they are working with groups serving young children to ensure a smooth transition for families as their children reach preschool. If families have different concerns than they did pre-pandemic, they are preparing to adjust, he said in a statement.
“For example, many families are going to prioritize their child’s socio-emotional education because during the pandemic the opportunities for their child to have peers of the same age have been drastically reduced,” she said.
Jagger said it would be difficult to tease out any impact of delayed intervention from other challenges facing children in 2020. He said many families faced financial stress, food insecurity, isolation and mental health problems, all of which can affect a child’s development.
That doesn’t mean kids will be scarred for life, but they’ll need more support from caring adults, Jagger said. He said children don’t always back down from challenges in their first years, but they do well when they receive targeted support and know their parents and others believe in their abilities.
He said that children have a tremendous ability to overcome adversity. “It’s all about doing what we can to support our children to their full potential.”