Racial Disparities in Developmental Delay Diagnosis and Services Received in Early Childhood
| Autor: | Alma D. Guerrero, Rebecca N. Dudovitz, Christopher Biely, Elizabeth S. Barnert, Paul J. Chung, Bergen B. Nelson, Abraham Gallegos, Peter G. Szilagyi, Tumaini R. Coker |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Longitudinal study Pediatric Research Initiative First language education Psychological intervention early childhood longitudinal study birth cohort Logistic regression Pediatrics Article Paediatrics and Reproductive Medicine 03 medical and health sciences Insurance 0302 clinical medicine Child Development Clinical Research 030225 pediatrics Behavioral and Social Science medicine Humans 030212 general & internal medicine Early childhood Longitudinal Studies Medical diagnosis Healthcare Disparities Child Preschool Minority Groups Receipt Pediatric Insurance Health business.industry Cognition Health Services Quality Education developmental delay disparities early intervention Health Child Preschool Family medicine Pediatrics Perinatology and Child Health Educational Status business |
| Zdroj: | Academic pediatrics, vol 21, iss 7 Acad Pediatr |
| Popis: | Background and Objective Racial disparities in diagnosis and receipt of services for early childhood developmental delay (DD) are well known but studies have had difficulties distinguishing contributing patient, healthcare system, and physician factors from underlying prevalence. We examine rates of physician diagnoses of DD by preschool and kindergarten entry controlling for a child's objective development via scoring on validated developmental assessment along with other child characteristics. Methods We used data from the preschool and kindergarten entry waves of the Early Childhood Longitudinal Study, Birth Cohort. Dependent variables included being diagnosed with DD by a medical provider and receipt of developmental services. Logistic regression models tested whether a child's race was associated with both outcomes during preschool and kindergarten while controlling for the developmental assessments, as well as other contextual factors. Results Among 7950 children, 6.6% of preschoolers and 7.5% of kindergarteners were diagnosed with DD. Of preschool children with DD, 66.5% were receiving developmental services, while 69.1% of kindergarten children with DD were receiving services. Children who were Black, Asian, spoke a primary language other than English and had no health insurance were less likely to be diagnosed with DD despite accounting for cognitive ability. Black and Latinx children were less likely to receive services. Conclusions Racial minority children are less likely to be diagnosed by their pediatric provider with DD and less likely to receive services despite accounting for a child's objective developmental assessment. The pediatric primary care system is an important target for interventions to reduce these disparities. |
| Databáze: | OpenAIRE |
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