Early Intervention Service Intensity and Change in Children’s Functional Capabilities

Published:November 25, 2019DOI:



      To estimate correlates of early intervention (EI) service dosage and gains in children’s functional capabilities from EI entry and discharge.


      Retrospective cohort study.


      Secondary analyses of a subset of data (N=1005) collected from an EI administrative database on children discharged from a large, urban EI program between October 1, 2014 and September 30, 2016.


      Children who were EI eligible due to developmental delay, had received an EI care plan and at least 1 billable EI service, and had outcomes data at EI entry and exit (N=1005). Measured child characteristics included age (49.0% 12-24mo; n=492), sex (36.0% female; n=362), number of developmental delays (76.1% had 1 developmental delay; n=765), and number of EI services received (78.5% received multiple; n=789).


      Not applicable.

      Main Outcome Measures

      Outcomes were EI service intensity (hours per month) and change in functional capabilities as measured via the state-mandated Child Outcomes Summary (COS). Adjusted quantile median regression estimated EI intensity. Adjusted linear regression estimated change in function for social-emotional, cognitive, and adaptive domains of the COS. Measures of children’s developmental delay severity, age at EI entry, race and ethnicity, sex, and language.


      Children older than 24 months old experienced significantly higher EI service intensity (b=0.40; 95% confidence interval, 0.18-0.63). Child age and EI service intensity were significantly linked to gains in social and cognitive COS score changes from EI entry to exit.


      Older children receive a higher intensity of EI services. EI service intensity and age were linked with positive changes in functional gains.


      List of abbreviations:

      BNH (black, non-Hispanic), CI (confidence interval), COS (Child Outcomes Summary), DI (developmental intervention), EI (early intervention), IQR (interquartile range), ONH (other, non-Hispanic), OT (occupational therapy), PT (physical therapy), ST (speech therapy), WNH (white, non-Hispanic)
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