Under the Individuals with Disabilities Education Act, states are designing and implementing comprehensive multidisciplinary early intervention services for families with young children with disabilities. It is the intent of the legislation that early intervention services reach populations that have been typically underserved. To understand ways in which services may promote utilization among typically underserved populations, it is necessary to examine the factors that have been associated with underutilization and their prevalence in the population of families with young children. In addition to a conceptual model of underutilization, we present statistics generated from the March 1991 Current Population Survey on the sociodemographic characteristics of families with children under 5 years of age. We also suggest four types of policies that may facilitate the participation of families who are likely to underutilize services.
Get full access to this article
View all access options for this article.
References
1.
Allen, D.A., Affleck, G., McGrade, B.J., & McQueeney, M. (1984). Factors in the effectiveness of early childhood intervention for low socioeconomic status families. Education and Training of the Mentally Retarded, 19, 254–260.
2.
Andersen, R., & Newman, J.F. (1973). Societal and individual determinants of medical care utilization in the United States. The Milbank Memorial Fund Quarterly: Health and Society, 51(1), 95–124.
3.
Arcia, E., Keyes, L., Gallagher, J.J., & Herrick, H. (1992). Potential Underutilization of Part H Services: An Empirical Study of National Demographic Factors. Carolina Policy Studies: Chapel Hill, NC.
4.
Brink, S., Martin, R., Golden, D., & Smith, L. (1985). Primary pediatric care: A comparison of use by adolescent and older mothers. Journal of Adolescent Health Care, 6, 201–205.
5.
Brizius & Foster and State Policy Research, Inc. (1990). States in profile. Alexandria, VA: Author.
6.
Bruder, M.B., Anderson, R.K., Schutz, G., & Caldera, M. (1991). Niños especiales program: A culturally sensitive early intervention model. Journal of Early Intervention, 15, 268–277.
7.
Bureau of the Census. (1989a). Households and family characteristics: March 1988 (Current Population Reports, Series P-20, No. 437, Tables 1, 8). Washington, DC: U.S. Government Printing Office.
8.
Bureau of the Census. (1989b). Studies in marriage and the family: Singleness in America (Current Population Reports Special Studies, Series P-23, No. 162, Table G). Washington, DC: U.S. Government Printing Office.
9.
Butler, J.A., Winter, W.D., Singer, J.D., & Wenger, M. (1985). Medical care use and expenditure among children and youth in the United States: Analysis of a national probability sample. Pediatrics, 76, 495–507.
10.
Children's Defense Fund. (1991). The state of America's children. Washington, DC.
11.
Egbuonu, L., & Starfield, B. (1982). Child health and social status. Pediatrics, 69, 550–557.
12.
Fergusson, D.M., Dimond, M.E., Horwood, L.J., & Shannon, F. T. (1984). The utilization of preschool health and education services. Social Science Medicine, 19, 1173–1180.
13.
Gallagher, J.J., Harbin, G., Eckland, J., & Clifford, R. (in press). State diversity and policy implementation: Infants and toddlers (P.L. 99–497, Part H). In J.B. Jordan, J.J. Gallagher, P.L. Hutinger, & M.B. Karnes (Eds.), Early Childhood Special Education: Birth to Three (Second Edition). Reston, VA: ERIC Clearinghouse on Handicapped and Gifted Children.
14.
Horwitz, S.M., Morgenstern, H., & Berkman, L.F. (1985). The use of pediatric medical care: A critical review. Journal of Chronic Diseases, 38, 935–945.
15.
Lowitzer, A.C. (1989, April). Family demographics, family functioning, and parent involvement. Paper presented at the meeting of the Society for Research in Child Development, Kansas City, MO.
16.
McDonald, T.P., & Coburn, A.F. (1988). Predictors of prenatal care utilization. Social Science Medicine, 27, 167–172.
17.
McKinney, J.D., & Hocutt, A.M. (1982). Public school involvement of parents of learning-disabled children and average achievers. Exceptional Education Quarterly, August, 64–73.
18.
National Center for Health Statistics. (1989). Advance report of final nationality statistics, 1987. Monthly Vital Statistics Report, 28(3), June 27, Table 22.
19.
National Commission on Children. (1991). Beyond rhetoric: A new American agenda for children and families. Washington, DC: US Government Printing Office.
20.
Neighbors, H.W. (1984). Professional help use among black Americans: Implications for unmet need. American Journal of Community Psychology, 12, 551–565.
21.
Rosenstock, I.M. (1966). Why people use health services. The Milbank Memorial Fund Quarterly, 44(3), 94–124.
22.
Rudolph, C.S., & Porter, K.L. (1986). Social services utilization by families of infants discharged from a neonatal intensive care unit. Journal of Social Service Research, 9(4), 1–19.
23.
Singer, J.D., Butler, J.A., & Palfrey, J.S. (1986). Health care access and use among handicapped students in five public school systems. Medical Care, 24(1), 1–13.
24.
Stein, R.C. (1983). Hispanic parents' perspectives and participation in their children's special education program: Comparisons by program and race. Learning Disability Quarterly, 6, 432–439.
25.
Tuma, J.M. (1989). Mental health services for children. In American Psychologist, 44(2) 188–199.
26.
Wolinsky, F.D. (1982). Racial differences in illness behavior. Journal of Community Health, 8(2), 87–101.
27.
Zill, N., & Schoenborn, C.A. (1990). Developmental, learning, and emotional problems: Health of our nation's children, United States, 1988. Advance Data, 836a(190), 1–18.
