Child developmental and special education service receipt: The intersection of health and poverty

Background: Children born of low birth weight (LBW) and/or premature may have developmental delays and difficulties. The vulnerability, without early intervention, would have detrimental lifelong effects. Objectives: This study examined 1) the relationship between LBW and prematurity and the occurrence and timing of children's receipt of developmental and special education services; and 2) whether poverty intersects with LBW and prematurity affecting service receipt. Methods: This population-based study used cross-sectional data from the National Survey of Children's Health which consisted of approximately 52,000 participants aged 1–17 between 2017 and 2018 in the United States. We conducted logistic regression to analyze the predictive relationship of LBW/prematurity and the occurrence of receiving developmental and special education services. We then conducted ordered logistic regression to examine whether LBW and prematurity predicted the timing of receiving developmental and special education services. Further, we conducted moderating analyses to examine whether the predictive relationships above varied with poverty. The analyses listed above were weighted to reflect the population drawn. Results: Children born with LBW and prematurity were more likely to receive developmental and special education services and they tended to receive services earlier than those born at normal weight and term. Educational disparities were evident among children in low-income families. Children of LBW in low-income families were less likely to receive earlier services than those in affluent families. Conclusions: This study indicates developmental and special education needs of children born LBW and/or premature. With restrained assets, low-income families may need more assistance to promote optimal development for their children.