Examining Transitions From Early Intervention to Preschool Services: A Retrospective Review of Therapeutic Service Access in a Clinical Sample of Children With Developmental Disabilities.
Karis Gorak, Alan Schwartz, Reshma Shah
90% of 194 preschoolers with developmental disabilities had no clinic-based therapy at evaluation.
Prior Early Intervention was the strongest predictor of school access, but children with intellectual disability or global developmental delay were less likely to receive school-based therapies than peers with other diagnoses.
Key findings
1At the time of their developmental evaluation, 90% of children were not receiving clinic-based therapies and 60% lacked school-based therapies.
2Children with a history of Early Intervention were more likely to be enrolled in preschool (70% vs. 47%; adjusted OR 3.21), to have an established IEP (60% vs. 29%; OR 4.47), and to be receiving school-based therapies (57% vs. 25%; OR 3.91) than children without EI history.
3Children diagnosed with intellectual disability or global developmental delay were less likely to be receiving school-based therapies than children without these diagnoses (35% vs. 50%; OR 0.37). No significant differences were found for speech/language delays, autism, or behavioral diagnoses.
Still to come
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Single clinic at one academic medical center in one Midwestern city; findings may not generalise to other regions or health systems. Retrospective chart review with incomplete and inconsistent documentation; EI history was a binary caregiver report with no data on service type, intensity, or duration. Cross-sectional design: captures service status at one point in time and cannot show whether children later enrolled in preschool, began therapies, or were found eligible after the visit. Children with primary motor delays may have been underrepresented because referrals to this developmental clinic predominantly reflected cognitive, language, behavioral, or social-emotional concerns. No information on service intensity, coordination, or timing of school-based therapies, making it impossible to determine whether EI services were sustained, modified, or discontinued at transition.
The easy way to misread this
Do not read the EI association as proof that Early Intervention causes better preschool access. This is a single-time-point chart review at one clinic; children who had EI may have had it because their families were more engaged, their needs were more clearly identified, or their insurance covered it. The cross-sectional design cannot establish that EI led to better access rather than both reflecting the same underlying family engagement. Likewise, do not read the lower school-based therapy rate for children with intellectual disability or global developmental delay as evidence that these children need less therapy — the authors suggest it may reflect longer evaluation timelines, more complex eligibility processes, or advocacy barriers rather than lower need.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →