https://doi.org/10.1177/1053815117708999
Journal of Early Intervention
2017, Vol. 39(3) 253–263
© 2017 SAGE Publications
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DOI: 10.1177/1053815117708999
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Article
The Relationship Between State
Lead Agency and Enrollment Into
Early Intervention Services
Erica Twardzik
1
, Megan MacDonald
1
, and Alicia Dixon-Ibarra
1
Abstract
Services offered through Part C of the Individuals With Disabilities Education Improvement
Act improve cognitive, behavioral, and physical skills for children less than 3 years old at risk
for or with a disability. However, there are low enrollment rates into services. Various Lead
Agencies oversee services through Part C, and states determine which agency is in charge of
administering these services. The objective of this study was to describe odds of enrollment
into early intervention services based on the department administering services (Lead Agency).
Each state’s Lead Agency (Education, Health, or Other), state population size, narrowness of
eligibility criteria, and state-level screening rates were fit into a negative binomial regression
model to predict odds of enrollment into Part C services. Results show that state’s reporting
from “Health” and “Other” as a Lead Agency had significantly higher odds for Part C services
compared with the state Lead Agency of Education (Health adjusted odds ratio [AOR] = 1.56,
95% confidence interval [CI] = [1.557, 1.561]; Other AOR = 2.40, 95% CI = [2.401, 2.405]).
Further research should describe unique components of a Lead Agency’s administrative practices
that contribute to the variation in enrollment. This study was an important step toward the
investigation of low enrollment rates into Part C services.
Keywords
lead agency, IDEIA, Part C, early intervention, state variation
Introduction
Improved child outcomes have been strongly associated with effective early intervention services
for children who have been identified as developmentally delayed or who are at risk for develop-
mental delays (Campbell, Ramey, Pungello, Sparling, & Miller-Johnson, 2002; Hebbeler et al.,
2007; Shonkoff et al., 2007; Shonkoff & Phillips, 2000). Early intervention during the first years
of life is critical to healthy development due to rapid growth and unique plasticity of the brain
during this time (Shonkoff et al., 2007). In other words, earlier access to appropriate services has
the potential to produce better outcomes for the child, and in many cases, children are less likely
to require intervention services later on in life. In addition, early interventions, in contrast to
interventions initiated later in development, have been indicated as more cost-effective (Barnett,
1
Oregon State University, Corvallis, USA
Corresponding Author:
Erica Twardzik, 1402 Washington Heights, Ann Arbor, MI 48109, USA.
Email: ericatwardzik@gmail.com
708999JEI XX X 10.1177/1053815117708999Journal of Early InterventionTwardzik et al.
research-article 2017