Comparison of referral rates for preschool children at risk for disabilities using information obtained from birth certificate records.

This study demonstrates the utility of integrating birth certificate record data with an existing disability-tracking database for the purpose of evaluating early identification efforts. The authors examined referral rates of preschool-age children for several known disability risk factors. Low birthweight, low maternal education, and prematurity were associated with increased odds of referral. The authors also examined referral rates for gender, race, and ethnicity. The odds of referral for boys were nearly twice those for girls. Compared to White children, the odds of referral were greater for Native American children and lower for Black and Asian/Pacific Island children. Odds of referral for non-Hispanic/non-Haitian children were greater than those for Hispanic or Haitian children. Identifying factors that are associated with the likelihood of referral will alert clinicians, parents, teachers, and policy makers to the existence of biasing factors and can be used to further improve Child Find procedures.

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Early identification has become recognized nationwide as a necessary tool in providing the most effective treatment and intervention services to children with disabilities. The responsibility of early identification often falls on Child Find, a process of locating, identifying, and assessing children in need of special services that was mandated by the 1997 amendments to the Individuals with Disabilities Education Act (IDEA). Children identified as at risk for a disability are typically referred for further screening and evaluation. This initial referral is often considered the most important step in the special education eligibility process because it (a) identifies which children will be considered for services and (b) is an important predictor of future eligibility for special education (Artiles & Trent, 1994; Ysseldyke & Algozzine, 1983). As such, it is essential that Child Find efforts result in the referral of those children who are at the most risk for disabilities.

Numerous disability risk factors have been identified and have typically been classified into the following three categories:

1. established conditions that are apparent at or soon after birth;

2. physical or medical trauma at the prenatal, perinatal, or neonatal stages; and

3. physical, social, familial, and/or emotional risk factors (Bergen, 1994; Pavri, 2001).