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Child behavioral problems and competencies contribute to changes in developmental functioning during Early Intervention

Fri, April 9, 12:55 to 1:55pm EDT (12:55 to 1:55pm EDT), Virtual

Abstract

Background: Part C Early Intervention (EI), which serves children under 3 years of age with developmental delays and disabilities, facilitates improvements in developmental functioning (Hebbler et al. 2007), including adaptive behaviors (Woodman et al., 2018) and cognitive skills (Scarborough, Hebbeler, Spiker, & Simeonsson, 2011). However, little is known about whether child social-emotional/behavior problems and competencies impact developmental gains while in EI, even though behavioral problem have been associated with lower adaptive and cognitive skills for children with developmental disabilities (Mitchell & Hauser-Cram, 2009).

Objective: The aim of this study was to determine whether child behavioral problems and competencies contribute to changes in developmental functioning among children enrolled in Part C EI services.

Method: Data were drawn from Department of Public Health records for 1,055 children receiving services from EI agencies participating in a multistage autism spectrum disorder (ASD) screening study from 2011-2019. A majority of children were boys (63.5%), non-White or White Latinx (72.4%), had a primary household language of English (67.4%), had public insurance (59.7%), and did not have an ASD diagnosis (82.3%). The Battelle Developmental Inventory, Second Edition (Battelle-2; Newborg, 2005) assessed children’s developmental functioning at the time of entry (Mean [M] age in months: 17, SD: 5.1, range: 1-31) and exit (M age = 29, SD = 4.1, range:14-36) (M EI enrollment: 394 days; range: 62-1026). The BITSEA (Briggs-Gowan & Carter, 2006) identified social-emotional/behavioral problems and competencies. Putative covariates included: child sex, days between EI entry and exit, age at EI entry, ASD diagnosis, family race and ethnicity, and primary household language. Multiple regression was used to assess the contribution of problems and competencies on change in developmental functioning controlling for covariates.

Results: A sequential multiple regression model predicting exit Battelle-2 scores was conducted with entry Battelle-2 scores at step 1; sociodemographic covariates at step 2; BITSEA behavior problems at step 3; and BITSEA behavior competencies at step 4. Overall, variables added at each step contributed significantly to the general model. At step 1, entry Battelle-2 scores significantly predicted exit Battelle-2 scores (β = .56, p<.001). At step 2, each covariate (with the exception of English vs other primary household language) significantly predicted exit Battelle-2 scores (βs = -0.26 – 0.39, all p<.01). At step 3, BITSEA behavioral problem scores significantly predicted exit Battelle-2 scores (β = -0.10, p<.001). At step 4, BITSEA behavioral competency scores significantly predicted exit Battelle-2 scores (β = .0.27, p<.001). Table 1 shows R2 statistics and relative change for each step. The full model accounted for 51% of the variance in exit developmental functioning. Notably, with the addition of behavior competencies, behavior problems no longer significantly predicted exit developmental functioning (β = -0.24, p = 0.35) whereas all other covariates remained significant.

Conclusions: For children receiving Part C EI services, social-emotional/behavioral competencies predict change in developmental functioning from entry to exit from EI, over and above the contribution of behavioral problems. It is unclear whether or not the addition of interventions that target children’s social-emotional/behavioral competencies in EI services would optimize developmental outcomes.

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