Characteristics and performance levels of high-risk and handicapped infants and young children in an early intervention program: Changes over a five-year period

Marked improvements in medical technology, an upsurge of maternal drug use during pregnancy, and an increase in the number of women delivering infants without the benefit of prenatal care are thought to have affected the types of problems found in children referred to early intervention programs in recent years. Questions have arisen about the developmental outcome of recently-born high-risk or handicapped infants.

This study described the changes which have occurred over a five-year period in the nature and severity of medical and developmental problems of 145 high-risk and handicapped infants enrolled in an early intervention program; 71 infants who were enrolled during the 1987-88 school year were compared with 75 infants enrolled during the 1982-83 school year. In addition, the handicapped children in both cohorts were examined in greater detail.

The results of this study indicated that later-born children experienced significantly more medical problems in 14 major categories (p =.004) and demonstrated an increase in the mean number of problems in the 14 major medical categories from 3.89 (SD = 1.7) in Cohort 1 to 4.75 (SD = 1.82) in Cohort 2. Children with more medical problems appeared to be at greater risk for developmental delays, as shown by a negative correlation between the number of medical problems and the developmental quotient (Cohort 1, r = -.25, p =.02 and Cohort 2, r = -.34, p =.002).

When comparing severely handicapped infants, later-born infants in Cohort 2 had a significantly greater number of medical problems in the major categories (p =.01), surgeries (p $<$.001), anesthesias (p $<$.001), and hospitalizations after birth (p =.01).

Infants in Cohort 2, when compared with infants in Cohort 1, showed a significant decline in the rate of gain of developmental skills (p =.049). This difference in development is expected to widen over time.

An examination of demographic variables showed no significant differences between the cohorts, suggesting that the variations found between these two groups of handicapped or at-risk infants and toddlers reflect an increase in developmental disabilities in later-born children.