Early intervention services like speech therapy can help children with developmental delays.
The Department of Education provides funding to states to identify children who need services and refer them to care. But our survey found that children of some backgrounds—such as American Indian—weren't evaluated for services as often as others.
Education doesn't collect children's demographic data before they enroll in the program, but many states do. We recommended that Education encourage states to use their data to ensure all children can access services, and that Congress consider giving Education authority to collect this data from all states.
What GAO Found
States and territories (states) use different definitions of “developmental delay” and different program eligibility criteria for their early intervention programs, which serve infants and toddlers with disabilities from birth through age 2. This reflects flexibilities provided to states under Part C of the Individuals with Disabilities Education Act (IDEA), which assists states in operating a statewide program of early intervention services. GAO surveyed 56 Part C programs, and 54 responded. When asked to name their top challenges serving eligible families, 48 states identified a lack of qualified service providers, and 23 cited staffing challenges at the state level.
According to GAO's survey, 53 percent of children referred for Part C services ultimately enrolled (see figure). To better understand the characteristics of children moving through each stage of the process, GAO analyzed demographic data for the 16 states able to report this information on GAO's survey. GAO found notable variation at different points in the enrollment process. For example, the percentage of children referred who received an evaluation ranged from 59 percent of American Indian or Alaska Native children to 86 percent of Asian children (a 27 point spread); whereas, the percentage of children deemed eligible who enrolled ranged from 91 percent of American Indian or Alaska Native children to 95 percent of Asian and White children (a 4 point spread).
Note: GAO conducted a survey of Part C programs. Fifty-four states and territories responded to our survey overall, and 41 provided responses included in this figure. Our survey requested data for the 12-month period from July 1, 2021 through June 30, 2022, however, three respondents provided data for a different, recent, 12-month period, in accordance with our survey instructions.
Education does not collect, or require states to collect, demographic data on children prior to enrollment in Part C. Officials said that IDEA does not provide them the authority to do so. If Education had statutory authority to collect such data throughout the enrollment process, it could focus its assistance on maximizing access to early intervention services for all infants and toddlers who need it—a key goal of IDEA. Many states, however, collect such data already, and some use it to identify ways to improve Part C access. Encouraging all states to improve their Child Find efforts by using the data they already collect would help them better identify and serve those infants and toddlers who need support.
Why GAO Did This Study
IDEA Part C programs served more than 770,000 children in 2021. Early intervention services, such as speech or physical therapy, can improve a child's outcomes. Research suggests that access to services varies by characteristics such as race and income.
GAO was asked to review barriers states may face in carrying out IDEA Part C requirements, and any inequities in access to early intervention services. This report examines (1) how states' Part C programs differ and challenges states face in serving eligible families; (2) available data on characteristics of children referred to, evaluated for, determined eligible for, and enrolled in Part C programs; and (3) how Education and states use available data to identify opportunities to increase children's access to services. To do so, GAO conducted a survey of 56 Part C programs: 50 states, five territories, and the District of Columbia. GAO also analyzed data from Education, and spoke with Education officials and stakeholders, and other experts.
Congress should consider providing authority to Education to collect demographic data from states on children throughout the Part C process and require Education to use these data to better assist states to identify and rectify gaps in access to services. GAO recommends that Education encourage states to use existing data to maximize children's access to Part C services. Education agreed with our recommendation.
Matter for Congressional Consideration
|Congress should consider strengthening efforts to maximize children's access to Part C early intervention services by 1) providing the Secretary of Education with authority to require states to collect and report to Education the demographic data on children for additional steps in the Part C enrollment process (i.e., at the referral, evaluation, and eligibility stages) and 2) requiring Education to use these data to better assist states in their efforts to identify and rectify gaps in access to Part C services. (Matter for Consideration 1)||
|We will monitor congressional efforts to address this matter.|
Recommendations for Executive Action
|Department of Education||The Assistant Secretary for Special Education and Rehabilitative Services should encourage all states to use demographic data they already collect to maximize children's access to Part C early intervention services. (Recommendation 1)||