Center-based childcare access to health screenings and developmental assessments in US children from birth to five

Research Objectives: To determine the odds of whether children from birth to five are referred for health screenings and developmental assessments based on child race/ethnicity and factors at the center-based childcare provider- and the program-level.

Design: Cross-sectional study with the 2019 National Survey of Early Care and Education (NSECE) center-based childcare provider survey.

Setting: Nationally representative survey on the use and payment of center-based childcare services among US families of children from birth to five.

Participants: Center-based childcare providers (n=1,306) caring for US children from birth to five years old and do not internally provide health screenings or developmental assessments.

Interventions: Not applicable

Main Outcome Measures: Center-based childcare providers that facilitate referrals for children from birth to five years old and their families (0 = no; 1 = yes).

Results: Among White, non-Hispanic children (OR= 1.01, 95% CI [1.00-1.02], p = .046), center-based childcare programs with mentorship provided to staff had greater odds of making referrals for health screenings and developmental assessments for children from birth to five (OR= 2.15, 95% CI [1.36-3.41], p = .001). After adjustment, Hispanic children had slightly lower odds of receiving referrals for health screenings and developmental assessments than White, Non-Hispanic, Black, Non-Hispanic, Asian, and Other racial groups (OR= 0.99, 95% CI [0.98-0.99], p = .030).

Conclusions: The observed data indicates a statistically significant association between referrals made for health screenings and developmental assessments and the provision of mentorship to staff in center-based childcare programs for children from birth to five. Center-based childcare programs that provided mentorship to their staff exhibited a roughly twofold increase in the odds of providing referrals. Childcare programs and pediatric rehabilitation professionals have the potential to jointly enhance the frequency of health screenings and developmental assessments, thereby facilitating prompt referrals to pediatric rehabilitation services within the educational intervention setting.

Author(s) Disclosures: The presenter declares no conflict of interest.