Developing a Foundational Understanding of the Sociohistorical Context
Structural Racism and Early Intervention
Based on the ways in which structural racism impacts Black, Indigenous, Latine, and other people of color in the legal, educational, and medical systems, it’s not surprising that there are outcome disparities for People of Color in Early Intervention. Black and Latine children are 78% less likely to receive early intervention services than their White peers (Magnusson, et al., 2015). Black toddlers are five times less likely than White toddlers to receive early intervention when there isn’t a diagnosed medical condition (like Down syndrome, Cerebral Palsy, etc.) (McManus, et al., 2020). This is likely due to the need for speech and behavioral delays to be identified through an observational assessment (Feinburg, et al., 2011; Barton, et al., 2016). These observational screenings and assessments are more objective than a medical diagnosis. They require the person doing the assessment to use their professional judgment. It’s impossible for anyone to leave their implicit biases out of their professional judgment. Many screeners are implicitly biased to have lower expectations for children of color which results in fewer children of color being referred to EI services. Additionally, children of color and children in low income households are significantly less likely to receive any kind of development screening before the age of three (Keating, 2022; McManus et al., 2020). Researchers have found that the lack of developmental screenings for low income children are correlated with a lack of health insurance, which results in fewer well-child pediatrician visits and/or attending a poor quality child care center that lacks resources to complete developmental screenings (Khowaja, et al., 2015).
Gaining access to early intervention services for families that speak a language other than English presents additional structural barriers. Though special education law mandates Early Intervention assessments and services are delivered in the family’s home language, there are generally not enough EI providers or interpreters available (Duran, et al., 2023).
For the families of color that are able to enroll their children in EI services, they have challenges finding practitioners that speak their home language (Duran, et al., 2023) or who practice in their neighborhoods (Feinburg, et al, 2011; Moran & Sheppard, 2023). For BIPOC families that do find EI providers, these providers are dismissive of family concerns and/or are disrespectful of the families’ cultures (Evans et al.,2016).
Data like this was very challenging for me to internalize when I started my journey to becoming a more culturally responsive EI practitioner. I didn’t see myself in it because I believed that I knew that I would never intentionally dismiss a family’s concerns. It was challenging for me to reconcile what the research said about families’ experiences and my perspective on the experiences families had working with me.
