Joshua R. Mann, M.D., M.P.H., Sarah Crawford, M.S., Lesly Wilson, Ph.D., O.T.R./L., Suzanne McDermott, Ph.D.†
This project was funded by the Centers for Disease Control (CDC) Health and Disability Cooperative Agreement U59/CCU421834.
Early identification of developmental delay is important for ensuring that children receive the early intervention services they need. Racial disparities exist for a number of childhood conditions, but it is not known whether there are racial disparities in the age of diagnosis with developmental delay.
This study aimed to determine the mean age of diagnosis with developmental delay for children ensured by South Carolina Medicaid. We hypothesized that African American children would be diagnosed later than white children.
A retrospective cohort study design explored South Carolina Medicaid claim records to determine the age when 5358 children with developmental delay (DD) were first diagnosed and whether there were racial disparities in age of diagnosis.
The mean age at diagnosis was 4.08 years for African American children and 4.27 years for white children. For children diagnosed with DD and mental retardation, the average age of first diagnosis was 2.6 years, and for children with DD plus cerebral palsy, the average age was 2.1 years. African American race was significantly associated with younger diagnosis with DD in a multivariable model, but the overall model explained little of the variation in age at diagnosis.
There were no clinically significant racial differences in the mean age of diagnosis with developmental delay. However, in general the age of diagnosis was undesirably late for both groups. Additional efforts are needed to ensure that children with DD, living in South Carolina, are identified near the beginning of early intervention services.