Project: High Impact Models of Early Intervention Support: Accelerating Child Outcomes and Systems Policies

Telehealth was introduced into early intervention (EI) service delivery models during the COVID-19 pandemic raising questions about changes in service access for children from marginalized groups, service type and intensity, as well as cost-effectiveness. We will use secondary data from two existing databases of detailed EI service utilization (the Technology-assisted Observation and Teaming Support system [TOTS]) and child outcome data (the Kentucky [KY] Early Childhood Data System [KEDS]) to determine which service delivery models most positively influence child developmental trajectories for which children, especially among historically underrepresented families. By leveraging and integrating data from TOTS and KEDS, we will pursue three specific aims:
Aim 1a: Evaluate the extent to which the introduction of telehealth influenced the configuration, provision, and utilization of EI services with regard to therapy type and intensity.
Aim 1b: Investigate the extent to which the expansion and change of EI service delivery models varied by child characteristics (child delay status, race, ethnicity, location, insurance type).
Aim 2: Model the impact and unintended consequences of changing EI service delivery models as a result of the introduction of telehealth on child developmental outcomes (i.e., cognitive, social-emotional, communication, fine motor, gross motor) of children aged 0-3 years as moderated by child delay status, race, ethnicity, location, and insurance type.
Aim 3: Evaluate the incremental cost effectiveness of new EI service delivery models, including telehealth and hybrid telehealth / in-person, compared to traditional models (i.e., in-person) on child developmental outcomes.