CoChat
Sign Up
Cited by 66Child and Adolescent HealthAutism Spectrum Disorder ResearchDown syndrome and intellectual disability research

Racial disparities in developmental delay diagnosis and services received in early childhood

Open access
Gallegos, Abraham, Dudovitz, Rebecca, Biely, Christopher, Chung, Paul J., Coker, Tumaini R., Barnert, Elizabeth, Guerrero, Alma D., Szilagyi, Peter G. +1 more·2021·Academic Pediatrics
DOI 10.1016/j.acap.2021.05.008PMC PMC9169674
Open this paper in CoChat — free account

Abstract

Background and objective Racial disparities in diagnosis and receipt of services for early childhood developmental delay (DD) are well known but studies have had difficulties distinguishing contributing patient, healthcare system, and physician factors from underlying prevalence. We examine rates of physician diagnoses of DD by preschool and kindergarten entry controlling for a child's objective development via scoring on validated developmental assessment along with other child characteristics.Methods We used data from the preschool and kindergarten entry waves of the Early Childhood Longitudinal Study, Birth Cohort. Dependent variables included being diagnosed with DD by a medical provider and receipt of developmental services. Logistic regression models tested whether a child's race was associated with both outcomes during preschool and kindergarten while controlling for the developmental assessments, as well as other contextual factors.Results Among 7950 children, 6.6% of preschoolers and 7.5% of kindergarteners were diagnosed with DD. Of preschool children with DD, 66.5% were receiving developmental services, while 69.1% of kindergarten children with DD were receiving services. Children who were Black, Asian, spoke a primary language other than English and had no health insurance were less likely to be diagnosed with DD despite accounting for cognitive ability. Black and Latinx children were less likely to receive services.Conclusions Racial minority children are less likely to be diagnosed by their pediatric provider with DD and less likely to receive services despite accounting for a child's objective developmental assessment. The pediatric primary care system is an important target for interventions to reduce these disparities.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1016/j.acap.2021.05.008

Cites

35 of 35 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Children from low-income families and those from minoritized communities have increased risk for developmental delay and are less likely to receive timely developmental support services than more socially advantaged peers.

    “Children from low-income families and those from minoritized communities face the double disadvantage of having increased risk for developmental delay and being less likely to receive timely developmental support services than their more socially advantaged peers.8, 9”

    From Sustained Effectiveness of a 211 Call Center With Early Childhood Care Coordination (2025) · cites this paper as [8]

    The Results (page not supplied) report lower odds of receiving developmental services by preschool for Black and Latinx children with a diagnosis, and by kindergarten for Black children and children in one lower-income bracket. The paper does not establish that these groups have an increased underlying risk of developmental delay; its Discussion says the lower diagnosis rate among racial and ethnic minority children was not explained by differences in underlying prevalence. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. [28]Pediatrics AAo. Periodic survey of fellows# 53: Identification of children< 36 months at risk for developmental problems and referral to early identification programs. Retrieved November 2003; 11: 2007

Cited by

Sorted by citations

Related

Authors
Gallegos, A., Dudovitz, R., Biely, C., Chung, P. J., Coker, T. R., Barnert, E., Guerrero, A. D., Szilagyi, P. G., & Nelson, B. B.
Affiliations
  • University of California, Los Angeles (US)
  • University of Washington (US)
  • Virginia Commonwealth University (US)
Corresponding author
Gallegos, Abraham
ORCID
Venue
Academic Pediatrics
Publisher
Elsevier BV
Published
2021-09
Volume
21
Issue
7
Pages
1230-1238
ISSN
1876-2859 (ISSN-L)
DOI
10.1016/j.acap.2021.05.008
PMC
PMC9169674
OpenAlex
W3163587188
Cited by
66
References
35
Citations by year
2026: 22 · 2025: 14 · 2024: 16 · 2023: 11 · 2022: 3
FWCI
8.43
Type
journal article
Language
en
Open access
Licence
Locations
  • Academic Pediatrics (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • University of California, Los Angeles
  • Clinical and Translational Science Institute, University of California, Los Angeles
  • National Institutes of Health
  • National Center for Advancing Translational Sciences
Topics
  • Health Sciences › Health Professions › General Health Professions › Child and Adolescent Health
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Down syndrome and intellectual disability research
Keywords
racial disparities, developmental delay, early childhood, developmental services, physician diagnosis, preschool children, kindergarten entry, Black children, Latinx children, language minority children, health insurance, pediatric primary care, developmental assessment, Early Childhood Longitudinal Study-Birth Cohort
MeSH terms
Child, Child Development, Child, Preschool, Educational Status, Humans, Insurance, Health, Longitudinal Studies, Minority Groups, Healthcare Disparities

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review