Patterns of Referral Recommendations for Ethnically Diverse Children in Subsidized Child Care

It is important for researchers and practitioners to understand how early referral decisions are made in communities because the long-term consequences of an at-risk child being referred (or not) to an agency for evaluation and intervention are profound. This study explored one referral/intervention program for ethnically diverse, low-income children receiving subsidies to attend center-based child care, and examined correlates of referral recommendations made by teachers and clinicians. In 67 child-care centers, 899 children ages 3 to 4 (67% Hispanic/Latino, 25% African American, and 8% Caucasian/other) were assessed at the beginning of the academic year on cognitive, language, and social-emotional skills, and 588 of these children scored at a level suggesting follow-up. Clinicians and teachers generally agreed on the group of children recommended for further evaluation/referral and interventions. The referred group of children consisted of the children with the lowest scores on the child assessments and those whose parents and teachers showed the most disagreement on self-control.