Early Intervention (EI) may be the key to ensuring your child is on track for proper development.
Whether a child is having challenges with speaking, walking, or playing like other children their age, research shows that early intervention can significantly improve life outcomes for children experiencing developmental challenges. However, in Black and Brown communities, several obstacles hinder children from accessing these crucial services.
In New York State, children between the ages of 0 to 3 years old with a developmental delay can receive assistance through the Early Intervention Program (EIP). Children must be referred to the program and demonstrate a significant delay in one or more developmental areas, such as communication or physical development, to qualify for assistance — but barriers often arise.
Georgina Gooden, a rehabilitation specialist and mother of a son with special needs, said she first learned of early intervention when her son’s Head Start teachers recommended that he be evaluated based on some concerning behaviors. On visiting her son’s pediatrician to address his behavior, though, Gooden said her concerns were dismissed.
The pediatrician told Gooden that “[my son] is going to grow out of it. ‘He’s going to do great,’ so I’m worrying about nothing,” she said. “But when the teachers brought it to my attention again in a meeting with the school counselor, they scheduled the evaluation. That’s when I had the evaluation done in person at my house.”
Gooden said she took parenting classes before becoming a mother and felt confident in her parenting skills. She recognized that her son needed intervention after identifying speech delays, but the evaluator disagreed with her assessment.
“When the evaluator came to my house, I thought I was doing a pretty good job, but he didn’t see us. He didn’t see my son. All he basically saw was our neighborhood, the color of our skin, and what we looked like,” she said. “He had some ‘great’ parenting tips for me and suggested that I could do with some more training as a mom. Following that, [my son] did not meet the qualifications to get early intervention services.”
Research validates Gooden’s experiences. Data from the NYS Department of Health reveals gaping disparities between different racial groups in access to early intervention.
Between 2018 and 2020, non-Hispanic Black children were less likely to receive a multidisciplinary evaluation to determine their eligibility for EIP compared to their non-Hispanic white counterparts. Non-Hispanic white children were referred to EIP at an earlier age than other races of children, enabling them to receive services at a more optimal stage in their development. Non-Hispanic white children also experienced faster rates of service initiation compared to non-Hispanic Black children, with 66% and 41% service initiation rates, respectively.
There is help. After being dismissed several times, Gooden thought it was the end until she discovered United for Brownsville (UB), a Brooklyn-based nonprofit fighting to improve racial equity in NYC through early intervention. Gooden first became aware of United for Brownsville through its food pantries and parenting workshops. One day, she learned they were seeking parents in Brownsville to join a new leadership group called the Family Advisory Board (FAB).
Gooden eagerly joined the board, connecting with other parents who faced similar challenges in accessing early intervention services.
“[Early intervention] became a specific focus when members of the FAB identified it as an issue in Brownsville,” she said. “I was one of the persons that created the role for the first early intervention ambassador.”
The Early Intervention Ambassador program at United for Brownsville tackles the crises of inequity head-on, supporting families through every step of the process of accessing services.
“[The ambassador] supported me to get another evaluation done, whereby she went through the screening process with me, explained the language that I needed to use, and explained what it is that I was seeing in a way that I could [understand],” Gooden said. “When the evaluation was done a second time, she made sure the evaluation went through. She followed up with the evaluator.”
Demystifying early intervention for families is the essence of Danielle Herring’s work: She is the early intervention ambassador for United for Brownsville. She said cultural stigmas and distrust are often barriers that prevent families from using early intervention services.
“I address what they’re dealing with or what they’ve experienced, and then I actually acknowledge it after that,” said Herring. “Once we do that, we turn around and replace [their beliefs] with factual information about how the early intervention process could help them.”
Other barriers include situations like Gooden’s, such as being unaware of early intervention or, when informed, experiencing bias and discrimination from specialists.
David Harrington, co-executive director of United for Brownsville, noted that some obstacles might not necessarily relate to early intervention itself. “[Families] may have many other unaddressed needs or complications in life like lack of transportation or not feeling comfortable having evaluations and services done in their home, so [Danielle] looks for ways to remove those barriers by inviting them to a neutral space,” he said. Examples include “[providing] MetroCards when we have them, [or] assisted technology for remote evaluations and services, and things like that.”
Challenges can even stem from pride. Herring, who has a 14-year-old son with special needs, discussed her personal experience in coming to terms with his diagnosis. “There’s a difference between the knowledge and the heart space when it comes to families, and I experienced that myself, even with my own son,” she said. “I was knowledgeable about early intervention, but when you’re coming from a heart space, and you’re a mom, you feel like it’s something that you did that was wrong. You feel like ‘I don’t want to label my son.’ In that case, a lot of times when families may have been aware of the process, [they think], ‘I didn’t want to [admit there was a problem]. I was thinking with my heart, and my heart was leading me,’ as opposed to the knowledge of what early intervention was.”
Access to early intervention has demonstrated long-term benefits, including physical, cognitive, behavioral, and social impacts: reduced childhood obesity; improved performance on standardized tests; increased higher education opportunities; decreased violence, aggression, and antisocial tendencies; and development of positive relationships.
Unequal access can contribute to more disparate and adverse outcomes, but data from United for Brownsville shows that their work is yielding positive results in the community: Between 2019 and 2022, there was a consistent rise in the number of children of color aged 0–2 enrolled in early intervention programs in Brownsville.
The organization collaborated with the NYC Department of Health’s Bureau of Early Intervention and many health and social service providers to initiate the Early Intervention Ambassador program.
“We’ve been able to train providers with the Department of Health on what it looks like to engage with families,” Herring said. “Once a year, we sit with 50 providers in all different boroughs, and we train them on what engagement should look like.”
Recognizing the Brownsville success, several nonprofits and organizations across the boroughs have adopted the Early Intervention Ambassador program, tailoring it to meet the needs of their own communities.
““For our community — because Spanish is, I would say, the first language that we are serving our communities, we ensured that our ambassadors were bilingual [so] we don’t run into [problems like] ‘Hold on, let me get someone on the phone to be able to interpret for you,’” said Maria Panora, director of South Bronx Rising Together (SBRT). SBRT is a collective impact initiative of Children’s Aid, a nonprofit that establishes pathways for children and youth’s success from childhood to career.
“We knew that having someone [who] speaks more Spanish as well was going to be super-helpful as we implemented the ambassador model.”
For Harrington, the data and adoption by other organizations validates their efforts to close the gap in early intervention access. He hopes that access rates for Black and Brown children will continue to soar.
“We want to ensure that children are set up on pathways to be as successful as they can in life, and early intervention is a great start to doing that,” said Harrington. “We want to continue that success we’ve had in Brownsville and not see [lack of access] drop any further.”
Gooden, who is now an Early Intervention Ambassador assistant at United for Brownsville, said the organization empowered her to fight for her son’s needs. “The Early Intervention Ambassador role taught me how to use my voice, and I was forced to use my voice to advocate for my own child,” she said. “That’s when I became motivated to take on the role of becoming an ambassador myself.”
While hurdles remain until equitable early intervention access is completely attained, it’s clear that work is being done to close the gap day by day toward guaranteeing that no child is left behind.