Alexis* was born prematurely at 26 weeks and experienced multiple complications in the neonatal intensive care unit. On the pediatrician’s advice, Alexis was evaluated through Illinois’ Early Intervention services once she returned home. She qualified for occupational, physical, developmental and eventually speech therapies. She received these therapies (except for speech) for six months.
After that, her service coordinator was unable to find a therapist in her area who would accept her family’s public insurance. For families like Alexis’, waiting lists for therapy can be as long as one year or more, and the cost of private therapy is out of reach. Alexis is now 19 months old and can no longer access needed services.
Another patient, a 33-month-old boy we will call Noah*, was evaluated at 27 months through Early Intervention and diagnosed with autism. His service coordinator tried for six months to access therapists. And failed.
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When Noah turns three, and no longer qualifies for Early Intervention assistance, he will need to transition into a program in his school district. His parents have private insurance, but it does not cover any of the therapies required for a child with autism.
After months with no Illinois state budget in place, professionals who provide services for infants and toddlers at developmental risk are still scrambling to be paid. With the window of access in Illinois soon closing even more tightly, many more children will be denied the help they need. This is a quandary faced in Illinois, but a challenge with hard-fought funds delivered or denied to families and communities in every state.
As the calendar year draws to an end, lawmakers continue to meet over the stalemate surrounding Illinois Gov. Bruce Rauner’s proposed cuts of $23 million in early childhood intervention funds for fiscal year 2016 and $4.3 million more in cuts specifically for autism. Before lawmakers recess for the holiday, it is critical to highlight the effects these proposed cuts will have.
Infants and young children from low-income families who are eligible for Child Care Assistance – another key element in the suite of services offered under Early Intervention – will also be denied the help they require.
Best practice guidelines from the American Academy of Pediatrics demonstrate that these early services are crucial. Together, we are a pediatrician and a psychologist, and we are convinced that interventions in the child’s first years minimize considerably the cascade of deleterious consequences that would otherwise follow them throughout development.
According to Illinois Rep. Greg Harris (D-Chicago), the governor plans to implement cuts to Early Intervention by providing services only to children who are at least 50 percent delayed in reaching developmental milestones in physical, language, cognitive or social abilities.
Early Intervention now covers nearly 24,000 children, including those with more moderate delays of at least 30 percent. The Chicago Medical-Legal Partnership for Children estimates that roughly half of these would lose services under Rauner’s 2016 proposal.
Organizations such as Easter Seals are lobbying to reverse the proposed cuts because children with delays from 30-40 percent show the most improvement with interventions.
This is why the Ounce of Prevention Fund,an early-childhood nonprofit headed by First Lady of Illinois Diana Rauner, criticized the proposed cuts to Early Intervention and Child Care Assistance Programs.
Because parents are engaged as partners in their child’s therapies, the positive outcomes are compounded. According to a recent policy brief from the Sackler Institute, children benefit from “a combination of home and center-based delivery models.”
Others agree. James Heckman, Nobel Laureate in Economics and Professor of Economics at the University of Chicago, writes that the return on investment for early intervention far exceeds the return on programs for school-aged children, adolescents and adults. He notes that the benefits of providing family-based services including educational, social, medical and nutritional interventions in the first years of life go beyond the individual child; these services have long-lasting benefits for society.
Beyond their impact on children, the proposed cuts are also economically unsound. The federal government and other agencies provide matching funds for every child enrolled in Early Intervention. If we reduce the number of children enrolled, we lose out on these contributions.
The proposed cuts threaten to place additional budgetary burdens on families, schools, hospitals and community-based organizations.
Families will likely turn increasingly to schools and community resources for help. But the cost of special education in preschool and elementary school is more than twice that of Early Intervention. And community resources too are facing drastic cuts – potentially $55.1 million in funding to the Division of Family and Community Services, whose programs support at-risk families. And the cost of special education in preschool and elementary school is more than twice that of Early Intervention.
Illinois’ $6.2 billion budget deficit is a serious problem. There is no doubt that we need solutions that will provide us stronger footing for the long-term. But withholding services to vulnerable infants and young children is not the way.
Nelson Mandela once said, “There can be no keener revelation of a society’s soul than the way in which it treats its children.”
If so, then the soul of our state is in jeopardy.
*Details have been changed for privacy.