Patterns of service use in preschool children: Correlates, consequences, and the role of early intervention

This article explores service use broadly by examining the mix of education al, health, and psychosocial services that preschool children received in t he fifth year of life. The sample included 869 children who participated in the Infant Health and Development Program, an early intervention program d esigned to evaluate the efficacy of a comprehensive early intervention for low-birth-weight, premature infants during the first 3 years of life and wh o were followed until age 5. Cluster analyses of services at age 5 yielded 4 service groups-basic health only (doctor visits; n = 114); basic health a nd educational services (doctor visits and school/preschool; n = 444); basi c health, educational, and psychosocial services (or multiple services; doc tor visits, school/preschool, and psychosocial services; n = 129); and spec ialized health and educational services (doctor visits, school/preschool, e mergency room visits and special medical visits [ear and/or eye examination s]; n = 182). Results suggest that neonatal health conditions, maternal edu cation at the time of the child's birth, child developmental status at age 3, and maternal health, family income, and insurance status at age 5 were a ssociated with patterns of services at age 5. Patterns of use are consisten t over time (the first 3 years of life to the 5th year of life). After cova rying the correlates of the service patterns, participation in the early in tervention was not associated with patterns of services at age 5, and servi ce patterns were associated with child well-being (health, school readiness , mental health), but results differed by intervention status. Findings are discussed in terms of preventive, responsive, and deficit models of servic e use.