The Impact of Definitions of High Risk on Services to Infants and Toddlers

Public Law 99-457 (Part H) makes possible the provision of services to three groups of infants and toddlers: handicapped, developmentally delayed, and high risk. States will have the discretion of defining the high-risk infant and toddler populations they will serve and which agency will be responsible. A national survey was conducted to compare definitions of high risk and to determine which agencies serve this population. In order to classify the responses, a Developmental Continuum of Risk model was developed. All 50 states were contacted; of the 26 states reported as serving the birth to 2 population, 24 responded with definitions of high risk. Of these, only 18 were inclusive of risk as defined by the model. Others were definitions of delays or handicaps. A majority of states reported housing services for high-risk infants and toddlers solely or collaboratively in departments of education. Only three states reported mandated entitlement legislation to serve the birth to 2 high-risk population. In general, definitions of high risk varied tremendously; further, many of the definitions lack conceptual clarity and indicate widespread misunderstanding of the concept.