Late start of early intervention in children with Down syndrome

Early intervention (EI) is key in the lives of children with Down syndrome (CHwDS). Starting it before 60 days of life (DOL) has better results in future development. Objective: To assess the factors that delay the beginning of EI in CHwDS. Subjects and Method: Parents of CHwDS who attended EI programs during their first year of life participated. Social, family, and health factors that could influence the time of initiation of EI were evaluated and compared according to the start of EI (before vs after 60DOL). For the analysis of categorical variables, Fisher's exact test was used and for the association between the numerical ones, the Student T-test for independent samples. Results: 125 questionnaires were analyzed. 51.2% started EI after 60DOL, and of them, 25% started after 6 months of age. Late initiation of EI was associated with hospitalization before 3 months of age (OR = 2.5), long hospital stays (OR = 2.4), lower educational level of the father (OR = 4.7) and of the mother (OR = 3.4), birth in the public health system (OR = 11.8), and access to free EI centers (OR = 2.4). The high socioeconomic level was the only protective factor (OR = 0.4) for early initiation. Conclusions: More than 50% of CHwDS begin EI programs late. This was associated with early hospitalization, prolonged hospital stays, and socioeconomic status. It is urgent to allocate resources and generate public policies that allow guaranteed access to EI programs.