Camden McKenney was 6 months old when his mother started noticing that something wasn’t quite right. Camden wasn’t rolling over and he couldn’t sit up. He was also low in weight.
Two and a half weeks after the family’s pediatrician made a referral, Camden was evaluated by a specialist and diagnosed with gross motor delay. He started physical therapy and has made noticeable progress.
"He couldn't teach himself how to feed himself and that was something that he learned through physical therapy,” said Camden’s mother, Laura McKenney. “We were able to avoid any other nutritional errors. In his (physical) movements, he's now more caught up to his peers."
Camden was lucky. The Children’s Agenda says 20 percent of children in Monroe County wait months for an appointment to receive critically important services for developmental delays.
According a report prepared by the Children’s Agenda, the problem has been about twenty years in the making. Over the past two decades, New York State reimbursement rates for early intervention services remained flat or decreased. Physical therapists, occupational therapists, and speech language pathologists who work with young children are paid significantly less than their similarly licensed peers who work in other settings, such as hospitals, school systems, and rehabilitation facilities.
Some therapists move on to other jobs for economic reasons. The seeds of the shortage in these fields are sown even earlier, too. College students are aware of the pay disparities and it influences their career choices.
"They're taking on debt to achieve these career goals they've set for themselves and those pressures come to bear when they have to make a choice of a speciality,” said Rick Costanza, assistant professor in the department of Education and Human Services at Monroe Community College. “As a result, we're seeing the system suffer. We don't even have enough people to do the evaluations let alone provide services in a timely fashion, and children will suffer as a result."
The whole community bears the economic burden when young children don’t get the developmental treatment they need, according to Christine Sheffer, school superintendent at Mary Cariola Children’s Center. Sheffer said the same children need even more support later in life if they don’t get it when they’re young.
"Children who don't get specialized supports they need early in life start school behind peers and they never catch up. They show a disproportionate decrease in skill acquisition. They miss the window sometimes. They learn maladaptive coping mechanisms that are hard to unlearn later."
The Children’s Agenda makes several recommendations to New York State: Raise reimbursement rates by 20 percent to 40 percent, establish a statewide rate-setting methodology, and link the funding streams for early intervention and preschool special education services and create equity between the two.
"We wouldn't want to just fix the early intervention funding problem and then we have the crisis the opposite way, where people aren't providing preschool Special Ed services anymore,” said Peter Nabozny, director of policy for the Children’s Agenda. “We have to figure out a way to link the funding between these systems because the people working in these fields are working with the same kids from the time they're one year old until they're four or five and transitioning into the school system."
State Senator Rich Funke says more money has been appropriated for these early intervention programs, but it's not going where it's needed.
"We have increased funding for early intervention services by $11 million in the last three and a half years that I've been in office and that money is not reaching where it's supposed to be reaching. We determined it's being chewed up in other ways, by administrative costs and so on."
If the changes recommended in the report aren’t made, Nabozny says the wait for early childhood developmental services will continue to grow.
Laura McKenney feels fortunate that she didn’t have to find out what that would have meant for her young son.
"I can't imagine if I was told that he qualified for these services and then had to wait, because it's just so tough to see your child, especially at day care, getting surpassed by kids younger than him."