Not A Lost Cause: Expand Early Intervention Services to Lead-Exposed Children in Illinois

"They don't even have a chance because it was taken from them when they were babies," said Tolanda McMullen, whose son suffered from lead exposure. She’s right: children who suffer from lead poisoning experience significant cognitive and behavioral challenges that alter the course of their entire lives. No amount of lead exposure, particularly in rapidly developing young children, is considered safe.

In the United States, lead poisoning still affects 1 in 38 children in the United States. While all children are at risk, this toxic exposure disproportionately affects low-income and minority infants, toddlers, and young children in urban areas. A Chicago study indicated that racial disparities are heightened through lead poisoning.

“We know exactly how to prevent lead poisoning, and that makes us responsible,” said Anita Weinberg, the director of the Civitas ChildLaw Center at Loyola University Chicago School of Law. A social worker and attorney interested in the health of children and families, she chaired the Lead Safe Housing Task Force, administrated Lead Safe Illinois, and co-authored amendments to the Illinois Lead Poisoning Prevention Act. “Because it’s criminal, when you know what to do, to ignore it instead.”

Lead exposure is an environmental equity and disability justice issue that we can not afford to ignore. Even though we cannot reverse the consequences of lead exposure, access to Early Intervention services can mitigate its effects. A subset of the Individuals with Disability Education Act (IDEA), Early Intervention (EI) provides services to help identify and support young children who are experiencing or at risk for developmental delay. While every state and territory has EI services, there is significant state variation in eligibility criteria.

In Illinois, childhood lead poisoning does not automatically entitle an infant or toddler to receive EI services, while 19 other states do allow automatic eligibility for EI when a child is exposed to lead. The national average for blood lead level (BLL) in American children between 1 and 5 years of age is 1.6 micrograms per deciliter (mcg/dL), but the risk of childhood lead poisoning is much higher in Illinois: in 2010, 3,356—or 1.10 percent—of Illinois children were found to have BLLs of 10 mcg/dL.

Weinberg is spearheading an initiative to ensure automatic access to EI for infants and toddlers exposed to lead in Illinois. Research indicates that children at risk for developmental delays benefit most from interventions that start at an early age, and EI services target children from birth to three years of age. Lead exposure is a significant risk factor for developmental disabilities, so interventions early on are desperately needed. Studies show that children who receive early intervention services have higher IQ scores than children who would benefit from those services but are not receiving them.

Opponents of expanding automatic eligibility for Illinois EI services may cite cost as a major barrier. Increasing access to EI, however, will reduce the need for special education services and its attendant costs later. With appropriate EI services, children exposed to lead make great progress in the areas of executive functioning, literacy, and impulse control—areas that often prove most difficult for lead-exposed children. These children will then be less reliant on special education services moving forward, as 54-62% of children who receive EI services enter K-12 functioning at levels equivalent to children without developmental delays.

Weinberg called lead poisoning the “silent epidemic,” because its effects are largely indistinguishable from other cognitive disabilities and behavioral delays. But mapping Illinois communities with poorly-funded schools and the greatest need for special education services reveals lead poisoning, Weinberg said, “and their lack of success impacts all of us in the end.”

Preventing lead exposure before it occurs is the only “cure,” but it does not account for children who have already faced the detrimental effects of lead exposure. These children are not a lost cause, and they are absolutely worthy of efforts to alleviate the impacts of lead-induced developmental delays. Their lives are not inherently a tragedy—with access to EI services during critical developmental stages, they can flourish.