Study: WIC staff often first to spot kids' health issues

Women, Infants and Children (WIC) program staff members who provide preventive health and nutrition services for families often are the first to identify developmental and behavioral issues among the young children they're serving, a new study shows. 

The study, published recently in the Journal of Developmental & Behavioral Pediatrics, found that although it is outside the primary scope of their work, WIC staff members frequently raise and address developmental and behavioral concerns in children whose families they are working with. 

"WIC staff members spend a great deal of time talking with families about child development concerns while delivering WIC services, even though WIC's primary mission is to provide public health nutrition services," said study co-author Julie Reeder, PhD, MPH, senior research analyst with Oregon's WIC Program, based at the Oregon Health Authority (OHA) Public Health Division. 

The findings by researchers at OHA and Oregon Health & Science University (OHSU) suggest that strengthening the system for referring families to community services that can address developmental and behavioral issues, and enhancing continuity of care between WIC and developmental providers, may improve child outcomes and reduce disparities. 

"We know that developmental disabilities affect one in six kids in the United States, and low-income and minority children are at risk for under-identification and treatment of developmental disabilities," said the study's lead author, Katharine Zuckerman, MD, MPH, associate professor of pediatrics at OHSU Doernbecher Children's Hospital and OHSU School of Medicine. 

For the study, researchers analyzed results from an online survey of more than 150 individuals who work in the Special Supplemental Nutrition Program for WIC. They found WIC staff members reported frequent interactions with families about topics related to child development. Nearly four in 10 WIC staff were asked about a child's development at least once per week, and nearly three in 10 noticed a developmental concern about a child at least once per week." 

"Given that the majority of WIC staff in our study could distinguish many instances of typical versus delayed development in young children, it is likely that many of the developmental concerns raised by WIC staff were well founded," the study's authors wrote. 

But even as the developmental concerns were prevalent, WIC staff members felt poorly connected to local developmental resources. The study found that almost 70 percent felt less than very connected with their county's early intervention/early childhood special education program (EI/ECSE) office, and 74 percent felt less than well connected with most pediatric health care providers. WIC staffers who fielded the most developmental concerns also felt poorly connected to primary care and community developmental resources. 

The study recommended that WIC staff members be provided more support to effectively refer children with developmental conditions and to improve continuity of care once early intervention or early childhood special education services are initiated. 

"...Although WIC's primary mission is to provide public health nutrition services and not to diagnose or address childhood developmental delays, WIC staff nonetheless spend significant time engaging with families on this topic in the course of delivery of standard WIC services," the study's authors concluded. 

As a result, WIC staff members and families may benefit from additional support for developmental issues. Such support could come in the form of family handouts, trainings for existing staff, additional personnel to handle developmental concerns, or even in the form of improved partnerships with community developmental resources. 

"While we are working on enhancing training opportunities for WIC staff, this article really is an awareness-raising tool," Reeder said. "It shows physicians and early intervention staff that WIC staff are a potential additional source of information about developmental delays." 

The study can be found at

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