Office of Epidemiology and Research, Division of Research

Advancing Applied MCH Research

(SDAS) Maternal depressive symptoms and participation in early intervention services

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Project Number: R40 MC 08953-01
Grantee: Boston University, BUMC
Department/Center: Maternal and Child Health/School of Public Health
Project Date: 2/1/2008

Final Report

(SDAS) Maternal depressive symptoms and participation in early intervention services Final Report (PDF) Exit Disclaimer

Principal Investigator

Emily Feinberg, Sc.D.
Assistant Professor
715 Albany Street, T5W
Boston, MA  02118-2526
Phone: (617) 414-1425


  • Perinatal/Infancy (0-12 months)
  • Toddlerhood (13-35 months)


The objective of this research is to utilize population-based data from the Early Childhood Longitudinal Study (ECLS) to examine a question that is a growing concern to the MCH community: the impact of maternal depression on young children. The research, which will focus on young children with special health care needs (CSHCN), is intended to provide new information, about the impact of maternal depressive symptoms on child participation in state birth to three Early Intervention programs (EI). Children ages birth to 3 years with demonstrated developmental delays or conditions known to impact developmental trajectories receive services through state-run EI programs. While eligibility guidelines vary state to state, not all eligible children enroll. One factor that may influence participation in EI and child outcomes once enrolled is maternal depression. We will use data from the birth cohort of ECLS, a federally-funded study designed to provide data about children's early life experiences, to address the following 3 research questions: 1) what is the prevalence of depressive symptoms among mothers of children eligible for EI services; 2) among children eligible for EI, does the presence of maternal depressive symptoms effect child participation in the program; 3) do maternal race, ethnicity, nativity, and English language proficiency mediate the relationship between maternal depressive symptoms and EI participation? Our primary exposure variable is maternal depressive symptoms, assessed using the Center for Epidemiological Studies Depression Scale. Our primary outcomes are 1) EI eligibility, ascertained from parental report, birth certificate data, and standardized assessments; and 2) EI participation, determined by parental report. A child will be presumed eligible if s/he meets any of the standard criteria for participation in EI, which include established risk for or established developmental delay. Using data from assessments conducted at 9 and 24 months from a nationally representative sample of 10,700 children, we will determine the prevalence and the corresponding 95% confidence interval of maternal depressive symptoms among children presumed EI eligible at 9 and 24 months; the proportion of eligible children participating in EI by maternal depression status; and the effect of mediating variables on the relationship between maternal depressive symptoms and child participation in EI. We will derive prevalence estimates from bivariate analyses. To examine the potential impact of primary and exploratory mediating factors, we conduct multivariate logistic regressions and GEE models for binary outcomes that take into account the correlated, longitudinal data characteristics. Findings from the proposed study address a gap in the current knowledge base: the absence of population-based data regarding depressive symptoms and their impact among mothers of young CSHCN. Results will provide information that can guide program and policy initiatives to improve family engagement in services that have the potential help the women affected and optimize child developmental and behavioral outcomes. Moreover, parents of CSHCN have suggested that attention to their emotional health needs is welcomed and often absent in their interactions with their child's health service providers. The proposed project most directly addresses MCHB strategic research issues II and IV. Increased participation of eligible children in EI services will support the optimal development of a CSHCN, consistent with Strategic Issue IV, promoting the healthy development of MCH populations.


Listed is descending order by year published.

Feinberg E, Donahue S, Bliss R, Silverstein M. Maternal depressive symptoms and participation in early intervention services for young children. Matern Child Health J. 2012 Feb;16(2):336-345.

Feinberg E, Silverstein M, Donahue S, Bliss R. The impact of race on participation in part C early intervention services. J Dev Behav Pediatr. 2011 Mar 8.


Special Health Care Needs, Depression, Early Intervention, Mental Health & Wellbeing

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