PROJECT SUMMARY
Communication disorders (CDs) have long-term impacts on young children and can exacerbate health
inequities in marginalized communities, especially for American Indian and Alaska Native (AI/AN) children
who have experienced historical trauma. Dr. Joshuaa Allison-Burbank, a member of the Navajo Nation and
Acoma Pueblo, aims to become an independent developmental scientist who conducts rigorous mixed-methods
research with AI/AN children with CDs. He aims to investigate the language development of young AI/AN youth
and how to best support positive developmental trajectories and mental health while responding to the harmful
effects of structural racism that exists in early childhood programs. CDs are conditions causing difficulty
producing or understanding speech and/or language, including autism spectrum disorder, hearing impairment,
and primary developmental speech and language disorders, and are the most prevalent class of disability in
early childhood, affecting about 1 in 5 children before age 6. As communication skills are essential to academic
and social-emotional development, CDs in early childhood are consistently linked to long-term costs to health
and well-being. Therefore, it is vital that CDs be addressed early in childhood to foster healthy developmental
trajectories for young children from communities that experience disproportionate health inequities. Aligning with
the purpose of PA-21-071, this diversity supplement builds on research from the parent award, Project ASCEND,
to specifically explore inequities in federally funded IDEA (Individuals with Disabilities Education Act) Part C early
intervention (EI) systems, specifically for AI/AN children. This diversity supplement aims to identify and disrupt
sources of structural inequity (e.g., differential referral, historical trauma, racism, and funding limitations) in early
care for AI/AN children with CDs to provide solutions that improve equity in EI programs, and support child and
family health outcomes. This supplement's goal will be to evaluate aggregated data on AI/AN families utilizing
IDEA Part C systems' data and interviews with AI/AN families and providers serving AI/AN families to identify
actionable steps in EI where inequity can be disrupted. In addition, there is limited data on how AI/AN families
who live on tribal lands specifically are accessing and experiencing EI programs. Understanding how AI/AN
families are navigating EI systems on tribal lands can help us to better understand the unique sociocultural
factors that influence developmental outcomes of young AI/AN children. Most critical is addressing CDs in AI/AN
families where the incidence of CDs is high. Our analysis will determine how access to community resources
and geographic factors can influence provision of EI services for AI/AN families, which can help the research
team to address structural factors that impact access to EI services through research and advocacy. This mixed
methods study includes the largest-ever analysis of available EI service use data for AI/AN child (N =
approximately 2050) in Arizona, Oregon, Indiana, Minnesota, and Florida (5 partner states with data on AI/AN
children) in conjunction with AI/AN families and providers.