All states have participated. Mental health programs have become catalysts, and often leading actors, in efforts that affect programs with far larger client systems. Eligibility for this program is broadly defined. It covers children with developmental delays, those who have conditions with a high probability of resulting in delays, and those at risk of such delays if they receive no early intervention. Health leaders in Washington and the states have a broad view of maternal and child health, which includes social dimensions.
Schools are where the children are, but schools have all they can do to improve educational results.
In any case, a variety of national developments have led schools to create or cooperate with programs for children with special problems and needs. Other initiatives pursue the notion of the school as a community center, with both universal and case-oriented capacities. They have tried to reposition the schools as more broadly based and focused institutions. The extreme localization and decentralization of school control and financing and schools' frequent separation from general-purpose government have produced diverse assessments of these possibilities. While the scale of activity in this area decreased substantially after the 1970s, services integration efforts in public welfare and related programs have never ceased.