Developmental disabilities prevention and the distribution of risk among American Indians.

Selected risk factors for developmental disabilities demonstrate an apparent differential pattern of risk for American Indians as compared to the U.S. general population. Indian children appear to experience comparable or even lower rates of certain congenital anomalies which are associated with developmental disabilities and are difficult to prevent. Conversely, Indians are reported to experience higher rates of conditions which can be effectively targeted for prevention, including those related to prenatal exposure to alcohol, cigarette smoking, and maternal diabetes, as well as disabling sequelae of accidents and otitis media. Primary prevention is critical because of the long-term chronic nature of developmental disabilities and strategies focused on risk factors of particular relevance to Indian communities can achieve the greatest potential benefit.