Incentive anyone??

"Alfonso is part of the wave of very young children swelling the ranks of this $10 billion disability program — once primarily for those with severe physical disabilities but now dominated by children with behavioral, learning, and mental disorders. Children under 5 are the fastest-growing age group qualifying for SSI benefits, representing four of every 10 new cases, according to data obtained from the Social Security Administration, which runs the program.

Driving much of that growth is the twelvefold spike since 1997 of children approved based on a primary diagnosis of delayed speech, a sometimes persistent but more often short-lived affliction that starts in toddlerhood.

It is a program with the idealistic goal of helping needy families with disabled children, part of the federal government’s broader drive to intervene early in such cases. But a Globe review has found that while SSI provides a coveted financial benefit for growing numbers of the very young children, it largely fails to monitor their progress or to guide out of the disability system those whose condition has improved.

Government data show that Social Security officials have, over the past decade, fallen far short when it comes to conducting the regular case reviews required by statute. A typical SSI disability case is supposed to get a full medical review every three years, but from 2000 to 2008 the agency examined, on average, only 10 percent of the children on SSI."