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Registry to referral: using birth defects registries to refer infants and toddlers for early intervention services
Anita M Farel1, Robert E Meyer, Margaret Hicken
1Department of Maternal and Child Health, School of Public Health, University of North Carolina at Chapel Hill, North Carolina 27599, USA. anita_farel@unc.edu
Insights
State birth defect surveillance programs are increasingly used to identify and refer children with special needs. While many programs are implementing referral systems, resource limitations and confidentiality concerns remain key barriers.
Area of Science:
- Public Health
- Epidemiology
- Child Health Services
Background:
- Birth defect surveillance systems traditionally monitor trends and conduct epidemiologic studies.
- Registries within these systems can identify children diagnosed with birth defects for service referral.
Purpose of the Study:
- To assess the extent to which state birth defect surveillance programs are used for identifying and referring children for services.
- To understand the methods and barriers associated with implementing such referral systems.
Main Methods:
- An 18-question electronic survey was distributed to State Birth Defects Surveillance Contacts in all 50 states, DC, and Puerto Rico.
- The survey inquired about the existence, development, and use of identification and referral systems within surveillance programs.
Main Results:
- All 52 surveyed entities responded; 32 have operational birth defect surveillance programs.
- 13 operational programs and all 16 developing programs have or are planning referral systems.
- Lack of resources and confidentiality concerns were identified as major barriers.
Conclusions:
- Utilizing surveillance data for program development is an emerging trend for birth defect registries.
- This expansion enhances the role of state-based systems in child-find efforts for children with special needs.
- An expanded focus may increase the public health utility of surveillance programs.
Background:
Although many birth defect surveillance systems were developed for the primary purpose of monitoring trends and conducting epidemiologic studies, a number of programs have recognized the potential of birth defects monitoring systems for identifying and referring children who may be eligible for services. Because almost all surveillance programs maintain a registry of all children who have been diagnosed with birth defects in a particular state or other defined geographic region, registries can play an important role in identifying eligible children and providing timely referral to specialized services.
Methods:
We sent electronically an 18-question survey to the Centers for Disease Control and Prevention's list of State Birth Defects Surveillance Contacts in all 50 states, the District of Columbia, and Puerto Rico. The survey queried states as to whether they had or were developing a birth defect surveillance program, the extent to which they were currently using or were considering using their program as a means of identifying and referring children for services, and if so, the manner in which referrals were made.
Results:
We received completed surveys from all 50 states, Washington, DC, and Puerto Rico. Thirty-two of the fifty-two respondents stated that their state or entity has an operational birth defect surveillance program. Of these, 13 have implemented an identification and referral system within the surveillance program. All 16 states that were planning a surveillance program are also are planning or beginning to implement a program that would include an identification and referral system. Respondents cited lack of resources and confidentiality concerns as being the major barriers to implementing a referral system for their registry.
Conclusions:
For many registries, using their surveillance data for program development purposes represents a new undertaking. This trend reflects increasing recognition of the role that state-based birth defect surveillance systems can play in supporting child-find efforts for children with special needs. In the long run, this expanded focus may further enhance the public health usefulness of birth defect surveillance programs.
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