Factors associated with early intervention referral and evaluation: a mixed methods analysis

Area of Science:

• Pediatric Health
• Developmental Pediatrics
• Public Health

Background:

• Early intervention (EI) services are crucial for children with developmental concerns.
• Referral and evaluation processes for EI can be complex and present barriers.

Purpose of the Study:

• To identify factors associated with early intervention (EI) referral and multidisciplinary evaluation (MDE) completion.
• To explore pediatrician perspectives on the EI referral process.

Main Methods:

• Secondary analysis of a randomized controlled trial involving children under 30 months.
• Logistic regression used to assess associations between characteristics and EI referral/MDE.
• Qualitative interviews with pediatricians to understand referral influences.

Main Results:

• 21% of children had developmental concerns; 58% were referred to EI, and 30% received MDE.
• Failure in multiple developmental domains increased EI referral and MDE likelihood.
• Faxed referrals significantly improved MDE completion compared to providing phone numbers.

Conclusions:

• A significant proportion of children with developmental concerns do not receive timely EI services.
• Practice-based strategies, such as electronic referral transmission, can enhance EI evaluation rates.
• Streamlining the connection between primary care and EI is essential for improving access to services.