Turning recommendations into action: A post-evaluation psychological service model to support families in pediatric care
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Ashley Ortiz1, Tara Bord1, Ying Wu1
1Kennedy Krieger Institute.
Abstract:
Pediatric psychological evaluations generate recommendations intended to guide treatment, educational planning, and service access; however, health systems often lack structured mechanisms to support families in implementing these recommendations. This study utilized a retrospective, observational design to describe the naturalistic clinical workflow of a post-evaluation psychological service model. A structured follow-up program, designed to address barriers to follow-through and enhance continuity of care within a pediatric assessment setting, was implemented and staffed by supervised postdoctoral fellows. The service provided caregiver-focused follow-up visits tailored to referral questions from evaluating psychologists and family-identified needs. Medical records and referral forms were reviewed and coded for referral targets, family-reported barriers, and clinician-provided services. Between September 2023 and April 2025, a total of 154 families participated (M patient age = 8.29 years, SD = 3.59), with common diagnoses including attention-deficit/hyperactivity disorder, autism spectrum disorder, language disorders, and anxiety. Overall, families were referred for follow-up across diverse domains, most frequently troubleshooting service access (72%), educational programming (68%), current concerns (56%), and medication management (45%). Caregivers reported at least one barrier to recommendation implementation in 83% of cases, with the most common challenges involving access to behavioral/mental health services (52%) and educational supports (41%). Clinicians addressed multiple areas per family, most often providing guidance on educational programming (61%), symptom management (60%), assessment of current functioning (56%), and referral coordination (51%). These findings highlight substantial unmet service needs following pediatric psychological evaluation and demonstrate the feasibility of a structured follow-up psychological program embedded within a larger pediatric health care system. Integrating post-evaluation support into pediatric assessment programs may improve care coordination, reduce implementation barriers, enhance the practical utility of recommendations, and improve outcomes for children and families. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
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