Capturing Unmet Therapy Need Among Young Children With Developmental Delay Using National Survey Data

Magnusson, Dawn; Palta, Mari; McManus, Beth M.; Benedict, Ruth E.; Durkin, Maureen S.

doi:10.1016/j.acap.2015.05.003

Cited by 40 publications

(27 citation statements)

References 32 publications

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“…Our results suggest the opposite. Access inequities and difficulties reaching out to families in vulnerable circumstances are well documented [17,18,31], but to our knowledge, this is the first time that program access is reported as a factor potentially influencing delay. This warrants more research but certainly suggests that not only paediatricians and family doctors might have a potential role in ensuring that families are aware of resources and supported in accessing services but also all community partners involved with preschool children.…”

Section: Discussionmentioning

confidence: 83%

“…There is also a growing recognition that other health care professionals and/or adults present in a child's daily environment should be involved in identifying children who are at risk, especially educators [15,16]. Identification strategies adopted in the educational environment may help to identify children who might otherwise be missed by traditional surveillance and screening programs, since many families who are vulnerable might not have access to traditional health services [17,18]. Failure to reach most vulnerable populations is known as the inequality paradox [19].…”

Section: Introductionmentioning

confidence: 99%

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Preschoolers’ Developmental Profiles and School-Readiness in a Low-Income Canadian City: A Cross-Sectional Survey

Camden

Héguy

Casoli

et al. 2020

IJERPH

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A joint initiative between community and public health stakeholders in a low-income Canadian city was created to describe the developmental profiles of children aged 2-5 years. A two-phase, cross-sectional design was used. Children's development was assessed using an online screening procedure. Those at risk of delays were invited for a school-readiness face-to-face brief assessment. Descriptive and exploratory analyses were conducted. In Phase 1, 223 families were screened; 100 children were at risk of delays (45%); 13% were at risk in ≥3 developmental domains; 26% were at risk in the fine motor domain. Risk of delay was associated with parental concerns, accessing more healthcare professionals, and using fewer public health/community programs. Lower incomes, and not attending day care showed trends towards an increased risk of delay. In Phase 2, 49 children were assessed; 69% were at risk of school-readiness delays; 22% had potential motor delays; 37% were at risk in the social domain. This study found a higher proportion of children at risk of delay than typically reported. Creating community partnerships could help identify all children needing developmental and school-readiness support. More research is needed to ensure these community-based partnerships are integrated into health/community programs responding to children's needs and parental concerns.

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Section: Discussionmentioning

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Preschoolers’ Developmental Profiles and School-Readiness in a Low-Income Canadian City: A Cross-Sectional Survey

Camden

Héguy

Casoli

et al. 2020

IJERPH

View full text Add to dashboard Cite

show abstract

“…3 Further, children whose parents have limited English proficiency may be more prone to experience delayed diagnosis and to not recognize their child’s health service needs. 30 For these reasons, we expect that the inclusion of these groups may have altered study findings. It should be acknowledged that while the study’s measure of child behavioral functioning—the brief SDQ—has been validated 26,27 to identify emotional and behavioral problems, it does not capture the broad complexity of behavioral functioning in children with developmental disabilities that could potentially be gathered through clinical observation.…”

Section: Discussionmentioning

confidence: 99%

Unmet Health Services Needs Among US Children with Developmental Disabilities: Associations with Family Impact and Child Functioning

Lindly

Chavez

Zuckerman

2016

J Dev Behav Pediatr

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Objectives To determine associations of unmet need for child or family health services with (1) adverse family financial and employment impacts and (2) child behavioral functioning problems among US children with autism spectrum disorder (ASD), developmental delay (DD), and/or intellectual disability (ID). Method This was a secondary analysis of parent-reported data from the 2009–10 National Survey of Children with Special Healthcare Needs linked to the 2011 Survey of Pathways to Diagnosis and Services. The study sample (n = 3,518) represented an estimated 1,803,112 US children aged 6–17 years with current ASD, DD, and/or ID (developmental disabilities). Dependent variables included adverse family financial and employment impacts, as well as child behavioral functioning problems. The independent variables of interest were unmet need for (1) child health services and (2) family health services. Multivariable logistic regression models were fit to examine associations. Results Unmet need for child and family health services, adverse family financial and employment impacts, and child behavioral functioning problems were prevalent among US children with developmental disabilities. Unmet needs were associated with an increased likelihood of adverse family employment and financial impacts. Unmet needs were associated with an increased likelihood of child behavioral functioning problems the following year; however, this association was not statistically significant. Conclusion Unmet needs are associated with adverse impacts for children with developmental disabilities and their families. Increased access to and coordination of needed health services following ASD, DD, and/or ID diagnosis may improve subsequent outcomes for children with developmental disabilities and their families.

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“…There is evidence to suggest that minority, poor, under insured children and those with more severe conditions were least likely to have their therapy needs met. 12,13 However, these studies examined unmet need for therapy, generally, and was not specific to EI so it is unclear if similar disparities would persist among an EI-enrolled cohort. Finally, there is a paucity of extant literature linking EI service use with outcomes.…”

mentioning

confidence: 99%

Social Disparities in Early Intervention Service Use and Provider-Reported Outcomes

Khetani

Richardson

McManus

2017

J Dev Behav Pediatr

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Objective To describe social disparities in early intervention service use and provider-reported outcomes. Methods Secondary data analysis of administrative data to ascertain EI service use of all EI and discipline-specific services and child and family characteristics. Adjusted logistic regression models estimated the odds of receiving each type of core EI service. Adjusted median regression models estimated differences in EI intensity for each type of core EI service. Adjusted ordinal regression models estimated the association between each type of EI therapy service and provider estimates of children’s global functional improvement. Results Children with a diagnosis (b=0.8 SE=0.2) and those whose caregiver had 12 years of education or less (b=0.6 SE=0.3) had higher EI intensity. Black, non-Hispanic (BNH) children had nearly 75% lower odds of receiving physical therapy (PT) [OR=0.3, 95%CI:0.1, 0.7] and greater odds of receiving speech therapy [OR=3.4, 95%CI:1.3, 9.3] than their white, non-Hispanic (WNH) peers. BNH who received PT received about an hour less per month (b=−0.7 SE=0.4) than their WNH peers. Hispanic children [b=1.0 SE=0.3)] and those with higher family income (b=0.7 SE=0.3) received greater intensity of PT compared to their peers who are WNH and from low-income families. Publically insured children had lower intensity of OT (b=−0.5 SE=0.3) and ST (b=−0.6 SE=0.3). Greater intensity of EI services was not associated with greater provider perceived improvement. Conclusions Results suggest disparities, by race and family income, in receipt of EI therapy services. These findings highlight opportunities to customize and coordinate care for improved EI access and care quality.

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Capturing Unmet Therapy Need Among Young Children With Developmental Delay Using National Survey Data

Cited by 40 publications

References 32 publications

Preschoolers’ Developmental Profiles and School-Readiness in a Low-Income Canadian City: A Cross-Sectional Survey

Preschoolers’ Developmental Profiles and School-Readiness in a Low-Income Canadian City: A Cross-Sectional Survey

Unmet Health Services Needs Among US Children with Developmental Disabilities: Associations with Family Impact and Child Functioning

Social Disparities in Early Intervention Service Use and Provider-Reported Outcomes

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