Role of the Medical Home in Family-Centered Early Intervention Services

Duby, John C.

doi:10.1542/peds.2007-2638

Cited by 61 publications

(10 citation statements)

References 30 publications

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“…Some studies indicate that children with an identified at-risk condition or a clinical diagnosis have an earlier age of first concern from parents or caregivers, an earlier development of an Individual Family Service Program, and an earlier receipt of early intervention services [74–77]. Other studies indicate that children with risk factors for cognitive deficits are more likely to be screened for developmental delays and that screened children are more likely to be referred for and receive early intervention services [76,78].…”

Section: Resultsmentioning

confidence: 99%

Universal newborn screening for congenital CMV infection: what is the evidence of potential benefit?

Cannon

Griffiths²,

Aston

et al. 2014

Reviews in Medical Virology

192

189

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SUMMARY Congenital CMV infection is a leading cause of childhood disability. Many children born with congenital CMV infection are asymptomatic or have nonspecific symptoms and therefore are typically not diagnosed. A strategy of newborn CMV screening could allow for early detection and intervention to improve clinical outcomes. Interventions might include antiviral drugs or nonpharmaceutical therapies such as speech-language therapy or cochlear implants. Using published data from developed countries, we analyzed existing evidence of potential benefit that could result from newborn CMV screening. We first estimated the numbers of children with the most important CMV-related disabilities (i.e. hearing loss, cognitive deficit, and vision impairment), including the age at which the disabilities occur. Then, for each of the disabilities, we examined the existing evidence for the effectiveness of various interventions. We concluded that there is good evidence of potential benefit from nonpharmaceutical interventions for children with delayed hearing loss that occurs by 9 months of age. Similarly, we concluded that there is fair evidence of potential benefit from antiviral therapy for children with hearing loss at birth and from nonpharmaceutical interventions for children with delayed hearing loss occurring between 9 and 24 months of age and for children with CMV-related cognitive deficits. We found poor evidence of potential benefit for children with delayed hearing loss occurring after 24 months of age and for children with vision impairment. Overall, we estimated that in the United States, several thousand children with congenital CMV could benefit each year from newborn CMV screening, early detection, and interventions. Copyright © 2014 John Wiley & Sons, Ltd.

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Section: Resultsmentioning

confidence: 99%

Universal newborn screening for congenital CMV infection: what is the evidence of potential benefit?

Cannon

Griffiths²,

Aston

et al. 2014

Reviews in Medical Virology

192

189

View full text Add to dashboard Cite

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“…10 While EI referrals and enrollment depend on state eligibility criteria, 11 many eligible children are not efficiently connected to services. 12-14 Families of poor 11 and minority children 13-15 may have more trouble accessing services and may be less satisfied when they do receive services.…”

Section: Introductionmentioning

confidence: 99%

Understanding Barriers to Early Intervention Services for Preterm Infants: Lessons From Two States

Little

Kamholz

Corwin

et al. 2015

Academic Pediatrics

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Objective To explore existing barriers and challenges to Early Intervention (EI) referral, enrollment, and service provision for very-low-birth-weight infants (VLBW; <1500g). Methodology We conducted 10 focus groups with parents of VLBW children (N=44) and 32 interviews with key informants from EI (N=7), neonatal intensive care units (N=17) and outpatient clinics (N=8) at six sites in two states. We used grounded theory to identify themes about gaps in services. Results Both parents and providers found EI helpful. However, they also identified gaps in the current EI system at the levels of eligibility, referral, family receptivity, and service provision and coordination with medical care. Inadequate funding and variable procedures for evaluation may affect children's eligibility. Referrals can be missed due to simple oversights or communication failures between hospitals, EI and families; referral outcomes often are not formally tracked. Families may not be receptive to services due to wariness of home visits, social stressors, denial about potential developmental delays, or lack of understanding of the benefits of EI. Once a child is deemed eligible, services may be delayed or terminated early, and EI providers may have little specialized training. Communication and coordination with the child's medical care team is often limited. Conclusions Systemic barriers, including funding and staffing issues, state and federal regulations, and communication with families and medical providers, have led to gaps in the EI system. The chronic care model may serve as a framework for integrating community-based interventions like EI with medical care for VLBW children and other vulnerable populations.

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“…EI functions include identification (eg, screening and referral), diagnosis, service coordination, and direct interventions. Both the Institute of Medicine10 and the American Academy of Pediatrics11 support use of comprehensive follow-up and EI services for premature infants. Additionally, EI enrollment for ELBW children during the first year of life has been shown to be positively associated with receipt of a needed follow-up ophthalmologic examination 12…”

mentioning

confidence: 99%

Factors Influencing the Enrollment of Eligible Extremely-Low-Birth-Weight Children in the Part C Early Intervention Program

Wang

Elliott

Rogowski

et al. 2009

Academic Pediatrics

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Objective To determine whether eligible extremely-low-birth-weight children (<1000 g) were enrolled in the federally enacted, state-coordinated Early Intervention (EI) program intended to help children with developmental delay or disability regardless of parental income, and the factors associated with enrollment. Methods Retrospective analysis of 884 EI-eligible ELBW children born in South Carolina with birth weight 401 to 999 g, gestation ≥24 weeks, and survival for the first 120 days of life. We created a linked data set with data from Early Intervention (1996–2001), Vital Records (1996–1998), death certificates, and Medicaid. Each child was followed from birth to 3 years old, the program eligibility period. Results A total of 54% of ELBW children were enrolled in EI at any time from birth to 36 months. Even among children ever enrolled in Medicaid (83% of all ELBW children), only 63% were enrolled in EI. Being born in a multiple gestational birth, having heavier birth weight (750 to 999 g), and having ever enrolled in Medicaid were positively associated with EI enrollment. Among Medicaid patients for whom perinatal data were available, additional risk adjustment showed that EI enrollment was more likely with birth in level 3 hospitals, birth weight 750 to 999 g, Neonatal Medical Index severity level V (most severe), and longer initial length of hospital stay. Conclusions Only about half of eligible ELBW children in South Carolina were enrolled—much lower than reported elsewhere. Efforts are needed to understand why eligible infants are not being enrolled and to develop strategies to remedy the situation.

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Role of the Medical Home in Family-Centered Early Intervention Services

Cited by 61 publications

References 30 publications

Universal newborn screening for congenital CMV infection: what is the evidence of potential benefit?

Universal newborn screening for congenital CMV infection: what is the evidence of potential benefit?

Understanding Barriers to Early Intervention Services for Preterm Infants: Lessons From Two States

Factors Influencing the Enrollment of Eligible Extremely-Low-Birth-Weight Children in the Part C Early Intervention Program

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