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Many at-risk infants not referred to early intervention
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A large proportion of infants with developmental delays who were potentially eligible for early intervention did not get referrals for those services, according to new study results.
Children who were previously hospitalized in neonatal ICUs are "at increased risk for long-term health and neurodevelopmental impairments, including sensory and motor disabilities, intellectual disability and behavioral problems," according to Brian G. Tang, MD, and colleagues, who identified 5,129 high-risk infants from a California quality-of-care initiative database. Participants were evaluated at their first visit between 4 and 8 months of age, and 1,737 infants evaluated at the second visit between 12 and 16 months of age.
The researchers calculated the rate at which the infants were referred to early intervention services in relation to their developmental status. The infants were classified as either “high concern” or “low concern” based on results from their developmental assessments.
All neonatal ICUs funded by the California Children’s Services are required to provide follow-up programs for eligible infants. According to the researchers, 6% of infants with low-concern status were referred to early intervention. Among infants with high-concern status, 28% were referred to early intervention. Results also showed that 34% of infants with high-concern status did not receive any referrals; this number was derived even after the researchers included referrals to other private therapies.
The researchers said they expected higher rates of referrals during the second visit, but the proportion of non-referrals was consistent with the proportion of the first visit.
“We were reassured that an additional 20% to 40% of infants in the high-concern group were referred to other therapies at both visits, but it is alarming that 34% to 37% received neither referrals to [early intervention] nor to other therapies,” they wrote.
The researchers added that identifying the reasons for the lack of referrals can assist in more informed interventions, and with budgets for children’s services being threatened across the United States, evaluating how follow-up care is provided should be made a high priority.
Disclosure: The researchers report no relevant financial disclosures.
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