Increasing Participation in Early Intervention Programs: A review of the literature
Many children who are eligible for early intervention services do not receive them. In this literature review we explore issues for health care providers, child care providers, and parents during the identification, referral, or uptake process that may contribute to gaps in service for children.
There are a number of barriers to implementation of developmental screeners and referral to early intervention for physicians and child care providers. We find lack of staff training and time are cited as barriers to implementation of developmental screeners for both physicians and child care providers. Inadequate reimbursement and attitudes about screening were also cited for physicians and child care providers, respectively. Referral rates for physicians may vary by screening tool used as well as by age of the child and type of delay. Child care providers may be discouraged from referring because of concerns about upsetting parents or uncertainty about their role and responsibilities in referring. Families experience a diverse set of barriers to accessing and participating in early intervention services. These fall into three basic categories; logistical (e.g., lack of transportation), knowledge (e.g., inadequate health literacy), and psychological (e.g., fear of stigma).
Key findings
We identify a number of best practices for increasing access and participation. For physicians and child care providers these include:
- training in and use of a standardized screening tool
- clear procedures for referral and follow up
- clear messaging for families about the value of early intervention
Best practices for families include:
- providing services in a natural setting
- peer to peer mentoring or pairing
- engaging parents as partners in the intervention
- service integration
