Cultural and Linguistic Diversity Among Children and Families Referred for Diagnostic Evaluation of Developmental Delay and Disability: Implications for Service Delivery

Abstract

AbstractA significant proportion of health‐ and disability‐sector consumers in Australia speak a language other than English (LOTE) at home. Barriers to service access in culturally and linguistically diverse (CALD) populations are acknowledged; however, there is limited data to guide service delivery among care providers. The aims of the present study were to investigate the linguistic diversity of preschool‐aged children and families presenting for diagnostic assessment of developmental delay and disability at the Disability Specialist Unit, a multidisciplinary assessment service, and assess whether CALD status was associated with poorer service engagement. Specifically, it was hypothesized that CALD status would be associated with decreased likelihood of receiving intervention (particularly multidisciplinary intervention) and attending center‐based care, and an increased likelihood of requiring referral to access available government funding. A retrospective record audit was undertaken of 88 clients seen by the Disability Specialist Unit over a 12‐month period to collect information about CALD status (whether a LOTE was spoken at home) and a range of clinically relevant variables including clinical diagnosis/es, age at assessment, involvement with therapies, attendance at center‐based child care, and whether a referral to access government funding was required. Differences between CALD and non‐CALD groups were explored statistically via odds ratios and independent samples t test. Children from CALD backgrounds were significantly less likely than non‐CALD children to be engaged in multidisciplinary therapy at the time of assessment and significantly more likely to require support to access funding than children from non‐CALD families. Furthermore, children from CALD backgrounds were significantly more likely to receive a diagnosis of autism spectrum disorder and global developmental delay or ID. These findings suggest that children from CALD backgrounds are disadvantaged compared to non‐CALD children with respect to service access at the point of tertiary diagnostic evaluation of a developmental disability. Implications for service delivery are discussed.