Factors Contributing to Early Intervention Evaluation

Abstract

Early Intervention (EI) programs promote early childhood development but remain underutilized. Few studies have examined correlations with completion of EI referrals using a standardized referral system. Our study examined a minority, underserved population for characteristics that affect this critical step. Subjects were referred from an inner-city pediatric primary care clinic for EI evaluation from 3/1/15-5/31/18. Subjects were <3 years of age at the time of referral, received pediatric care at the clinic, and were referred for EI. The dependent variable was completion of EI evaluation, verified by the medical record. Independent variables included demographic, maternal (eg, depression), child (eg, chronic illness), and referral characteristics. A multivariable logistic regression model was used to determine the predictors for completing an evaluation. Of 181 children referred to EI, 61.9% completed an EI evaluation; the average age was 18.9 (SD 7.4) months at first referral. For every additional month of age at the initial referral, a child was 5.0% less likely to complete an evaluation (adjusted odds ratio [aOR], 0.95; 95% confidence interval [CI], 0.90-0.99; P=.02). Two factors more than doubled the odds of completing an EI evaluation: having a chronic medical illness at the time of referral (aOR=2.41, CI 1.21-4.79; P=.01), and being a child from a non-English speaking family (aOR=2.22, CI 1.09-4.50; P=.03). The child's age and medical history, and language spoken at home affected the odds of successfully completing an EI evaluation. These findings can help clinicians target families at risk of failing to complete EI programs.