Factors influencing access to early intervention for families of children with developmental disabilities: A narrative review.
Suzi J Sapiets, Vasiliki Totsika, Richard P Hastings
PMID 33354863WHAT IT FOUND
Access to early intervention fails at three stages: parents not recognising need, delayed diagnosis, and barriers to receiving support.
Low income, minority ethnicity and female child gender consistently block access. Universal free services and proactive professional responses to parental concerns are the strongest facilitators.
Key findings
01Lower parental socioeconomic status and belonging to ethnic minority groups act as barriers to recognising potential developmental needs.
02Professionals responding passively to parental concerns or reassuring them that there is no problem is a barrier to the formal identification of developmental disabilities.
03Strict eligibility criteria and complex referral systems place the burden on parents and act as barriers to actually receiving early intervention services.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
This is a narrative review, not a systematic review, so the selection of studies was not pre-registered or exhaustively searched, which may introduce bias. The majority of evidence comes from high-income countries (USA and UK), limiting the generalisability of findings to low- and middle-income contexts. The review identifies factors that influence access but does not test interventions to improve access, so it cannot confirm which strategies are most effective. Some factors were only studied in one phase of the pathway, so their influence on other phases is assumed rather than evidenced.
Declared interests
No conflicts of interest or funding sources are declared in the provided text.
The easy way to misread this
Do not interpret this as evidence that specific early intervention programmes are effective. This paper reviews barriers to access, not clinical outcomes, so it tells you why families may not get help, not whether the help works.