Health care service for families with children at early risk of developmental delay: an All Our Families cohort study.
Matthew J Russell, Shainur Premji, Sheila Mcdonald and 2 others
PMID 31469170WHAT IT FOUND
Children flagged as at risk for developmental delay did not use more health services than peers unless they received a formal diagnosis.
The extra allied health costs were driven almost entirely by the diagnosed group, suggesting screening alone does not trigger service use.
Key findings
01Increased allied health service use and costs were driven by children who received a neurodevelopmental disorder diagnosis, not by those merely at risk.
02Mothers of children at risk for delay were less likely to use informal play groups, but showed no difference in workforce participation or overall community engagement.
03Only 3% of children had a neurodevelopmental disorder diagnosis by age 3, which is lower than estimated rates in middle childhood.
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
The ASQ relies on maternal perception, which can lead to misclassification of risk. Cost estimates were conservative and likely lower than actual expenses because they excluded some testing and services. The sample retained families with higher incomes and education levels, which may limit generalizability to less affluent populations. Community engagement measures may have lacked the sensitivity to detect subtle changes in support use.
Declared interests
Funded by the Alberta Children’s Hospital Foundation, Max Bell Foundation, and CIHR Health System Impact Fellowship. No specific conflicts of interest were declared by the authors.
The easy way to misread this
Do not assume that identifying a child as at risk for delay is sufficient to ensure they receive therapy. The study found that increased service use was primarily driven by children who had already received a formal diagnosis, not those who were just flagged as at risk.