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October 2012Vol. 13, No. 9Barriers to Early Intervention Service Delivery

While research shows that 10–13 percent of children under age 3 are affected by developmental delays, just 2–3 percent of those children receive Early Intervention (EI) services. Moreover, there is a gap between the identification of a developmental delay (or the concern of a delay) and the receipt of services. A new policy brief by PolicyLab aims to identify barriers to children receiving EI services, highlight promising approaches to collaboration, and offer policy actions for improving service delivery.

The policy brief proposes the adoption of the SERIES paradigm—Screening, Early Identification, Referral, Intake, Evaluation, and Services—a coordinated approach to meeting child developmental needs. SERIES challenges all child-serving entities to share responsibility in ensuring children complete the path from identification to service delivery.

In 2006, the American Academy of Pediatrics (AAP) recommended developmental screening for all children from birth through age 3 as part of well-child care. From December 2008 through June 2010, the Translating Evidence-based Developmental Screening (TEDS) study followed 2,100 children under age 30 months through their well-child visits. During the 1,424 well-child visits that fell within the AAP screening schedule, an Ages and Stages Questionnaire was administered at 72.6 percent of the visits. Roughly 19 percent of the screens were failed and providers only referred the child for services 50 percent of the time. Just 66 percent of children referred completed the first step in the EI intake process.

The authors explore multiple barriers to SERIES completion and present recommendations for mitigating said barriers. Recommendations include the following:

  • To increase the rates of developmental screening by primary care providers, reimbursement practices must better incentivize screening and care coordination.
  • To minimize drop-off after children cross systems, States and individual provider sites should implement cross-system information exchanges and data sharing.
  • Better coordinated eligibility and intake processes across several child-serving systems may expand access to services.

SERIES: An Integrated Approach to Supporting Child Development, by Jane Kavanagh, Marsha Gerdes, Katherine Sell, Manuel Jimenez, and James Guevara, is available on the PolicyLab website: (548 KB)