Early rehabilitation service utilization patterns in young children with developmental delays.
OBJECTIVE
There is a growing demand for interdisciplinary rehabilitation services for children with developmental disabilities, however, information is lacking on service utilization patterns. This study describes the type, frequency and location of initial rehabilitation services provided to young children recently diagnosed with a developmental delay.


METHODS
A telephone survey was conducted on a consecutive cohort of children referred to subspecialists for the first investigation of their delay.


RESULTS
Out of 129 respondents, only 30 (23%) did not receive any rehabilitation services within the first 6 months following medical evaluation, and 61 (47%) received two or more services. Services were provided most frequently in the hospital setting, especially for occupational or physical therapy (73-80%). Services were less often rendered in a rehabilitation centre (5-13%) or in the community (< 10%). Services were provided privately for a subset, particularly for speech language pathology and psychology (34% and 30% respectively). Interventions were typically given weekly or bi-weekly. Children receiving physical therapy were significantly younger whereas children referred to speech language pathology were older than the age of our cohort at intake. Overall, parents' educational level did not influence services received with the exception of private services, which were more likely to occur in children of fathers with university education.


CONCLUSIONS
The findings would suggest that long waiting times and lack of resources may limit access to comprehensive services, particularly in community settings. Service utilization patterns were not consistent within types of developmental disability, suggesting that formal and co-ordinated interdisciplinary programmes are not in place for this population of interest.
Majnemer
A
A
School of Physical & Occupational Therapy, McGill University, Montreal, Quebec, Canada. annette.majnemer@mcgill.ca
Shevell
M I
MI
Rosenbaum
P
P
Abrahamowicz
M
M
D002675:Child, Preschool; D015331:Cohort Studies; D003153:Community Health Services / Q000706:statistics & numerical data*; D002658:Developmental Disabilities / Q000534:rehabilitation*; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006302:Health Services Research; D006801:Humans; D009864:Ontario; D011792:Quebec; D012017:Referral and Consultation; D012047:Rehabilitation Centers / Q000706:statistics & numerical data*; D014850:Waiting Lists