title: Equitable access to developmental surveillance and early intervention--understanding the barriers for children from culturally and linguistically diverse (CALD) backgrounds.
abstract: OBJECTIVE
  Children from culturally and linguistically diverse (CALD) backgrounds are at risk of having developmental problems go undetected prior to starting school, and missing out on early intervention. Our aim was to explore the family and service characteristics, beliefs and experiences that influence the journey of families from CALD backgrounds in accessing developmental surveillance (DS) and early intervention services in south-eastern Sydney, Australia.
  
  
  METHODS
  This qualitative study used in-depth interviews conducted with 13 parents from CALD backgrounds and 27 health and early childhood professionals in Sydney. The Andersen Behavioural Model of Health Service Use (BM) was the underlying theoretical framework for thematic analysis.
  
  
  CONCLUSIONS
  Family and service knowledge about early childhood development (ECD), community attitudes, social isolation and English language proficiency were dominant themes that impacted on the probability of families accessing services in the first place. Those that impeded or facilitated access were resources, extended family and social support, information availability, competing needs, complex service pathways and community engagement. There were variable practices of early detection through DS. Children from CALD backgrounds with developmental problems were perceived to miss out on DS and early intervention despite language delay being a key issue identified by participants.
  
  
  CONCLUSIONS
  This study highlights the importance of increased community and family awareness and professional training in ECD; better coordination of health and early childhood services, with simpler referral pathways to early intervention to prevent children from CALD backgrounds 'slipping through the net'.
authors.affiliation: Sydney Children's Hospital, Sydney, NSW, Australia.
authors.forename: Susan
authors.initials: S
authors.lastname: Woolfenden
authors.affiliation: South East Neighbourhood Centre, Sydney, NSW, Australia.
authors.forename: Natalie
authors.initials: N
authors.lastname: Posada
authors.affiliation: Benevolent Society, Sydney, NSW, Australia.
authors.forename: Renata
authors.initials: R
authors.lastname: Krchnakova
authors.affiliation: Sydney Children's Hospital, Sydney, NSW, Australia.
authors.forename: Jill
authors.initials: J
authors.lastname: Crawford
authors.affiliation: South East Neighbourhood Centre, Sydney, NSW, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Gilbert
authors.affiliation: South East Neighbourhood Centre, Sydney, NSW, Australia.
authors.forename: Bronwynn
authors.initials: B
authors.lastname: Jursik
authors.affiliation: Sydney Children's Hospital, Sydney, NSW, Australia.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Sarkozy
authors.affiliation: Sydney Children's Hospital, Sydney, NSW, Australia.
authors.forename: Deborah
authors.initials: D
authors.lastname: Perkins
authors.affiliation: School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia.
authors.forename: Lynn
authors.initials: L
authors.lastname: Kemp
mesh_terms: D000328:Adult; D001315:Australia; D002675:Child, Preschool; D003144:Communication Barriers; D003469:Culture; D018479:Early Intervention, Educational / Q000379:methods*; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D036301:Qualitative Research
keywords: culturally and linguistically diverse; early childhood development; health and early childhood services; parents; qualitative research