Abstract:
Background: Early identification and intervention for infants and young children with
developmental delays may negate or minimise the negative effect of a disability on a
child's development. Poor follow-up on early detection referrals, however,
undermines the effectiveness of early intervention programmes. Objectives: To
identify factors, including text message reminders, that influence follow-up
adherence for early intervention after developmental screening in primary health
care. A secondary objective surveyed reasons for follow-up default. Methods: The
PEDS Tools was used to screen 247 high-risk children. A risk assessment
questionnaire was completed with caregivers whose children were referred for
speech-language and/or occupational therapy (n=106, 43%). A quasi-experimental
study was employed to identify risk factors for defaulting on appointments. A
thematic analysis of telephonic interviews was also employed to determine reasons
for follow-up defaults. Results: Follow-up adherence was 17%. Participants who
were divorced, widowed or never married were 2.88 times more likely to attend a
follow-up appointment than those who were married or living together (95%, CI 0.97-
8.63). Text message reminders did not significantly improve follow-up. More than
half (58%) of participants who defaulted on appointments could be reached for
telephonic interviews. During the telephonic interviews 87% of participants did not
report concern about their child's development. Reasons for defaulting were
employment, logistical issues, other responsibilities and forgetfulness.
Conclusions: Detecting possible developmental delays did not lead to acceptable
follow-up adherence for early intervention services at primary health care levels.
Increased awareness and education regarding the importance of development for
educational success is needed.
