PolicyWise for Children & Families, Edmonton, Canada.
Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada.
Dev Med Child Neurol. 2021 Jan;63(1):81-88. doi: 10.1111/dmcn.14478. Epub 2020 Jan 31.
To investigate which families with young children with disabilities used disability services and when they used services to inform policy on service delivery.
We used linked administrative data from different ministries in Alberta to describe families' use of disability services when their children were between the ages of 3 and 8 years old. Disability was investigated on the basis of the presence of a severe special education code for children, and level of special education code. The outcome was the use of family disability services.
Of 31 346 children, 24 761 (79.0%) had no special education code, 3982 (12.7%) had a mild special education code, and 2603 (8.3%) had a severe special education code. Level of special education code was associated with child characteristics and service use. Children with severe special education codes generally were more likely to report service use and have poor outcomes than those with less severe codes. Of note, 26% of children with severe special education codes used family disability services. In addition, among children with severe special education codes, many years of severe coding (compared with fewer years) had the strongest association with family disability service use (prevalence ratio 5.50; 95% confidence interval 4.10-7.37). Associations with family disability service use were seen with mental health, health care, and educational achievement. Interactions between child characteristics and service use were observed.
This study provides evidence that families were more likely to use disability services when they were involved with other services, and that use interacts with various factors. The findings highlight the importance of considering service eligibility, referral, and integration.
调查有残疾儿童的家庭使用残疾服务的情况以及使用服务的时间，以为服务提供政策提供信息。
我们使用艾伯塔省不同部门的关联行政数据，描述了当儿童年龄在 3 至 8 岁之间时，家庭使用残疾服务的情况。残疾是根据儿童严重特殊教育代码和特殊教育代码级别来确定的。结果是使用家庭残疾服务。
在 31346 名儿童中，24761 名（79.0%）没有特殊教育代码，3982 名（12.7%）有轻度特殊教育代码，2603 名（8.3%）有严重特殊教育代码。特殊教育代码的级别与儿童特征和服务使用有关。通常，患有严重特殊教育代码的儿童比患有轻度代码的儿童更有可能报告服务使用情况和较差的结果。值得注意的是，26%患有严重特殊教育代码的儿童使用了家庭残疾服务。此外，在患有严重特殊教育代码的儿童中，与编码年限较少的儿童相比，编码年限较长（与编码年限较短相比）与家庭残疾服务使用的关联最强（患病率比 5.50；95%置信区间 4.10-7.37）。与家庭残疾服务使用相关的还有心理健康、医疗保健和教育成就。观察到儿童特征与服务使用之间存在相互作用。
本研究提供了证据表明，当家庭参与其他服务时，他们更有可能使用残疾服务，并且使用情况与各种因素相互作用。这些发现强调了考虑服务资格、转介和整合的重要性。
