Ke Jasmine C, Hayati Rezvan Panteha, Vanderbilt Douglas, Mirzaian Christine B, Deavenport-Saman Alexis, Smith Beth A
Division of Developmental-Behavioral Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, USA.
Biostatistics and Data Management Core, The Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, CA, USA.
Early Hum Dev. 2024 Mar;190:105971. doi: 10.1016/j.earlhumdev.2024.105971. Epub 2024 Feb 14.
Infants with prematurity, low birthweight, and medical comorbidities are at high risk for developmental delays and neurodevelopmental disabilities and require close monitoring. Due to the COVID-19 pandemic, high-risk infant follow-up (HRIF) programs have adapted to perform developmental assessments via telehealth.
Describe the referral rates to initiate, continue, or increase/add early intervention (EI) therapies based on in-person use of the Bayley Scales of Infant and Toddler Development, 4th Edition (BSID-IV) or telehealth use of the Developmental Assessment in Young Children, 2nd Edition (DAYC-2).
A retrospective chart review was conducted on 203 patients seen in the HRIF program at an academic medical center in Southern California. Patients were divided into in-person (BSID-IV) and telehealth (DAYC-2) assessment groups. Statistical analyses were performed to describe demographic characteristics, medical information, and referral rates for EI therapies by the types of visits.
The in-person and telehealth groups demonstrated similar demographic and clinical characteristics and comparable referral rates for initiating EI therapies. Telehealth patients already receiving therapies were recommended to increase/add EI therapies at a higher rate compared to in-person patients.
The BSID-IV is widely used to assess for developmental delays in the high-risk infant population, but in-person administration of this tool poses limitations on its accessibility. Telehealth administration of an alternative tool, such as the DAYC-2, can lead to similar EI referral rates as in-person administration of the BSID-IV. Increased use of telehealth developmental assessments can promote timely detection of developmental delays and minimize gaps in healthcare access.
早产、低出生体重以及患有合并症的婴儿出现发育迟缓及神经发育障碍的风险很高，需要密切监测。由于新冠疫情，高危婴儿随访（HRIF）项目已采用远程医疗进行发育评估。
描述基于面对面使用《贝利婴幼儿发展量表》第4版（BSID-IV）或远程医疗使用《幼儿发育评估》第2版（DAYC-2）启动、继续或增加早期干预（EI）治疗的转诊率。
对南加州一家学术医疗中心HRIF项目中诊治的203例患者进行回顾性病历审查。患者被分为面对面（BSID-IV）评估组和远程医疗（DAYC-2）评估组。进行统计分析以描述人口统计学特征、医疗信息以及按就诊类型划分的EI治疗转诊率。
面对面评估组和远程医疗评估组在人口统计学和临床特征方面相似，启动EI治疗的转诊率相当。与面对面评估组的患者相比，已经接受治疗的远程医疗患者被建议增加/添加EI治疗的比例更高。
BSID-IV被广泛用于评估高危婴儿群体的发育迟缓情况，但该工具的面对面使用在可及性方面存在局限性。使用替代工具（如DAYC-2）进行远程医疗评估可导致与面对面使用BSID-IV相似的EI转诊率。增加远程医疗发育评估的使用可以促进发育迟缓的及时发现，并最大限度减少医疗服务可及性方面的差距。
