Shah Reshma, Savastano Giovanna Elena, Fehrenbach Monica, Acharya Kruti
Department of Pediatrics, College of Medicine, University of Illinois at Chicago.
Department of Occupational Therapy, College of Applied Health Sciences, University of Illinois at Chicago.
Fam Syst Health. 2024 Dec;42(4):620-625. doi: 10.1037/fsh0000893. Epub 2024 Apr 11.
A large portion of preschool-age children with developmental delays and disabilities (PCw/DD) do not receive recommended therapeutic services, including legally mandated school-based therapies. This study examines the feasibility of a community-clinical linkage using virtual patient navigation and a medical-educational care plan called Preschool and Me (PreM) to connect clinical settings serving historically marginalized communities with early childhood special education (ECSE) services.
Parents of PCw/DD attending an urban pediatric clinic from January to March 2022 were enrolled to receive PreM which included navigation support for ECSE, overcoming barriers accessing ECSE, and health care provider communication. Families completed measures of demographics and indicators of feasibility at baseline and 4-month follow-up.
Of the 34 families referred, 30 were eligible and enrolled. Most parents identified as mothers (97%). Most participant children (70% male, 60% Black, 30% Hispanic) were enrolled in public health insurance (93%) and were not receiving any clinic-based therapies (93%). Parents overwhelmingly found PreM acceptable with the majority stating it would be a strong reason to continue care at the clinic. Among families who received PreM, 26 (96%) completed an individualized education plan (IEP) evaluation (96%). Of these, 24 (92%) children were eligible for an IEP. Nineteen children enrolled in an ECSE program; two families awaited school assignments and three families did not consent to the assigned school placement due to neighborhood safety concerns.
Our findings suggest PreM was feasible, acceptable, and demonstrated promise in supporting families to navigate the ECSE process. Future studies examining effectiveness are warranted. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
很大一部分发育迟缓及残疾的学龄前儿童（PCw/DD）未获得推荐的治疗服务，包括法定的校内治疗。本研究探讨了通过虚拟患者导航以及一项名为“学前与我”（PreM）的医学教育护理计划建立社区与临床联系的可行性，该计划旨在将为历史上边缘化社区提供服务的临床机构与幼儿特殊教育（ECSE）服务相连接。
招募了2022年1月至3月在一家城市儿科诊所就诊的PCw/DD儿童的家长，为他们提供PreM，其中包括ECSE导航支持、克服获取ECSE服务的障碍以及与医疗服务提供者沟通。家庭在基线和4个月随访时完成了人口统计学测量及可行性指标。
在被转诊的34个家庭中，30个符合条件并被纳入研究。大多数家长为母亲（97%）。大多数参与研究的儿童（70%为男性，60%为黑人，30%为西班牙裔）参加了公共医疗保险（93%），且未接受任何基于诊所的治疗（93%）。家长们绝大多数认为PreM是可接受的，大多数人表示这将是他们继续在该诊所接受治疗的一个有力理由。在接受PreM的家庭中，26个（96%）完成了个性化教育计划（IEP）评估（96%）。其中，24个（92%）儿童符合IEP资格。19名儿童参加了ECSE项目；两个家庭等待学校分配，三个家庭因邻里安全问题不同意所分配的学校安置。
我们的研究结果表明，PreM是可行的、可接受的，并且在支持家庭完成ECSE流程方面显示出前景。有必要开展未来研究以检验其有效性。（PsycInfo数据库记录（c）2024美国心理学会，保留所有权利）
