Identifying reasons for delay in accessing Early Intervention Services for rural Indigenous children with developmental disability: is there a gap and how do we close it?

Emma Gorman, Jennifer Preddy,
John Preddy, Head of Paediatrics, WWRRH, Wagga Wagga NSW Australia,
Pooja Kashap, Paediatric Registrar, WWRRH, Wagga Wagga NSW Australia 

Background

Significant differences exist in the prevalence of developmental delay between Indigenous and non-Indigenous children. Many factors influence engagement of the Indigenous population with intervention services, including cultural and social factors and accessibility in rural areas. This study aimed to evaluate delay in assessment and commencement of early intervention services (EIS) for Indigenous children with developmental disability (DD) compared to non-Indigenous children in the same region of rural NSW, and possible contributing barriers. 

Approach

This is a quantitative study comparing timing of EIS delivery to rural Indigenous and non-Indigenous children with DD. Indigenous children attending EIS were identified and separated into 2 groups: Indigenous and an equivalent number of non-Indigenous children selected after randomisation. Data was collected using a paper-based questionnaire. Results were interpreted using the Mann Whitney U test, to evaluate statistical significance.

Outcomes / Results

There was no significant difference between age of DD diagnosis between Indigenous and non-Indigenous, however there was significant delay (11.25 months versus 5.2 months) in referral of Indigenous children to EIS. Delay was attributed to lack of awareness regarding early intervention improving outcomes. Delay in assessment was worse for Indigenous children receiving ‘Out of Home Care’, reportedly because of frequent carer changes. Once referred, Indigenous and non-Indigenous children were assessed within a similar timeframe. 

Take Home Message

Significant delay exists in referral of Indigenous children for assessment and intervention for recognised DD. This delay was exaggerated for the most vulnerable Indigenous group, those in ‘Out of Home Care’. To improve outcomes, Indigenous children with suspected or confirmed DD should be immediately referred for EIS. Furthermore, those in ‘Out of Home Care’ should be routinely screened for DD and referred urgently to EIS as soon as a problem is identified.