Date of Award

2017

Embargo Period

8-1-2024

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

College

College of Nursing

First Advisor

Shannon Phillips

Second Advisor

Lynne S. Nemeth

Third Advisor

Martina Mueller

Fourth Advisor

Cynthia P. May

Abstract

The purpose of this dissertation was to explore and identify barriers to accessing early intervention services and how these barriers have been reported in the literature. A preliminary integrative review conducted to explore how barriers to accessing early intervention services have been studied and reported in the literature. For this review, an ecological framework was used to determine if identified barriers could be categorized into one or more ecological levels. Identified gaps validate the need for additional research to assess the referral and enrollment process and to design and implement interventions to increase referral and enrollment rates. A second integrative review was conducted to identify and compare instruments used to measure developmental delays in infants and children from birth to 3 years of age. Developmental delays can include difficulties with speech, mobility and learning. Findings indicated that the Denver Developmental Screening II (DDST-II), Ages and Stages Questionnaires (ASQ), and the Parents' Evaluation of Developmental Status (PEDS) are frequently used to assess for developmental delays. Early accurate detection of developmental delays in children is needed to guarantee early intervention services are received to decrease delays in early stages of development. Lastly, a mixed-method research study was conducted to identify a cohort of infants and children under the age of 3 at risk for or diagnosed with developmental delays that were referred from a NICU to a High-Risk Clinic or BabyNet services but did not receive services, and to describe the characteristics of those infants and children not receiving services. Qualitative and quantitative data were collected and compared to referral and enrollment rates in EI programs, to identify factors associated with lack of referral and enrollment into EI programs. Further provider and parental perceptions of early intervention services were explored to determine common barriers in accessing and obtaining services and to identify key characteristics associated with accessing and obtaining EI services.

Rights

All rights reserved. Copyright is held by the author.

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