Early Intervention Service Intensity and Change in Children's Functional Capabilities.

OBJECTIVE: To estimate correlates of early intervention (EI) service dosage and gains in children's functional capabilities from EI entry and discharge. DESIGN: Retrospective cohort study. SETTING: Secondary analyses of a subset of data (N=1005) collected from an EI administrative database on children discharged from a large, urban EI program between October 1, 2014 and September 30, 2016. PARTICIPANTS: Children who were EI eligible due to developmental delay, had received an EI care plan and at least 1 billable EI service, and had outcomes data at EI entry and exit (N=1005). Measured child characteristics included age (49.0% 12-24mo; n=492), sex (36.0% female; n=362), number of developmental delays (76.1% had 1 developmental delay; n=765), and number of EI services received (78.5% received multiple; n=789). INTERVENTION: Not applicable. MAIN OUTCOME MEASURES: Outcomes were EI service intensity (hours per month) and change in functional capabilities as measured via the state-mandated Child Outcomes Summary (COS). Adjusted quantile median regression estimated EI intensity. Adjusted linear regression estimated change in function for social-emotional, cognitive, and adaptive domains of the COS. Measures of children's developmental delay severity, age at EI entry, race and ethnicity, sex, and language. RESULTS: Children older than 24 months old experienced significantly higher EI service intensity (b=0.40; 95% confidence interval, 0.18-0.63). Child age and EI service intensity were significantly linked to gains in social and cognitive COS score changes from EI entry to exit. CONCLUSIONS: Older children receive a higher intensity of EI services. EI service intensity and age were linked with positive changes in functional gains.

Community engagement to pilot electronic patient-reported outcomes (e-PROs) in early intervention: Lessons learned.

BACKGROUND: Electronic data capture is essential to advancing family-centered coordinated care in early intervention (EI). The purpose of this paper is to report on EI service coordinator response to piloting an electronic parent-reported outcome (e-PRO) assessment as part of their routine workflow, including lessons learned that may inform future phases of e-PRO implementation. METHODS: This second pilot study involved families enrolled in a large EI program (n=1040 families) in concert with their implementation of a statewide quality improvement initiative for care plan development and outcomes reporting. A total of 22 EI service coordinators and supervisors were engaged in three phases: initial e-PRO intervention, peer mentor enhancement, and standard recruitment protocol. RESULTS: Implementation of the e-PRO intervention and peer mentoring enhancement yielded low enrollment rates over the first six months (n=17). A standard recruitment protocol has resulted in enrollment growth (n=83) towards the targeted enrollment rate (n=832). CONCLUSIONS: This study reports on early insights for building and sustaining a productive academic-community partnership for e-PRO implementation to support family-centered coordinated care. Lessons learned from this academic-community partnership with respect to strategies for enhancing community significance, collaboration, return, and control are discussed as they inform further development of this intervention prior to scale-up.