(Reuters Health) - When mothers trust their friends and neighbors more than doctors or struggle to access or afford care, they may be less likely to seek out medical help for young kids with developmental delays, a small U.S. study suggests.
The study focused on kids who are eligible for therapy through what’s known as Early Intervention, a government program that funds services for infants and toddlers who have developmental delays in things like motor skills, communication, behavior and cognitive function. Fewer than one in four kids eligible for Early Intervention get services, researchers note in Pediatrics.
The study team interviewed 22 low-income mothers of African-American and Latino children up to 36 months old who qualified for Early Intervention.
All of the kids received routine well-child visits and had developmental delays.
But 59 percent of the mothers said their children had never enrolled in Early Intervention.
“In the United States, one in four children under the age of 5 years is at moderate to high risk of developmental delay, a situation in which children do not achieve motor, language, cognitive, social or adaptive skills when they should,” said lead study author Dawn Magnusson of the University of Colorado Anschutz Medical Campus in Aurora.
“Many mothers in our study experienced challenges accessing early intervention services due to logistical challenges or competing social and financial stressors that resulted in delayed or forgone care,” Magnusson said by email. “These findings highlight the importance of supporting families throughout the referral process and helping to address their social and financial needs.”
Only two mothers in the study had attended college, and 13 had not completed high school.
All eight of the African-American women in the study were born in the U.S., while 11 of the Latino women were from Mexico and the rest were from Central America. Only seven of the Latino mothers had been in the U.S. for 10 years or more.
A majority of the kids had developmental delays in expressive communication; motor delays were the second most common problem.
Few mothers, however, identified their child as having developmental delays, the interviews found.
Often, women said they believed all children developed at their own pace, or that children who lagged in one area seemed to be ahead in other areas that made their mothers question whether the child could have developmental delays.
Women seemed more open to Early Intervention when they had friends who had found these services helpful for their children.
Scheduling pressures, finances and other logistics and competing obligations made it hard for some women to start or continue Early Intervention services for their child.
Beyond its small size, another limitation of the study is that all of the mothers interviewed had kids who received regular medical care. Parents of kids who don’t get routine well-child checkups might have different beliefs about Early Intervention than the women in the study, the authors note.
Mothers of other racial or ethnic backgrounds, and fathers, might also have different perspectives about Early Intervention.
Even so, the findings highlight the importance of parental beliefs in determining what treatment children may get for developmental delays, said Dimity Dornan, founder and executive director of Hear and Say, an advocacy group for kids with delays based in Brisbane, Australia.
“One has to believe there is a problem and have the time and education to take an active role,” Dornan, who wasn’t involved in the study, said by email.
“Children’s brains need to learn basic skills (like crawling) before other skills (like walking) can be learned,” Dornan added. “If one of the building blocks in development is missing, then the gap between what a delayed child can do physically and what a typical child can do just get larger and larger as the child gets older.”
SOURCE: bit.ly/2yteKjG Pediatrics, online October 16, 2017.