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Accessing Child Educational Services (ACES)

The Accessing Child Educational Services (ACES) Project investigated barriers, motivators, and strategies that influence parents and service providers to act early when child developmental milestones are late.

EDUCATION SYSTEM

  • BARRIERS:
    • Families’ grieving process when they are faced with serious developmental concerns may take longer or be out of sync with professional protocols and timelines for diagnosis and referral, and parents may appear resistant to services at a given point in time
    • Families from non-majority cultures may appear resistant to service providers when the agency’s message is out of sync with family views and communication styles
    • Early Intervention services are poorly understood by parents, and the local agency can be difficult to locate.
    • Parents with relationships with other government-funded programs may perceive Early Intervention as an intrusion.
    • Daycare providers and community preschool teachers often lack awareness of typical development and available.
  • RECOMMENDATIONS:
    • Public campaigns normalizing the benefits of early special education services in local communities
    • Public advertisements that mention specific developmental delays, particularly communication problems, will alert families who are looking for help with specific concerns. Communication, the most common EI/ECSE service, may not be recognized by some families as part of “development.”
    • Friends and extended family members should be targeted in PR education campaigns to act when they observe developmental delays
    • Pediatricians should encourage at-ri

FAMILY

  • BARRIERS:
    • Many parents had long-term concerns but did not know where to get help.
    • Lack of knowledge of developmental milestones or experience with children.
    • Difficult or unstable life circumstances delayed acting on developmental concerns.
    • Friends or relatives don’t know how to bring up concerns.
    • Extended families often “normalized” the child’s problems.
    • Many children were not identified until they entered Head Start or were placed in community preschools.
    • Parents not aware that they can self-refer to services.
  • RECOMMENDATIONS:
    • When families choose not to engage in recommended diagnostics or special services, early education settings can continue to encourage families and work on developmental goals
    • Do not rush the identification/ referral process – bring families along by explaining what the developmental concerns are, and solicit and address parents’ concerns
    • Establish and maintain avenues of communication with local pediatricians
    • Include cultural communities through partnerships with community leaders and building expertise within communities

PHYSICIAN

  • BARRIERS:
    • During well-child visits, physicians did not see a representative sample of child behavior, and had a compromised relationship with the family
    • Pediatricians often advised parents to “wait and see” if a child would mature
    • If a developmental concern occurred around age 2, the physician’s “wait and see” stance could delay referral until the next well-child check-up at age 3, or 4
    • Parent persistence was often necessary to obtain a referral – it was not uncommon that parents changed doctors
    • Parents, not doctors, identified developmental concerns in siblings of children with disabilities
  • RECOMMENDATIONS:
    • Elicit and give credibility to parent concerns at well-child check-ups
    • When developmental concerns exist, screen and monitor children’s development more frequently than recommended by the AAP
    • Proactively use a developmental screen with children who have siblings with a disability or who have a family history of special education
    • Check back with family on referrals
    • Training on available early intervention and related services, and referral protocols, as well as developmental screening should be available to all those in the health care profession working with young children