Weekly versus fortnightly Allied Health early intervention for children with diagnosed/suspected developmental delay

Abstract

Aim and background: Reviewing service provision is prudent for early childhood development teams to ensure efficient and high quality service delivery. The context of this study is an outpatient, clinic-based, Allied Health Early Intervention service, for children, aged 1-4years with diagnosed/suspected developmental delay and their families, which is currently provided fortnightly over 10-weeks. This study aimed to compare the impact on carer and clinician preferences, client outcomes and efficiencies such as attendance rates, of weekly versus fortnightly clinics. Methods: A prospective multi-informant, group comparison design was conducted comparing fortnightly interventions over 10-weeks and weekly interventions over 5-weeks. Intervention outcome data (Canadian Occupational Performance Measure), attendance rates and questionnaire data completed by clinicians and carers, were compared between the two frequency periods. Results: No statistically significant difference was found between both models for overall attendance rates or outcome measures (n=25 fortnightly, n=29 weekly). Carers’ (n=97) and clinicians’ (n=36) perceptions showed a variety of preferences. Carers suggested weekly was preferable for children who function well with routine, have shorter term goals and homework and for rapport building. Concerns for vulnerable families regarding a shorter contact period of 5-weeks with the weekly service, compared to 10-weeks (for fortnightly service), were identified by clinicians. Consistent feedback from carers was weekly over 10-weeks as the best option. Clinician themes included perception of increased workload with weekly and additional time needed to observe change for some children. Carers for both models articulated practical attendance barriers.

Conclusions: A flexible model of service frequency is recommended, to suit the needs of children and carers, aligning with clinicians’ clinical reasoning. Decision making considerations should include condition, type of therapy (need for intensity/longer period/routine/relationship building), family practicalities, family vulnerability and benefits of service contact time.

Published
2020-07-26