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Using a Centralized Government-Run Call Center to Refer Young Children to Early Childhood and Early Intervention Services

August 1, 2024

Although we know that early intervention—and the earlier, the better—is important for young children who have developmental delays, only 10% of those who are eligible for early intervention are receiving it by their 2nd birthday.

In an article being early released in Pediatrics, Dr. Bergen Nelson from Virginia Commonwealth University and her colleagues from the University of California-Los Angeles and University of Southern California describe a novel approach to improving referral rates to early intervention (10.1542/peds.2023-065232).

The authors used the 211 LA system, which is the general call center for Los Angeles County’s Department of Health and Human Services, and trained early childhood care coordinators who worked for 211 LA. The research staff then conducted developmental screenings on 565 young children (12–42 months) who had upcoming well-child visits between January 2020 and October 2021 and then randomized them to receive usual well-child care or usual well-child care plus a telephone connection to an early childhood care coordination specialist at 211 LA. The 211 LA specialist discussed the developmental screening results and then, based on the child’s age, developmental risk, and family eligibility, referred the family to early intervention, early care and education services (including child care and Early Head Start), behavioral health services, and food and housing services. The 211 LA specialist then followed up approximately every 2 weeks with the family to assure that they had been connected with services.

What happened?

  • Children who were connected with 211 LA were more likely to be referred to services (25% versus 16%) and to be enrolled in services (15% versus 9%). While it’s unclear why referral rates continued to be low, part of this may be because many services were closed during the COVID-19 pandemic.
  • Importantly, 57% of those with moderate or high developmental-behavioral risk were referred to and 36% enrolled in services by 19 months of age, compared to 34% and 17%, respectively, in the children receiving usual well-child care only.

There are many other findings in this paper, so I urge you to check it out. The authors used an already existing governmental program, and that’s smart. However, I wonder how scalable this is if you do it for all children. But if you start with those families with children at developmental-behavioral risk and connect them in real time with a specialist who can talk to them and help them understand and access resources, that would be a huge improvement over the current status quo.

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