Challenges with Access to Early Intervention Services Following NICU Discharge in California

Abstract Early alterations in function are evident in preterm infants during their neonatal intensive care unit (NICU) hospitalization. Therefore, it is common for preterm infants to be referred to early intervention (EI) as they transition from hospital to home. Access to EI is often assumed, but understanding gaps in service delivery is important. The aims of this project were to (1) determine rates of EI access at the first high-risk infant follow-up (HRIF) appointment (4–8 months corrected age) at a safety-net hospital in Los Angeles, and (2) identify relationships between infant, clinic, and EI factors with EI service uptake. Through a retrospective medical record review, EI utilization at the first HRIF appointment was documented among 189 NICU-graduate preterm infants born ≤32 weeks estimated gestational age who had their first HRIF visit (4–8 months corrected age) between January 2019 and November 2020. Ninety-two (49%) of the infants were receiving EI at their first HRIF appointment at 4 to 8 months corrected age. Extremely preterm infants were more likely to receive EI services than those born very preterm (p = 0.005). No other relationships between factors were identified. Successful uptake of EI services cannot be assumed. Challenges with access to EI persist, even within systems designed to foster identification and access to therapy following NICU discharge. Future research is needed to identify the reasons for the lack of access to EI and to identify the impact of different types of programming to aid access to EI for high-risk populations.