Families Face Long Waits for Developmental Pediatricians

Developmental pediatricians are specifically trained to treat children with developmental disorders, including autism spectrum disorders (ASD), attention-deficit/hyperactivity disorder (ADHD), conduct disorders, or cerebral palsy.

And while these conditions are quite common — an estimated one in six children in the United States has a development disorder — there are only 1,000 developmental pediatricians in the country.

In fact, a new study at Rutgers University finds that the wait time to see one of these specialists is particularly lengthy — averaging between five and six months — further delaying the start of intervention strategies designed to treat the young patients’ behavioral, emotional, social, and/or educational struggles.

In addition, the researchers found that there is an insufficient number of programs that offer accommodations for non-English speaking families.

“Relative to the number of children who would benefit from seeing a developmental pediatrician, the number of specialized physicians in the field is relatively few,” said Manuel Jimenez, M.D., M.S., assistant professor of pediatrics, and family medicine and community health at Rutgers Robert Wood Johnson Medical School, who led the study.

“This has the potential to limit access to rigorous diagnostic evaluations which in turn can ensure access to specialized services and therapies. Given that individuals with limited English proficiency often have difficulty navigating the health care system, we were especially interested to see if there would be differences when we called in English versus Spanish.”

After finding no documented evidence on the subject, the researchers first investigated the barriers to obtaining an appointment for an initial evaluation. Some of the researchers, who were posing as “mystery shoppers,” made phone calls to request an appointment at specialized developmental pediatric programs associated with children’s hospitals across the country.

Of the 140 unique programs that were called, 75 provided a wait time with an average of nearly five and a half months. Among these, 62 were reached in Spanish within a 24-hour period of the initial call. Only 55 percent offered a wait time estimate and nearly one-third did not offer any Spanish-language services for the caller.

Although Jimenez said he was not particularly surprised at finding long wait times nationally, he was surprised at the number of programs that did not offer a wait time in Spanish, although a wait time had been offered in English just 24 hours prior. He was equally surprised at the lack of accommodations for families for whom English is a second language.

“Our study serves as a reminder to physicians to be mindful of the difficulty our patients experience to obtain an initial assessment including an extended waiting period and barriers to language services,” said Jimenez, who also is an attending developmental and behavioral pediatrician at PSE&G Children’s Specialized Hospital.

“For researchers and policy makers, our findings underscore the importance of evaluating different care models to leverage the strengths of professionals to ensure that children with developmental concerns reach the appropriate providers at the appropriate time.”

Jimenez emphasized that more work is needed to identify strategies that provide better access to all children who are in need of specialized services, as developmental and behavioral problems are among the most prevalent health concerns faced by children.

The findings are published in the Journal of Developmental & Behavioral Pediatrics.

Source: Rutgers University