Access Barriers Still Common for At-Risk Families Seeking Developmental Evaluations

Children from low-income or low-English-proficiency (LEP) families are at higher risk for receiving delayed receipt of developmental diagnoses (e.g., autism) compared with English-speaking and middle-income families.

To investigate barriers to care in this setting, researchers used a “mystery shopper” design to gather information from U.S. children's hospitals with developmental-behavioral evaluation programs. A bilingual researcher called each hospital program, first in English and then in Spanish, trying to make an appointment for a 5-year-old son with school difficulty. Outcomes included estimated wait time, ability to speak with someone in Spanish, and ability to make an appointment.

Of 140 hospitals contacted, 36 sent the caller to voice…