New Approach Helps Vulnerable Families Overcome Barriers to Early Intervention
As reported previously in SafeMinds Shares, autism rates have been increasing among the socioeconomically disadvantaged as well as in African American and Hispanic families. Sadly, each of these groups tend to receive autism diagnoses and services later than other demographics. In order to address these disparities, a recent study was conducted testing an approach called “family navigation.” By using the assistance of trained community health workers known as “navigators,” family navigation aims to help disadvantaged families overcome barriers to receiving a diagnosis and setting up early intervention services for their at-risk children. Navigators are typically bilingual members of the same demographic as the family they are matched with, giving the family cultural support. Navigators typically meet with their families at least once in-person to discuss potential obstacles and to problem solve together. At this meeting, the navigator trains the family on how to make an appointment for an autism diagnostic evaluation and to explain what to expect during this appointment at the clinic or practice. If the child is ultimately diagnosed with autism, the navigator assists the family to establish recommended early intervention services. In order to determine if family navigation was helpful, researchers recruited 249 families with children aged 15 to 27 months from primary care practices in three northeastern cities. This cohort was racially diverse and 82% of the families were accessing Medicaid for their health insurance. Clinicians had identified children from these families at risk for an autism diagnosis. The research team randomly selected 126 families to receive navigator assistance. The remaining families were introduced to a “care manager” by phone who reminded them of their diagnostic evaluation, provided resources, and offered to answer questions. However, after the initial phone call, it was up to the family to contact the care manager about any of their concerns. At the end of a year, 86% of families that received family navigation had completed a diagnostic assessment. By comparison, 76% of the control families had completed the same assessment. The study showed that Hispanic families benefited more from family navigation than non-Hispanic families, boosting their proportion of families that completed the diagnostic evaluation by 41%. The research team concluded that family navigation could have a big impact on the most vulnerable families and hopes that it could become part of routine care.
