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Rutgers study finds long-wait times for children in need of pediatric evaluations

A new Rutgers study found evidence confirming that extended wait times for pediatric evaluations could be severely detrimental to the diagnosis and early intervention strategies needed for treatment.

Published in the Journal of Developmental & Behavioral Pediatrics, the study found that the average wait time nationally for development pediatric evaluations falls between five to six months. 

When comparing appointments made in Spanish, about one-third of the programs contacted did not provide language accommodations, said Manuel Jimenez, an assistant professor of pediatrics, family medicine and community health at Rutgers Robert Wood Johnson Medical School.

The study specifically focused on diagnostic evaluation delays for pediatricians who specialize in autism, attention deficit, hyperactivity disorder and cerebral palsy. 

There are only 1,000 pediatricians nationally who are specially trained to treat these disorders, which is likely one of the reasons why there are such lengthy wait times, according to the study’s press release in Rutgers Today.

“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. 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,” Jimenez said in an interview with Rutgers Today.

Prior to this study, there had only been one other peer-reviewed study exploring wait times for pediatric evaluations, which found a three-month average wait time for children who are diagnosed on the autism spectrum. The previous study had been confined to a small metropolitan area, and thus inspired Jimenez for a more diverse and updated study, he said. 

Supported by the Robert Wood Johnson Foundation Harold Amos Medical Faculty Development Program, the team consisted of Jimenez, Jerome Williams, a professor and prudential chair for the Rutgers Business School and Brian L. Strom, a chancellor for the Department of Biomedical and Health Sciences, according to Rutgers Today.

The study was conducted through a mystery shopper strategy, in which a bilingual research assistant called various programs asking to make an appointment for his son who was experiencing difficulty in school, Jimenez said. This technique is largely used in market research, although has been rarely applied in health research.

According to the study’s press release, 140 programs were contacted, and 75 provided wait times of nearly five and a half months. Of the 62 programs reached in Spanish, only 55 percent responded with a wait time estimate and one-third did not offer non-English speaking accommodations.

Jimenez said his team was not surprised by the studies’ outcome, anticipating the result to have lengthy wait times, although he did not expect the lack of language accommodations for patients scheduling appointments.

“As we expected, we identified long wait times, in fact, on average the estimated wait time nationally was over five months. While this study was not designed to answer why the wait can be so long, we do know that developmental behavioral concerns are common among children and there are relatively few developmental pediatricians nationally,” Jiminez said.

Jimenez said the study highlights the need to improve health access for children with developmental concerns much earlier, as well as improving language accommodations for patients.

“For researchers, our findings reinforce the need to examine different care models that can leverage the strengths of different professionals to ensure children reach the right provider at the optimal time. For clinicians and families it's important to remember that there can be long wait times for these evaluations and it's important to seek therapies and other supports simultaneously,” Jimenez said.

More work and further study are needed to identify different strategies on how to better provide access to all children in need, and overcome such obstacles like language barriers. Fortunately, that has been the precise focus of Jimenez and his team as they attempt to find solutions for these issues, Jimenez said.

“At Children's Specialized Hospital, we've been working hard to reduce the wait times for our families including several innovative, ongoing pilots that we are in the process of evaluating,” Jimenez said. 

Marissa Scognamiglio is a School of Arts and Sciences first-year student. She is a contributing writer for The Daily Targum.

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