178: A New Tool for Improving Access to Developmental Service: The Developmental Passport
Notice bibliographique
Résumé
Receiving a new developmental diagnosis is challenging for families. The considerable variability in how long it takes families to access services and the proportion of services families receive reflects challenges families face in navigating and accessing the right developmental services. To determine how developmental pediatricians can better support families with a new developmental diagnosis to access the right developmental services. To develop a new tool designed to better support these families through iterative dialogue with both physicians and families. We conducted a written survey with developmental pediatricians to elicit concerns on whether families are accessing the right developmental services and to determine the features of an ideal standardized instrument. We used this feedback to develop a new tool, the Developmental Passport, designed to better support parents while accessing services. This tool is inspired by existing passport-type tools already used in healthcare (eg, immunization record), but tailored for the needs of families with a new developmental diagnosis. We conducted a focus group with developmental pediatricians and standardized telephone interviews with caregivers of children with ASD to evaluate the design and utility of the Developmental Passport. We performed a thematic analysis with a semantic approach. Among the 14 developmental pediatricians, half felt that families are usually able to access fewer than 50% of developmental services recommended. The physicians recognized important barriers exist to service access, but indicated families can best identify these. Important barriers identified by 11 caregivers included 1) feeling overwhelmed, both by the diagnosis and their child's symptom severity; 2) difficulty in navigating the developmental service system, which is archaic, time-consuming, and not transparent; 3) financial barriers; 4) lack of communication with publicly-funded developmental service agencies. To provide family-centered care, physicians suggested parents should take ownership of the Developmental Passport. Families supported the Developmental Passport as a simple, effective tool. They made concrete suggestions on the tool's design including best organization of agency presentation and greater focus on accessing financial support. The final tool is a product of an iterative dialogue among the tool's developers, developmental pediatricians, and caregivers. Families are struggling to access the right services. Both developmental pediatricians and families supported the Developmental Passport in its current form and believe it will be an effective tool to both identify and address these gaps. Further evaluation of the Developmental Passport is required to determine its utility prospectively.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,014 | 0,067 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,002 |
| Bibliométrie | 0,008 | 0,003 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,003 | 0,008 |
| Science ouverte | 0,002 | 0,006 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,017 | 0,004 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».