178: A New Tool for Improving Access to Developmental Service: The Developmental Passport
Bibliographic record
Abstract
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.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.014 | 0.067 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.008 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.008 |
| Open science | 0.002 | 0.006 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.017 | 0.004 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".