Seeing the Signs- or Missing Them? Early Intervention in NYC

Lisa Belle

Co-Presenters: Individual Presentation

College: College of Health Professions and Human Services

Major: SLPD.SPCHLANGPATH

Faculty Research Mentor: Patten, Sarah  

Abstract:

Culturally and Linguistically Diverse (CLD) children in NYC’s Early Intervention (EI) Program often face delayed diagnosis of developmental delays and Autism Spectrum Disorder (ASD), despite evidence of early diagnosis benefits. While pediatricians may refer, the EI providers conduct initial evaluations and make referral decisions, thereby positioning them as gatekeepers. This qualitative study examines how EI providers may contribute to under-identification and service delays, exploring their perspectives, decision-making, and policies to identify barriers such as training gaps, cultural competence, bias, parental engagement, and systemic issues. Participants were recruited via email from various NYC EI agencies, and responses were obtained from professionals across disciplines, including speech-language pathologists. Participants completed surveys with an embedded video of a CLD child during play and were asked various closed- and open-ended questions. Questions were also based on EI policies and procedures. Participants were then interviewed to gather more detailed information. By centering the provider’s role, this study shifts the focus from family- and child-level explanations to modifiable professional and systemic factors. Results may reveal discrepancies between providers’ perceived and actual abilities to detect early signs, thereby revealing systemic gaps. Findings may support the use of structured decision-making tools, increased collaboration across EI disciplines, and ongoing self-reflection to reduce bias in evaluation practices. Strengthening provider knowledge and confidence may improve early identification, promote appropriate referrals, and ensure timely, equitable access to services for CLD children.