Date Presented 04/22/2023

This study surveyed families in early intervention (EI) to identify perceived barriers to accessing EI services. By supporting parents in overcoming these barriers, OTs can support child health outcomes and health equity.

Primary Author and Speaker: Cathy Leslie

Additional Authors and Speakers: Stefanie Johnston

Contributing Authors: Kris Martone-Levine, Amirra Johnson

Low rates of access to Individuals with Disabilities Education Act (IDEA) Part C early intervention (EI) services for infants and toddlers have been well-documented (Rosenberg, 2013) despite substantial evidence that intervening early supports positive health outcomes and child development (National Scientific Council on the Developing Child, 2020). Low-income, underrepresented families are disproportionately affected (McManus et al., 2020; Twardzik, 2018), contributing to pediatric health disparities. Additional research is needed to identify factors that impede access to EI for all families. To guide EI program improvement efforts, this study answered the question: What are the perceived barriers related to accessing EI services for families of children from birth to age 3 who have received EI services in Massachusetts (MA)? A descriptive, mixed-methods study design was used. Participants were MA parents of a child who has received EI services. An anonymous electronic survey was developed based on a literature review and consultation with EI providers and parents, then pilot tested, revised, and distributed. For completed surveys (n=156), descriptive data analysis was performed for quantitative data using IBM SPSS Statistics 25. Qualitative themes were identified using content analysis. Study findings identified barriers, including: not understanding what EI services were or importance of EI for their child; COVID-related issues; communication difficulties with EI center; and logistical issues, such as EI center hours. Study results provide key insights from EI families that can guide occupational therapy (OT) practitioners to eliminate barriers to EI access and improve health outcomes and health equity for vulnerable children. Specifically, OTs can provide families with clear information about EI services and benefits of participation, and assist directly with the referral process to ensure families connect with the correct EI center.


Rosenberg, S. A., Robinson, C. C., Shaw, E. F., & Ellison, M. C. (2013). Part C Early Intervention for Infants and Toddlers: Percentage Eligible Versus Served. PEDIATRICS, 131(1), 38–46.

National Scientific Council on the Developing Child. (2020). Connecting the Brain to the Rest of the Body: Early Childhood Development and Lifelong Health Are Deeply Intertwined: Working Paper No. 15. Retrieved from

McManus, B. M., Richardson, Z., Schenkman, M., Murphy, N. J., Everhart, R. M., Hambidge, S., & Morrato, E. (2020). Child characteristics and early intervention referral and receipt of services: A retrospective cohort study. BMC Pediatrics, 20(84), 1-10.

Twardzik, E., Cotto-Negrón, C., & MacDonald, M. (2017). Factors related to early intervention Part C enrollment: A systematic review. In Disability and Health Journal.