For children with developmental disabilities, early diagnosis and intervention is critical for ensuring the best possible future as they grow up.
This is the principle behind a new program launched this summer at Whittier Street Health Center in Roxbury, where a new clinician has been brought on board specifically to speed up the diagnoses of children with developmental disabilities — particularly low-income and children of color, who more often struggle to get these services.
“We are focused on addressing racial and ethnic disparities in health care,” said Whittier President and CEO Frederica Williams. “And if our patients have issues or behavior that’s going to impede their academic success, their social interaction, their wealth … people who are disabled from a low-income community or from a minority end up in poverty.”
Whittier has hired Dr. Michael Oanea to launch a new practice in evaluating children for developmental disabilities to move them more quickly to diagnosis and treatments or interventions.
Oanea said the goal is to close the gap between initial screenings and diagnostic evaluations — a gap that can stretch for more than a year, which can have devastating consequences for children.
After routine initial screenings, often “referrals are made, but sometimes there are lapses in not being able to actually get the family to find the right clinic or to get them to just complete their initial intake,” Oanea said. “The wait times can be over a year.”
Experts say these delays are partly because of an overtaxed system that does not have enough qualified evaluators available for the growing patient load. Diagnoses of developmental disabilities ranging from anxiety to attention deficit disorders to autism became more common during the COVID pandemic, Williams said, and there are not enough service providers to respond quickly.
But practitioners say minority and low income families also face additional barriers that make it harder to complete the evaluation process to get to a diagnosis.
Meaghan Hamilton, director of pediatric complex care at NeighborHealth, formerly known as the East Boston Neighborhood Health Center, said “these appointments are not easy to navigate” and she has observed that it gets harder for families if transportation is unreliable or they are not proficient in English.
“There’s multiple steps,” Hamilton said about the diagnosis process. “There is an intake that is a general review of the patient’s developmental history and medical history. And then often the next appointment is the actual evaluation. And I cannot even tell you how many patients have gone to the first appointment and not understood and missed the second.”
Speeding up this process is critically important, Hamilton said. “If you’re two years old and you have to wait a year, that is a significant portion of your life that you spend waiting and not having services.”
Hamilton, whose health center provides autism evaluations and diagnoses, said adding another place where children can complete diagnostic evaluations is a big win. “The challenge is not for pediatricians to recognize the signs of autism, because pediatricians are very familiar,” she said. “We see it all the time in our practices. The challenge is finding the people who can actually diagnose.”
That’s what Oanea, a neurologist with a specialty in neurodevelopmental disabilities, hopes to help address with the new Whittier program.
“It’s not uncommon that I’ll see a family for a first time visit and they’ve told me, ‘yeah, I’ve been on a couple of other waitlist but each of those were, you know, at least eight months.’” he said. “So my hope is that on a grander scale it’ll make at least a little bit of a difference having this other outlet for developmental evaluations.”
