Abstract
ChildServ, a coordinated, region-wide system of early detection and intervention for at-risk children, was implemented in Hartford, Conn, in 1998. In this article, we report our experience with the design and implementation of the program and describe lessons learned and implications for subsequent program expansion. From 1998 to 2001, 124 child health providers referred 358 children with 516 different needs. One third of referred children had multiple needs. Developmental assessment, speech and language services, parenting classes, and counseling were frequently recommended. Only 43% of referred children ultimately received services, despite an average of 6.9 contacts with the family following initial referral. Boys, Hispanic children, and children with private insurance were more likely to receive services. We believe that ChildServ helps to address a critical gap in service delivery to children at risk for poor developmental and behavioral outcomes. A system of triage, referral, and care coordination appears to facilitate access to program and services. However, additional strategies are necessary to more successfully reach and engage families. In our experience, outreach capacity and such financial barriers as lack of private insurance should be included in the design and implementation of early detection and intervention programs.