Understanding Barriers to Timely Enrollment of Early Intervention Services for Children who are Deaf and Hard of Hearing.

The Joint Committee on Infant Hearing guidelines recommend that children who are deaf and hard of hearing should begin early intervention by six months of age. However, prior work has revealed a substantial percentage of children who receive a diagnosis of hearing loss by three months of age, but do not enroll in early intervention by six months of age (Grey et al., 2022). To further understand barriers to enrollment in early intervention for these families, we completed qualitative semi-structured interviews with 10 caregivers whose children were diagnosed with hearing loss by three months of age but did not begin early intervention by six months. We recruited from participants in Grey et al. (2022). Interviews were coded using the Bioecological Model of Human Development (Bronfenbrenner & Morris, 2006) as a guiding framework. The interviews revealed widespread barriers encountered by families of children who are deaf and hard of hearing across ecological systems, ranging from child characteristics to macro-level issues like insurance coverage. To ensure that all children who are diagnosed with hearing loss have timely access to early intervention, changes to current policy and practice are needed across multiple ecological systems.