Referral Patterns as a Contextual Variable in Pediatric Brain Injury: A Retrospective Analysis Purpose Access to speech-language pathology (SLP) services is a critical variable in the rehabilitation of pediatric brain injury. In this study, we examined patterns of SLP referral and factors affecting referral during the acute period following brain injury in 2 large pediatric specialty hospitals. Method In a retrospective, ... Research Article
Research Article  |   November 01, 2016
Referral Patterns as a Contextual Variable in Pediatric Brain Injury: A Retrospective Analysis
 
Author Affiliations & Notes
  • Angela Hein Ciccia
    Case Western Reserve University, Cleveland, OH
  • Jennifer P. Lundine
    Nationwide Children's Hospital, Columbus, OH
    The Ohio State University, Columbus
  • Alyssa Coreno
    Case Western Reserve University, Cleveland, OH
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication. ×
  • Correspondence to Angela Hein Ciccia: angela.ciccia@case.edu
  • Editor: Krista Wilkinson
    Editor: Krista Wilkinson×
  • Associate Editor: Travis Threats
    Associate Editor: Travis Threats×
Article Information
Healthcare Settings / Professional Issues & Training / Attention, Memory & Executive Functions / Traumatic Brain Injury / Research Articles
Research Article   |   November 01, 2016
Referral Patterns as a Contextual Variable in Pediatric Brain Injury: A Retrospective Analysis
American Journal of Speech-Language Pathology, November 2016, Vol. 25, 508-518. doi:10.1044/2016_AJSLP-15-0087
History: Received June 26, 2015 , Revised December 14, 2015 , Accepted February 15, 2016
 
American Journal of Speech-Language Pathology, November 2016, Vol. 25, 508-518. doi:10.1044/2016_AJSLP-15-0087
History: Received June 26, 2015; Revised December 14, 2015; Accepted February 15, 2016

Purpose Access to speech-language pathology (SLP) services is a critical variable in the rehabilitation of pediatric brain injury. In this study, we examined patterns of SLP referral and factors affecting referral during the acute period following brain injury in 2 large pediatric specialty hospitals.

Method In a retrospective, cohort chart review study, data collection focused on referrals made during the acute period using International Classification of Diseases, Ninth Revision, Clinical Modification codes for primary diagnoses of brain injury between 2007 and 2014 (Centers for Disease Control and Prevention [CDC], 2014). A total of 200 charts were reviewed. Data extraction included demographic and injury-related variables, referral for rehabilitation across disciplines, and plans of care following assessment.

Results Samples for both facilities were similar except for primary mechanism of traumatic brain injuries and severity. SLP referral rate at Hospital 1 was 36% and only 2% at Hospital 2. Regression revealed that individuals were less likely to receive an SLP referral if injury severity was classified as unknown or mild or if they were younger in age.

Conclusion SLP referral rates in the early acute period for children with brain injury were poor, creating a barrier to rehabilitation. This not only limits access to SLP services, but also may have broader and long-term impact.

Acknowledgments
We would like to thank the medical records and IT staff at both institutions for their support of this project. Also, we would like to thank Dr. Gerry Taylor for his guidance in retrospective chart review data collection.
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