Modeling Lost to Intervention in Early Hearing Detection and Intervention: A Modified eDelphi Study.

Purpose: The purpose of this study was to develop a functional model of the drivers behind why families may decline early intervention services following the identification of a child as D/deaf or hard of hearing.

Method: This model was developed using a modified eDelphi method. Invited experts ( = 155) were provided proposed models of why families may decline early intervention services in accordance with current literature. In the first phase of feedback, participants ( = 23) provided changes they would make to the model to be more in line with their perceptions of lost to intervention. These changes were implemented, and a second phase of feedback with participants ( = 25) moved to accept the model as presented.

Results: Agreement was reached on five main barriers to early intervention access for children who have been identified as D/deaf or hard of hearing (family experience, family culture, perceived vulnerability, perceived benefits, and perceived barriers). Each of these main barriers has associated examples of how they may manifest across different early intervention programs and situations.

Conclusions: This is the first theoretical model of why loss to intervention happens within early hearing detection and intervention. Having a model provides the opportunity for future work to implement novel approaches to support families during the early intervention enrollment process.