# Assessment of Service Delivery Modifications by Providers Serving Families With Developmental Disabilities During the COVID-19 Pandemic

## TL;DR

This study explores how healthcare providers adapted their services for children with developmental disabilities during the pandemic and identifies best practices for future emergencies.

## Contribution

The study identifies specific service delivery modifications that were effective during the pandemic and provides consensus-based best practices for future use.

## Key findings

- Nine out of 16 modified practices reached consensus among providers for their helpfulness and feasibility.
- Virtual visits and electronic portals were widely seen as beneficial for service delivery.
- Keeping in-person visits brief received negative consensus from providers.

## Abstract

Background and objective

The COVID-19 pandemic has forced healthcare professionals to find innovative ways to deliver healthcare services. The objective of this study is to understand service modifications made by providers to continue care for children with developmental disabilities (DD) and their families during the height of the COVID-19 pandemic and develop best practices for future emergencies.

Methods

A modified Delphi method was used to understand service delivery modifications for children with DD and providers’ perspectives on these modifications. Ten providers from multiple specialties rated 16 modified practices during the COVID-19 pandemic on four measures: frequency of use in their individual practice, helpfulness in delivering care and/or meeting clients’ learning needs, feasibility of delivering care and/or meeting clients’ learning needs, and likelihood to use after the COVID-19 pandemic. A three-round modified Delphi process with an expert panel discussion was conducted to achieve consensus agreement on best practices.

Results

Consensus, defined as at least 70% of the panelists giving a high rating (4 or 5) or low rating (1 or 2) for a modified practice, was reached for a total of nine (56%) of the 16 modified practices. Panelists agreed that modifications helpful for service delivery beyond the pandemic included dedicated staff for follow-up and referrals; electronic portals to send reminders, information, and handouts; personalized handouts and materials targeting clients’ needs; and real-time client feedback. Panelists also reached a positive consensus that virtual visits, alternate service delivery settings, and the provision of personal protective equipment were helpful and feasible to enhance care delivery. However, negative consensus was noted on keeping in-person visits brief and strictly for essential activities.

Conclusions

This study highlights important service modifications that were helpful during the COVID-19 pandemic from the perspective of service providers.