Evaluating the Effectiveness of an Integrated Care Model for Children With Learning and Language Disorders (LLD)

OBJECTIVES: A French national experimentation aimed at structuring the healthcare pathway and facilitating access to multidisciplinary services for children with LLD. The objective of this study is to evaluate the effectiveness of this model of care by focusing on the prescribed and performed multidisciplinary health assessments and rehabilitative care.

METHODS: This evaluation employed a mixed-methods approach, combining quantitative and qualitative analyses as part of a realist evaluation of the new integrated care models. Quantitative data were derived from longitudinal study implemented from January 1, 2021, to April 30, 2023, encompassing 3406 children aged 7 to 15 years. The prescriptions of multidisciplinary assessments and rehabilitative care were analyzed, including psychomotricity, occupational therapy, psychology, and complementary assessments in neuropsychology and memory.

RESULTS: Of the 3406 children included, 66% received a prescription for psychomotricity/occupational therapy assessments, 58% for psychological assessments, 43% for speech therapy and/or orthoptic assessments, and 34% for neuropsychology and memory assessments. In terms of performing these assessments, 77% of the children initiated the prescribed psychomotricity/occupational therapy assessments, 82% completed the psychological assessments, and 69% completed the prescribed neuropsychology assessments. The results show that 72% of the children received at least one prescription for rehabilitative care. 67% of the children began psychomotricity or occupational therapy, and 36% started psychological follow-up. Regarding the parental skills training sessions, 28% of the families began this program. The duration from the medical evaluation consultation to the start of the care project was 4 months. The data also show a significant reduction in parental burden (Mini-Zarit Scale).

CONCLUSIONS: The experiment led to a significant improvement in the quality of care, with high rates of prescribed and performed assessments and rehabilitative care. The model demonstrated its effectiveness and could be applied on a larger scale.