Understanding variation in provider referral rates to early intervention for children with developmental delays

Early developmental delays (DD) and autism spectrum disorder (ASD) can be identified in early childhood, and timely referral to Early Intervention (EI) is associated with improved developmental outcomes. Despite widespread screening in pediatric primary care, referral rates to EI remain low following positive screening results. This qualitative study examines pediatric primary care providers’ perspectives on factors influencing EI referral decisions. Virtual interviews were conducted with Oregon pediatricians recruited from the Autism Access Link for Early Referral and Treatment (Autism ALERT) study. Findings aim to clarify how clinical guidelines, screening results, and contextual factors influence referral decision‑making, helping to address the persistent gap between identifying developmental concerns and accessing early intervention services.