Dropout from Rehabilitation and Its Associated Factors in Children with Developmental Disabilities in Tehran Rehabilitation Centers

: Background: Improvement of the quality of life of people with developmental disorders and their full integration within the society requires comprehensive mental, intellectual and physical rehabilitation. In order to achieve a favourable outcome, rehabilitation should be delivered in a continuous manner and with small attrition. Research in this area is scarce. Objectives: The current study was aimed to determine the incidence of drop out from rehabilitation and its associated factors in children with developmental disorders. Methods: In this prospective study, 225 children with developmental disorders and their parent(s) seeking rehabilitation services for the first time participated. They attended different centres in all regions of Tehran during 2016-2017. We completed a checklist using a semi-structured interview. Follow up was performed every three months for at least 6 months to record the dropout from rehabilitation and the associated factors. Data analysis included Chi-square test and logistic regression. Results: Dropout rate was found to be 10.9% within three months and reached a total of 19.3% in six months and was significantly associated with the following factors after eliminating confounding effects: Poor family satisfaction with the centres, OR=10.76 (CI: 2.764-41.906, P=0.001) in three months and OR= 4.51 (CI: 1.30-15.67, P <0.02) after six months; type of service sectors (public and charity vs private), OR=7.12 (CI: 2.12-23.93, P=0.002); Moderate severity of developmental disorder, OR=4.55 (CI: 1.24-16.78, P<0.03 in 3 month analysis), child's perceived “lack of cooperation” in attending the rehabilitation sessions, OR=6.79 (CI: 1.42-32.53, P<0.02) in six months, and type of developmental disability (specific learning disorder vs others), OR=6.68(CI: 2.85-15.65, P<0.001) in six months. In the open questions, high cost of the services was stated as the most important reason for drop out. Conclusions: Our findings indicate that dropout was associated with family dissatisfaction with the low quality of services mainly in the public and charity centres. Children with disabilities of moderate severity were most likely to drop out from rehabilitation. Specific learning disorders seem to be the most challenging types of disabilities and lead to highest dropout rates. The findings provide opportunities for further research in this area and provide more information to render rehabilitation services more efficient.