"It All Goes Back to the Services": A Rural/Urban Comparison of Barriers and Facilitators to Disability Services

Background: Children with disabilities and their families face a variety of barriers in accessing services throughout their lifespan.  The purpose of this study was to explore rural/urban differences in barriers and facilitators of services for youth with disabilities and their families in southeast Georgia. 

Methods: Twenty in-depth interviews (N=11 urban; N=9 rural) were conducted with organizational representatives who provide disability services.  Two researchers coded the data until 100% consensus was reached.  Convergence and divergence across rural and urban perspectives were examined.  Major themes were identified and illustrative quotes selected. 

Results: Multiple barriers cutting across both communities (e.g., lack of health insurance, high out of pocket expenses) emerged.  Access to public transportation and a range of services were major barriers in rural communities but not urban.  Key services (e.g., dentists) are absent in rural areas or have long waiting lists.  Socio-economic status is the determining factor in overcoming barriers to service provision, with many low income families in rural areas lack resources (e.g., transportation) to overcome barriers.  Several facilitators of services emerged (e.g., training parents to deliver services on their own). 

Conclusion: Whereas there are range of services available in urban communities, low income, rural families of children with disabilities face unique barriers, particularly when their child transitions out of the school system.  Service providers reported extensive efforts to work with parents to overcome   barriers; however, community-based strategies (e.g., opportunities for community engagement) are recommended to overcome service barriers in rural communities.