Detection of Speech-Language Delay in the Primary Care Setting: An Electronic Health Record Investigation.
Catherine Frelinger, Rebecca M Gardner, Lynne C Huffman and 3 others
PMID 36978234WHAT IT FOUND
Primary care detected speech-language delay in 14.2% of children, with a mean age of first documentation at 25.4 months.
Boys and those with public insurance were identified more often. Using standardized screeners did not lower the age of detection compared to routine surveillance.
Key findings
01Speech-language delay was documented in 14.2% of the cohort, with the mean age of first identification at 25.4 months.
02Practices using the standardized Ages and Stages Questionnaire did not identify speech-language delay at a younger age than practices using non-validated surveillance questionnaires.
03Boys were more than twice as likely to be identified with speech-language delay as girls, and publicly insured patients were more likely to be identified than privately insured patients.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study relied entirely on electronic health records, so any delays addressed by clinicians but not coded as a diagnosis were missed. Race and ethnicity data were missing for over 40% of the cohort, preventing analysis of disparities in these groups. The population was predominantly English-speaking and privately insured, which may not reflect the experiences of more diverse or lower-income communities. The study did not measure whether children actually received referrals or treatment after identification. Only three of ten practices used a standardized screener, and one of those was an outlier with late identification, which may skew the comparison of screening methods.
Declared interests
The authors declared no conflicts of interest. The work was supported by non-U.S. government and NIH extramural grants.
The easy way to misread this
Do not conclude that standardized screeners are unnecessary or that surveillance is equally effective for all outcomes. This study only measured the age of first documentation, not the accuracy of the diagnosis or the rate of referral. The lack of difference in timing could be due to the small number of practices using the screener or the specific nature of the surveillance tools used.