How We Fail Children With Developmental Language Disorder.
Karla K McGregor
PMID 32755505WHAT IT FOUND
Most children with developmental language disorder are not identified, and service receipt varies by language, race, behavior, and location.
Research attention to DLD remained low compared with other conditions.
Key findings
01Among the poorest performers, only 39% had ever been identified as having language deficits; in England, only 3.5% of children meeting DLD criteria had a Statement of Special Educational Needs, and 39% were receiving language intervention outside school.
02Children who spoke English as an additional language were about 50% less likely to be identified as service eligible, and Black children had 61% lower odds than White children in 1999.
03DLD had 61% more papers in 2010 to 2019 than in 2000 to 2009, but it still had 0.03 papers per 100 affected U.S. children.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The paper is a narrative review and bibliometric analysis, not a trial of identification or service delivery. Publication counts are a proxy for research attention and do not show study quality, clinical impact, or implementation. The new analysis uses U.S. case estimates, so its absolute publication index cannot be directly compared with Bishop's U.K. figures. Service inequity findings come from observational studies, and adjusted estimates do not prove that a particular policy caused the disparity. Screening and advocacy recommendations are proposed, not evaluated in this paper. Some evidence is anecdotal, such as reports that school SLPs are told not to diagnose.
Declared interests
The work was supported by National Institute on Deafness and Other Communication Disorders Grant R01 DC011742-07, with Karla K. McGregor as principal investigator. No other conflicts of interest are reported.
The easy way to misread this
Do not read this as evidence that sentence recall screening or advocacy will improve child outcomes. The paper summarizes existing inequities and recommends further development and testing of tools and policies.