Screening for Speech and Language Delay in Preschool Children: Recommendation Statement

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Language Development and Disorders Early Childhood Education and Development Child and Adolescent Health

Abstract

The US Preventive Services Task Force (USPSTF) concludes that the evidence is insufficient to recommend for or against routine use of brief, formal screening instruments in primary care to detect speech and language delay in children up to 5 years of age (I recommendation; see Appendix 1). Speech and language delay affects 5% to 8% of preschool children, often persists into the school years, and may be associated with lowered school performance and psychosocial problems. The USPSTF found insufficient evidence that brief, formal screening instruments that are suitable for use in primary care for assessing speech and language development can accurately identify children who would benefit from further evaluation and intervention. Fair evidence suggests that interventions can improve the results of short-term assessments of speech and language skills; however, no studies have assessed long-term outcomes. Furthermore, no studies have assessed any additional benefits that may be gained by treating children who are identified through brief, formal screening who would not be identified by addressing clinical or parental concerns. No studies have addressed the potential harms of screening or interventions for speech and language delays, such as labeling, parental anxiety, or unnecessary evaluation and intervention. Thus, the USPSTF could not determine the balance of benefits and harms of using brief, formal screening instruments to screen for speech and language delay in the primary care setting. Address correspondence to Ned Calonge, MD, MPH, US Preventive Services Task Force, Agency for Healthcare Research and Quality, 540 Gaither Rd, Rockville, MD 20850. E-mail: uspstf{at}ahrq.gov

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References

2006Screening for Speech and Language Delay in Preschool Children: Systematic Evidence Review for the US Preventive Services Task Force 2001Validation of the Language Development Survey (LDS)2000Randomised controlled trial of community based speech and language therapy in preschool children 2000Improving the Positive Predictive Value of Screening for Developmental Language Disorder 1998Concurrent and Predictive Validity of an Early Language Screening Program 1982Validation of an Early Language Milestone Scale in a High-Risk Population 1993The Fluharty Preschool Speech and Language Screening Test 1991Can Clinical Judgment Detect Children with Speech-Language Problems?

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