USPSTF: 'We need studies' to decide on screening for speech and language delay, disorder

Key takeaways:

• The USPSTF said it could not make a recommendation for or against screening for speech and language delay and disorders in children.
• For now, a task force member said PCPs should use their clinical judgement.

There is not enough evidence to adequately assess the benefit-harm balance of screening for speech and language delay and disorders in asymptomatic children aged 5 years and younger, according to the U.S. Preventive Services Task Force.

The I draft recommendation statement aligns with the task force’s 2015 final recommendation on the subject, calling for more research on the outcomes of screening this population for speech and language delay and disorders.

“Unfortunately, we didn't find enough evidence to determine whether or not routine screening for speech and language delay and disorders among children ages 5 and younger can improve health outcomes for children and well-being for families,” Tumaini Rucker Coker, MD, MBA, division head of General Pediatrics and professor of pediatrics at the University of Washington School of Medicine and Seattle Children’s, told Healio.

The task force based its recommendation on a review of 38 studies that reported on 41 articles (n = 9,006), but no study assessed the direct benefits of screening compared with no screening. After reviewing the evidence, task force members concluded it was insufficient to determine whether screening leads to improved speech, language or other outcomes like performance at school.

“We need studies that focus on children who screen positive in a primary care setting,” Coker said. “The studies should focus on health and wellness outcomes in children who are identified by this routine screening for speech and language delays and disorders and ... outcomes that include things like ... social, emotional health and academic performance or child health and well-being — the health outcomes that are important for kids.”

Coker also emphasized the need for studies focusing on populations of children who are at the most risk for speech and language delay and disorders, including “children who are impacted negatively by structural inequities, like Black, Latino and Native American children, and those from low-income households.”

Notably, the recommendation is only for asymptomatic children, not for those showing signs of difficulty or whose parents raise concerns about language development or speech. These children, according to the USPSTF, should be evaluated and receive treatment if needed.

In light of the scarce evidence, Coker said that primary care physicians should “use your clinical judgment to determine how to screen children who don't have signs or symptoms.”

The task force’s draft recommendation statement and draft evidence review are available for public comments, which can be submitted here until August 21.

References:

• Speech and language delay and disorders in children screening draft evidence review. https://uspreventiveservicestaskforce.org/uspstf/document/draft-evidence-review/speech-language-delay-disorders-children-age-5-years-younger-screening. Published July 25, 2023. Accessed July 24, 2023.
• Speech and language delay and disorders in children screening draft recommendation statement. https://uspreventiveservicestaskforce.org/uspstf/draft-recommendation/speech-language-delay-disorders-children-age-5-years-younger-screening. Published July 25, 2023. Accessed July 24, 2023.