USPSTF: Insufficient evidence to screen for speech, language delay in asymptomatic kids
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Key takeaways:
- Clinicians should use their judgment when deciding to screen for speech and language delay, the task force said in its final recommendation on the issue.
- Experts called for more research on both the harms and benefits of screening.
There is not enough evidence to assess the benefits and harms of screening asymptomatic young children for speech and language delay and disorders, the U.S. Preventive Services Task Force ruled in a final recommendation.
Instead, clinicians should use their judgment when determining if screening and treatment are needed.
The I grade recommendation, published in JAMA, is consistent with the task force’s draft recommendation in July 2023 and its 2015 final recommendation on the topic.
“Caring for children with speech and language delay and disorders is incredibly important; however, the task force found that there is not enough evidence to tell us whether or not it is helpful to screen children 5 years and younger who do not have signs or symptoms,” USPSTF member Tumaini Rucker Coker, MD, MBA, said in a press release.
According to a 2023 report from technology platform company Komodo Health, the number of children aged 0 to 12 years with a speech delay or disturbance diagnosis doubled during the COVID-19 pandemic, whereas new diagnoses in youth aged 3 to 5 years increased by 107%.
The task force’s recommendation was based on a review of 38 studies (n = 9,006), although no studies evaluated the direct benefits of screening vs. no screening.
“We are urgently calling for more evidence, particularly for those who are more likely to experience speech and language delay and disorders, such as Black and Hispanic or Latino children, as well as children in households with low incomes,” Coker said.
The task force also called for more literature on the potential harms of screening and treatment, which may include caregiver anxiety, stigma, labeling and further social harms.
The USPSTF noted that this recommendation applies only to asymptomatic children, and that children who show signs of difficulty — or whose parents express concerns over speech and language delays — should be evaluated and given treatment, if needed.
“Speech and language are the building blocks of development, so delays and disorders can be hard for kids and their families,” task force member Li Li, MD, PhD, MPH, said in the release. “In the absence of evidence, health care professionals should use their judgment when deciding whether or not to screen children who are not showing signs of speech and language delay and disorders.”
In a related editorial, Marisha L. Speights, PhD, CCC-SLP, an assistant professor of communication sciences and disorders at Northwestern University, and colleagues reiterated the need for greater research on the harms and benefits of speech and language screening.
“Understanding how current screening tools support not only early identification but also access to early intervention for all children with speech and language delays/disorders is critical for maximizing long-term academic outcomes and reducing disparities,” they wrote. “Given the USPSTF findings, federal funding agencies should make this a priority research area.”
References:
- Felter C, et al. JAMA. 2024;doi:10.1001/jama.2023.24647.
- Louder than words: Pediatric speech disorders skyrocket throughout pandemic. https://www.komodohealth.com/hubfs/2023/Speech_Pathology_Research_Brief.pdf. Accessed Jan. 18, 2023.
- Speights M, et al. JAMA. 2024;doi:10.1001/jama.2023.26817.
- USPSTF. JAMA. 2024;doi:10.1001/jama.2023.26952.
- U.S. Preventive Services Task Force issues final recommendation statement on screening for speech and language delay and disorders in children. https://www.uspreventiveservicestaskforce.org/uspstf/sites/default/files/file/supporting_documents/speech-language-delay-screening-children-final-rec-bulletin.pdf. Published Jan. 23, 2023. Accessed Jan. 23, 2023.