Screening for language and speech delay in children under five years
1Barcelona Institute for Global Health, University of Barcelona, Barcelona, Spain. sophjullien@gmail.com.
Insights
Universal screening for childhood language and speech delay lacks evidence of effectiveness and potential harms. Targeted interventions show some benefit, but their impact on screened children is unproven.
Area of Science:
- Pediatrics
- Developmental Psychology
- Speech-Language Pathology
Background:
- Language and speech delays affect young children's development.
- Early detection through screening is often recommended.
- Evidence on the effectiveness of universal screening is limited.
Purpose of the Study:
- To review evidence on universal screening for language and speech delay in children under 5.
- To assess short- and long-term outcomes of screening and interventions.
- To evaluate the accuracy of screening tools and potential harms.
Main Methods:
- Literature search up to November 2019.
- Systematic review of recommendations and evidence.
- Summarized accuracy of screening tests and efficacy of interventions.
Main Results:
- Screening tools vary widely in accuracy.
- Targeted interventions improve some outcomes, but evidence for screened children is lacking.
- No evidence shows universal screening improves outcomes or identifies harms.
Conclusions:
- The effectiveness of universal screening for language and speech delay is not established.
- More research is needed on the benefits and harms of screening and interventions.
- Current evidence does not support universal screening in primary care settings.
Abstract:
We looked at existing recommendations and supporting evidence on the effectiveness of universal screening for language and speech delay in children under 5 years of age for short- and long-term outcomes.We conducted a literature search up to the 20th of November 2019 by using key terms and manual search in selected sources. We summarized the recommendations and the strength of the recommendation when and as reported by the authors. We summarized the main findings of systematic reviews with the certainty of the evidence as reported on the accuracy of the screening tests for detecting language and speech delay, the efficacy of existing interventions for children with language and speech delay, and the potential harms associated with screening and the associated interventions.Several screening tools are used to assess language and speech delay with a wide variation in their accuracy. Targeted interventions improve some measures of speech and language delay and disorders. However, there is no evidence on the effectiveness of such interventions in children detected by screening with no specific concerns about their speech or language before screening. There is no evidence assessing whether universal screening for language and speech delay in a primary care setting improves short and long-term outcomes (including speech and language outcomes and other outcomes). Finally, there is no evidence on the harms of screening for language and speech delay in primary care settings, and there is limited evidence assessing the potential harms of interventions.
