Who Receives Speech/Language Services by 5 Years of Age in the United States?

Abstract

Purpose: We sought to identify factors predictive of or associated with receipt of speech/language services during early childhood. We did so by analyzing data from the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B; Andreassen & Fletcher, 2005), a nationally representative data set maintained by the U.S. Department of Education. We addressed two research questions of particular importance to speech-language pathology practice and policy. First, do early vocabulary delays increase children's likelihood of receiving speech/language services? Second, are minority children systematically less likely to receive these services than otherwise similar White children? Method: Multivariate logistic regression analyses were performed for a population-based sample of 9,600 children and families participating in the ECLS-B.Results: Expressive vocabulary delays by 24 months of age were strongly associated with and predictive of children's receipt of speech/language services at 24, 48, and 60 months of age (adjusted odds ratio range = 4.32-16.60). Black children were less likely to receive speech/language services than otherwise similar White children at 24, 48, and 60 months of age (adjusted odds ratio range = 0.42-0.55). Lower socioeconomic status children and those whose parental primary language was other than English were also less likely to receive services. Being born with very low birth weight also significantly increased children's receipt of services at 24, 48, and 60 months of age. Conclusion: Expressive vocabulary delays at 24 months of age increase children's risk for later speech/language services. Increased use of culturally and linguistically sensitive practices may help racial/ethnic minority children access needed services.

Subgroups in language trajectories from 4 to 11 years: the nature and predictors of stable, improving and decreasing language trajectory groups

“…Targeting interventions should be guided by cumulative risk models based on child and family factors identified as important to prognosis. These factors are considered when children present to specialist services; however, many children with low language do not (Morgan et al., ; Skeat et al., ). The application of cumulative risk models to targeting in communities ‘at risk’ of both language difficulties and limited access to services should be considered.…”

Risk of early neurodevelopmental outcomes associated with prenatal exposure to the antiepileptic drugs most commonly used during pregnancy: a French nationwide population-based cohort study

“…Speech therapists can also be consulted for various medical reasons, and access to speech therapists is associated with socioeconomic status. 41 Furthermore, because the study outcomes were limited to three subtypes of neurodevelopmental disorders (pervasive developmental disorders, mental retardation and visits to a speech therapist as a proxy for communication-related disorders), no conclusion can be drawn concerning all of the other subtypes of neurodevelopmental disorders.…”

The Changing Perception of Communication Needs—A Litmus Test for the Warnock Legacy

“…Approximately 8 per cent of children at school entry may have DLD (Norbury et al, 2016), making it as prevalent as childhood obesity (reported to be 7% Australian Bureau of Statistics, 2009) although this figure is likely to be much higher once children with less pronounced difficulties are included (Locke et al, 2002;Law et al, 2011) and when children across from across the social spectrum are compared (McKean et al, 2018). Access to services was an issue not directly addressed by Warnock but it is clear that it is not easy for all children to access the services they need and it is often the families who are most in need of these services who access them the least (Moore et al, 2015) and cost, availability and accessibility may also be issues (Ou et al, 2011;Morgan et al, 2016). A recent Australian study by Reilly and colleagues mapped the distribution of speech pathology services across metropolitan Melbourne and examined the level of need in these areas according to language vulnerability and social disadvantage (Reilly et al, 2016).…”