Recommendations for Speech and Language Screenings

Abstract

A recent Evidence Report from the US Preventive Services Task Force (USPSTF) 1,2 highlights a persistent gap in research regarding preventive care services for children showing no obvious signs or symptoms of speech and language delay and disorder. In the accompanying Recommendation Statement, 3 the task force concludes that the "evidence is insufficient to assess the balance of benefits and harms of screening for speech and language delay and disorders in children 5 years or younger without signs or symptoms (I statement)." The USPSTF recommendation was determined based on the general lack of evidence for screening rather than the absence of sound findings on the topic of speech and language delays, which underscores the importance of prioritizing research in this area to fill the current knowledge gaps. Given the rigorous data-driven approach of the USPSTF to evaluate the current evidence base, we as speech-language pathologists agree with the conclusions.Contained within the USPSTF Recommendation Statement is the acknowledgment, shared by the American Speech-Language-Hearing Association (ASHA), that speech and language delays/disorders can have adverse effects on educational, social, and mental health outcomes. 4 As speech-language pathologists, we are concerned about the number of children and families that could benefit from speech and language interventions. Robust research is essential to endorsing universal screening, but resources and time are needed to establish this evidence base. Notably, in the 8 years since the previous recommendation in 2015, there has been no new evidence to evaluate the utility of universal screening. 5 Children and families cannot wait, and it is necessary to consider the potential harm caused by the misinterpretation of USPSTF findings and discuss the steps that pediatric primary care clinicians can take in the interim.The USPSTF finding of insufficient evidence applies to "Asymptomatic children 5 years or younger whose parents or clinicians do not have specific concerns about their speech, language, hearing, or development." 3 In other words, there is not sufficient evidence to recommend universal screening for all children, particularly those not showing any signs of speech or language delay. However, the USPSTF recommendation does not apply to children whose parents or pediatric primary care clinicians are concerned about a child's speech and language development. For those children whose parents or pediatric primary care clinicians are concerned about speech and/or lan-