Evidence to support language screening for all young children is weak
Doctors and new parents are eager to do everything they can to help young babies develop well. But the latest research shows that testing infants for signs of speech or language difficulties may not end up helping the young ones.
The U.S. Preventive Services Task Force, a government-appointed group of experts that reviews existing health and behavior data, analyzed the available studies on how effective screening for speech and language delays during infancy can be in improving children’s communication skills later. Most such screening is done by pediatricians during routine well-child visits and includes specific tests requiring parents to answer questions about their babies’ development, as well as the doctors’ own observations of the babies’ behavior and responses to verbal cues.
The task force reviewed 24 studies that looked at how accurate the most popular screening tools are. The trials involved children younger than five years old and revealed that the data is not strong enough to support using these studies as a reliable way to identify children who may have speech or language delays or who might have the early symptoms of language disorders.
The group came to a similar conclusion when it evaluated interventions designed to improve children’s development in speech and language areas. The studies showed inconsistent results and were of varying quality.
“There’s not enough evidence to say that these instruments should be used regularly,” says Dr. Alex Kemper, professor of pediatrics at Duke University and a member of the task force. “It could be that the instruments work well, and it could be that they don’t; we just don’t have enough evidence to say that all children ought to receive these tests at well-child visits routinely. We just don’t know whether or not they lead to benefit.”
In fact, the committee noted, the tests could contribute to harm, as the identification of potential problems could cause anxiety and result in time, effort and money spent by parents to address the problem. While an estimated 2.6% of children between ages three and five years received additional services for speech and language disabilities in 2007, the researchers say that many children who may be slower to develop speech or language skills eventually catch up and may not need specific services or interventions.
In his own practice, Kemper says that he employs the screening only when he or the parents of infants have concerns about a child’s language development. And that should be the guideline for other physicians and parents as well, he says—at least until stronger data can provide support for the idea of screening all infants, and for determining how to conduct the screening so that infants who need the most help can receive it.