Speech pathology and early intervention – when should I refer?

Speech pathologists increasingly are advocating early intervention for children with suspected speech and /or language delay, and want to promote the message to GPs that a “wait and see” approach is not supported by recent research. Early intervention in speech pathology refers to services that are provided to infants and toddlers (birth to 3 years) who have, or are at risk for speech, language, feeding, and/or emergent literacy problems. While there is evidence of huge variability in children’s language development, and many “late talkers” turn out to be “late bloomers”, the decision regarding the risk of ongoing language delay in a child is much more than the absence or delay of first words and phrases.

There are much more critical and wide-ranging skills (social, cognitive, and linguistic), which are important foundations and are known to underpin the “typical” development of language and communication. Speech Pathologists can evaluate early developing and very basic skills in social responsiveness, joint attention, and understanding of intentions that normally emerge prior to verbal communication and develop through the first and second years of life. Recent research findings suggest that impairment of these “sociocognitive skills” contribute to, and may even be responsible for later social communication problems, and they are a relatively strong predictor of language outcomes.

The development of communication skills begins at birth through everyday loving interactions with others—sharing books, telling stories, singing songs, and taking turns. In the first 3 years, infants and toddlers begin understanding and acquiring the first of thousands of words they will use throughout their lives. Like other areas of development, communication skills are cumulative, and therefore the efficient acquisition of skills in later childhood is affected by the preceding skill set. Research has shown that the toddler and preschool years are a critical period for mastery of the words, grammatical structure, accent and rhythm of a language.

Speech and language difficulties can affect learning at school including literacy, numeracy and interacting socially with other children. Well documented, long term implications of speech and language impairment include poor academic achievement, risk to mental health, reduced employment options and social isolation. Specifically, children with communication disorders often have poorer skills in phonological skill areas that are crucial for reading development, (e.g. these children are six times more likely to have a reading problem than children without language impairment).

Early intervention is critically important to preventing or reducing the lifelong implications for many Australians living with communication impairment, can directly target sociocognitive skills, as well as strengthen pre‐literacy skills and school readiness.

In conclusion, speech pathologists encourage early referral, as soon as there is an indication or concern, as there is much that can be done to reduce the likelihood of social, learning or literacy difficulties associated with speech or language delay.

Magdalen Rozsa
Speech Pathologist.
30 August 2014