The evidence is still insufficient to recommend either for or against screening children aged 5 years and younger for speech and language problems in the primary care setting, according to a U.S. Preventive Services Task Force recommendation statement published online July 7 in Pediatrics.
The USPSTF last issued recommendations regarding this issue in 2006, when it concluded that the evidence was insufficient to assess the balance of benefits and harms of primary caregivers screening this patient population for speech and language delay and disorders. After reviewing the literature published since then, including 5 good-quality and 19 fair-quality randomized controlled trials, other systematic reviews, and cohort studies assessing 20 different screening tools, the current task force came to the same conclusion, said Dr. Albert L. Siu, chair of the task force and professor of population health science and policy at Mount Sinai Medical Center, New York.
As with the earlier recommendation statement, this one addresses only asymptomatic children aged 5 years and younger whose parents or clinicians do not have specific concerns about their speech, language, hearing, or overall development. Although some interventions can improve some measures of speech and language for some of these children, the evidence does not show whether primary care physicians’ use of the Ages and Stages Questionnaire, the Language Development Survey, the MacArthur-Bates Communicative Development Inventory, or other screening instruments ultimately improves speech or language disorders, academic achievement, behavioral competence, socioemotional development, or quality of life, Dr. Siu and his associates said ( Pediatrics 2015 July 7 [doi:10.1542/peds.2015-1711] ).
In contrast, the American Academy of Pediatrics recommends that developmental surveillance be incorporated at every well-child visit from birth through age 3 years, and that screening tests be administered at well-child visits at ages 9, 18, and 24 or 30 months.