Children Evaluated for Speech and Language Concerns: One Year Outcomes
Davis, Tonia Nicole
There is an ongoing need for public health information in pediatric speech-language pathology and newly adopted electronic health record procedures in clinics provide an opportunity to address this need. One-year outcomes of 198 children first seen for speech-language evaluation between 18-30 months in an outpatient clinic at the Vanderbilt Bill Wilkerson Center were examined in this project. The following predictors of initial enrollment and discharge or retention in treatment are considered: receptive language, medical history, and access to resources. The results indicated that children with lower receptive and expressive language were more likely to be referred to treatment (n=154). Children who lived closer to the clinic were more likely to enroll in treatment (n=67). Of the children whose medical record include both treatment and outcome, 13% demonstrated positive outcomes as defined by discharged from treatment due to meeting goals or reaching normal limits. Positive outcomes could be predicted by high receptive language, lack of comorbid medical history, and high income based on zip code data. 60% of the cases remained in treatment either at Vanderbilt or in the local school system. Retention after the first year could be significantly predicted by low receptive language. In addition, attrition from treatment as defined by discharged due to non-attendance accounted for 16% of the sample. The remaining 10% are children who were discharged by parent request, often due to the family relocating outside the Nashville region. Moreover, the project illustrates how electronic medical records can yield interpretable and useful public health data. The clinical and public health significance of these results are discussed.