Abstract
This study investigated predictors of decisions made by speech and language therapists (SLTs) to offer intervention for pre-school children and the children's outcomes relative to that decision. The study uses data from 347 children who were first assessed aged under 3 years 6 months by community speech and language therapists in the UK. Of these, 158 were offered therapy, 189 were either discharged or offered only monitoring appointments. After adjusting for the child's age and gender, six variables were significantly associated with the therapist's original decision: being a quiet baby, not using two word utterances or making comments on their play, being unintelligible to strangers and the child's score on auditory comprehension and expressive language scales of the Preschool Language Scales (PLS-3). These show a focus on communication variables rather than broader demographic and medical variables. At follow-up, aged 7 – 9 years, 56% of the children were available for re-assessment. Therapists' decisions at initial assessment show a sensitivity of .85 and a specificity of .61 relative to children's outcomes. Of the 191 children seen at follow-up, 21 were deemed to have ongoing difficulties.
Highlights
As clinicians delivering speech and language therapy (SLT) services we are under enormous pressure to make best use of our resources
This paper reports a study whose purpose is to understand more about how those decisions are made, which factors seem to be influential and importantly, what the outcomes are for children we decide not to take-on for intervention
In a mixed method investigation of therapists’ selection of preschool children for speech and language therapy, Roulstone (2001) identified sources of agreement and disagreement between therapists. They agreed about the categories or variables they investigated as they assessed a child and about the interpretation of the nature of the child’s problems; there was significant agreement about the relative priority of ten case profiles assessed by therapists
Summary
As clinicians delivering speech and language therapy (SLT) services we are under enormous pressure to make best use of our resources. In a mixed method investigation of therapists’ selection of preschool children for speech and language therapy, Roulstone (2001) identified sources of agreement and disagreement between therapists They agreed about the categories or variables they investigated as they assessed a child and about the interpretation of the nature of the child’s problems; there was significant agreement about the relative priority of ten case profiles assessed by therapists. Stothard et al (1998) in the later follow-up of these children, focus on the nature of the children’s deficits, whether specific language impairment or a more general delay The authors note the complex relationship between the severity of the impairment and the decision to intervene
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