Prevalence and Risk Factors of Speech and Language Delay in Children Less Than Three Years of Age

Abstract

Background: There is a large amount of data on the prevalence and risk factors of speech and language delay from the West, but relatively scanty data from India. Objectives: The aim of this study was to assess the prevalence and risk factors of speech and language delay in children less than three years old, using the Langauge Evaluation Scale Trivandrum (LEST 0-3). Materials and Methods: A descriptive, cross sectional study was conducted in the under-five clinic of our institute, on a sample of 200 children, less than three years old. Language was assessed using Language Evaluation Scale Trivandrum (LEST 0-3) and development in other domains was assessed using the Trivandrum Development Screening Chart (TDSC). The Home Screening Questionnaire (HSQ) was used to assess the home environment. Various biological and environmental risk factors were analyzed. Results: The prevalence of speech and language delay was found to be 27%. In univariate analysis, parameters found to be significantly associated with speech and language delay were male gender, poor home environment (score ≤ 19 in the Home Screening Questionnaire) and family history of speech and language delay. In multivariate analysis, poor home environment (CI = 0.20 - 0.80, P = 0.01) and positive family history (CI = 0.09 - 0.72, P = 0.01) were significant risk factors. There was a significant association between delay in TDSC and speech delay. However, TDSC alone had a low sensitivity of 33% in detecting speech and language delay. Conclusions: Prevalence of speech and language delay is high (27%) in children less than three years of age attending the Under-Five clinic for at-risk children. Negative home environment and family history of speech and language disorders are significant risk factors for speech and language delay. The strong association of speech delay with delay in TDSC reemphasizes the need for a complete developmental assessment in any child with speech delay. The TDCS alone fails to detect significant number of cases of speech delay, showing the need to perform a separate speech screening test.