S4A-24 SESSION 4A: GENERALITIES IN CRANIOSYNOSTOSIS – PART I A LONGITUDINAL AUDIT OF EARLY LANGUAGE ASSESSMENT OF CHILDREN WITH CRANIOSYNOSTOSIS AND IMPLICATIONS FOR THE DEVELOPMENT OF MULTI-DISCIPLINARY CARE

Abstract

Introduction: At Birmingham Children’s Hospital all children who present with single suture synostosis undergo speech and language assessment at 18 months, 3, 5, 7 and 10 years. Based on assessment findings and clinical judgement at these key ages, children are referred on to community speech and language therapy (SLT) services as required. An increase in referrals to the Birmingham Craniofacial Unit, and the subsequent increased demand on Speech and Language resources, highlighted the need to review the assessment care pathway, focusing on language assessment at 18 months, 3 years and 5 years of age. Methods: A retrospective, longitudinal audit of SLT notes of 87 children with single suture synostosis was carried out. Each child had undergone language assessment at 18 months, 3 years and 5 years of age. The outcomes for each child were categorised using a 3 point scale and were plotted and compared. Data on the nature of early intervention offered was also analysed. Results: The results showed that normal language assessment outcomes at 18 months are predictive of normal outcomes at 5 years in 84% of the cohort. The results also showed that 28% of children assessed at 18 months presented with language difficulties; all were given advice and/or referred onto the community SLT Service. By 5 years of age, 68% of the delayed children had improved to normal language levels. Conclusion: 15% percent of children with single suture synostosis in this audit had a language difficulties at 5 years of age. Detailed language assessment at 18 months by a trained SLT clinician has a predictive value for language outcomes at 5 years. It also allows for effective early intervention in the form of advice or referral to community SLT. Resource prioritisation and streamlining of care pathways for children with craniosynostosis were indicated and have now been implemented.