Timeliness of care received by children with speech and language disorders attending a speech therapy clinic at a tertiary care hospital

Abstract

Introduction: Speech and language therapy is an evolving field in the Sri Lankan health setting which enhances the quality of life of speech disabled children. However, timely identification and intervention is a key determinant in the success of speech therapy. Objective: To assess the timeliness of care received by children with speech and language disorders attending the Speech and Language Therapy Clinic at the Lady Ridgeway Hospital for Children, Colombo. Methods: A cross-sectional study design was used to collect data on timeliness of disease identification, care seeking and referral as well as the sources of identification, care seeking and referral. The time gaps between identification, care seeking and referral were calculated. Factors associated with timeliness of identification and the differences of time gap between various sub groups were analyzed. Results: Mean ages of identification, care seeking and referral of speech/language disorder were 15.3, 18.3 and 24.3 months respectively. Female sex, higher maternal education, being an extended family, positive family history and having an associated condition were significantly associated with earlier age of identification. The Medical Officer of Health team was involved in identification of only 11 (4.3%) children, despite the frequent encounters. The time gap between identification and care seeking was more than 3 months in 102 (40%) subjects. Multilingual family and having an employed mother were significantly associated with lesser time gap. The time gap between seeking of care and referral for speech therapy was more than 3 months in 96 (41.6%). Most (57.1%) parents had sought care from a doctor or other health worker in the primary health care setting. However, 236 (92.5%) of referrals were by a child specialist within or outside Lady Ridgeway Hospital. Altogether 79.6% of the study sample was referred for speech therapy before the age of 3 years. Conclusions: Current timeliness of disease identification and age of intervention is satisfactory but there is room for improvement with regard to the valuable time lost between identification to care seeking and referral. (Key words: Speech and language therapy; children; timeliness) Sri Lanka Journal of Child Health , 2014; 43 (3): 147-153 DOI: http://dx.doi.org/10.4038/sljch.v43i3.7374