Voice, Speech, and Language Problems in the U.S. Pediatric Population: The 2012 National Health Interview Survey (NHIS)

INTRODUCTION:  Communication is essential to early child development, yet many speech and language disorders go untreated.  Increasing the proportion of young children with communication disorders who receive treatment is a United States public health objective included in Healthy People 2020.

METHODS:  To obtain data, the National Institute on Deafness and Other Communication Disorders collaborated with the National Center for Health Statistics to fund a Voice, Speech and Language (VSL) Supplement to the 2012 NHIS, a nationally-representative household interview survey that includes a child health questionnaire.  Parents reported on their children’s voice, swallowing, speech, and language problems and provided age at onset, duration, severity, and visits to health care professionals for evaluation/treatment.  The  sample comprised 13,275 children aged <18 years, a 90.7% response rate conditional on successful family interview, or 69.7% after accounting for household and family non-response.                                               

RESULTS:  Based on 4,202 sample children 3–8 years of age, representing 24.1 million U.S. children, the prevalence of VSL problems lasting one week or longer during the last 12 months was 10.0%.  Multivariable logistic models showed increased risks for:  males, odds ratio (OR)=2.1, 95% confidence interval (CI):1.5-2.9; younger age (3-5 vs. 6-8), OR=1.8 (CI:1.3-2.4); non-Hispanic (NH) black (vs. NH white), OR=2.0 (CI:1.3-3.1); seizures, OR=2.9 (CI:1.0-8.4); first spoken word >=15 months, OR=3.2 (CI:1.9-5.3); anemia, OR=2.6 (CI:1.1-1.6); chronic ear infections, OR=1.9 (CI:1.2-3.5); strep/tonsillitis last year, OR=1.7 (CI:1.1-2.7); dental pain, OR=2.2 (CI:1.3-3.5); other developmental delay, OR=8.8 (CI:5.5-14.1); learning disability, OR=7.5 (CI:4.4-12.8).  The proportion receiving VSL healthcare last year was 60.3%, increasing to 74.1% for problems with “moderate or worse” severity.  The most common healthcare providers were speech-language pathologists, 42.8%, early intervention specialists, 25.3%, and occupational/physical therapists, 8.2%.

CONCLUSIONS:  VSL problems can be more severe when accompanied by other disorders, however, many manifest as idiopathic conditions.  When left untreated, VSL problems may have serious lifelong consequences.