Healthcare costs associated with language difficulties up to 9 years of age: Australian population-based study

PURPOSE: This study aimed to quantify the non-hospital healthcare costs associated with language difficulties within two nationally representative samples of children. METHOD: Data were from three biennial waves (2004-2008) of the Longitudinal Study of Australian Children (B cohort: 0-5 years; K cohort: 4-9 years). Language difficulties were defined as scores ≤ 1.25 SD below the mean on measures of parent-reported communication (0-3 years) and directly assessed vocabulary (4-9 years). Participant data were linked to administrative data on non-hospital healthcare attendances and prescription medications from the universal Australian Medicare subsidized healthcare scheme. RESULT: It was found that healthcare costs over each 2-year age band were higher for children with than without language difficulties at 0-1, 2-3, and 4-5 years, notably 36% higher (mean difference = $AU206, 95% CI = $90, $321) at 4-5 years (B cohort). The slightly higher 2-year healthcare costs for children with language difficulties at 6-7 and 8-9 years were not statistically different from those without language difficulties. Modelled to the corresponding Australian child population, 2-year government costs ranged from $AU1.2-$AU12.1 million (depending on age examined). Six-year healthcare costs increased with the persistence of language difficulties in the K cohort, with total Medicare costs increasing by $192 (95% CI = $74, $311; p = .002) for each additional wave of language difficulties. CONCLUSION: Language difficulties (whether transient or persistent) were associated with substantial excess population healthcare costs in childhood, which are in addition to the known broader costs incurred through the education system. It is unclear whether healthcare costs were specifically due to the assessment and/or treatment of language difficulties, as opposed to conditions that may be co-morbid with or may cause language difficulties.

Developmental language disorders and adolescent risk: a public-health advocacy role for speech pathologists?

Within the multi-disciplinary team concerned with child and adolescent development, speech pathologists are uniquely positioned to understand the nature and overall developmental significance of language acquisition in childhood and adolescence. Other disciplines contribute valuable insights about psychosocial development during the childhood and adolescent years. The field of developmental psychology, for example provides a large and convincing body of evidence about the role of academic success as a protective factor against a range of psychosocial harms, in particular substance misuse, truancy, early school leaving, and juvenile offending. In this paper, we argue that juvenile offending embodies the notion of "adolescent risk", but in Australia in particular, has been under-investigated with respect to possible associations with developmental language disorders and subsequent academic failure. We present findings pertaining to a sample of 30 male juvenile offenders completing community based orders. Performance on a range of oral language processing and production skills was poorer than that of a demographically similar comparison group. Our results confirm the need to conceptualize language within a broader risk and protective framework. We therefore emphasize the public health importance of early language competence, by virtue of the psychosocial protection it confers on young people with respect to the development of prosocial skills, transition to literacy and overall academic achievement. We argue that speech pathologists are best positioned to advocate at a policy level about the broader public health importance of oral language competence.

Building a model of support for preschool children with speech and language disorders

Speech and language disorders impede young children’s abilities to communicate and are often associated with a number of behavioural problems arising in the preschool classroom. This paper reports a small-scale study that investigated 23 Australian educators’ and 7 Speech Pathologists’ experiences in working with three to five year old children with speech and language disorders. The participants responded to a questionnaire relating to the types of SaLD; social and emotional challenges experienced by children; their role in providing support and issues confronting both professions. The findings highlighted that educators play a valuable role in supporting children’s speech and language disorders through the social context of the preschool classroom. Furthermore inter-professional practice between Speech Pathologists and educators was viewed as highly valuable. Drawing upon these findings, a model of support is presented to improve interventions for holistic development.