3 mistakes and 4 essential referrals
"Let's follow up and see how their speech is doing in a few months." Even though you may have seen this during training, and it might seem like a reasonable approach, it's no longer recommended.
Pull quote: EARLY DETECTION IS CRUCIAL
When a patient brings up their child's speech delay, make sure you don't delay the next steps. Don't make these mistakes!
Mistake 1: Skipping milestone checks.
Instead, be sure to conduct ongoing surveillance by always asking about milestones until at least age 4.
Red Flag: Not having 50 words at 2 years of age
Mistake 2: Using outdated excuses: 'they're bilingual' or 'they are the youngest, their older siblings speak for them.' Instead, use the same referral criteria for all.
Mistake 3: Delaying referral. Instead, do the essential referrals below, and don't wait for testing before pediatrics referral.
Here are 4 essential referrals to make for any child presenting with speech or developmental delay:
- Hearing test
- Speech-language pathology
- Vision assessment (for global developmental delay)
- Pediatrics or developmental pediatrics
A 'watchful waiting' approach is no longer recommended.
Don't delay referral as early intervention is key!
Sources
AFP 2023, 108(2):181-188.
CPS Position Statement. Paediatr Child Health 2018, 23(6):403–410.
CTFPHC 2016.
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