Predictors and outcomes of speech and language therapists' treatment decisions

Abstract

This study investigated predictors of decisions made by speech and language therapists (SLTs) to offer intervention for pre-school children and the children's outcomes relative to that decision. The study uses data from 347 children who were first assessed aged under 3 years 6 months by community speech and language therapists in the UK. Of these, 158 were offered therapy, 189 were either discharged or offered only monitoring appointments. After adjusting for the child's age and gender, six variables were significantly associated with the therapist's original decision: being a quiet baby, not using two word utterances or making comments on their play, being unintelligible to strangers and the child's score on auditory comprehension and expressive language scales of the Preschool Language Scales (PLS-3). These show a focus on communication variables rather than broader demographic and medical variables. At follow-up, aged 7 - 9 years, 56% of the children were available for re-assessment. Therapists' decisions at initial assessment show a sensitivity of .85 and a specificity of .61 relative to children's outcomes. Of the 191 children seen at follow-up, 21 were deemed to have ongoing difficulties.</p