Rise in Speech-Language Disorders in SSI-Supported Children Reflects National Trends A new national report reviews the prevalence and implications of speech-language disorders for children living in poverty. Policy Analysis
Free
Policy Analysis  |   March 01, 2016
Rise in Speech-Language Disorders in SSI-Supported Children Reflects National Trends
Author Notes
  • Lemmietta McNeilly, PhD, CCC-SLP, is ASHA chief staff officer for speech-language pathology. lmcneilly@asha.org
    Lemmietta McNeilly, PhD, CCC-SLP, is ASHA chief staff officer for speech-language pathology. lmcneilly@asha.org×
Article Information
Regulatory, Legislative & Advocacy / Policy Analysis
Policy Analysis   |   March 01, 2016
Rise in Speech-Language Disorders in SSI-Supported Children Reflects National Trends
The ASHA Leader, March 2016, Vol. 21, online only. doi:10.1044/leader.PA2.21032016.np
The ASHA Leader, March 2016, Vol. 21, online only. doi:10.1044/leader.PA2.21032016.np
The conclusion of a national report—that the growing prevalence of children receiving federal disability benefits for speech and language disorders mirrors trends in the general population— is foundational to future policy, practice and research initiatives.
The total number of children receiving public benefits for speech and language impairment from 2004 to 2014 increased from 78,827 to 213,688 children—a 171 percent increase—according to Speech and Language Disorders in Children: Implications for the Social Security Administration’s Supplemental Security Income Program. The report was issued by the National Academies of Sciences, Engineering and Medicine in response to the Social Security Administration’s request to examine trends in the prevalence of speech and language disorders among all children living in the U.S. and to compare them with those of children who receive Supplemental Security Income (SSI) benefits for treatment of the disorders.
The committee conducting the investigation included experts from speech-language pathology, neurology, psychiatry, psychology, pediatrics, law, social work and special education. Its report details the current status of speech-language diagnosis and treatment; the level of impairment these disorders cause in children; past and current trends in the prevalence and persistence of speech and language disorders in U.S. children; and comparison of these trends with those in the SSI childhood disability population.
To qualify for SSI benefits for a speech or language disorder:
  • A child must be from a family living in poverty.

  • A child must present with speech and language delays that are more than 2–3 standard deviations below the mean.

  • The disorders must persistently affect the child’s ability to function and learn.

  • The disorders must require strategies to facilitate the child’s ability to function in school, home and the community.

The report highlights the long-term and profound impact of severe speech and language disorders on children and their families. The severity level and persistence of the disorders, combined with other risk factors such as poverty, can increase a child’s risk for mental health disorders, learning disabilities, behavior disorders, poor academic achievement, and chronic underemployment.
The report also indicates that:
  • More research is needed on epidemiology of speech and language disorders to enhance understanding of prevalence, variability by race, ethnicity and socioeconomic factors.

  • Speech and language disorders affect 3 percent to 16 percent of children living in the U.S.

  • Twenty-six percent of children with speech and language disorders live in poor or low-income households; 21 percent of children who did not present with speech and language disorders live in poverty.

  • Children in low-income families are more likely than the general population to exhibit disabilities, including speech and language disorders. Of the 0.31 percent of children living in the U.S. who receive SSI benefits for speech and language disorders, 16 percent were receiving them for a primary speech and language impairment.

  • About 40 percent of SSI children with severe speech and language disorders had one other condition, including intellectual disability, autism spectrum disorder, attention deficit hyperactivity disorder, and other neurodevelopmental and behavioral disorders.

The report found that the benefits of treatment vary—children’s ability to function increased with intervention in some areas, but some delays persisted. With persistent delays, the children continue to be medically eligible for services, resulting in low SSI attrition rates.
The findings of this report reinforce the need for clinical research on the factors that contribute to the increased prevalence of speech and language disorders in young children and the need for more research to understand the driver of these trends.
The report concludes that:
  • Severe speech and language disorders represent a serious threat to children’s social, emotional, education and employment outcomes.

  • The total number of children receiving SSI for speech and language disorders more than tripled in the last decade. Additionally, prevalence of these disorders in the general U.S. child population is primarily explained by two factors:

  • Speech and language disorders affect between 3 and 16 percent of children living in the U.S.

  • Children of families with low incomes are more likely than the general population to have disabilities, including speech and language disorders.

  • The best evidence available indicates an increase in the prevalence of speech and language disorders over the past decade in the U.S. child population.

  • Children with mild to moderate speech and language disorders benefit from a variety of treatment approaches.

  • Treatment of children with severe speech and language disorders improves function; however substantial functional limitations persist for most of these children.

  • Severe speech and language disorders are debilitating at any age but their effects on children are particularly serious because of their widespread adverse effects and the cumulative nature of these negative consequences over time.

  • Severe speech and language disorders may be one of the earliest detectable symptoms of other serious neurodevelopmental conditions and are important entry points for early intervention.

  • The three-fold increase in the number of children receiving SSI for speech and language disorders more than tripled over the last decade is explained primarily by two factors: The introduction of a new SSI impairment code for speech and language disorders in 1994, and the continuing eligibility of children whose severe speech and language disorders persist throughout childhood.

As speech-language pathologists assess children to determine their eligibility for speech and language impairment in the SSI program, they should be aware of the report findings and their impact on clinical practice. Identification of strategies that enhance a child’s ability to function in a variety of settings will help the child acquire additional skills and improve the child’s functional communication.
0 Comments
Submit a Comment
Submit A Comment
Name
Comment Title
Comment


This feature is available to Subscribers Only
Sign In or Create an Account ×
FROM THIS ISSUE
March 2016
Volume 21, Issue 3