Clinical characteristics and outcomes of referrals for speech and language delay to the Speech Therapy and Audiology department at a district hospital in Gauteng, South Africa

Abstract

Background: Speech and language skills are essential for effective communication. Speech and language delays may have far-reaching consequences on a child’s development; their early identification and intervention are paramount to a child reaching their full potential.
Objectives: To describe the referral process, clinical characteristics, risk factors and outcomes of paediatric referrals to a Speech Therapy and Audiology (STA) department at a district-level hospital in Gauteng, South Africa.
Method: A retrospective record review was conducted on paediatric outpatient referrals to the STA department between the 01 January 2021 and 30 June 2022. Descriptive statistical analysis was performed on the categorical data. Associations between receptive and expressive language delays and the presence of maternal comorbidities or a bilingual household were analysed using the Chi-squared test and Fisher’s exact test.
Results: A total of 150 referrals were reviewed, with speech delay being the most common reason for referral (38%). Children under 2 years old accounted for 42% of the referrals. Of the children seen by the speech therapists and audiologists, 58 (49.2%) defaulted on follow-up appointments, and three (2.5%) were identified as having hearing loss. Twenty-eight children (23.7%) were referred for neurodevelopmental assessments, of whom 52% received a diagnosis of autism spectrum disorder (ASD). The mean age of ASD diagnosis was 49.54 months (standard deviation 11.47).
Conclusion: Understanding the clinical profile and outcomes of children referred to a STA department at a district-level hospital provides valuable insight into the vital role of the speech therapists and audiologists in early identification and intervention of children with speech and language delay.
Contribution: The STA departments at South African district hospitals are well-positioned for early identification and intervention, particularly for neurodevelopmental conditions, including ASD.