Neurology
Voice, Swallowing, Speech, and Language Problems in the United States Pediatric Population: The 2022 National Health Interview Survey (NHIS) Howard J. Hoffman* Howard J. Hoffman Chuan-Ming Li May S. Chiu Stephen M. Tasko Mabel L. Rice
Communication is essential to early child development, yet many speech and language disorders go untreated. Increasing the proportion of children who receive treatment is a US public health priority included in Healthy People 2030. A Voice, Speech and Language (VSL) Supplement was included in the 2022 National Health Interview Survey (NHIS), the principal source of information on the health of the US civilian noninstitutionalized population. A nationally representative sample (n= 6,125), representing 60.7 million children aged 3-17 years, is analyzed. Parents reported on their children’s communication disorders (CD) of voice, swallowing, speech, or language, including the duration, severity, changes in past year, and healthcare visits for evaluation/treatment. An estimated five million children had CD lasting one week or longer during the last 12 months, a prevalence of 8.3% (12.6%, 6.6%, 5.9% by age groups, 3-7, 8-12, and 13-17 years). Males had a higher CD prevalence, 9.5% [95% confidence interval (CI): 8.4%-10.8%], compared to females, 7.1% [95% CI: 6.1%-8.2%]. Speech disorder prevalence was 5.9%, language, 3.6%, voice, 1.6%, and swallowing, 0.8%. CD prevalence increased significantly with decreasing parental education and household income. Health conditions associated with CD were poorer general health, early developmental delay, learning disability, sensory impairment (vision, hearing, and motor), anxiety or depression, and asthma. The proportion receiving healthcare last year was 49.1% for moderate and 74.3% for worse problems. Diagnosis with COVID-19 was not associated with increased CD, but likely led to fewer healthcare visits during the pandemic. Healthcare providers included speech-language pathologists, early intervention specialists, and occupational/physical therapists. VSL problems can be more severe when accompanied by other disorders, however, many manifest as idiopathic. When left untreated, VSL problems may have serious lifelong consequences.