Re: NY Times article on speech delays in boys

[Guest guest]

Pediatric journal here is the abstract not able to access full study yet

maybe someone else can access it.

[Guest guest]

> Pediatric journal here is the abstract not able to access full

study yet

> maybe someone else can access it.

>

>

>

tehttp://pediatrics.aappublications.org/cgi/content/abstract/113/2/274

xt portions of this message have been removed]

[Guest guest]

Thanks!

Here is a bit more on this with the actual article from the Times and both

abstracts I found on it.

Basically this is a " heads up " to those with late talkers (most are boys):

TIMES NEWS TRACKER

VITAL SIGNS

Disparities: Boy Talk Takes a Back Seat

By JOHN O'NEIL

Published: February 3, 2004

Even though boys are more likely than girls to have developmental

disabilities involving language, doctors appear more likely to refer

girls for further evaluation than boys, a new study shows.

The study's lead researcher, Dr. Sices of Case Western Reserve

University in Cleveland, said the results showed that " the myth is

still out there that being male can be an adequate explanation for a

speech delay. "

In the study, published on Sunday in the journal Pediatrics, Dr.

Sices noted that while pediatricians and family physicians had

increased their screenings for developmental problems, many early

warning signs were still missed.

She cited figures showing that fewer than half of the young children

considered eligible for special services were identified before

kindergarten.

To help uncover what factors contributed to the missed opportunities

for early diagnosis, Dr. Sices sent a survey to a random sample of

the nation's pediatricians and family physicians. The survey,

completed by 427 physicians, outlined a series of hypothetical

vignettes and asked what action would be taken in each case.

When a hypothetical situation involved an 18-month-old who was

failing to meet developmental milestones for speech, doctors were 60

percent more likely to refer a girl for further testing than a boy.

" There's a kind of a sense when you see that in a boy that he'll

catch up, that he's just a late talker, " Dr. Sices said. In fact,

she added, the opposite is true. Disorders involving serious speech

problems are twice as likely to be diagnosed in boys as girls, Dr.

Sices said.

" Both boys and girls benefit greatly from early detection of

language delays, " she said.

http://www.nytimes.com/2004/02/03/health/03DISP.html?ex=1076389200 & en=a2a2f39433\

21c248 & ei=5062 & partner=GOOGLE

How do primary care physicians manage children with possible

developmental delays? A national survey with an experimental design.

Sices L, Feudtner C, McLaughlin J, Drotar D, M.

Division of Behavioral Pediatrics and Psychology, Rainbow Babies and

Children's Hospital and Case Western Reserve University, Cleveland,

Ohio 44106-6038, USA. .Sices@...

OBJECTIVE: Although early detection and treatment of developmental

delays can improve outcome, little is known about factors that

influence how primary care physicians manage young children with

probable developmental delays. The objective of this study was to

describe physician referral practices for children with

developmental delays and to test whether the probability of referral

is increased by 1) the expression of parental concern; 2) female

gender in a child with language delay; 3) disruptive, as opposed to

avoidant behaviors; and 4) physician characteristics, including

female gender or being a pediatrician. METHODS: A cross-sectional

survey was mailed to a national random sample of 800 pediatricians

and 800 family practice physicians in primary care practice, using

an experimental randomized block design. Recipients randomly

received alternative variants of clinical vignettes, which differed

only in regard to the variable specific to each of the first 3

hypotheses. Physicians answered questions about the likelihood of

referral on a 5-point scale for listed referral options. Hypotheses

were tested using multivariable logistic regression modeling. A

total of 55% of pediatricians and 43% of family practice physicians

returned the survey, for an overall response rate of 49%. RESULTS: A

girl with language delay was 60% more likely to be referred to

audiology than a boy (odds ratio: 1.6; 95% confidence interval: 1.1-

2.3), and respondents who were female or pediatricians were more

likely to refer patients. The expression of parental concern did not

increase the probability of referral to diagnostic and treatment

services, and avoidant rather than disruptive patient behaviors were

associated with an increased probability of referral. CONCLUSIONS:

Patient gender and type of behavioral presentation seem to influence

referrals to diagnostic and treatment services for young children

with probable developmental delays described in clinical vignettes.

These findings can guide targeted educational interventions to

increase rates of detection and referral for young children with

developmental delays.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

4754938 & dopt=Abstract

How do primary care physicians identify young children with

developmental delays? A national survey.

Sices L, Feudtner C, McLaughlin J, Drotar D, M.

Department of Pediatrics, Case Western Reserve University,

Cleveland, Ohio, USA. .Sices@...

Little is known about the current practices of primary care

physicians regarding developmental surveillance and screening during

pediatric preventive care visits. We conducted a mailed survey of a

random national sample of pediatricians and family physicians to

describe their practices and identify factors that predict use of

developmental screening tools, an efficacious way of identifying

children with developmental delays. Most physicians reviewed

developmental milestones and prompted parents for developmental

concerns at preventive care visits. Approximately half of the

physicians used a formal developmental screening instrument. Female

physician gender predicted higher rates of use of screening tools

for family physicians, but not for pediatricians. Most physicians

seemed committed to the early diagnosis of developmental delays.

Substantial variability in surveillance and screening practices,

barriers of time and reimbursement, and under-reliance on parent-

completed questionnaires underscore areas for improvement.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

4671474 & dopt=Abstract

=====