Speech disorder diagnoses in children doubled during COVID, Komodo Health finds

Speech disorder diagnoses in children more than doubled during the pandemic, a new analysis by Komodo Health shows. 

The rate of new diagnoses increased progressively as the pandemic continued. About 1.5 million children ages 0 to 12 received a new diagnosis in 2022, up from an average of 570,000 from 2018 and 2019 combined. 

Infants and children up to age 2 were most impacted, with a 136% increase in diagnoses in 2022 compared to the pre-pandemic rate. Developmental milestones in this age group make them especially vulnerable to speech problems associated with change, the Komodo research brief said. They also faced the most time without a vaccine approval and many did not start daycare as early as is typical.

Diagnoses for pediatric speech delays soared even as evaluations remained stable — pre-pandemic, there were nine newly diagnosed patients for every 100 speech assessments performed for ages 0 to 12. In 2022, that jumped to 21 newly diagnosed patients for every 100 assessments. 

The latest analysis builds on other work Komodo has done on COVID-related delays in care, medical director Tabby Khan, M.D., told Fierce Healthcare. 

“The pandemic resulted in this drop off in anything that was considered elective or preventative care,” Khan said. But behavioral health interventions are often overlooked in such data. 

The past three years have been demonstrably challenging for parents and their children, with COVID-19 social distancing restrictions and mask mandates reducing socialization. While there isn’t clear evidence to support the claim that masking drives speech development delays, experts have expressed concern about some students, like those with autism, adapting to a changing environment. 

The Centers for Disease Control & Prevention guidance on universal indoor masking does not take into account speech or language impairment as a condition for exemption, the brief noted. And masking was an expectation in other settings beyond school. Children already receiving speech-language therapy transitioned to remote sessions, which can be tough for young kids, or to masked in-person sessions, which can be disruptive.

While screening for speech disorders is typically a regular part of pediatricians’ practice, it’s possible providers were especially diligent during COVID-19, Khan suggested. 

The consequences of leaving speech disorders untreated can be serious — from behavioral challenges to difficulty making friends. That affects the rest of one’s life, and the longer they wait to get treatment, the harder it becomes to treat

“The earlier you intervene, the better outcomes actually end up being,” Khan said. Disparities are no doubt more pronounced for children of color, she added.

Pediatricians can help, such as using the Denver Developmental Screening Test, Khan said. They should also look for responses to verbal cues in infants. Teachers who observe a child falling behind should refer them to treatment. 

However, identifying a problem, or screening, isn’t enough: “My mentality is always how does this impact the care we are delivering to the patient,” Khan said.

Moving forward, it will be important to also capture patients that have yet to be diagnosed, since delays in treatment have their own consequences. Khan didn’t rule out the possibility of tracking kids who actually get care and whether they meet appropriate developmental milestones and progress out of speech therapy.