Criteria for determining disability in speech-language disorders
Agency for Healthcare Research and Quality
Record ID 32002000326
English
Authors' objectives:
Approximately 42 million Americans have some type of communication disorder, costing the nation $30 billion to $154 billion for lost productivity, special education, and medical care annually. The quality of the numerous evaluation procedures and instruments for clinical decisionmaking about language, speech, or voice disorders influences decisions about access to services and funding (e.g., special education services, Social Security disability income). The RTI-University of North Carolina at Chapel Hill Evidence-based Practice Center conducted a systematic review of the literature to address two key questions about evaluating and diagnosing speech and language disorders in adults and children of particular concern to the Social Security Administration in making disability eligibility determinations: (1) What instruments have demonstrated reliability, validity, and normative data? (2) Do these instruments have predictive validity for an individual's communicative impairment, performance, or both?
Authors' results and conclusions:
Among language disorder instruments, one (of three) for adults and four (of eight) for children met or nearly met our evaluation criteria for reliability and validity; two child-specific instruments provided data for subpopulations. Although these five instruments had norms, only the child-specific instruments provided nationally representative data. Two (of three) instruments for voice disorders met evaluation criteria; speech disorder instruments did not. Only four studies gave information on prediction of future communicative functioning and impairment.
Authors' recommendations:
Reliability and validity data for the majority of instruments rarely came from peer-reviewed literature; instrument manuals yielded most such data. Some manuals provided comprehensive data from well-conducted standardization studies; most did not. Because normative data were usually not derived from nationally representative samples, generalizing results beyond the populations studied was difficult. Sample size and representativeness problems limited the predictive validity studies. Overall, evidence about diagnostic or predictive properties of instruments addressing language, speech, and voice disorders is weak and incomplete at this time. The sparse evidence base suggests a substantial methodologic, clinical, and policymaking research agenda.
Authors' methods:
Systematic review
Details
Project Status:
Completed
Year Published:
2002
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
United States
MeSH Terms
- Communication Disorders
- Language Disorders
Contact
Organisation Name:
Agency for Healthcare Research and Quality
Contact Address:
Center for Outcomes and Evidence Technology Assessment Program, 540 Gaither Road, Rockville, MD 20850, USA. Tel: +1 301 427 1610; Fax: +1 301 427 1639;
Contact Name:
martin.erlichman@ahrq.hhs.gov
Contact Email:
martin.erlichman@ahrq.hhs.gov
Copyright:
Agency for Healthcare Research and Quality (AHRQ)