Briefly describe a specific question, or set of related questions, about a health care test or treatment that this program should consider.

For children with speech disorder, what is the comparative effectiveness of speech therapy delievered through school based speech pathologist vs outpatient.

Does your question include a comparison of different health care approaches? (If no, your topic will still be considered.)

yes

If yes, explain the specific technologies, devices, drugs, or interventions you would like to see compared:

Speech therapy is primarily delivered through the school system for the school aged children with speech delay or disorder. Most health plans and other health care insurance plans do not cover speech services for school aged children. The question is whether there is evidence that the speech therapy leads to better outcomes for these children receiving care through the school system in comparison with children receiving speech services through an alternative delivery setting.

What patients or group(s) of patients does your question apply to? (Please include specific details such as age range, gender, coexisting diagnoses, and indications for therapy.)

pediatric patients with speech therapy

Are there subgroups of patients that your question might apply to? (For example, an ethnic group, stage or severity of a disease.)

Describe the health-related benefits you are interested in. (For example, improvements in patient symptoms or problems from treatment or diagnosis.)

outcome improvement for children with speech delay and disorder.

Describe any health-related risks, side effects, or harms that you are concerned about.

the opportunity loss for improved speech and language outcomes for school aged children.

Appropriateness for EHC Program

Does your question include a health care drug, intervention, device, or technology available (or likely to be available) in the U.S.?

unsure

Which priority area(s) and population(s) does this topic apply to? (check all that apply)

EHC Priority Conditions (updated in 2008)

• Developmental delays, attention-deficit hyperactivity disorder, and autism

AHRQ Priority Populations

• Children

Federal Health Care Program

• Medicaid
• Medicare
• State Children's Health Insurance Program (SCHIP)
• Other

Importance

Describe why this topic is important.

The prevalence of speech sound disorders in young children is 8-9% according to American Speech-Language Hearing Association.

What specifically motivated you to ask this question? (For example, you are developing a clinical guideline, working with a policy with large uncertainty about the appropriate approach, costly intervention, new research you have read, items in the media you may have seen, a clinical practice dilemma you know of, etc.)

I have not seen significantly improved speech evaluation scores for children after years of speech services.

Does your question represent uncertainty for clinicians and/or policy-makers? (For example, variations in clinical care, controversy in what constitutes appropriate clinical care, or a policy decision.)

no

If yes, please explain:

Potential Impact

How will an answer to your research question be used or help inform decisions for you or your group?

For parents and the general public to make informed decision on the delivery setting of the speech therapy for better outcomes. For the policy makers to change any current policy to restructure the effective delivery of speech therapy to improve speech outcomes of school-aged children.

Describe the timeframe in which an answer to your question is needed.

As early as possbile.

Describe any health disparities, inequities, or impact on vulnerable populations your question applies to.

Health disparities on the speech services may be greater for ethnic minority populations.

Nominator Information

Other Information About You: (optional)

Please choose a description that best describes your role or perspective: (you may select more than one category if appropriate)

For parents and the general public to make informed decision on the delivery setting of the speech therapy for better outcomes. For the policy makers to change any current policy to restructure the effective delivery of speech therapy to improve speech outcomes of school-aged children.

Are you making a suggestion as an individual or on behalf of an organization?

Individual

Please tell us how you heard about the Effective Health Care Program