Speech, Language, And Hearing Services For Children Brochure

Speech, Language, andHearing Servicesfor ChildrenA Smart Investment

IntroductionChildren withspeech, language,and hearingdisorders struggle tocommunicate withothers and to expressthemselves. If leftuntreated, thesedisorders can affecta child’s ability tointeract with othersand can impact theireducational andvocational potential.Audiologists andspeech-language pathologists can assist children with these disorders.These services can be provided throughout the lifespan but are often themost effective when disorders are identified and treated early.Audiologists and Speech-Language PathologistsAudiologists are experts in providing services in the prevention, diagnosis,and treatment of hearing and balance disorders. Services includedetermining candidacy for and selection, fitting, and programming ofhearing devices and cochlear implants, audiologic rehabilitation, andmonitoring for ototoxicity of the auditory and vestibular systems as a resultof prescription drugs or treatments, such as chemotherapy. Audiologistshold a master’s or doctoral degree in audiology from an accredited programand are licensed in all states and in the District of Columbia.Speech-language pathologists (SLPs) are experts in assessing, diagnosing,and treating speech-language and swallowing disorders, includingspeech sound disorders, stuttering, voice disorders, and language deficits.They provide services and devices for augmentative and alternativecommunication (AAC)—for example, speech-generating devices. SLPshold a master’s or doctoral degree in speech-language pathology froman accredited program and are licensed in all states and in the District ofColumbia.Learn more about these disorders, discover treatment options, and find aprofessional at http://www.asha.org/public/.2

Children Need Speech, Language,and Hearing ServicesASHA’s Identify the Signs campaign (http://identifythesigns.org/) can helpyou understand what to look for. Here are some examples of how speech,language, and hearing services work.c When Jared was born, he received a newbornhearing screening in the hospital that indicateda possible hearing loss. His parents took himfor a follow-up hearing screening, whichwas suggested at the hospital. The followup screening indicated the need for furthertesting, and he was referred to a pediatricaudiologist. The audiologist confirmed amoderate hearing loss in both ears. Thefamily chose an auditory/oral communicationapproach for Jared. This treatment includedbeing fitted with hearing aids (one for each ear)at 3 months of age. He was also recommendedfor biweekly intervention services provided by an audiologist and aspeech-language pathologist with a focus on auditory/listening skills,speech and language development, and parent education. After 3years of consistent hearing aid use and regular treatment services,Jared entered preschool with normal receptive and expressivelanguage.c Sarah is a 2-year-old child with a bilateral cleft palate that wassurgically repaired at 11 months of age. Now, when she speaks, herspeech sounds are not clear, and she has excessive nasality thatimpairs her ability to communicate. Sarah’s care is coordinated bya cleft palate/craniofacial team that includes a plastic surgeon, anorthodontist, an SLP, a pediatrician, and additional providers. TheSLP assesses Sarah’s articulation, language, voice, and resonanceand determines the presence of nasal emission during consonantproduction. Treatment may include (a) surgery to eliminatehypernasality and/or nasal emission and (b) speech-language therapyto correct abnormal compensatory articulation placement errors. Withappropriate speech-language services, Sarah will learn techniquesto correct her speech errors and increase speech intelligibility,allowing her to communicate with others at an age-appropriate level.Professional collaboration with the cleft palate/craniofacial team anda coordinated care plan will ensure that Sarah achieves maximumfunctional communication.3

c Ethan is a 4-year-old with lots to say, but speech and language impairmentsget in the way. His speech is only 65% intelligible, causing him frustration.Ethan has weak oral-motor coordination skills, which affects his ability tomake the precise motor movements necessary for speech. Ethan sees anSLP twice a week to learn correct sound production and to develop hislanguage skills to age-level expectations. He is gaining communicationproficiency and confidence with each treatment session.Employers Can Play a RoleMost employers want to provide health plan coverage that offers necessaryservices for children, including speech, language, and hearing services. Despitethe need for these services, employers are surprised to find thatc common policy language covers adults but often excludes coverage forchildren andc adding pediatric speech, language, and hearing coverage to benefit plans isinexpensive and cost-effective.Policy Language Can Be Confusing and MisleadingSpeech, language, and hearing coverage policy can be confusing. Here aresome examples:c Speech-language therapy for a child may not be covered if the policy statesthat therapy is approved for disorders that are “acquired” or are the resultof “an accident, illness, or injury.” Children with communication disordersusually “acquire” the disorder congenitally or during the neonatal period.Therefore, the exact “accident, illness, or injury” that caused the disorder isusually impossible to determine.c Therapy may also be denied if the policy states that therapy must “restorespeech” or provide “rehabilitation.” This means that, in order for coverageto be approved, the child must have developed speech, then subsequentlylost the ability to speak. However, children who need speech-languageservices have a disorder that disrupts or prevents the acquisition ofcommunication skills from birth.c Coverage may be denied if the disorder is characterized as a “developmentaldelay.” Insurance companies often argue that developmental delay is aneducational issue and not a medical condition. However, developmentaldelay is not a cause but rather a symptom of a neurological disorder, whichis a medical condition. The neurological disorder causes a disruption in thedevelopment of speech and language skills.4

Early Access to Speech, Language,and Hearing Services Is VitalA critical period of speech and language development occurs betweenbirth and age 5. During this time, the child’s central nervous system israpidly developing in response to auditory, visual, and tactile stimulation.If communication skills are not developing normally, therapy should bestarted immediately in order to take advantage of this critical period. Iftherapy is delayed, the brain becomes “hard-wired.” As a result, it takesmuch longer to achieve results through therapy—and the outcomes oftreatment are often less successful.Children who need—but do not receive—speech, language, and/orhearing services can ultimately drive up health care costs and othersocietal costs. Untreated speech, language, and hearing disorders canlead to poor school performance, behavior disorders, depression, andlimited vocational potential. However, if treated early, these childrencan receive a chance to reach their full potential and become positivecontributors to society.The Cost of AddingSpeech, Language,and HearingServices Is MinimalMilliman provides an estimateof the total cost of providingselected hearing services,speech-language therapy,and hearing supplies, devices,and related professionalservices, in a commercialemployer group population,noting a utilization rateof approximately one perthousand, with PMPM (permember per month) claimcosts of approximately 1.48for 2014. These estimatesare based on current levelsof coverage, eligibility andbenefit design.5

Investing in Pediatric Therapy CoverageCan Benefit the Employer’s Bottom LineAccording to a report released by the National Business Group onHealth (NBGH), investing in pediatric therapy and improving thehealth of children benefits employers in at least four ways:1. Lower health care costs. Healthy children use less health careservices.2. Increased productivity. Parents of healthy children miss fewerworkdays than those with ill children and are less likely to takefamily medical leave, personal sick leave, or paid time off due to achild’s health problem. They may also be more productive at workbecause they do not suffer stress related to caregiving.3. Improved retention/reduced turnover. Employers withcomprehensive benefits are able to recruit and retain the bestemployees.4. Healthier future workforce. Children and adolescents of todayare the workforce of tomorrow. Employers benefit (from lowerhealth care costs and improved productivity) when the people inthe community or region where they recruit are healthy.What You Can DoBe sure your company’s healthinsurance plan covers speech,language, and hearing servicesfor all children, includingthose with disorders thatare congenital, neurological,developmental, or functionalin nature. Visit your employer’shuman resources office today.The American-SpeechLanguage-Hearing Associationhas staff available to assistwith speech, language,and hearing coveragepolicies. Please contact us atreimbursement@asha.org.6

About ASHAThe American Speech-Language-HearingAssociation (ASHA) is the national professional,scientific, and credentialing association for 191,500members and affiliates who are audiologists; speechlanguage pathologists; speech, language, andhearing scientists; audiology and speech-languagepathology support personnel; and students. Theseindividuals are qualified to meet the needs of theestimated 49 million children and adults in theUnited States with communication disorders.Know the Facts About Speech,Language, and Hearing Disordersc 2–3 of every 1,000 children in the United Statesare born with a detectable level of hearing loss inone or both ears.c Nearly 1 in 12 (7.7 %) U.S. children ages 3–17 hashad a disorder related to voice, speech, language,or swallowing in the past 12 months.c More than 3 million Americans (about 1%) stutter.Stuttering can affect individuals of all agesbut occurs most frequently in young childrenbetween the ages of 2 and 6.i.American Speech-Language-Hearing Association. (n.d.). Essential Coverage: Rehabilitative and Habilitative Services andDevices. Retrieved from abilitative-Services-Devices.pdfii.American Speech-Language-Hearing Association. (n.d.). Essential Coverage: Rehabilitative and Habilitative Services andDevices. Retrieved from abilitative-Services-Devices.pdfiii.Cincinnati Children’s Hospital Medical Center. (n.d.). Speech Therapy for Children, A Smart Investment. Retrieved fromhttps://www.cincinnatichildrens.org/search?q a smart investment&site entire-site&start 10iv.Cincinnati Children’s Hospital Medical Center. (n.d.). Speech Therapy for Children: A Smart Investment. Retrieved fromhttps://www.cincinnatichildrens.org/search?q a smart investment&site entire-site&start 10v.Cincinnati Children’s Hospital Medical Center. (n.d.). Speech Therapy for Children: A Smart Investment. Retrieved fromhttps://www.cincinnatichildrens.org/search?q a smart investment&site entire-site&start 10vi.Milliman is an actuarial consulting firm with offices worldwide.vii.National Business Group on Health. (2008). Investing in Maternal and Child Health: An Employer’s Toolkit. Retrieved fromhttp://www.businessgrouphealth.org/toolkits/et maternal.cfmviii.National Institute on Deafness and Other Communication Disorders. (2016). Statistics and epidemiology. Retrieved fromhttps://www.nidcd.nih.gov/health/statistics7

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speech and language development, and parent education. After 3 years of consistent hearing aid use and regular treatment services, Jared entered preschool with normal receptive and expressive language. c Sarah is a 2-year-old child with a bilateral cleft palate that was