ASSESSMENT OF LANGUAGE DELAY AMONG 0-3 YEAR CHILDREN ATTENDING THE WELL BABY CLINIC IN A TERTIARY CARE CENTRE USING LEST

Dr. Rajeshwari N 1 and Dr. Lavanya R 2 . 1. DCH, MD (Paediatrics), PGDDN, Consultant and Head of the Department, Paediatrics, Developmental Neurologist, Head of Child Development Centre, Dr. Kamakshi Memorial Hospital, Pallikaranai, Chennai. 2. DCH, DNB (Paediatrics), Senior Registrar, Dr. Kamakshi Memorial Hospital, Pallikaranai, Chennai. ...................................................................................................................... Manuscript Info Abstract ......................... ........................................................................ Manuscript History


ISSN: 2320-5407
Int. J. Adv. Res. 6(6), 675-679 676 community to identify probable language delay among 0-3 year children, so as to enable mother to initiate speech and language stimulation at home itself with appropriate referral to a center for intervention when required. Paediatricians are in an excellent position to identify children's speech and language problems early during the well baby and immunization visits and to make appropriate referrals for further evaluation and treatment services.

Materials and Methods:-
The study was conducted in the Well baby clinic, Department of Paediatrics, Dr. Kamakshi Memorial Hospital, Pallikaranai, Chennai. Informed consent was taken from parents. This is a cross sectional descriptive study of 200 children of age group birth to 3 years attending well baby clinic of a tertiary care centre, Dr. Kamakshi Memorial Hospital from April 2014 to June 2014.
Inclusion Criteria was children in the age group of 0-3 years attending the outpatient clinic of Paediatric Department for routine check-up and vaccination. Children with severe or chronic illness and delay in other domains of development like gross motor, fine motor and social-personal were excluded.
Study was done using a Proforma consisting of Socio-demographic parameters like age, sex, family order. Details of parental age, education, occupation and socio-economic status are assessed by modified Kuppuswamy scale [9]. Speech and Language assessment is done using Language Evaluation Scale, Trivandrum (0-3 years). [4] [7] Interpretation of language delay using LEST [4][7]: Normal -All items done Suspect -Two items not done Questionable -One item not done Delay -Three or more items not done

Results:-
Age and Speech Delay:-Out of 200 children in age group of 0-3 years in the present study ,30.5% were in the age group of 0-6 months,27.5% in the range of 7-12 months ,19% in the group 13-18 months ,14.5% between 19-24 months and rest between 2-3 years.

31-36 months
Present study was limited to age group of 0-3 years and children were sampled as random sample. No statistical significance was obtained between the age of the children and speech and language delay (p=0.244). However it was interesting to note that delay was predominantly found after the age of 1 year.

Lest Interpretation:-
In the present study out of 200 children,162 children(81%) were found to be normal.38 children(19%) were found to have one or more item delay by LEST assessment. Among the 38 children,25 children(12.5%) had one item delay, 4 children(2%) had two item delay and 9 children(4.5%) had three item delay.6.5% children had two or more item delay.

Discussion and Conclusion:-
A cross sectional study in 200 children was conducted using Language Evaluation Scale Trivandrum (LEST 0-3) from the age group birth to 3 years of age to find out the prevalence of language and speech delay.
In the present study out of 200 children, 162 children (81%) were found to be normal. 38 children (19%) were found to have one or more item delay by LEST assessment. Among the 38 children, 25 children (12.5%) had questionable delay (one item delay), 4 children (2%) had suspect delay (two item delay) and 9 children (4.5%) had delay (three item delay).
In a study conducted by CDC Trivandrum, there was 4.5% language delay. In a Cochrane study [10] there was approximately 6% language delay. In the study by Shiji et al [11], prevalence of speech delay was 5.5% .In comparison our study showed a prevalence of speech delay was 4.5% which is comparable. All the above studies show a prevalence of about 4-6 % language delay. [7] [11] 5.5% According to a recent Cochrane study, for pre-school children 2-4.5 years, the prevalence rates for combined speech and language delay ranges from 5% -8% and of language delay alone from 2.3%-19%. Prevalence of speech and language delay in children without any neonatal risk factors was observed to be 4.5%.

Recommendations:-
It has been shown that language disorders top the list of childhood disability in children less than 3 years of age. Delay in the language development is an early marker of Pervasive Developmental disorders, Intellectual disabilities and Specific Learning disorders. 1. The prevalence of 4.5% language delay in children aged 0-3 years attending well baby clinic emphasises the need for early screening programs.