Figure 1. Analytic Framework and Key Questions

The analytic framework represents an outline of the evidence review and includes the patient population, interventions, outcomes, and adverse effects of the screening process. The key questions examine a chain of evidence about the effectiveness, accuracy, and feasibility of screening children age 5 years and younger for speech and language delay in primary care settings (key questions 1 and 2), adverse effects of screening (key question 3), the role of enhanced surveillance in primary care (key question 4), effectiveness of interventions for children identified with delay (key questions 5, 6, and 7), and adverse effects of interventions (key question 8).

1. Does screening for speech & language delay result in improved speech & language as well as improved other non speech & language outcomes?
2. Do screening evaluations in the primary care setting accurately identify children for diagnostic evaluation and interventions?
   1. Does identification of risk factors improve screening?
   2. What are screening techniques and how do they differ by age?
   3. What is the accuracy of screening techniques and how does it vary by age?
   4. What are the optimal ages and frequency for screening?
3. What are the adverse effects of screening?
4. What is the role of enhanced surveillance by primary care clinicians?
5. Do interventions for speech & language delay improve speech & language outcomes?
6. Do interventions for speech & language delay improve other non speech & language outcomes?
7. Does improvement in speech & language outcomes lead to improved additional outcomes?
8. What are the adverse effects of interventions?

* Autism, mental retardation, Fragile X, hearing loss, degenerative and other neurologic disorders.
† School performance, family function, social behavior, and others.

Return to Document