Speech and Language Disorders in Children Implications for the Social Security Administration's Supplemental Security Income Program (2016) / Chapter Skim
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6 Overall Conclusions
6 Overall Conclusions
Pages 207-234
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In addition, the committee's findings and conclusions could be used to inform eligibility criteria and ongoing monitoring of children with speech and language disorders within the SSI program. Finally, the committee's review of the literature and multiple sources of data provides insight into current data collection efforts related to children with speech and language disorders.
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This final chapter highlights supporting evidence and examples included in the report for each of these overall conclusions. The chapter ends with the committee's reflections on how its work can contribute to advancing understanding of and improving outcomes for children with severe speech and language disorders.
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of childhood speech and language disorders. To do so, the committee consulted numerous sources of data, including clinical data from small treatment studies, population-based data from large national surveys, and administrative data from large federal programs.
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Conversely, speech and language disorders may be included in other reported categories, such as "development delays" or "multiple disabilities," or reported as secondary impairments, thereby effectively deflating the number of speech and language disorders reported. Although the committee encountered challenges, it found sufficient evidence to estimate that 3 to 16 percent of the general population of children from birth to through age 21 experience problems with speech or language.1 Specifically, studies on childhood speech sound disorders show overall prevalence rates ranging from 2 to 13 percent (Campbell et al., 2003; Eadie et al., 2015; Shriberg et al., 1999)
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Thus, it is important both to carefully examine the speech and language skills of children with other developmental disorders and to identify other neurodevelopmental disorders among children presenting with speech and language impairments. Among populations of children with conditions as diverse as autism spectrum disorder, attention deficit hyperactivity disorder, traumatic brain injury, and genetic disorders, speech and language disorders may be the most easily identified area of impairment because of the central role of language and communication in the functional capacity of children and adolescents.
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children receive SSI benefits for speech and language disorders. An analysis of the impact of SSI revealed that the receipt of children's SSI benefits reduced the percentage of families with incomes below the federal poverty level from 58 percent to 32 percent.
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Based on its review of professional standards of care and the documentation included in a random sample of case files, the committee concluded that 4. To determine the severity of speech and language disorders in children, the Social Security Administration employs the results of professionally administered assessments and also takes into ac count other clinical evidence that would be consistent with severe speech and language disorders.
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Even fewer children -- only about 1 of every 1,000 -- would be expected to have scores more than three standard deviations below the mean, the standard for extreme limitation. In children younger than 3 years of age, for whom norm-referenced testing is generally infeasible, chronological age is used as the reference standard for defining limitations sufficiently severe to functionally equal the Listings.
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population under age 18 and to compare those trends with trends observed among participants in the SSI childhood disability program. To do so, the committee analyzed clinical studies, nationally representative survey data, and administrative or service data from a range of sources.
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child population. Trends in annual Supplemental Security Income initial allowances parallel this overall increase.
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An implication of this conclusion is that a severe disorder will persist over time, thereby necessitating ongoing educational, social, and health supports and, in the case of children from low-income families, continuing eligibility for financial assistance through the SSI program. Trends Among Supplemental Security Income Program Participants To identify trends among participants in the SSI program, the committee reviewed administrative data collected by the SSA on initial allowances and recipients based on primary speech and language impairments.
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Given that children with severe speech and language impairments are likely to continue to have those severe impairments throughout adolescence and into adulthood, the total number of SSI recipients who received benefits under this new code in any given year approaches the total number of children who became eligible in each of the preceding 18 years. As a result, the total number of children receiving SSI benefits for speech and language impairments in 2013 will include almost all of the children who became eligible in the years from 1996 through 2013.
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2-6. Children with severe speech and language disorders have an in creased risk of a variety of adverse outcomes, including mental health and behavior disorders, learning disabilities, poor academic achieve ment, and limited employment and social participation.
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Currently, 0.31 percent of U.S. children receive SSI benefits for speech and language disorders.
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5-6. The number of children receiving SSI benefits for a primary speech or language impairment increased by 171 percent between 2004 and 2014.
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7. The total number of children receiving Supplemental Security Income for speech and language disorders more than tripled in the past decade.
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5-6. The number of children receiving SSI benefits for a primary speech or language impairment increased by 171 percent between 2004 and 2014.
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Mild speech and language impairments in preschool will sometimes be transient; severe forms of these disorders have a high probability of being long-term disabilities. Chapter 2: Childhood Speech and Language Disorders in the General U.S.
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Conclusions 2-1. Severe speech and language disorders represent serious threats to children's social, emotional, educational, and employment outcomes.
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4-3. analysis of the impact of SSI revealed that children's SSI benefits An raised family income above the federal poverty level by 26.4 percent for families with child SSI beneficiaries.
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children receive SSI benefits for speech and language disorders.
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5-13. The greatest number of child SSI recipients are those with the lowest family incomes (at or below 100 percent of the federal poverty level)
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the introduction in 1994 of a new impairment code for speech and language impairment, and (2) the marked and extreme levels of impairment among children who receive SSI benefits for speech and language disorders that are unlikely to be resolved by the time a child reaches age 18.
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children and compares these trends with those found in the SSI childhood disability population. The evidence presented in this report underscores the long-term and profound impact of severe speech and language disorders on children and their families, as well as the degree to which children with such disorders can be expected to be a significant presence in a program such as SSI, whose purpose is to provide basic financial assistance to families of children with the severest disabilities.
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Despite its limitations, the evidence presented in this report offers valuable insight into the relationship between the general population of children with speech and language disorders on the one hand and the presence of children with these disorders in the SSI program on the other. Furthermore, the evidence presented here can assist policy makers, health and education professionals, and SSI program administrators in understanding the extent to which the program's basic design and administrative process operate together to connect the nation's most severely impaired and disadvantaged children with speech and language disorders to the benefits the program offers.
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2015. Adolescent outcomes of children with early speech sound disorders with and without language impairment.
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2014. Prenatal, perinatal, and neonatal risk factors for specific language impairment: A prospective pregnancy cohort study.
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