Pediatric brain injury referrals to SLPs very low

Pediatric brain injury isn’t just a temporary medical problem, but something that can cause cognitive–communication issues that last well past the acute phase and have a significant academic and social impact. The authors of this study emphasize that SLPs are ideal professionals to address these issues, and have “…a unique set of knowledge and skills that is needed in pediatric brain injury management…”
So the primary question in this article was—are these kids with pediatric brain injury being referred to SLPs (as they should be) while in the hospital? The medical records of 200 children*, from two hospitals, with intake between 2012–2014, were carefully examined. The authors found that at Hospital 1, 36% of children with pediatric brain injury were referred to an SLP, and at Hospital 2, only 2% were. Surprisingly, these were “specialty children’s hospitals affiliated with academic medical centers."
The authors describe their sample: the top three diagnoses were concussion, skull fracture, and hemorrhage, and the most frequent mechanisms were falls, motor vehicle collisions, and sports. Referral patterns were predicted most strongly by injury severity (more severe injuries get SLP referral) and age (older children more likely to get SLP referral). Now—the 36% an 2% stats are sad enough, but the fact that younger kids are less likely to get SLP referral is just painful. The authors propose several possible reasons for this (though the current data set can’t confirm it), with one of them being that perhaps young children’s behavioral repertoire (e.g. communication skills) aren’t as advanced, so deficits are simply more likely to go unnoticed. The authors indicate additional research in progress to help address the questions of why referral rates are so low and exhibit age and severity trends.
Ciccia, A.H., Lundine, J.P., Coreno, A. (2016) Referral Patterns as a Contextual Variable in Pediatric Brain Injury: A Retrospective Analysis. American Journal of Speech-Language Pathology. Advance online publication.  doi: 10.1044/2016_AJSLP-15-0087

*There were more cases of pediatric brain injury than this, but many records had to be excluded from analyses because they were incomplete or inconsistent in some way.