Thank you, Mr. Chair and members of the health committee.
I would like to thank you on behalf of Speech-Language and Audiology Canada and our 7,500 members. I appreciate the opportunity to speak to you today about timely diagnosis and access to speech-language pathology and audiology services for children.
We know that effective communication is foundational to a child’s social, emotional and educational development. Research has shown that the first three years are a critical period for normal speech, language and hearing development. Early identification of difficulties is therefore key to ensuring timely access to appropriate interventions for long-term success. Learning is cumulative. Difficulties not addressed early are compounded in later years. Thus, addressing communication health needs early has a decisive influence on later academic accomplishments, health, well-being and quality of life. Our members are vital in terms of being part of a primary health care team to support this process.
Across Canada, our services are offered through a combination of public, private and school-based providers. However, insufficient positions and inconsistencies in service delivery result in inadequate access to care. The situation is worse in many rural and remote areas. Parents report lengthy wait-lists in both public and private settings during this critical developmental window, which can be exacerbated for specialized groups such as children with autism. The demand for our services exceeds the capacity of available professionals.
Detection of hearing health issues is critical in the very early stages of life. Access across Canada is inconsistent. Almost half of the provinces and territories received a failing grade on a 2019 early hearing detection and intervention report card. Related, most provinces and territories do not offer universal newborn screening for congenital cytomegalovirus, despite its being the most common infection transmitted from mother to baby during pregnancy. The prevalence rate of CMV is approximately one in 200 newborns and is the leading non-genetic cause of neurologic disabilities and permanent hearing loss worldwide.
In the preschool population, acute otitis media—or middle ear—infections are extremely common, affecting approximately 75% of children at least once before starting school. Chronic suppurative otitis media in early childhood can lead to increased risk of auditory processing disorders later in life.
When speaking to their child’s health care providers, parents often report speech and language delays as a primary concern. Prevalence data suggest these difficulties are common. Speech sound disorders in preschool children range from 2% to 19%. Developmental language disorder is one of the most common childhood disorders, affecting 7% of children. Speech sound disorders range from 2.3% to 24%.
Communication difficulties follow a child later into their school years. A recent report indicated that there are insufficient speech-language pathologists working in Canadian schools to meet the needs of students who require their services. These staffing shortages are long-standing. However, closure of day cares and schools during COVID-19 further exacerbated the issue with increased levels of burnout and heavier caseloads. Prior to the pandemic, many indigenous children were already missing literacy benchmarks for their age groups.
Long-standing communication difficulties and their far-reaching effects cannot be easily remediated, though an early investment can have a multiplier effect. A dollar invested in addressing problems today will mean many more saved in the long term. In other words, inaction now carries very high long-term costs. Delayed intervention costs 10 times more than if intervention were accessed early. Children who do not achieve optimal early language learning are not prepared or equipped for compulsory formal education by age five.
We recommend that the federal government work with provinces and territories through recent day care deals to train early childhood educators on speech and hearing delays; that we integrate speech language pathology and audiology services into licensed day care settings, in collaboration with provinces and territories; and that the federal government establish a primary health care transition fund to assist provinces and territories in their work to expand access to speech-language pathologists and audiologists through primary health care teams. Of course, we desperately need initiatives to recruit and retain speech-language pathologists and audiologists in any federal efforts to improve health human resources.
Again, thank you for the opportunity to be here today. We are happy to answer questions.