Danger of assumptions

“Early is better!”

Earlier detection of a speech, language, communication or swallowing difficulties is not necessarily better.

Early intervention in SLT is often better, but this is not always the case.

Screening (testing) people to detect problems or providing therapy to people with speech, language, communication or swallowing problems is only helpful if two conditions are met. First, there must be an effective intervention. Second, people who receive speech and language therapy before the problems become apparent must do better than people who receive speech and language therapy after the problem have become apparent.

Screening and treating people at risk of a speech, language, communication or swallowing problems can lead to overdiagnosis and overtreatment. Screening tests can be inaccurate (e.g. wrongly indicating that people have problems when they do not, or vice versa) and not everyone who has ‘risk factors’ will develop a difficulty (e.g. not every infant with a cleft abnormality will have difficulty feeding).

BEWARE of claims that early detection of speech, language, communication or swallowing problems and early therapy is always better than offering therapy to people after the problems become apparent.

REMEMBER: Early intervention is not necessarily better.