Abstract
Objective
The purpose of this study was to establish prevalences and sociodemographic characteristics
associated with parent-reported speech and hearing difficulties among children with
special health care needs (CSHCN); determine unmet needs for therapy, hearing aids,
and communication devices; and examine the association between unmet needs and resources
such as health insurance, early intervention/special education, and a medical home.
Methods
Data were analyzed for 300 910 children without special health care needs and 40 723
CSHCN from the 2005–2006 National Survey of Children with Special Health Care Needs.
Prevalence, sociodemographic characteristics, and unmet needs for 7132 CSHCN with
speech difficulties and 1982 CSHCN with hearing difficulties were assessed. Logistic
regression was used to determine the associations between unmet needs for therapy
or hearing/communication devices and resources for addressing needs for therapy, hearing,
and communication aids.
Results
The parent-reported prevalence of speech difficulty among CSHCN in the general population
was 2.9% and approximately 20% among all CSHCN, in contrast to the lower prevalence
of hearing difficulty (0.7% and 5%, respectively). Relative unmet need was greatest
for communication devices and least for hearing aids. The strongest association with
reducing unmet needs was having a medical home, and the most significant aspect of
medical home was having effective care coordination.
Conclusions
Having a medical home is significantly associated with fewer unmet needs for therapy
and hearing/communication devices among CSHCN with speech and hearing difficulties.
Care coordination may constitute an important factor that allows the primary care
provider to link with services that CSHCN with communication problems require.
Keywords
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Article Info
Publication History
Accepted:
January 10,
2011
Received:
September 14,
2010
Footnotes
The views in this article are those of the authors and not necessarily those of the Health Resources and Services Administration of the U.S. Department of Health and Human Services.
Identification
Copyright
Published by Elsevier Inc.
