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Pepper Lecture: CSD Professor Shares Research on Improving Early Intervention for Children with Language Delays

How can more children with language delays access early treatment and improved outcomes? If diagnostic tests are made widely available and parents take a more hands-on role with therapy, they can and will, says Megan Roberts, the Jane Steiner Hoffman and Michael Hoffman Assistant Professor of Communication Sciences and Disorders, who gave the 2019 Pepper Lecture in the Frances Searle Building on May 8.

From Left: Richard Pepper, Dean Barbara O’Keefe, Megan Roberts, Roxelyn Pepper

Roberts, a licensed speech-language pathologist with more than 10 years of clinical and research experience and the principal investigator of the Early Intervention Research Group in the Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, presented findings that address the need to make early interventions work better for children who have language delays due to hearing loss, language learning disorders, or autism.

“If we want to move the needle on early access to high-quality interventions for kids with autism, we need to continue to think outside the box,” she said. “We need to use existing measures in different ways and we need to borrow metric techniques from other fields.”

Her research found that 40 percent of children with autism have language delays but only 10 percent of those children get early interventions before the age of 3, in large part because in Illinois, parents typically need an official diagnosis of autism in order to access intervention services. However, there are only 19 diagnostic centers and 32 pediatrician specialists statewide to make those determinations, so waiting lists often number in the hundreds. Families commonly wait six to 12 months for an official diagnosis, a loss of crucial treatment time. Her research looked at ways to use different diagnostics that could help streamline the process.

“Imagine a scenario where we could identify with certainty the kids who definitely didn’t have autism, and imagine another scenario where we could identify the kids who definitely had autism,” she said. “If we were able to do that, then you can imagine a scenario where the kids we weren’t sure about, those would be the kids who’d be on the waitlist for the specialist developmental and behavioral pediatrician.”

Her research found that there could be multiple ways this might happen, including using a “weighted” approach by pediatricians, who could score certain behaviors higher than others to make a more likely autism diagnosis. She also found accuracy with using a panel of five experts who viewed a couple of two-minute video clips showing a child’s social interaction with a parent and with a stranger. This panel could potentially rule out autism or affirm it in definitive cases.

Roberts also presented findings on how teaching parents the techniques in early interventions for language development had the potential to reduce in-clinic therapy time and produce better results.

Jennifer Phelan, an audiologist at the Northwestern University Center for Audiology, Speech, Language, and Learning who attended the lecture, said Roberts’ breakthroughs are essential. 

“Her work is so important because it makes tough questions accessible,” she said. “People use anecdotal evidence for treatments, but she shows you that you can get proof, you can do the research. She’s a wonderful advocate for—whom she calls—the little humans.”

Sumit Dhar, professor, Hugh Knowles Center fellow, and chair of the department, agreed.

“In a very short period of time, [Roberts] has been able to change the conversation about how we do early these early interventions and she’s really changed lives,” he said.

The annual lecture was made possible by a generous gift from Roxelyn Pepper (C53) and Richard Pepper (McC53), longtime donors to the University who in 2005 made a gift to endow the School of Communication Department of Communication Sciences and Disorders. The Peppers attended the lecture and were thanked for their continued support by School of Communication Dean Barbara O’Keefe.

“It’s of particular importance that the Peppers have chosen to put their name on this department,” O’Keefe said, adding that their support demonstrates how vital the work of CSD is to the University and beyond.

By Cara Lockwood