Investigation of Factors Influencing Families of Late Talkers to Pursue Early Communication Evaluations

Communication delays are prevalent in young children, but outcomes are highly variable. The most common communication delay is late language emergence, or "late talking," defined as fewer than 50 words and no two-word combinations at 24 months. Many late talkers do not receive communication evaluations in a timely manner to allow for early intervention services-a problem that is exacerbated for Spanish-speaking families with limited English proficiency. "Access outliers" may provide insight on how to support more families to pursue early communication evaluations. There is little research on "access outliers," that is, families who raise concerns about their child's communication delays and then successfully pursue evaluation in their child's first three years of life. These families may pursue communication evaluations for a variety of reasons, including characteristics related to their children's phenotype, family, demographics, environment, and/or culture. The evidence-informed decision-making (EIDM) theory suggests that complex decisions require not only a range of relevant evidence, but also rely on values/preferences and expert judgments. Our goal is to understand the factors that influence families to pursue communication evaluations early (before age three) for their late talking children, as well as to determine how professionals or other supporters helped families in obtaining those evaluations. Using focus groups, we will co-design a theory to identify the factors that influenced caregivers to successfully pursue communication evaluations in their children's first three years of life.