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Comment: Don’t ignore children who need speech support

A commentary by Dr. Jennifer Balfour, Dr. Brett Schrewe and the Department of Pediatrics, Victoria General Hospital.

A commentary by Dr. Jennifer Balfour, Dr. Brett Schrewe and the Department of Pediatrics, Victoria General Hospital.

We welcomed our emergency medicine colleagues’ recent comments regarding the limitations of Telehealth to provide necessary comprehensive clinical assessments.

The negative impacts that this aspect of virtual care has on patients and the acute-care emergency department alike represents one more underappreciated ripple effect of COVID-19.

The pediatricians of Victoria would like to highlight another consequence and untold story of loss and suffering resulting from COVID.

The basic human right of access to support with speech and communication is being denied, in large part because the capacity of our public health units that offer this critical service are overwhelmed by COVID vaccine provision and testing.

The public needs to consider that if a preschooler cannot process language or communicate effectively, a range of consequences ensue, including social dysfunction, anxiety, school difficulties and behaviour problems.

The parents suffer, sometimes being told their children cannot attend child-care as their needs are too excessive. Underemployment can follow.

A detrimental life narrative begins here, setting these children up for negative self-concept, lack of success in school and poor social fluidity.

We welcome the government and the public to follow with us how the story of a three-year-old who cannot talk leads to a kindergartener and Grade 3 student who talks poorly, who learns differently, who sees themselves as “less than” and one step after another follows to early school leaving, sometimes substance use, sometimes poverty, sometimes dire social consequence.

Early intervention and treatment, drawing upon highly effective strategies, is thus paramount. Yet access since the onset of the pandemic has plummeted, wait times have skyrocketed, and the stories of the children and families awaiting vital speech therapy services are unvoiced and unheard.

Dr. Bonnie Henry and her Public Health colleagues are necessarily directing their attention and resources to many urgent matters, including getting shots in arms, and controlling spread.

They are doing nothing short of heroic work and have made British Columbians tremendously proud.

Yet their resources have been strained beyond belief, and the consequences of this are losses accrued in developmental progress and the right to communicate by young children, especially those that live close to poverty, which may never be made up to them. And we fear nobody is noticing.

The public is familiar with stories of full ERs, overwhelmed ICUs and surgical waitlists that require a process of post-COVID catch-up.

Perhaps the story we tell lacks drama and a sense of urgency. But we invite our leaders to listen to the stories we can tell that lead right from the preschool years through grade and high school and sometimes directly to the street and substance use when one is underserved, does not have essential developmental needs met, and their families spiral with them into unemployment and underachievement.

We are a small group of practitioners, looking after a population often called “resilient,” but there are some losses that cannot be recovered from, and the debt we will owe these children for failing to support their basic right to communicate is unconscionable.

Don’t say we didn’t tell you. We are right here trying to tell their story, and for their sake, we ask for an audience.