Girls slip through the cracks due to ‘referral bias’: Australian-first study

Young girls are just as likely to be living with language difficulties despite more boys being referred for support services, according to a new Curtin-led study that seeks to shatter the “referral bias” and help parents advocate for their children.

The study – the first to detail the prevalence of Developmental Language Disorder (DLD) in Australian children – examined the language skills of more than 1,600 children aged 10 years as part of the Raine Study, the nation’s longest-running public health study.

Published today in the Journal of Paediatrics and Child Health, it found the most significant predictor of a child being diagnosed with DLD at 10 years of age was being exposed to smoking during pregnancy, with the odds of meeting the criteria of DLD 2.56 times greater than mothers who did not smoke at 18 weeks gestation.

Lead author Dr Sam Calder, from the Curtin School of Allied Health, said he was concerned more young girls were not being diagnosed with DLD given the potentially life-long consequences of not receiving the appropriate care and support.

“This study suggests an alarming number of children aren’t getting the help they need, meaning they may go their entire lives without realising a language disorder could explain why they had such a hard time learning at school or struggled in social situations more than their peers,” Dr Calder said.

“Despite more young boys being referred for clinical services, our study found no significant difference between boys and girls meeting the criteria for DLD, pointing to a ‘referral bias’ for young boys.

“It is therefore vitally important for parents, educators and health professionals to be vigilant in advocating for young girls with language and learning challenges to ensure they receive the same support boys are receiving.” 

Co-author Dr Lizz Hill, also from the Curtin School of Allied Health, said the study showed about two kids in every WA classroom was likely to experience life-long language problems that may impact their psychological, academic, and vocational wellbeing and success.

“The study showed a higher proportion of 10-year-old children meeting the criteria for DLD were born preterm, exposed to smoking in pregnancy, had a father that did not live at home, and were read to less than once per week as a three-year-old,” Dr Hill said.

“After analysing the experiences of more than 1,600 children, we found smoking in pregnancy was the most significant predictor of a child being diagnosed with DLD. It is critical that we identify and support these children early in order to promote the best possible outcomes. This includes raising awareness of the potential impact of smoking during pregnancy on a child’s life-long language and communication skills.”

DLD is a brain difference that makes talking and listening difficult, for no known reason.

The study also involved experts from the Telethon Kids Institute and The University of Western Australia.

On October 14, Developmental Language Disorder Awareness Day will help to raise awareness of this little-known neurological condition that affects an average of two students in every class of 30.

The full paper, ‘The Prevalence of and Potential Risk Factors for Developmental Language Disorder at 10 years in the Raine Study’, can be viewed online here.