| Sumario: | There is consensus regarding the developmental sequencing of receptive, expressive, and phonologic skills in early childhood and the role of exposure to speech sounds in language development. Strong research evidence implicates genetic and environmental factors in the causes of speech-language disorders. (18) Strong evidence suggests that speech-language disorders are prevalent and are associated with increased risk for learning and behavioral problems. (18) Based on strong evidence regarding the impact of the environment on language development, clinicians should guide parents in providing a language-rich environment, which includes talking to, reading to, and encouraging reciprocal communication with their children from infancy onward. (4) Scientific evidence is mixed concerning the efficacy of early intervention and treatment of speech-language disorders, and more controlled studies are needed. There is consensus that the pediatric clinician is in a unique position to identify delays early through a continuous process of surveillance and screening. A 'gold standard' for screening is difficult to find because of inconsistent measures and terminology. At this time, evidence is insufficient that a specific speech and language screening instrument is more effective than clinical observation and parental concerns to identify children who require further evaluation.
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