In Victoria, the community where I live and practice, most children receive their vaccinations through appointments with the public health nurse at 2, 4, 6, 12, and 18 months of age, following the BC child immunization schedule. During these appointments the public health nurse will get to observe the child and Health Checks are completed by the parent(s).
The Health Checks are essentially simple screens for speech-language, hearing, nutrition, and dental milestones. If a milestone has not been met, or if the parent has concerns, the public health nurse may: give some recommendations to support development in that area, do a more in-depth screen (such as the Ages and Stages Questionnaire), or refer to another professional.
Many of the referrals I receive come from the public health nurse, so you can probably already tell where I am going with this...
If a family does not immunize their child, then they will not be having these regular appointments with the public health nurse and it is possible that developmental delays, including speech and/or language delays, may be missed.
Parents often, but not always, know when their child is not developing as expected. If parents always knew, then there wouldn't be any need for these sorts of checks. Often times parents of children with speech or language difficulties will tell me that this was their first child and they didn't know what to expect or that they thought boys, or the second child, might talk less than an older sister or a precocious older brother.
Of course these children will most likely be seen by their family doctors but, as we all well know, doctors' time with their patients can be very brief and there is a chance that they may miss something that would be spotted by the public health nurse, who may spend more time with a child and family.
The takeaway: Whether you immunize your child or not please familiarize yourself with developmental milestones so that you know what to expect and when to refer your child to a speech and language (or other developmental) specialist.
Below you will find some links that may be of help to anyone interested in their child's speech-language development:
(Disclaimer: These tools are not intended to replace the expertise of a health professional. If you have concerns about your child's development, even if these links below do not indicate a concern, then I recommend you make an appointment to discuss these concerns with the appropriate health professional)
- Richmond Public Library: Speak, Read, Succeed Interactive Checklist (Free; British Columbia)
- My Child's Talk (Paid; Canada) [at the time of writing this, this site was undergoing redevelopment, but I have included it so that it will be available in the future]
- Talking Point: Progress Checker (Free; United Kingdom)
Did you know: Most speech-language programs for preschool-aged children, including Island Health, accept referrals from parents as well as physicians, public health nurses, and other community professionals? Therefore, if you have concerns regarding your child's speech or language development, you can make the referral yourself (you do not need to request a referral from your family doctor).