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Risk factors in the link between Language Impairment and Emotional Behavioural Difficulties . Leila Mackie Speech and Language Therapist. Background My PhD – what it covers Section discussed today Method Assessment battery/ info gathered Results so far Next steps…. . Overview.

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Risk factors in the link between Language Impairment and Emotional Behavioural Difficulties

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Risk factors in the link between Language Impairment and Emotional Behavioural Difficulties

Leila Mackie

Speech and Language Therapist


Background

My PhD – what it covers

Section discussed today

Method

Assessment battery/ info gathered

Results so far

Next steps….

Overview


Relationship between emotional development, behaviour and language development is widely recognised in the literature

Co-existence of language difficulties and EBD:

Review of literature, Benner et al 2002

On average 71% children referred with EBD had co-existing language deficits… and approximate 57% of children with diagnosed language deficits were also identified with EBD

Cohen et al 1998

….In total 63.6% of children referred (to child psychiatric clinics) had a language impairment

Background


Furthermore language impairments often go unidentified. For example a child may be:

Less responsive to language

Less able to mix appropriately with peers

and this may be viewed as non-compliance or immaturity

“41% met criterion for unsuspected language impairment” Cohen et al (1998)

Background


Brownlie et al 2004 and Beitchman et al 1996; 1999; 2001)

Long term longitudinal study of children with LI at early school age to adulthood. Those with co-existing behaviour problems at school had high incidence of:

high drop out rate from education

unemployment

conduct and social problems

Long term picture


A better understanding of these issues therefore has the potential to feed directly into the management of these children at school as well longer term implications at a societal level.

At a personal level interested in this area due to:

clinical experience

psychology background

Importance of research in this area


It is clear that these difficulties frequently co-exist but still don’t know why

Does one cause the other?

Is there a common underlying cause?

???

Pump Priming Project – small pilot project prior to PhD

considered role of pragmatic language skills in LI-EBD link

Recruited children referred to EP due to behavioural issues (n=17)

High level of pragmatic language, structural language and word decoding difficulties

Language difficulties did not co-occur with EBD without pragmatic and/or word decoding difficulties

Arriving at my questions…


Needed a bigger group

Wanted to investigate differences between children with EBD and no LI and LI with no EBD

In particular wanted to consider:

psychosocial factors (parental wellbeing and SES)

social cognition

So from here:


My PhD


Recruitment –

Boys in P4 to P7 in mainstream classes

Identified on Integration Support Audit with primary support need:

Language & Comm

SEB/ Behaviour & Learning

Exclusions – diagnosis of ASD; EAL; HI; neurological signs

50 boys now recruited

Control group: 50 boys matched for age and school….almost there!

Method


Assessment battery/ data collection


Questions

  • To what extent is language ability associated with EBD?

    • Are other commonly associated factors more closely associated?

  • Are there variables that indicate “group membership” amongst boys with

    • LI

    • LI & EBD

    • EBD

EBD

LI


Results so far….

  • Approximately 50:50 split lang&comm versus behaviour on Audit

  • These two groups similar in the proportions and types of language difficulties


Results - LI & EBD association

  • What is the level of association between LI and EBD?

  • Are the boys with LI more likely to be at high risk of an EBD diagnosis?

  • No: Very little difference between groups


Results - SES & EBD association

  • If we look specifically at the boys at high risk of a behavioural disorder there is a significant association with SES

  • (p=0.032)


Results –SES and LI association

  • Boys with LI significantly more likely to be from low SES backgrounds

  • (p=0.008)


Continue with analysis …..

Due for completion autumn 2009

[email protected]

Next Steps


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