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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

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

Leila Mackie

Speech and Language Therapist

overview
Background

My PhD – what it covers

Section discussed today

Method

Assessment battery/ info gathered

Results so far

Next steps….

Overview
background
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
background4
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
long term picture
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
importance of research in this area
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
arriving at my questions
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…
so from here
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:
method
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
questions
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
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
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
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
Results –SES and LI association
  • Boys with LI significantly more likely to be from low SES backgrounds
  • (p=0.008)
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