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

1. Risk factors in the link between Language Impairment and Emotional Behavioural Difficulties Leila Mackie Speech and Language Therapist

2. Background My PhD – what it covers Section discussed today Method Assessment battery/ info gathered Results so far Next steps…. Overview

3. 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

4. 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

5. 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

6. 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

7. 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…

8. 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:

9. My PhD

10. 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

11. Assessment battery/ data collection

12. 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

13. 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

14. 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

15. 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)

16. Results –SES and LI association • Boys with LI significantly more likely to be from low SES backgrounds • (p=0.008)

17. Continue with analysis ….. Due for completion autumn 2009 lmackie@qmu.ac.uk Next Steps