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Liu M, Han J, Zhang Y, Wen J, Wang Y, Hu X, Sun M, Qu L, Han X, Xu L, Zhao H, Lu H, Liu Q. Phonological Development in 3-6-Year-Old Mandarin-Speaking Children with Autism, Developmental Delays, and Typical Development. J Autism Dev Disord 2024:10.1007/s10803-024-06522-z. [PMID: 39177934 DOI: 10.1007/s10803-024-06522-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2024] [Indexed: 08/24/2024]
Abstract
Research on the phonological development of children with autism spectrum disorder (ASD) has not yet reached consistent conclusions, and systematic studies from different language groups are needed. This study aimed to systematically investigate the characteristics of phonological development in 3-6 year-old Mandarin-speaking children with ASD. We analyzed 10 min speech samples from 21 children with ASD, 18 development level-matched children with developmental disorders (DD), and 15 chronological age-matched typically developing (TD) children during semi-structured parent-child free play based on Mandarin phonological features. The children with ASD had a significantly smaller inventory than those with TD on the initial and final inventories. The children with ASD had only a significantly smaller initial inventory than those with DD in Phases 2 and 4. Compared with TD children, children with ASD used a higher proportion of V1 and V1V2C and a smaller proportion of V1V2V3, CV1C, and CV1V2C. No significant differences existed between ASD and DD children in the proportion of any syllable structure, but V1V2V3, CV1, and CV1V2C numbers were significantly fewer than in DD children. Children with ASD were significantly greater than children with TD in the diversity of V1V2, CV1, and overall syllables. ASD children had significantly fewer different types of syllables in both V1V2C and CV1 than did DD children and significantly greater diversity in CV1 and overall syllables than did DD children. These preliminary data suggest that the gap between TD and ASD children's language abilities increased with age, and this gap was reflected in initial, final, and syllable complexity and diversity. Children with DD and ASD showed similar language abilities, and children with DD showed detailed differences from those with ASD regarding initial, syllable complexity and diversity.
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Affiliation(s)
- Min Liu
- Shanghai Institute of AI for Education, East China Normal University, Shanghai, China
| | - Jinhe Han
- Department of Rehabilitation Science, Faculty of Education, East China Normal University, Shanghai, China
| | - Yuexin Zhang
- Sunshine Intellectual Disability (Autism) Early Childhood Education and Rehabilitation Center, Jiaxing, China
| | - Jieling Wen
- Department of Rehabilitation Science, Faculty of Education, East China Normal University, Shanghai, China
| | - Yanxia Wang
- Department of Rehabilitation Science, Faculty of Education, East China Normal University, Shanghai, China
| | - Xinyu Hu
- Department of Rehabilitation Science, Faculty of Education, East China Normal University, Shanghai, China
| | - Mudi Sun
- Department of Rehabilitation Science, Faculty of Education, East China Normal University, Shanghai, China
| | - Lu Qu
- Shanghai Institute of AI for Education, East China Normal University, Shanghai, China
| | - Xuling Han
- Department of Rehabilitation Science, Faculty of Education, East China Normal University, Shanghai, China
| | - Lian Xu
- Sunshine Intellectual Disability (Autism) Early Childhood Education and Rehabilitation Center, Jiaxing, China
| | - Hang Zhao
- Department of Rehabilitation Science, Faculty of Education, East China Normal University, Shanghai, China
| | - Haidan Lu
- Department of Rehabilitation Science, Faculty of Education, East China Normal University, Shanghai, China
| | - Qiaoyun Liu
- Department of Rehabilitation Science, Faculty of Education, East China Normal University, Shanghai, China.
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Neumann D, Peterson ER, Underwood L, Morton SMB, Waldie KE. The Association Between Persistence and Change in Behavioral Difficulties During Early to Middle Childhood and Cognitive Abilities at Age 8. Child Psychiatry Hum Dev 2024; 55:1031-1043. [PMID: 36372805 PMCID: PMC11245443 DOI: 10.1007/s10578-022-01453-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 07/25/2022] [Accepted: 09/26/2022] [Indexed: 11/15/2022]
Abstract
We investigated the association between persistence and change in behavioral difficulties during early to middle childhood and several cognitive outcomes. We observed 3904 8-year-olds enrolled in the longitudinal study Growing Up in New Zealand (50% male/female; 23% Māori, 9% Pacific Peoples, 13% Asian, 2% Middle Eastern/Latin American/African, 9% Other, 43% European). The NIH Toolbox Cognition Battery was used to assess cognitive functioning at 8 years and the Strengths and Difficulties Questionnaire for behavioral difficulties at 4.5 and 8 years. Multivariate logistic regression analyses were conducted, controlling for well-known sociodemographic confounders. Children with persistent or later onset of behavioral difficulties were at higher risk for poorer vocabulary, reading, inhibitory control/attention, episodic memory, working memory and processing speed at age 8 compared to children with no or improved difficulties. Our study supports the importance of addressing both cognitive and behavioral aspects when planning educational programmes and interventions in early and middle childhood.
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Affiliation(s)
- Denise Neumann
- School of Psychology, Faculty of Science, University of Auckland, Private Bag 92019, 1142, Auckland, New Zealand.
- Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand.
- School of Population Health, The University of Auckland, Auckland, New Zealand.
| | - Elizabeth R Peterson
- School of Psychology, Faculty of Science, University of Auckland, Private Bag 92019, 1142, Auckland, New Zealand
- Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand
| | - Lisa Underwood
- Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand
| | - Susan M B Morton
- Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand
- School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Karen E Waldie
- School of Psychology, Faculty of Science, University of Auckland, Private Bag 92019, 1142, Auckland, New Zealand
- Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand
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Keating J, Uljarević M, van Goozen SHM, Abbot-Smith K, Hay DF, Leekam SR. Assessing pragmatic language difficulties using the Revised Children's Communication Checklist-2. Exploratory structural equation modeling and associations with restricted and repetitive behaviors. Autism Res 2024; 17:584-595. [PMID: 38311962 DOI: 10.1002/aur.3100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 01/10/2024] [Indexed: 02/06/2024]
Abstract
In this paper, we investigated the psychometric properties of the Child Communication Checklist-Revised (CCC-R) for the first time with an English-speaking sample. We used a confirmatory application of exploratory structural equation modeling (ESEM) to re-evaluate the CCC-R's psychometric properties. We found strong support for its use as an assessment for pragmatic and structural language. Our second main aim was to explore associations between pragmatic and structural language and restricted and repetitive behaviors (RRBs), two hallmark characteristics of autism. We used the CCC-R and Repetitive Behavior Questionnaire (RBQ-2) to investigate these associations in a diverse non-clinical sample of children, taking a transdiagnostic approach. We intentionally excluded autism and other neurodevelopmental diagnoses to test, (1) the CCC-R in a broad sample and (2) the association between pragmatic language and RRB in children not already selected for that association. The sample comprised two groups of children, one was community sampled (n = 123) and the other (n = 143) included children with non-specific behavioral, emotional and/or cognitive difficulties referred to an assessment unit by schools. We found clear associations between pragmatic language difficulties and RRBs in both groups. Regression analysis showed that pragmatic language was the only significant contributor to RRBs even after Grammatical-Semantic score, age, sex, and socioeconomic status were controlled. The pattern was the same for both recruitment groups. However, the effects were stronger for the school-referred group which also had more pragmatic difficulties, grammatical-semantic difficulties and RRBs. A robust link between pragmatic language and RRBs, established in autism, has continuity across the broader non-clinical population.
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Affiliation(s)
- Jennifer Keating
- Cardiff University Centre for Human Developmental Science, School of Psychology, Cardiff University, Cardiff, UK
| | - Mirko Uljarević
- Department of Psychiatry and Behavioural Sciences, Stanford University, Stanford, California, USA
| | - Stephanie H M van Goozen
- Cardiff University Centre for Human Developmental Science, School of Psychology, Cardiff University, Cardiff, UK
| | | | - Dale F Hay
- Cardiff University Centre for Human Developmental Science, School of Psychology, Cardiff University, Cardiff, UK
| | - Susan R Leekam
- Cardiff University Centre for Human Developmental Science, School of Psychology, Cardiff University, Cardiff, UK
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Berenguer C, Baixauli I, Rosa E, De Stasio S. Sleep problems in children with autism spectrum disorder and attention-deficit/hyperactivity disorder: A comparative study and effects on communication skills. Autism Res 2024; 17:355-365. [PMID: 38158389 DOI: 10.1002/aur.3077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 12/07/2023] [Indexed: 01/03/2024]
Abstract
Sleep disturbances are highly prevalent among children with neurodevelopmental disorders, like Autism Spectrum Disorder (ASD) and Attention-Deficit/Hiperactivity Disorder (ADHD). The first objective of this study is to examine the differences in sleep problems between a group of children with ASD without intellectual disabilities, a group with ADHD and a typically developing (TD) group. A second objective is aimed at analyzing the effects of sleep problems and symptom severity on their communication skills. Participants were 122 children between 7 and 12 years old distributed in three groups: 32 TD children, 47 children with ASD and 43 children with ADHD, matched on age and intelligence. Parents completed different questionnaires that measured sleep disturbances and communication skills. Findings show significant differences between the clinical groups and the TD group in most types of sleep disorders. Moreover, the group with ADHD showed significantly more sleep breathing disorders and hyperhidrosis in comparison with ASD and TD, as well as more total sleep problems. In contrast to ASD, the predictive power of sleep problems on communication difficulties was greater in the group with ADHD. The results of the mediation analysis indicate that in both groups, sleep problems partially mediate the relationship between symptoms and communication. This investigation highlights the need of considering sleep disorders when assessing communication skills in ASD and ADHD, given its indirect influence in this domain. Understanding the sleep dysfunctions of both conditions and their repercussions is crucial to develop adjusted interventions.
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Affiliation(s)
- Carmen Berenguer
- Departamento de Psicología evolutiva y de la educación, Universitat de València, València, Spain
| | - Inmaculada Baixauli
- Departamento de Logopedia, Universidad Católica de Valencia San Vicente Mártir, València, Spain
| | - Eva Rosa
- Departamento de Psicología Básica, Universitat de València, València, Spain
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Goh CJ, Kwon HJ, Kim Y, Jung S, Park J, Lee IK, Park BR, Kim MJ, Kim MJ, Lee MS. Improving CNV Detection Performance in Microarray Data Using a Machine Learning-Based Approach. Diagnostics (Basel) 2023; 14:84. [PMID: 38201393 PMCID: PMC10871075 DOI: 10.3390/diagnostics14010084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 12/26/2023] [Accepted: 12/28/2023] [Indexed: 01/12/2024] Open
Abstract
Copy number variation (CNV) is a primary source of structural variation in the human genome, leading to several disorders. Therefore, analyzing neonatal CNVs is crucial for managing CNV-related chromosomal disabilities. However, genomic waves can hinder accurate CNV analysis. To mitigate the influences of the waves, we adopted a machine learning approach and developed a new method that uses a modified log R ratio instead of the commonly used log R ratio. Validation results using samples with known CNVs demonstrated the superior performance of our method. We analyzed a total of 16,046 Korean newborn samples using the new method and identified CNVs related to 39 genetic disorders were identified in 342 cases. The most frequently detected CNV-related disorder was Joubert syndrome 4. The accuracy of our method was further confirmed by analyzing a subset of the detected results using NGS and comparing them with our results. The utilization of a genome-wide single nucleotide polymorphism array with wave offset was shown to be a powerful method for identifying CNVs in neonatal cases. The accurate screening and the ability to identify various disease susceptibilities offered by our new method could facilitate the identification of CNV-associated chromosomal disease etiologies.
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Affiliation(s)
- Chul Jun Goh
- Eone-Diagnomics Genome Center, Inc., 143, Gaetbeol-ro, Yeonsu-gu, Incheon 21999, Republic of Korea; (C.J.G.); (H.-J.K.); (Y.K.); (S.J.); (J.P.); (I.K.L.); (B.-R.P.); (M.-J.K.)
| | - Hyuk-Jung Kwon
- Eone-Diagnomics Genome Center, Inc., 143, Gaetbeol-ro, Yeonsu-gu, Incheon 21999, Republic of Korea; (C.J.G.); (H.-J.K.); (Y.K.); (S.J.); (J.P.); (I.K.L.); (B.-R.P.); (M.-J.K.)
- Department of Computer Science and Engineering, Incheon National University (INU), Incheon 22012, Republic of Korea
| | - Yoonhee Kim
- Eone-Diagnomics Genome Center, Inc., 143, Gaetbeol-ro, Yeonsu-gu, Incheon 21999, Republic of Korea; (C.J.G.); (H.-J.K.); (Y.K.); (S.J.); (J.P.); (I.K.L.); (B.-R.P.); (M.-J.K.)
| | - Seunghee Jung
- Eone-Diagnomics Genome Center, Inc., 143, Gaetbeol-ro, Yeonsu-gu, Incheon 21999, Republic of Korea; (C.J.G.); (H.-J.K.); (Y.K.); (S.J.); (J.P.); (I.K.L.); (B.-R.P.); (M.-J.K.)
| | - Jiwoo Park
- Eone-Diagnomics Genome Center, Inc., 143, Gaetbeol-ro, Yeonsu-gu, Incheon 21999, Republic of Korea; (C.J.G.); (H.-J.K.); (Y.K.); (S.J.); (J.P.); (I.K.L.); (B.-R.P.); (M.-J.K.)
| | - Isaac Kise Lee
- Eone-Diagnomics Genome Center, Inc., 143, Gaetbeol-ro, Yeonsu-gu, Incheon 21999, Republic of Korea; (C.J.G.); (H.-J.K.); (Y.K.); (S.J.); (J.P.); (I.K.L.); (B.-R.P.); (M.-J.K.)
- Department of Computer Science and Engineering, Incheon National University (INU), Incheon 22012, Republic of Korea
- NGENI Foundation, San Diego, CA 92127, USA
| | - Bo-Ram Park
- Eone-Diagnomics Genome Center, Inc., 143, Gaetbeol-ro, Yeonsu-gu, Incheon 21999, Republic of Korea; (C.J.G.); (H.-J.K.); (Y.K.); (S.J.); (J.P.); (I.K.L.); (B.-R.P.); (M.-J.K.)
| | - Myeong-Ji Kim
- Eone-Diagnomics Genome Center, Inc., 143, Gaetbeol-ro, Yeonsu-gu, Incheon 21999, Republic of Korea; (C.J.G.); (H.-J.K.); (Y.K.); (S.J.); (J.P.); (I.K.L.); (B.-R.P.); (M.-J.K.)
| | - Min-Jeong Kim
- Diagnomics, Inc., 5795 Kearny Villa Rd., San Diego, CA 92123, USA;
| | - Min-Seob Lee
- Eone-Diagnomics Genome Center, Inc., 143, Gaetbeol-ro, Yeonsu-gu, Incheon 21999, Republic of Korea; (C.J.G.); (H.-J.K.); (Y.K.); (S.J.); (J.P.); (I.K.L.); (B.-R.P.); (M.-J.K.)
- Diagnomics, Inc., 5795 Kearny Villa Rd., San Diego, CA 92123, USA;
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Bohn M, Tessler MH, Kordt C, Hausmann T, Frank MC. An individual differences perspective on pragmatic abilities in the preschool years. Dev Sci 2023; 26:e13401. [PMID: 37089076 DOI: 10.1111/desc.13401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 03/28/2023] [Accepted: 04/05/2023] [Indexed: 04/25/2023]
Abstract
Pragmatic abilities are fundamental to successful language use and learning. Individual differences studies contribute to understanding the psychological processes involved in pragmatic reasoning. Small sample sizes, insufficient measurement tools, and a lack of theoretical precision have hindered progress, however. Three studies addressed these challenges in three- to 5-year-old German-speaking children (N = 228, 121 female). Studies 1 and 2 assessed the psychometric properties of six pragmatics tasks. Study 3 investigated relations among pragmatics tasks and between pragmatics and other cognitive abilities. The tasks were found to measure stable variation between individuals. Via a computational cognitive model, individual differences were traced back to a latent pragmatics construct. This presents the basis for understanding the relations between pragmatics and other cognitive abilities. RESEARCH HIGHLIGHTS: Individual differences in pragmatic abilities are important to understanding variation in language development. Research in this domain lacks a precise theoretical framework and psychometrically high-quality measures. We present six tasks capturing a wide range of pragmatic abilities with excellent re-test reliability. We use a computational cognitive model to provide a substantive theory of individual differences in pragmatic abilities.
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Affiliation(s)
- Manuel Bohn
- Department of Comparative Cultural Psychology, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Michael Henry Tessler
- DeepMind, London, UK
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Clara Kordt
- Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Tom Hausmann
- Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
| | - Michael C Frank
- Department of Psychology, Stanford University, Stanford, California, USA
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Kohn BH, Vidal P, Chiao R, Pantalone DW, Faja S. Sexual Knowledge, Experiences, and Pragmatic Language in Adults With and Without Autism: Implications for Sex Education. J Autism Dev Disord 2023; 53:3770-3786. [PMID: 35922688 PMCID: PMC9362056 DOI: 10.1007/s10803-022-05659-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2022] [Indexed: 11/18/2022]
Abstract
Autistic adults have similar levels of desire for sexual and romantic relationships as their non-autistic peers. However, autistic adults are less likely to be in relationships and have less dating experience. We compared sexual knowledge, experiences, and pragmatic language ability in a community sample of young adults with (n = 27, mean age = 22.11) and without autism (n = 122, mean age = 19.47). Receipt of sex education and sexual knowledge did not differ between groups. However, autistic adults had significantly fewer partnered experiences and impaired pragmatic language. Within both groups, pragmatic skill predicted accurate sexual knowledge above and beyond general communication abilities. Findings suggest that sex education for autistic adults must address the social communication component of healthy romantic and sexual relationships.
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Affiliation(s)
- Brooke H Kohn
- Boston Children's Hospital, Boston, MA, USA
- New York University Langone Health, New York, NY, USA
| | - Paige Vidal
- Boston Children's Hospital, Boston, MA, USA
- Boston College, Boston, MA, USA
| | - Rachael Chiao
- Boston Children's Hospital, Boston, MA, USA
- Boston University, Boston, MA, USA
| | - David W Pantalone
- University of Massachusetts, Boston, MA, USA
- The Fenway Institute, Fenway Health, Boston, MA, USA
| | - Susan Faja
- Boston Children's Hospital, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
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Morken F, Helland WA, Evanger E, Vårvik A, Jones LØ. Oral language skills and mental health in female prisoners: pragmatic skills are essential. Front Psychol 2023; 14:1212121. [PMID: 37588247 PMCID: PMC10426285 DOI: 10.3389/fpsyg.2023.1212121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 07/11/2023] [Indexed: 08/18/2023] Open
Abstract
Introduction There are strong indications of an elevated incidence of both language problems and problems with mental health among prisoners. We also know that women in prison are a particularly vulnerable group who often face conditions that foremost accommodate the needs of men. In order to adapt prison conditions to women's needs and give better help, we need more information about their characteristics. In this study, we wanted to explore associations between oral language problems and mental health (depression and anxiety) in women in prison. Method Participants were 58 women, recruited from high and low security women's and mixed prisons. They completed a questionnaire covering demographic variables and several self-report measures. In the present study, the language measures were a Language Composite score (comprising articulation, impressive and expressive language, and pragmatics) and the La Trobe Communication Questionnaire (LCQ), measuring pragmatic skills specifically. Hopkins Symptom Checklist-10 (HSCL) was used as a measure of psychological distress. First, we assessed correlations between the language measures and mental health. Second, we performed group comparisons with groups defined as over or under cut-off on the Language Composite, LCQ total, and HSCL total scores. Results Results supported a clear connection between overall language and overall mental health. Pragmatic skills were the main driver of this effect. There was no difference in mental health between those scoring above and below cut-off for general language problems but the group with possible pragmatic impairment showed poorer mental health than those without. Conversely, there was no difference in general language skills between the groups scoring within and outside the range of psychological distress, but the first group evaluated their pragmatic skills as significantly poorer than the latter. Discussion We conclude that pragmatics seem to be core to the association between oral language skills and mental health among female prisoners. This should have implications for language services in prisons, as attending to these issues could positively affect prognosis and outcome.
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Affiliation(s)
- Frøydis Morken
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Wenche Andersen Helland
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
- Department of Research and Innovation, Helse Fonna Health Authority, Haugesund, Norway
| | | | | | - Lise Øen Jones
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
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Saul J, Griffiths S, Norbury CF. Prevalence and functional impact of social (pragmatic) communication disorders. J Child Psychol Psychiatry 2023; 64:376-387. [PMID: 36114685 PMCID: PMC10087005 DOI: 10.1111/jcpp.13705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/24/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND The aim of this study was to evaluate the Children's Communication Checklist-2 (CCC-2) for measuring social-pragmatic communication deficits and to ascertain their prevalence and functional impact in a community sample. METHODS We used parent and teacher responses to the CCC-2 to approximate inclusion (poor social-pragmatic skills) and exclusion (poor structural language skills or autistic symptomatology) criteria for social (pragmatic) communication disorder (SPCD). We tested the prevalence of social-pragmatic deficits in a population-based sample of children (n = 386) aged 5-6 years old using CCC-2 algorithms. We also investigated the academic and behavioural profiles of children with broadly defined limitations in social-pragmatic competence on the CCC-2. RESULTS Regardless of the diagnostic algorithm used, the resulting prevalence rates for social-pragmatic deficits indicated that very few children had isolated social-communication difficulties (0-1.3%). However, a larger proportion of children (range: 6.1-10.5%) had social-pragmatic skills outside the expected range alongside structural language difficulties and/or autism spectrum symptoms, and this profile was associated with a range of adverse academic and behavioural outcomes. CONCLUSIONS A considerable proportion of children in the early years of primary school has social-pragmatic deficits that interfere with behaviour and scholastic activity; however, these rarely occur in isolation. Exclusionary criteria that include structural language may lead to underidentification of individuals with social-pragmatic deficits that may benefit from tailored support and intervention.
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Affiliation(s)
- Jo Saul
- University College London, London, UK
| | | | - Courtenay Frazier Norbury
- University College London, London, UK.,Department of Special Needs Education, University of Oslo, Oslo, Norway
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Overbeck G, Kragstrup J, Gørtz M, Rasmussen IS, Graungaard AH, Siersma V, de Voss S, Ertmann RK, Shahrzad S, Appel CL, Wilson P. Family wellbeing in general practice: a study protocol for a cluster-randomised trial of the web-based resilience programme on early child development. Trials 2023; 24:7. [PMID: 36597136 PMCID: PMC9810520 DOI: 10.1186/s13063-022-07045-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 12/20/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Social, emotional and behavioural problems in early childhood are associated with increased risk for a wide range of poor outcomes associated with substantial cost and impact on society as a whole. Some of these problems are rooted in the early mother-infant relationship and might be prevented. In Denmark, primary health care has a central role in preventive care during pregnancy and the first years of the child's life and general practice provides opportunities to promote a healthy mother-infant relationship in early parenthood. OBJECTIVE In the context of standardised antenatal and child development assessments focused on psychosocial wellbeing, we examine the impact of a complex intervention designed to improve maternal mentalisation skills, involving training of general practice clinicians and signposting towards a web-based resource. Joint main outcomes are child socio-emotional and language development at age 30 months measured by parentally reported questionnaires (Communicative Development Inventory and Strengths and Difficulties Questionnaire). METHODS The study is a cluster-randomised controlled trial based in general practices in the Capital Region and the Zealand Region of Denmark. Seventy practices were included. Practices were randomised by a computer algorithm in a ratio of 1:1 to intervention or control groups. Each practice was asked to recruit up to 30 women consecutively at their first scheduled antenatal assessment. Clinicians in both groups received one day of training in preventive antenatal and child development consultations with added focus on parental psychosocial well-being, social support, and parent-child interaction. These preventive consultations delivered in both trial arms require enhanced data recording about psychosocial factors. In intervention clinics, clinicians were asked to signpost a web page at three scheduled antenatal consultations and at four scheduled consultations when the child is 5 weeks, 5 months, 1 and 2 years. DISCUSSION We hypothesise that the intervention will increase mothers' ability to be sensitive to their child's mental state to an extent that improves the child's language and mental state at 30 months of age measured by parent-reported questionnaires. TRIAL REGISTRATION ClinicalTrials.gov NCT04129359. Registered on Oct 16 2019.
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Affiliation(s)
- Gritt Overbeck
- grid.5254.60000 0001 0674 042XUniversity of Copenhagen, Department of Public Health, Centre for General Practice, University of Copenhagen, Copenhagen, Denmark
| | - Jakob Kragstrup
- grid.5254.60000 0001 0674 042XUniversity of Copenhagen, Department of Public Health, Centre for General Practice, University of Copenhagen, Copenhagen, Denmark
| | - Mette Gørtz
- grid.5254.60000 0001 0674 042XDepartment of Economics and Center for Economic Behavior and Inequality (CEBI), University of Copenhagen, Copenhagen, Denmark
| | - Ida Scheel Rasmussen
- grid.5254.60000 0001 0674 042XUniversity of Copenhagen, Department of Public Health, Centre for General Practice, University of Copenhagen, Copenhagen, Denmark
| | - Anette Hauskov Graungaard
- grid.5254.60000 0001 0674 042XUniversity of Copenhagen, Department of Public Health, Centre for General Practice, University of Copenhagen, Copenhagen, Denmark
| | - Volkert Siersma
- grid.5254.60000 0001 0674 042XUniversity of Copenhagen, Department of Public Health, Centre for General Practice, University of Copenhagen, Copenhagen, Denmark
| | - Sarah de Voss
- grid.5254.60000 0001 0674 042XUniversity of Copenhagen, Department of Public Health, Centre for General Practice, University of Copenhagen, Copenhagen, Denmark
| | - Ruth Kirk Ertmann
- grid.5254.60000 0001 0674 042XUniversity of Copenhagen, Department of Public Health, Centre for General Practice, University of Copenhagen, Copenhagen, Denmark
| | - Sinead Shahrzad
- grid.5254.60000 0001 0674 042XUniversity of Copenhagen, Department of Public Health, Centre for General Practice, University of Copenhagen, Copenhagen, Denmark
| | - Clara Lundmark Appel
- grid.5254.60000 0001 0674 042XUniversity of Copenhagen, Department of Public Health, Centre for General Practice, University of Copenhagen, Copenhagen, Denmark
| | - Philip Wilson
- grid.5254.60000 0001 0674 042XUniversity of Copenhagen, Department of Public Health, Centre for General Practice, University of Copenhagen, Copenhagen, Denmark ,grid.7107.10000 0004 1936 7291Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland
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Mood D, Sheldon R, Tabangin M, Wiley S, Meinzen-Derr J. Technology assisted language intervention (TALI) for children who are deaf/hard of hearing: promising impact on pragmatic skills. DEAFNESS & EDUCATION INTERNATIONAL : THE JOURNAL OF THE BRITISH ASSOCIATION OF TEACHERS OF THE DEAF 2022; 24:334-355. [PMID: 37304207 PMCID: PMC10254572 DOI: 10.1080/14643154.2022.2135731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 09/30/2022] [Accepted: 10/10/2022] [Indexed: 06/13/2023]
Abstract
Children who are deaf and hard of hearing (DHH) often demonstrate pragmatic language difficulties which can impact academic and social outcomes. This randomized control trial for DHH children, ages 3-12 years, explored the Technology-Assisted Language Intervention (TALI), incorporating augmentative and alternative communication technology (AAC) into traditional speech/language therapy, compared to treatment-as-usual (TAU) to determine impact on pragmatics. Pragmatic outcome measures included parent reported Pragmatics Profile of the CELF-5 (for children age ≥5 years) and CELF-P Descriptive Pragmatics Profile (for children <5 years) in addition to parent reported Social and Communication domains of the Vineland Adaptive Behavior Scales,Third Edition (VABS). Over 24 weeks, children ≥5 years in the TALI made significantly more progress (increase in raw scores) on the Pragmatics Profile compared to children in TAU (12.7 points vs. -6.0 points; p = 0.04) and also showed significant gains on two of the three subscales. For children ≥5 years, no significant VABS changes were seen in either intervention group. For children <5 years, there were no statistically significant differences in growth on the CELF-P total pragmatics raw score or on any subdomain. However, children in TALI had significant increases in the mean VABS Communication (86.7-99.1) and Social domain standard scores (91.8-97.4;p = 0.01), while gains for children in TAU on the Communication and Social domain standard scores were not statistically significant. These promising results support the need for additional research exploring the effectiveness of AAC supported speech/language therapy to enhance DHH children's pragmatic language skills. Trial registration ClinicalTrials.gov identifier: NCT02998164.
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Affiliation(s)
- Deborah Mood
- Division of Developmental and Behavioral Pediatrics, Children’s Hospital Colorado, Department of Pediatrics, University of Colorado Anschutz, Aurora, CO, USA
| | - Rose Sheldon
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Meredith Tabangin
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH USA
| | - Susan Wiley
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Jareen Meinzen-Derr
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH USA
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12
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Camia M, Benassi E, Giovagnoli S, Scorza M. Specific learning disorders in young adults: Investigating pragmatic abilities and their relationship with theory of mind, executive functions and quality of life. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 126:104253. [PMID: 35526492 DOI: 10.1016/j.ridd.2022.104253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 02/23/2022] [Accepted: 04/24/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Specific Learning Disorders (SLD) are lifelong conditions often associated with language difficulties, executive dysfunctions, and psychological problems. Previous research has shown that communicative-pragmatic ability may be impaired in SLD. However, the role of other cognitive abilities in explaining pragmatic difficulties has still not been fully investigated. The relationship between pragmatics and quality of life is not yet clear, as well. AIMS Firstly, the study assessed pragmatic comprehension abilities in adults with SLD. Secondly, we examined the relationship between pragmatics, theory of mind, executive functions and quality of life. METHOD AND PROCEDURES We enrolled 26 adults with SLD and 30 adults without SLD. Standardized tests assessing pragmatic comprehension, theory of mind and executive functions were used. The quality of life was investigated with a self-reported questionnaire. OUTCOMES AND RESULTS Pragmatic comprehension abilities were compromised in young adults with SLD. In this clinical population we also found a link between pragmatic comprehension and visual theory of mind. Finally, independently from the presence of SLD, pragmatics abilities were in relationship with quality of life. CONCLUSIONS AND IMPLICATIONS Overall, these data highlight the importance of including pragmatic abilities both in the clinical evaluation, as well as in psychological intervention for adults with SLD.
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Affiliation(s)
- Michela Camia
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Campus San Lazzaro, Via Amendola 2, Reggio Emilia, Italy.
| | - Erika Benassi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Campus San Lazzaro, Via Amendola 2, Reggio Emilia, Italy.
| | - Sara Giovagnoli
- Department of Psychology "Renzo Canestrari", University of Bologna, Viale Berti Pichat 5, Bologna, Italy.
| | - Maristella Scorza
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Campus San Lazzaro, Via Amendola 2, Reggio Emilia, Italy.
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13
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Social communication and quality of life in children using hearing aids. Int J Pediatr Otorhinolaryngol 2022; 152:111000. [PMID: 34883326 DOI: 10.1016/j.ijporl.2021.111000] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 11/10/2021] [Accepted: 12/02/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVES This study compared the parent-reported structural language and social communication skills-measured with the Children's Communication Checklist-2 (CCC-2)-and health-related quality of life (HR-QOL)-measured with the Pediatric Quality of Life Inventory (PedsQL)-of children who use hearing aids (HAs) and their typical-hearing (TH) peers. DESIGN The participants were 88 children (age range of 5; 6 to 13; 1 (years; months)) and their parents: 45 children with bilateral moderate to severe hearing loss using HAs who had no additional disabilities and 43 children with typical hearing. The groups were matched based on chronological age, gender, nonverbal IQ, and parental education level. The parents completed questionnaires related to their children's communication skills, including subdomains structural language and social communication, and HR-QOL. RESULTS The HA group had significantly poorer overall communication skills than the TH group (r = 0.49). The children in the HA group scored significantly lower than the TH group on both structural language (r = 0.37) and social communication (r = 0.41). Half of the children in the HA group had overall communication scores that either indicated concern or required further investigation according to the instrument's manual. In terms of psychosocial functioning, which was measured as HR-QOL, the subdomain school functioning was the main driver of the difference between groups, with the HA group being at least twice as likely (OR = 2.52) as the TH group to have poor HR-QOL in the school domain. Better parent-reported social communication was associated with better parent-reported psychosocial functioning in the children using HAs-even when background variables were taken into account. CONCLUSION The results suggest that traditional assessments and interventions targeting structural aspects of language may overlook social communication difficulties in children with HAs, even those with no additional disabilities. As school functioning stood out as the most problematic domain for children with HAs, efforts to improve the well-being of these children should focus on this area.
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14
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Dall M, Fellinger J, Holzinger D. The link between social communication and mental health from childhood to young adulthood: A systematic review. Front Psychiatry 2022; 13:944815. [PMID: 36276323 PMCID: PMC9584641 DOI: 10.3389/fpsyt.2022.944815] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 09/13/2022] [Indexed: 12/03/2022] Open
Abstract
UNLABELLED This systematic review investigates the current state of the literature on the association between social communication (SC) skills and mental health outcomes in children and young adults. We ran searches using terms describing SC and mental health in the following databases: PubMed, the Psychology and Behavioral Sciences Collection, APA PsychInfo, the Education Resource Information Center (ERIC) and the Cumulative Index to Nursing and Allied Health Literature (CINAHL). We included studies that both measured SC before age 21 years and assessed a mental health component, such as behavior/conduct problems, anxiety, depression, or emotional problems, before age 30. Only peer-reviewed articles published in or after 2000 were retained. In total, 27 studies were included in the narrative synthesis. Overall, the methodological quality was good. A longitudinal design was used in 12 studies, seven of which sourced data from the Avon Longitudinal Study of Parents and Children. Most studies investigated the broad concept of pragmatic language and its influence on internalizing, externalizing, and peer-relationship problems. The analyzed publications included population-based studies and studies investigating special populations with existing mental health problems or at increased risk of developing them. The population-based cross-sectional studies showed significantly higher rates of SC problems in children with mental health problems while those with a longitudinal design found earlier onset and more persistent mental health problems in children who had the most severe SC difficulties. Studies with special populations confirmed more SC problems as compared to typically developing children and worse mental health outcomes in children with additional SC difficulties. The available literature thus shows consistently significant, mostly moderate associations between SC skills and mental health outcomes. SC difficulties earlier in life can predict mental health problems and impact their trajectories. SYSTEMATIC REVIEW REGISTRATION [https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=286598], identifier [CRD42022286598].
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Affiliation(s)
- Magdalena Dall
- Research Institute for Developmental Medicine, Johannes Kepler University Linz, Linz, Austria
| | - Johannes Fellinger
- Research Institute for Developmental Medicine, Johannes Kepler University Linz, Linz, Austria.,Institute of Neurology of Senses and Language, Hospital of St. John of God, Linz, Austria.,Clinical Department of Social Psychiatry, University Clinic for Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Daniel Holzinger
- Research Institute for Developmental Medicine, Johannes Kepler University Linz, Linz, Austria.,Institute of Neurology of Senses and Language, Hospital of St. John of God, Linz, Austria.,Faculty of Humanities, Institute of Linguistics, University of Graz, Graz, Austria
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15
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Lewis BA, Benchek P, Tag J, Miller G, Freebairn L, Taylor HG, Iyengar SK, Stein CM. Psychosocial Comorbidities in Adolescents With Histories of Childhood Apraxia of Speech. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:2572-2588. [PMID: 34609155 PMCID: PMC9132062 DOI: 10.1044/2021_ajslp-21-00035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 04/18/2021] [Accepted: 06/29/2021] [Indexed: 06/13/2023]
Abstract
Purpose Adolescent psychosocial outcomes of individuals with histories of childhood apraxia of speech (CAS) were compared to outcomes of individuals with histories of speech sound disorders (SSD) only and SSD with language impairment (LI). It was hypothesized that individuals with more severe and persistent disorders such as CAS would report poorer psychosocial outcomes. Method Groups were compared using analyses of variance on a psychosocial assessment battery that included measures of hyperactivity and inattention, anxiety, depression, internalizing and externalizing behaviors, thought problems, and social outcomes. Results Results revealed significant group differences on self-report of social problems and parent report of hyperactivity, thought problems, and social problems at adolescence. Compared to the SSD-only group, the CAS group had significantly higher parental ratings of hyperactivity and social problems in adolescence. The CAS and SSD + LI groups did not differ on psychosocial measures, possibly due to the high rate of comorbid LI in the CAS group. The CAS group also had more individuals who scored in the borderline/clinical range on self-report of social problems than the SSD-only group. The CAS group did not differ from the SSD + LI group in the number of participants scoring in the borderline/clinical range on measures. Conclusions Individuals with histories of CAS demonstrate increased rates of social problems and hyperactivity based on parent ratings compared to adolescents with histories of SSD only; however, most do not score within the clinical range. The persistence of speech sound errors combined with self-reported and parent-reported social difficulties suggests that speech-language pathologists should be sensitive to the social and emotional impact of CAS and make appropriate referrals to mental health professionals when warranted.
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Affiliation(s)
- Barbara A. Lewis
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH
| | - Penelope Benchek
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH
| | - Jessica Tag
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH
| | - Gabrielle Miller
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH
| | - Lisa Freebairn
- Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH
| | - H. Gerry Taylor
- Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH
- Department of Pediatrics, The Ohio State University, Columbus
| | - Sudha K. Iyengar
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH
| | - Catherine M. Stein
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH
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16
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17
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Miller AB, Machlin L, McLaughlin KA, Sheridan MA. Deprivation and psychopathology in the Fragile Families Study: A 15-year longitudinal investigation. J Child Psychol Psychiatry 2021; 62:382-391. [PMID: 32407580 PMCID: PMC7666037 DOI: 10.1111/jcpp.13260] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/16/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Early adversity consistently predicts youth psychopathology. However, the pathways linking unique dimensions of early adversity, such as deprivation, to psychopathology are understudied. Here, we evaluate a theoretical model linking early deprivation exposure with psychopathology prospectively through language ability. METHODS Participants included 2,301 youth (47.5% female) enrolled in the Fragile Families and Child Wellbeing Study. We include data from assessment points at ages 1, 3, 5, 9, and 15. Latent factors for deprivation and threat were modeled from multiple indicators at ages 1 and 3. Youth language ability was assessed at Age 5. Indicators of psychopathology were assessed at ages 5, 9, and 15. A structural equation model tested longitudinal paths to internalizing and externalizing psychopathology from experiences of deprivation and threat. RESULTS Deprivation from birth to Age 3 was associated with an indirect effect on internalizing and externalizing symptoms in early childhood (Age 5), later childhood (Age 9), and adolescence (Age 15) via language ability in early childhood (Age 5). Early threat exposure was associated with increased internalizing and externalizing psychopathology across all ages. There was no significant indirect effect from threat to psychopathology via language ability. CONCLUSIONS The effects of deprivation on psychopathology during early childhood, late childhood, and adolescence are explained, in part, through early childhood language ability. Results provide insight into language ability as a possible opportunity for intervention.
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Affiliation(s)
- Adam Bryant Miller
- Department of Psychology and Neurosciences, University of
North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Laura Machlin
- Department of Psychology and Neurosciences, University of
North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Margaret A. Sheridan
- Department of Psychology and Neurosciences, University of
North Carolina at Chapel Hill, Chapel Hill, NC, USA
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18
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Parke EM, Becker ML, Graves SJ, Baily AR, Paul MG, Freeman AJ, Allen DN. Social Cognition in Children With ADHD. J Atten Disord 2021; 25:519-529. [PMID: 30541372 DOI: 10.1177/1087054718816157] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Objective: Despite evidence of social skill deficits in children with ADHD, there is no consensus regarding a social cognitive profile and whether these skills predict behavior. Therefore, a comprehensive battery was used to investigate the relationship between social cognition and behavioral functioning. Method: Children ages 7 to 13 with ADHD (n = 25) and controls (n = 25) completed tests assessing social cognitive domains (affect recognition and theory of mind [ToM]). Parents completed measures of social cognition (pragmatic language ability and empathy), behavioral symptoms, and adaptive functioning. Results: Children with ADHD performed significantly worse on measures of cognitive ToM and affect recognition and received lower ratings of pragmatic language and cognitive empathy than typically developing peers. These domains, particularly pragmatic language, predicted parent ratings of problematic and adaptive behaviors. Conclusion: Results establish a relationship between specific social cognitive abilities and daily functioning, which has implications for treatment.
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19
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Murphy S, Joffe V, Donald L, Radley J, Sunthararajah S, Welch C, Bell K, Messer D, Crafter S, Fairhurst C, Corbacho B, Rodgers S, Torgerson D. Evaluating 'Enhancing Pragmatic Language skills for Young children with Social communication impairments' (E-PLAYS): a feasibility cluster-randomised controlled trial. Pilot Feasibility Stud 2021; 7:5. [PMID: 33390188 PMCID: PMC7780650 DOI: 10.1186/s40814-020-00724-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 11/10/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND This article reports the results from a feasibility study of an intervention ('E-PLAYS') aimed at supporting children who experience difficulties with social communication. E-PLAYS is based around a dyadic computer game, which aims to develop collaborative and communication skills. A pilot study found that when E-PLAYS was delivered by researchers, improvements on communication test scores and on collaborative behaviours were observed. The aim of this study was to ascertain the feasibility of running a full-scale trial to test the effectiveness of E-PLAYS in a National Health Service (NHS) setting with delivery by speech and language therapists and teaching assistants. METHODS The study was a two-arm feasibility cluster-randomised controlled trial of the E-PLAYS intervention with a treatment as usual control arm. Data relating to recruitment and retention, treatment fidelity, acceptability to participants, suitability of outcomes and feasibility of collecting health economic measures and of determining cost-effectiveness were collected. Speech and language therapists selected suitable children (ages 4-7 years old) from their caseload. E-PLAYS intervention (experimental group) was then delivered by teaching assistants overseen by speech and language therapists. The control group received usual care. Assessments included blinded language measures and observations, non-blinded teacher-reported measures of peer relations and classroom behaviour and non-blinded parent-reported use of health and education resources and quality of life. RESULTS Planned recruitment was for 70 children, in the event, 50 children were recruited which was sufficient for feasibility purposes. E-PLAYS was very highly rated by children, teaching assistants and speech and language therapists and treatment fidelity did not pose any issues. We were able to collect health economic data which suggests that E-PLAYS would be a low-cost intervention. CONCLUSION Based on recruitment, retention and adherence rates and our outcome measures, a full-scale randomised controlled trial estimated appears feasible and warranted to assess the effectiveness of E-PLAYS for use by the NHS and schools. TRIAL REGISTRATION ISRCTN 14818949 (retrospectively registered).
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Affiliation(s)
- Suzanne Murphy
- Institute of Health Research, University of Bedfordshire, University Square, Luton, LU1 3JU UK
| | - Victoria Joffe
- University of Essex, Wivenhoe Park, Colchester, CO4 3SQ UK
| | - Louisa Donald
- Institute of Health Research, University of Bedfordshire, University Square, Luton, LU1 3JU UK
| | - Jessica Radley
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX UK
| | - Sailaa Sunthararajah
- Research and Development Office, North East London NHS Foundation Trust, Goodmayes Hospital, Barley Lane, Ilford, IG3 8XJ UK
| | - Charlie Welch
- Department of Health Sciences, University of York, Heslington, YO10 5DD UK
| | - Kerry Bell
- Department of Health Sciences, University of York, Heslington, YO10 5DD UK
| | - David Messer
- Education & Language Studies, Faculty of Wellbeing, Open University, Walton Hall, Kents Hill, Milton Keynes, MK7 6AA UK
| | - Sarah Crafter
- School of Psychology, Faculty of Arts & Social Sciences, Open University, Walton Hall, Kents Hill, Milton Keynes, MK7 6AA UK
| | - Caroline Fairhurst
- Department of Health Sciences, University of York, Heslington, YO10 5DD UK
| | - Belen Corbacho
- Department of Health Sciences, University of York, Heslington, YO10 5DD UK
| | - Sara Rodgers
- Department of Health Sciences, University of York, Heslington, YO10 5DD UK
| | - David Torgerson
- Department of Health Sciences, University of York, Heslington, YO10 5DD UK
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20
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Weber C, Weber C, Fellinger J, Holzinger D. Development of a Social Communication Questionnaire (QSC-ID) for People With Intellectual Disability in a Deaf Sample: A Pilot and Feasibility Study. Front Psychiatry 2021; 12:755993. [PMID: 34955917 PMCID: PMC8692566 DOI: 10.3389/fpsyt.2021.755993] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 11/16/2021] [Indexed: 11/30/2022] Open
Abstract
Background: Social communication (SC) includes the use and interpretation of verbal and non-verbal messages within a social context and thus requires more than knowledge of language. Social communication skills are essential for connecting and engaging with others, and SC deficits are often associated with emotional and behavioral problems. There is a lack of feasible instruments for assessing SC skills in individuals with intellectual disability (ID). Methods: A questionnaire on social communication in adults with ID (QSC-ID) comprising 20 Likert-scaled items was developed and completed on behalf of participants (n = 52) from three Austrian therapeutic living communities for people with ID and deafness by their living- and working-facility key caregivers. The sample of adults with hearing loss was considered ideal for the development of a measure of SC that is not restricted to a specific communication mode or overly related with language skills. Results: The preliminary results showed high construct validity. Correlations were high between SC and language, social skills, and severity of autism spectrum disorder (ASD), moderate between SC and adaptive skills, and non-verbal intelligence and, as expected, low between SC and motor skills. Interrater reliability was found to be good or at least acceptable for all items. Total raw scores were well-distributed over the whole range-Cut-offs based on the 10th and 20th percentile are suggested to identify atypical and borderline SC skills. Caregiver feedback and completeness of data suggest that the questionnaire is highly feasible. Conclusion: Questionnaire on social communication in adults with ID is an easy-to-use caregiver-reported questionnaire for use with individuals with mild to severe forms of ID. Initial testing of validity looks promising. Further validation in populations with typical hearing is required. Due to substantial correlations between SC and structural language skills the calculation of specific SC cut-offs for different levels of linguistic skills should be considered when sufficient data is available.
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Affiliation(s)
- Chantal Weber
- Institute of Neurology of Senses and Language, Hospital of St. John of God, Linz, Austria.,Research Institute for Developmental Medicine, Johannes Kepler University Linz, Linz, Austria
| | - Christoph Weber
- Research Institute for Developmental Medicine, Johannes Kepler University Linz, Linz, Austria.,Department for Inclusive Education, University of Education Upper Austria, Linz, Austria
| | - Johannes Fellinger
- Institute of Neurology of Senses and Language, Hospital of St. John of God, Linz, Austria.,Research Institute for Developmental Medicine, Johannes Kepler University Linz, Linz, Austria.,Division of Social Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Daniel Holzinger
- Institute of Neurology of Senses and Language, Hospital of St. John of God, Linz, Austria.,Research Institute for Developmental Medicine, Johannes Kepler University Linz, Linz, Austria.,Institute of Linguistics, University of Graz, Graz, Austria
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21
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Bush L, Martin GE, Landau E, Losh M. A Longitudinal Study of Parent-Child Interactions and Language Outcomes in Fragile X Syndrome and Other Neurodevelopmental Disorders. Front Psychiatry 2021; 12:718572. [PMID: 34819882 PMCID: PMC8606641 DOI: 10.3389/fpsyt.2021.718572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 10/11/2021] [Indexed: 11/23/2022] Open
Abstract
Difficulties with pragmatic language (i.e., language in social contexts, such as conversational ability) are a noted characteristic of the language profiles of both fragile X syndrome (FXS) and autism spectrum disorder (ASD), conditions which show significant phenotypic overlap. Understanding the origins and developmental course of pragmatic language problems in FXS and other developmental conditions associated with language impairment is a critical step for the development of targeted interventions to promote communicative competence across the lifespan. This study examined pragmatic language in the context of parent-child interactions in school-age children with FXS (who did and did not meet ASD criteria on the ADOS; n = 85), idiopathic ASD (n = 32), Down syndrome (DS; n = 38), and typical development (TD; n = 39), and their parents. Parent-child communicative interactions were examined across multiple contexts, across groups, and in relationship to pragmatic language outcomes assessed 2 years later. Results showed both overlapping and divergent patterns across the FXS-ASD and idiopathic ASD child and parent groups, and also highlighted key differences in pragmatic profiles based on situational context, with more pragmatic language difficulties occurring for both ASD groups in less structured interactions. Differences in parental language styles during parent-child interactions were associated with child language outcomes, likely reflecting the complex interplay of discourse style inherent to a parent, with the inevitable influence of child characteristics on parent language as well. Together, findings help delineate the dynamic and multifactorial nature of impaired pragmatic skills among children with FXS and other neurodevelopmental disorders associated with language impairment, with potential implications for the development of targeted interventions for pragmatic communication skills.
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Affiliation(s)
- Lauren Bush
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, United States.,Department of Psychiatry and Behavioral Sciences, Autism Assessment, Research, Treatment, and Services Center, Rush University Medical Center, Chicago, IL, United States
| | - Gary E Martin
- Department of Communication Sciences and Disorders, St. John's University, Staten Island, NY, United States
| | - Emily Landau
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, United States
| | - Molly Losh
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, United States
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22
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Yoshinaga-Itano C, Sedey AL, Mason CA, Wiggin M, Chung W. Early Intervention, Parent Talk, and Pragmatic Language in Children With Hearing Loss. Pediatrics 2020; 146:S270-S277. [PMID: 33139440 PMCID: PMC8237329 DOI: 10.1542/peds.2020-0242f] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/31/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Pragmatic language skills form the foundation for conversational competence, whereas deficits in this area are associated with behavioral problems and low literacy skills. Children who are deaf or hard of hearing demonstrate significant delays in this critical area of language. Our purpose with this research was to identify variables associated with pragmatic language ability in children who are deaf or hard of hearing. METHODS This was a longitudinal study of 124 children with bilateral hearing loss between 4 and 7 years of age living in Colorado. As part of a comprehensive speech and language assessment, pragmatic language skills were evaluated annually by using the Pragmatics Checklist. RESULTS The children's pragmatic skills increased significantly with age. Higher levels of pragmatic language ability at 7 years of age were predicted by (1) meeting Early Hearing Detection and Intervention 1-3-6 guidelines (hearing screening by 1 month, identification of hearing loss by 3 months, and receiving intervention by 6 months of age), (2) greater quantity of parent talk, (3) higher nonverbal intelligence, (4) lesser degrees of hearing loss, and (5) higher maternal education. CONCLUSIONS With the findings of this study, we underscore the importance of pediatricians and other health care professionals counseling parents about the value of adherence to the Early Hearing Detection and Intervention 1-3-6 guidelines with regard to intervention outcomes. The strong association between amount of child-directed parent talk in the first 4 years of life and pragmatic language outcomes at 7 years of age emphasizes the need for professionals to encourage parents to talk to their children as much as possible.
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Affiliation(s)
| | - Allison L. Sedey
- Institute of Cognitive Science, University of Colorado-Boulder, Boulder, Colorado;,Colorado School for the Deaf and the Blind, Colorado Springs, Colorado
| | - Craig A. Mason
- School of Learning and Teaching, University of Maine, Orono, Maine
| | - Mallene Wiggin
- Institute of Cognitive Science, University of Colorado-Boulder, Boulder, Colorado
| | - Winnie Chung
- Centers for Disease Control and Prevention, Atlanta, Georgia
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23
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Nilsen ES, Silva J, McAuley T, Floto S. Executive functioning moderates associations between shyness and pragmatic abilities. SOCIAL DEVELOPMENT 2020. [DOI: 10.1111/sode.12485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | - Janel Silva
- Psychology Department University of Waterloo Waterloo ON Canada
| | - Tara McAuley
- Psychology Department University of Waterloo Waterloo ON Canada
| | - Shanan Floto
- Psychology Department University of Waterloo Waterloo ON Canada
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Ramsook KA, Welsh JA, Bierman KL. What you say, and how you say it: Preschoolers' growth in vocabulary and communication skills differentially predict kindergarten academic achievement and self-regulation. SOCIAL DEVELOPMENT 2020; 29:783-800. [PMID: 33041538 DOI: 10.1111/sode.12425] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The idea that language skills support school readiness, predicting later self-regulation and academic success, is widely accepted. Although vocabulary is often emphasized in the developmental literature, the ability to use language appropriately in the classroom, or social communication skills, may also be critical. This paper examined longitudinal contributions of children's vocabulary and social communication skills, from preschool to kindergarten, to kindergarten academic achievement (reading and math) and self-regulation (executive functions and learning behaviors). Participants were 164 children (14% Latinx, 30% Black, 56% White; 57% girls) enrolled in Head Start programs. Results revealed that initial levels and growth in vocabulary and communication skills predicted better academic achievement. Social communication skills uniquely predicted self-regulation, after accounting for vocabulary. We discuss potential mechanisms for these links and recommend that strategies to build social communication skills be incorporated in preschool interventions promoting school readiness.
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James K, Munro N, Togher L, Cordier R. The Spoken Language and Social Communication Characteristics of Adolescents in Behavioral Schools: A Controlled Comparison Study. Lang Speech Hear Serv Sch 2020; 51:115-127. [PMID: 31603367 DOI: 10.1044/2019_lshss-18-0090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose Working with students with emotional behavioral disorders is a challenging area of speech-language pathology practice. In this study, we compare and profile the narrative discourse, structural language, and social communication characteristics of adolescents attending behavioral support and mainstream schools. We also examine relationships between narratives, structural language, social communication, and behavior. Method Fifty-four students aged between 12 and 16 years participated. Twenty-seven students were from 3 Australian government Schools for Specific Purposes for students with behavioral difficulties, and 27 typically developing students were from a mainstream, government school. Students were matched for age and closely matched for sex and socioeconomic status. All students completed 3 communication assessments: oral narrative, structural language, and social communication skills. Teachers were asked to complete 2 behavioral questionnaires. Results Students in behavioral schools had significant difficulties generating narratives. Their structural language and overall social communication skills were also significantly poorer than their mainstream peers. One third of the behavioral group experienced significant difficulties across all 3 of these communication areas. Externalizing behavior was significantly related to narrative, structural language, and social communication only when the data were pooled across both groups. Conclusions Language and social communication difficulties were evident in adolescents who attend alternative school settings-behavioral schools. These findings confirm the need for speech-language pathologists to be engaged in specialist behavioral schools and provide impetus to service providers, speech-language pathologists, and educators to address relationships between behavior and communication ability.
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Affiliation(s)
- Karen James
- Discipline of Speech Pathology, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Natalie Munro
- Discipline of Speech Pathology, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia.,School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia, Australia
| | - Leanne Togher
- Discipline of Speech Pathology, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Reinie Cordier
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia, Australia.,Faculty of Educational Sciences, Department of Special Needs Education, The University of Oslo, Norway
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26
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Baixauli I, Mira A, Berenguer C, Roselló B, Miranda A. Family Factors and Communicative Skills in Children with Autism Without Intellectual Disability. J Autism Dev Disord 2019; 49:5023-5035. [DOI: 10.1007/s10803-019-04216-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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27
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Socher M, Lyxell B, Ellis R, Gärskog M, Hedström I, Wass M. Pragmatic Language Skills: A Comparison of Children With Cochlear Implants and Children Without Hearing Loss. Front Psychol 2019; 10:2243. [PMID: 31649586 PMCID: PMC6794448 DOI: 10.3389/fpsyg.2019.02243] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 09/19/2019] [Indexed: 11/27/2022] Open
Abstract
Pragmatic language ability refers to the ability to use language in a social context. It has been found to be correlated with success in general education for deaf and hard of hearing children. It is therefore of great importance to study why deaf and hard of hearing children often perform more poorly than their hearing peers on tests measuring pragmatic language ability. In the current study the Pragmatics Profile questionnaire from the CELF-IV battery was used to measure pragmatic language ability in children using cochlear implants (N = 14) and children without a hearing loss (N = 34). No significant difference was found between the children with cochlear implants (CI) and the children without hearing loss (HL) for the sum score of the pragmatics language measure. However, 35.71% of the children with CI performed below age norm, while only 5.89% of the children without HL performed below age norm. In addition, when dividing the sum score into three sub-measures: Rituals and Conversational skills (RCS), Asking for, Giving, and Responding to Information (AGRI), and Nonverbal Communication skills (NCS), significant differences between the groups were found for the NCS measure and a tendency for a difference was found for the RCS measure. In addition, all three sub-measures (NCS, AGRI, RCS) were correlated to verbal fluency in the children with CI, but not the children without HL.
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Affiliation(s)
- Michaela Socher
- Swedish Institute of Disability Research, Linköping University, Linköping, Sweden
| | - Björn Lyxell
- Swedish Institute of Disability Research, Linköping University, Linköping, Sweden.,Special Needs Education, University of Oslo, Oslo, Norway
| | - Rachel Ellis
- Swedish Institute of Disability Research, Linköping University, Linköping, Sweden
| | - Malin Gärskog
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Ingrid Hedström
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Malin Wass
- Department of Business Administration, Technology and Social Sciences, Luleå University of Technology, Luleå, Sweden
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Brenne E, Rimehaug T. Pragmatic language impairment general and specific associations to mental health symptom dimensions in a child psychiatric sample. Scand J Child Adolesc Psychiatr Psychol 2019; 7:1-10. [PMID: 33520766 PMCID: PMC7709940 DOI: 10.21307/sjcapp-2019-001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Background The results of several international studies indicate a high prevalence of language and communication impairments among children who are referred to child psychiatric services. However, these impairments are likely to remain undetected unless language and communication impairments are evaluated during the psychiatric assessment. Aims The aim of the present study is to investigate the specific association between general and specific mental health problems, as expressed by the problem scales of Child Behavior Checklist (CBCL) and Teachers Report Form (TRF), and pragmatic skills and pragmatic language impairments (PLI) as defined the Pragmatic Composite of the Child Communication Checklist (CCC-PC). Methods Children aged from 8 to 13 years (n = 73) were recruited in sequence following referral to a child and adolescent psychiatry (CAMHS) outpatient clinic within 12 months. Children with possible or established autism or intellectual disability were excluded. Standardized instruments measuring language, communication and mental health symptoms were distributed to parents and teachers, an intelligence test administered for clinical purposes, and demographic information was included. Results The parent reports showed PLI among 38% of the children and revealed strong associations with the CBCL scales for emotional problems, thought problems and, especially, social and withdrawal symptoms, which mean more associations to internalized and non-externalized problems. PC-scores were at similar levels and PLI was reported by teachers at similar rates (compared to parent reports) with moderate agreement. Teacher PC-scores showed associations to only one TRF-scale, social problems. The CCC-PC subscale with the strongest associations to mental health symptoms was «Use of Context» («Social Relationships» do not contribute to the CCC-PC scores). Conclusion There was a general increase in PC-scores and increased prevalence of PLI in this clinical sample. PC-scores correlated with symptom scores for internalizing and non-externalizing problems scales. The strongest common factors appear to be related to the social aspects of mental health. Pragmatic skills should be considered as a protective factor for mental health rather than investigating pragmatic impairment as a risk or vulnerability factor.
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Affiliation(s)
- Edel Brenne
- Child psychiatry department, Nord-Trondelag Health Trust, Levanger, Norway
| | - Tormod Rimehaug
- Child psychiatry department, Nord-Trondelag Health Trust, Levanger, Norway.,Norwegian University of Science and Technology Trondheim, Norway
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29
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Martin GE, Bush L, Klusek J, Patel S, Losh M. A Multimethod Analysis of Pragmatic Skills in Children and Adolescents With Fragile X Syndrome, Autism Spectrum Disorder, and Down Syndrome. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2018; 61:3023-3037. [PMID: 30418476 PMCID: PMC6440309 DOI: 10.1044/2018_jslhr-l-18-0008] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 05/26/2018] [Accepted: 07/16/2018] [Indexed: 05/19/2023]
Abstract
PURPOSE Pragmatic language skills are often impaired above and beyond general language delays in individuals with neurodevelopmental disabilities. This study used a multimethod approach to language sample analysis to characterize syndrome- and sex-specific profiles across different neurodevelopmental disabilities and to examine the congruency of 2 analysis techniques. METHOD Pragmatic skills of young males and females with fragile X syndrome with autism spectrum disorder (FXS-ASD, n = 61) and without autism spectrum disorder (FXS-O, n = 40), Down syndrome (DS, n = 42), and typical development (TD, n = 37) and males with idiopathic autism spectrum disorder only (ASD-O, n = 29) were compared using variables obtained from a detailed hand-coding system contrasted with similar variables obtained automatically from the language analysis program Systematic Analysis of Language Transcripts (SALT). RESULTS Noncontingent language and perseveration were characteristic of the pragmatic profiles of boys and girls with FXS-ASD and boys with ASD-O. Boys with ASD-O also initiated turns less often and were more nonresponsive than other groups, and girls with FXS-ASD were more nonresponsive than their male counterparts. Hand-coding and SALT methods were largely convergent with some exceptions. CONCLUSION Results suggest both similarities and differences in the pragmatic profiles observed across different neurodevelopmental disabilities, including idiopathic and FXS-associated cases of ASD, as well as an important sex difference in FXS-ASD. These findings and congruency between the 2 language sample analysis techniques together have important implications for assessment and intervention efforts.
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Affiliation(s)
- Gary E. Martin
- Department of Communication Sciences and Disorders, St. John's University, Staten Island, NY
| | - Lauren Bush
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL
| | - Jessica Klusek
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia
| | - Shivani Patel
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL
| | - Molly Losh
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL
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30
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Lewis FM, Bohan JK. Early adolescent language development following intrathecal chemotherapy for acute lymphoblastic leukaemia. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2018; 20:485-493. [PMID: 28394186 DOI: 10.1080/17549507.2017.1309066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 03/14/2017] [Accepted: 03/16/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE Central nervous system (CNS) prophylaxis in the treatment of childhood acute lymphoblastic leukaemia (ALL) is routinely achieved through intrathecal chemotherapy (ITC). The presence of high level language deficits in older children who received CNS-directed ITC for ALL in early childhood is yet to be elucidated, with previous research suggesting that high level language deficits may appear later in ALL survivors' development at an age when these skills typically emerge. METHOD A test battery covering foundational language skills and higher-order language skills was administered to five participants (aged 10-15 years) with a history of ITC for ALL. Conversion of each child's language performance scores to z scores allowed for clinical interpretation of data across the language areas tested. RESULT Foundational language skills were, in general, of no clinical concern. Three of the five children presented with clinically impaired language skills in areas including resolving ambiguity, making inferences and composing novel sentences. Performance variation between the participants and within the individual participants was noted. CONCLUSION Given the importance of early adolescent language abilities to academic and social development in late primary and secondary schooling, these preliminary findings suggest further research into emerging adolescent language abilities following ITC for ALL is warranted.
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Affiliation(s)
- Fiona M Lewis
- a School of Health and Rehabilitation Sciences , The University of Queensland , Brisbane , Australia
| | - Jaycie K Bohan
- a School of Health and Rehabilitation Sciences , The University of Queensland , Brisbane , Australia
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31
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Posserud M, Hysing M, Helland W, Gillberg C, Lundervold AJ. Autism traits: The importance of "co-morbid" problems for impairment and contact with services. Data from the Bergen Child Study. RESEARCH IN DEVELOPMENTAL DISABILITIES 2018; 72:275-283. [PMID: 26826893 DOI: 10.1016/j.ridd.2016.01.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 12/08/2015] [Accepted: 01/04/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Co-occurring problems are common in individuals with clinical autism spectrum disorder (ASD) but their relevance for impairment and contact with health services in ASD is largely unexplored. AIMS We investigated the extent of co-occurring problems in children with high ASD traits from a total population sample. We explored the contribution of co-occurring problems to impairment and service contact, and whether there were children without co-occurring problems in this group; as proxy for "ASD only". METHODS AND PROCEDURES Children screening positive on the Autism Spectrum Screening Questionnaire (ASSQ) were used as proxy for ASD. Attention Deficit/Hyperactivity Disorder (ADHD) and Oppositional Defiant Disorder (ODD) were operationalised using symptom counts. A parent or teacher report above the 95th percentile counted as "problem" present for other symptom domains. OUTCOMES AND RESULTS 92% of ASSQ high-scorers had a minimum of two other problems. Emotional problems, ADHD symptoms and learning problems were the most commonly reported problems, also predicting impairment and contact with services. CONCLUSIONS AND IMPLICATIONS Co-occurring problems were common in ASD screen positive children and contributed strongly to both impairment and to contact with services. Gender differences indicated that female symptoms were perceived as less impairing by parents and teachers.
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Affiliation(s)
- M Posserud
- Department of Child and Adolescent Mental Health, Division of Psychiatry, Haukeland University Hospital, Norway.
| | - M Hysing
- Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Norway
| | - W Helland
- Section of Research and Innovation Helse Fonna HF, Haugesund, Norway; Department of Speech and Language Disorders, Statped Vest, Bergen, Norway; Department of Biological and Medical Psychology, University of Bergen, Norway
| | - C Gillberg
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Sweden
| | - A J Lundervold
- Regional Centre for Child and Youth Mental Health and Child Welfare, Uni Research Health, Norway; Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Sweden; K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, University of Bergen, Norway; Department of Biological and Medical Psychology, University of Bergen, Norway
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32
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Nevill R, Hedley D, Uljarević M, Sahin E, Zadek J, Butter E, Mulick JA. Language profiles in young children with autism spectrum disorder: A community sample using multiple assessment instruments. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2017; 23:141-153. [DOI: 10.1177/1362361317726245] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study investigated language profiles in a community-based sample of 104 children aged 1–3 years who had been diagnosed with autism spectrum disorder using Diagnostic and Statistical Manual of Mental Disorders (5th ed.) diagnostic criteria. Language was assessed with the Mullen scales, Preschool Language Scale, fifth edition, and Vineland-II parent-report. The study aimed to determine whether the receptive-to-expressive language profile is independent from the assessment instrument used, and whether nonverbal cognition, early communicative behaviors, and autism spectrum disorder symptoms predict language scores. Receptive-to-expressive language profiles differed between assessment instruments and reporters, and Preschool Language Scale, fifth edition profiles were also dependent on developmental level. Nonverbal cognition and joint attention significantly predicted receptive language scores, and nonverbal cognition and frequency of vocalizations predicted expressive language scores. These findings support the administration of multiple direct assessment and parent-report instruments when evaluating language in young children with autism spectrum disorder, for both research and in clinical settings. Results also support that joint attention is a useful intervention target for improving receptive language skills in young children with autism spectrum disorder. Future research comparing language profiles of young children with autism spectrum disorder to children with non-autism spectrum disorder developmental delays and typical development will add to our knowledge of early language development in children with autism spectrum disorder.
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Affiliation(s)
| | - Darren Hedley
- La Trobe University, Australia
- Nationwide Children’s Hospital, USA
| | | | | | | | - Eric Butter
- The Ohio State University, USA
- Nationwide Children’s Hospital, USA
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Helland WA, Helland T. Emotional and behavioural needs in children with specific language impairment and in children with autism spectrum disorder: The importance of pragmatic language impairment. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 70:33-39. [PMID: 28886424 DOI: 10.1016/j.ridd.2017.08.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 08/15/2017] [Accepted: 08/16/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Language problems may negatively affect children's behaviour and have detrimental effects on the development of peer-relations. AIMS We investigated and compared emotional and behavioural profiles in children with SLI and in children with ASD aged 6-15 years and explored to what extent pragmatic language problems contributed to the emotional and behavioural needs (EBN) in these clinical groups. METHODS AND PROCEDURES The ASD group consisted of 23 children (19 boys; 4 girls) and the SLI group consisted of 20 children (18 boys; 2 girls). In order to assess EBN and language abilities, the Strength and Difficulties Questionnaire (SDQ) and the Children's Communication Checklist -2 (CCC-2) were filled out by parents. OUTCOMES AND RESULTS Our main findings were that although EBN was common in both groups; the children in the ASD group were significantly impaired relative to the children in the SLI group. However, in both groups pragmatic language problems were found to be significantly associated with EBN. IMPLICATIONS A comprehensive assessment of EBN as well as pragmatic language abilities should be an integral part of the assessment procedure. Considering the substantial influence of pragmatic language abilities on social function and in resolving interpersonal conflicts with peers further development of therapy plans and interventions targeting pragmatics is strongly needed.
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Affiliation(s)
- Wenche Andersen Helland
- Section of Research and Innovation, Helse Fonna Health Authority, Norway; Department of Biological and Medical Psychology, Faculty of Psychology, University of Bergen, Jonas Liesvei 91, 5009 Bergen, Norway.
| | - Turid Helland
- Department of Biological and Medical Psychology, Faculty of Psychology, University of Bergen, Jonas Liesvei 91, 5009 Bergen, Norway
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Lee M, Bush L, Martin GE, Barstein J, Maltman N, Klusek J, Losh M. A Multi-Method Investigation of Pragmatic Development in Individuals With Down Syndrome. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2017; 122:289-309. [PMID: 28654411 PMCID: PMC5800500 DOI: 10.1352/1944-7558-122.4.289] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
This longitudinal study examined pragmatic language in boys and girls with Down syndrome (DS) at up to three time points, using parent report, standardized and direct assessments. We also explored relationships among theory of mind, executive function, nonverbal mental age, receptive and expressive vocabulary, grammatical complexity, and pragmatic competence. Controlling for cognitive and language abilities, children with DS demonstrated greater difficulty than younger typically developing controls on parent report and standardized assessments, but only girls with DS differed on direct assessments. Further, pragmatic skills of individuals with DS developed at a delayed rate relative to controls. Some sex-specific patterns of pragmatic impairments emerged. Theory of mind and executive function both correlated with pragmatic competence. Clinical and theoretical implications are discussed.
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Affiliation(s)
- Michelle Lee
- Michelle Lee and Lauren Bush, Northwestern University; Gary E. Martin, St. John's University; Jamie Barstein and Nell Maltman, Northwestern University; Jessica Klusek, University of South Carolina; and Molly Losh, Northwestern University
| | - Lauren Bush
- Michelle Lee and Lauren Bush, Northwestern University; Gary E. Martin, St. John's University; Jamie Barstein and Nell Maltman, Northwestern University; Jessica Klusek, University of South Carolina; and Molly Losh, Northwestern University
| | - Gary E Martin
- Michelle Lee and Lauren Bush, Northwestern University; Gary E. Martin, St. John's University; Jamie Barstein and Nell Maltman, Northwestern University; Jessica Klusek, University of South Carolina; and Molly Losh, Northwestern University
| | - Jamie Barstein
- Michelle Lee and Lauren Bush, Northwestern University; Gary E. Martin, St. John's University; Jamie Barstein and Nell Maltman, Northwestern University; Jessica Klusek, University of South Carolina; and Molly Losh, Northwestern University
| | - Nell Maltman
- Michelle Lee and Lauren Bush, Northwestern University; Gary E. Martin, St. John's University; Jamie Barstein and Nell Maltman, Northwestern University; Jessica Klusek, University of South Carolina; and Molly Losh, Northwestern University
| | - Jessica Klusek
- Michelle Lee and Lauren Bush, Northwestern University; Gary E. Martin, St. John's University; Jamie Barstein and Nell Maltman, Northwestern University; Jessica Klusek, University of South Carolina; and Molly Losh, Northwestern University
| | - Molly Losh
- Michelle Lee and Lauren Bush, Northwestern University; Gary E. Martin, St. John's University; Jamie Barstein and Nell Maltman, Northwestern University; Jessica Klusek, University of South Carolina; and Molly Losh, Northwestern University
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Vissers C, Koolen S. Theory of Mind Deficits and Social Emotional Functioning in Preschoolers with Specific Language Impairment. Front Psychol 2016; 7:1734. [PMID: 27867370 PMCID: PMC5095688 DOI: 10.3389/fpsyg.2016.01734] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 10/20/2016] [Indexed: 01/24/2023] Open
Abstract
Children with Specific Language Impairment (SLI) often experience emotional and social difficulties. In general, problems in social emotional functioning can be cognitively explained in terms of Theory of Mind (ToM). In this mini-review, an overview is provided of studies on social-emotional functioning and ToM in preschoolers (average age from 2.3 to 6.2 years) with SLI. It is concluded that, similar to school-aged children with SLI, preschoolers with SLI have several social-emotional problems and that both cognitive and affective aspects of ToM are impaired in those children. Based hereon, three possible causal models for the interrelation between language, ToM and social emotional functioning are put forward. It is proposed that future research on the construct and measurement of early ToM, social emotional functioning and language development in preschoolers with SLI is needed to achieve early detection, tailored treatment, and ultimately insight into the pathogenesis of SLI.
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Affiliation(s)
- Constance Vissers
- Royal Dutch Kentalis, Kentalis AcademySt Michielsgestel, Netherlands
- Behavioural Science Institute, Radboud University NijmegenNijmegen, Netherlands
| | - Sophieke Koolen
- Royal Dutch Kentalis, Kentalis AcademySt Michielsgestel, Netherlands
- Pro Persona for Mental HealthArnhem, Netherlands
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Song S, Yang Y, Kim YT, Yim D. A Meta-analysis of Children’s Communication Checklist (CCC) for Children & Adolescents with Pragmatic Language Impairment. COMMUNICATION SCIENCES & DISORDERS 2016. [DOI: 10.12963/csd.16302] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Ronniger P, Melzer J, Petermann F, Rißling JK. Klassifikation von Sprachentwicklungsstörungen. KINDHEIT UND ENTWICKLUNG 2016. [DOI: 10.1026/0942-5403/a000197] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Zusammenfassung. Sprache ist ein wichtiger Bestandteil unserer Kultur und ermöglicht den Austausch von Gedanken und Gefühlen sowie die Aneignung von Wissen. Defizite in den sprachlichen Fähigkeiten können sich auf verschiedenen linguistischen Ebenen äußern, was in der Diagnostik von Sprachentwicklungsstörungen berücksichtigt werden sollte. Es folgt ein Überblick zur Symptomatik und zur Untergliederung von Sprachentwicklungsstörungen in den psychiatrischen Klassifikationssystemen DSM-5 und ICD-10. Zusätzlich wird ein Ausblick auf die ICD-11 (Beta-Entwurf) gegeben. Die diagnostischen Klassifikationssysteme werden der Interdisziplinären S2k-Leitlinie gegenübergestellt. Keines der dargestellten Systeme berücksichtigt die einzelnen linguistischen Ebenen der Sprache, wie es in der S2k-Leitlinie gefordert wird. Zudem bestehen deutliche Unterschiede in den Diagnosekriterien. In der Praxis führt dies zu erheblichen Schwierigkeiten in der differenzierten Erfassung von Sprachdefiziten. Die zuverlässige Abklärung einer Sprachentwicklungsstörung erfordert eine umfassende berufsübergreifende Diagnostik. Dafür ist eine eindeutige interdisziplinäre Klassifikation notwendig.
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Affiliation(s)
- Pola Ronniger
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
| | - Jessica Melzer
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
| | - Franz Petermann
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
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Rißling JK, Ronniger P, Petermann F, Melzer J. Psychosoziale Belastungen bei Sprachentwicklungsstörungen. KINDHEIT UND ENTWICKLUNG 2016. [DOI: 10.1026/0942-5403/a000198] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Die umschriebenen Entwicklungsstörungen des Sprechens und der Sprache gehören zu den häufigsten Entwicklungsstörungen. Aufgrund der zentralen Bedeutung sprachlicher Kompetenzen für verschiedene Lebensbereiche beeinträchtigen Sprachentwicklungsstörungen nicht nur die schulische, sondern auch die soziale und emotionale Entwicklung eines Kindes und wirken bis ins Jugend- und Erwachsenenalter hinein. Es folgt eine Übersicht über die psychosozialen Belastungen bei betroffenen Kindern und Jugendlichen sowie ihren Angehörigen. Kinder mit Sprachentwicklungsstörungen tragen ein erhöhtes Risiko für komorbide internalisierende und externalisierende Störungen sowie für Schwierigkeiten mit Gleichaltrigen, die im Jugendalter zunehmend an Bedeutung gewinnen. Eltern von Kindern mit Sprachentwicklungsstörungen weisen im Vergleich zur Allgemeinbevölkerung höhere Stress- und Depressionswerte auf, die insbesondere durch die mangelnde Akzeptanz und Unterstützung durch das soziale Umfeld beeinflusst werden. Es existieren zu wenig therapeutische Angebote, die auf die besondere Situation der Betroffenen angepasst sind. Die Implikationen für Forschung und klinische Praxis werden diskutiert.
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Affiliation(s)
| | - Pola Ronniger
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
| | - Franz Petermann
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
| | - Jessica Melzer
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
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Selås M, Helland WA. Pragmatic language impairment in children with Noonan syndrome. CLINICAL LINGUISTICS & PHONETICS 2016; 30:899-910. [PMID: 27348294 PMCID: PMC5152542 DOI: 10.1080/02699206.2016.1188422] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 05/03/2016] [Accepted: 05/08/2016] [Indexed: 06/06/2023]
Abstract
Noonan syndrome (NS) is a disorder causing symptoms like short stature, characteristic facial features, congenital heart disease, possible mental retardation, and pragmatic difficulties. This study describes the pragmatic skills in NS and discusses the linguistic profile of 17 informants aged 6-15 years, by comparing the participants' scores on the Children's Communication Checklist, 2nd edition (CCC-2) (Bishop, 2011), with a group of typically developing children of matching age and gender. Language impairments were common in the NS group. The results show that children and adolescents with NS do not have one coherent pragmatic profile. However, 76.5% of the participants displayed communication impairments, and pragmatic skills were significantly lower than in the control group.
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Affiliation(s)
- Magnhild Selås
- Department of Biological and Medical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Wenche Andersen Helland
- Department of Biological and Medical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
- Section of Research & Innovation, Helse Fonna, Haugesund, Norway
- Department of Speech and Language, Statped Vest, Bergen, Norway
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Rißling JK, Melzer J, Petermann F. Konstruktion eines Sprachstandserhebungsverfahrens für Kinder im Alter zwischen 3 und 5 Jahren. ZEITSCHRIFT FUR ENTWICKLUNGSPSYCHOLOGIE UND PADAGOGISCHE PSYCHOLOGIE 2016. [DOI: 10.1026/0049-8637/a000145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Umschriebene Entwicklungsstörungen des Sprechens und der Sprache gehören zu den häufigsten Entwicklungsstörungen und beeinträchtigen die psychosoziale, kognitive und schulische Entwicklung eines Kindes. Insbesondere im Vorschulalter gewinnt die Diagnostik sprachlicher Kompetenzen zunehmend an Bedeutung. Die Anforderungen an eine valide Diagnostik gestalten sich vor dem Hintergrund der Heterogenität der Symptomatik und der Abhängigkeit vom Alter der Kinder entsprechend komplex. Vor diesem Hintergrund wurde der Sprachstandserhebungstest für Kinder im Alter zwischen 3 und 5 Jahren (SET 3 – 5) entwickelt, der eine umfassende Beurteilung sprachlicher Kompetenzen ermöglicht. Es werden die Ergebnisse der Konstruktionsstichprobe des Verfahrens berichtet. Hierfür wurden 316 Kinder im Alter von 3;0 bis 5;11 Jahren mit dem SET 3 – 5 überprüft. Die Aufgabenanalyse zeigt gute Itemschwierigkeiten und Itemtrennschärfen im mittleren bis hohen Bereich. Die internen Konsistenzen (Cronbachs Alpha) sind ebenfalls als zufriedenstellend bis gut zu bewerten.
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Affiliation(s)
| | - Jessica Melzer
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
| | - Franz Petermann
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
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Melzer J, Rißling JK, Petermann F. Kognitive Kompetenzen und Sprachentwicklung bei Kindern im Alter zwischen vier und fünf Jahren. ZEITSCHRIFT FÜR NEUROPSYCHOLOGIE 2016. [DOI: 10.1024/1016-264x/a000170] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Zusammenfassung. Ziel der vorliegenden Studie ist es den Zusammenhang von verschiedenen kognitiven Basiskompetenzen und sprachlichen Fähigkeiten bei Vorschülern zu untersuchen. Verglichen werden die kognitiven Kompetenzen von Kindern mit niedrigen Leistungen im Wortschatz und/oder in der Grammatik (n = 69) und einer sprachlich unbeeinträchtigten Vergleichsgruppe (n = 69). Weiter wird eine multiple hierarchische Regressionsanalyse gerechnet um die Bedeutung von kognitiven Basiskompetenzen für die Pragmatik zu untersuchen. Insgesamt zeigt sich, dass die Vergleichsgruppe über bessere kognitive Fähigkeiten verfügt als die Risikogruppe, insbesondere in der Verarbeitungsgeschwindigkeit. Im Bereich Pragmatik konnte das Arbeitsgedächtnis als wichtiger Prädiktor identifiziert werden. Anhand der Analysen wird deutlich, dass kognitive Basiskompetenzen für verschiedene sprachliche Bereiche von Bedeutung sind.
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Affiliation(s)
- Jessica Melzer
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
| | | | - Franz Petermann
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
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Quels sont les liens entre le développement du langage et les troubles externalisés du comportement ? Étude chez trois groupes d’enfants d’âge préscolaire. ANNEE PSYCHOLOGIQUE 2015. [DOI: 10.4074/s0003503315000226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Brassart E, Schelstraete MA. Quels sont les liens entre le développement du langage et les troubles externalisés du comportement ? Étude chez trois groupes d’enfants d’âge préscolaire. ANNEE PSYCHOLOGIQUE 2015. [DOI: 10.3917/anpsy.154.0533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Huber M, Burger T, Illg A, Kunze S, Giourgas A, Braun L, Kröger S, Nickisch A, Rasp G, Becker A, Keilmann A. Mental health problems in adolescents with cochlear implants: peer problems persist after controlling for additional handicaps. Front Psychol 2015; 6:953. [PMID: 26236251 PMCID: PMC4502340 DOI: 10.3389/fpsyg.2015.00953] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 06/25/2015] [Indexed: 12/04/2022] Open
Abstract
The aims of the present multi-center study were to investigate the extent of mental health problems in adolescents with a hearing loss and cochlear implants (CIs) in comparison to normal hearing (NH) peers and to investigate possible relations between the extent of mental health problems of young CI users and hearing variables, such as age at implantation, or functional gain of CI. The survey included 140 adolescents with CI (mean age = 14.7, SD = 1.5 years) and 140 NH adolescents (mean age = 14.8, SD = 1.4 years), their parents and teachers. Participants were matched by age, gender and social background. Within the CI group, 35 adolescents were identified as “risk cases” due to possible and manifest additional handicaps, and 11 adolescents were non-classifiable. Mental health problems were assessed with the Strengths and Difficulties Questionnaire (SDQ) in the versions “Self,” “Parent,” and “Teacher.” The CI group showed significantly more “Peer Problems” than the NH group. When the CI group was split into a “risk-group” (35 “risk cases” and 11 non-classifiable persons) and a “non-risk group” (n = 94), increased peer problems were perceived in both CI subgroups by adolescents themselves. However, no further differences between the CI non-risk group and the NH group were observed in any rater. The CI risk-group showed significantly more hyperactivity compared to the NH group and more hyperactivity and conduct problems compared to the CI non-risk group. Cluster analyses confirmed that there were significantly more adolescents with high problems in the CI risk-group compared to the CI non-risk group and the NH group. Adolescents with CI, who were able to understand speech in noise had significantly less difficulties compared to constricted CI users. Parents, teachers, and clinicians should be aware that CI users with additionally special needs may have mental health problems. However, peer problems were also experienced by CI adolescents without additional handicaps.
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Affiliation(s)
- Maria Huber
- Department of Otorhinolaryngology, Head and Neck Surgery, Paracelsus Medical University Salzburg Salzburg, Austria
| | - Thorsten Burger
- Department of Otorhinolaryngology, Cochlear Implant Center Freiburg, University of Freiburg Freiburg, Germany
| | - Angelika Illg
- Department of Otolaryngology, Hannover Medical School Hannover, Germany
| | - Silke Kunze
- Socialpediatric Center Munich Munich, Germany
| | | | - Ludwig Braun
- Section of Communication Disorders, Clinic of Otorhinolaryngology, Head and Neck Surgery, University of Mainz Mainz, Germany
| | - Stefanie Kröger
- Department of Otorhinolaryngology, Cochlear Implant Center Freiburg, University of Freiburg Freiburg, Germany
| | | | - Gerhard Rasp
- Department of Otorhinolaryngology, Head and Neck Surgery, Paracelsus Medical University Salzburg Salzburg, Austria
| | - Andreas Becker
- Department of Child and Adolescent Psychiatry, University of Goettingen Goettingen, Germany
| | - Annerose Keilmann
- Section of Communication Disorders, Clinic of Otorhinolaryngology, Head and Neck Surgery, University of Mainz Mainz, Germany
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