Association Between Emotional Disorders and Speech and Language Impairments: A National Population-Based Study

The association between speech impairments and depression in Chinese adults aged 45 and older: insights from the CHARLS database

BACKGROUND

Speech impairments significantly affect communication and are associated with social and psychological difficulties, particularly among adults aged 45 years and older. This study examines the relationship between speech impairments and depression using data from the China Health and Retirement Longitudinal Study (CHARLS).

METHODS

A total of 67,014 participants aged 45 years and older were included in the analysis. The baseline characteristics of participants with and without speech impairments were compared using chi-square tests. Multivariable logistic and linear regression models were employed to assess the association between speech impairments and depression. Sensitivity and subgroup analyses were performed to explore variations across different demographic and lifestyle characteristics.

RESULTS

Participants with speech impairments exhibited a significantly greater likelihood of depression, with adjusted odds ratios (Model II: OR = 2.16, 95% CI: 1.56-2.97, p < 0.0001) and higher depression scores (Model II: β = 3.03, 95% CI: 2.24-3.81, p < 0.0001) after controlling for confounders. Sensitivity analysis confirmed the robustness of these findings. Subgroup analysis revealed consistent associations across all the examined subgroups, with a statistically significant interaction between speech impairments and place of residence (p for interaction = 0.02), indicating a stronger association in urban residents.

CONCLUSION

Speech impairments are strongly associated with a greater likelihood of depression in middle-aged and elderly Chinese adults. This finding underscores the importance of targeted mental health interventions and support for this population, particularly in urban settings.

CLINICAL TRIAL NUMBER

Not applicable.

The clinical practice of speech and language therapists with preschool-age children with syntactic impairment

BACKGROUND

Children with syntactic impairment associated with autism spectrum disorder and developmental language disorder benefit from speech and language therapy intervention. Despite that, few studies focus on the clinical practice of the speech and language therapist (SLT).

AIM

The aim of the study is to explore the clinical practice of SLTs with preschool-age children with syntactic impairment.

METHODS & PROCEDURES

A cross-sectional survey was carried out in Portugal, using a questionnaire designed specifically for this study. The survey is composed of 109 questions divided into eight sections. A total of 357 participants responded, representing 10% of the total population of SLTs in Portugal.

OUTCOMES & RESULTS

Considering the academic background, 46% of SLTs held a master's degree and only 19% attended complementary training in syntax. Regarding professional experience, 92% of SLTs work with preschool-age children with syntactic impairment. Between 89% and 91% of the SLTs report that they have never used any specific program, method or approach for syntactic intervention. Over 40% of SLTs report not feeling confident in assessing syntactic skills, while 43% report not feeling confident in intervening. Between 92% and 98% of SLTs report the need to obtain more academic knowledge and practical training.

CONCLUSIONS & IMPLICATIONS

In Portugal, there seems to be a lack of scientific evidence regarding the procedures used in the clinical practice of SLTs in preschool-age children with syntactic impairment. This fact may relate to the need felt by SLTs for more academic and practical training. The current findings highlight the need to address training in syntactic disorder within graduate and postgraduate programs.

WHAT THIS PAPER ADDS

What is already known on the subject Children with autism spectrym disorder (ASD) and children with developmental language disorder (DLD) experience language disorders, which in turn may have an impact on their socialisation and behaviour, namely when they have syntactic impairment. It is proven that these children benefit from speech and language therapy. Several studies analyse the effectiveness of assessment and intervention procedures in speech and language therapy, defining evidence-based best practices. Thus, there is a lot of research into how SLTs should conduct assessment and intervention. There is, however, little research about SLTs clinical practices. What this paper adds to existing knowledge This study paints a broad picture of the clinical practice of SLTs in Portugal, bringing insights specifically into their syntactic domain assessment and intervention practices with preschool-age children. This study also serves to identify the perceived needs of SLTs regarding the syntactic domain, related to academia, complementary training and day-to-day practice in the assessment and intervention of these children. What are the potential or actual clinical implications of this work? There are some studies of the assessment and intervention clinical practices of SLTs as well as methods, programs and approaches for syntactic impairment clinical practice with preschool-age children with ASD and children with DLD. However, most of the studies are for the English language. Through this study, it was understood that SLTs in Portugal have a low level of confidence in assessing and intervening with this population. SLTs have identified the need for additional training and theoretical knowledge which can contribute to the adaptation of current academic curricula and broaden the complementary training opportunities.

The relationship between activities of daily living and speech impediments based on evidence from statistical and machine learning analyses

Introduction

Speech impediments (SIs) are increasingly prevalent among middle-aged and older adults, raising concerns within public health. Early detection of potential SI in this demographic is critical. This study investigates the potential of Activities of Daily Living (ADL) as a predictive marker for SI, utilizing data from the 2018 China Health and Retirement Longitudinal Study (CHARLS), which includes 10,136 individuals aged 45 and above. The Barthel Index (BI) was used to assess ADL, and the correlation between ADL and SI was examined through statistical analyses. Machine learning algorithms (Support Vector Machine, Decision Tree, and Logistic Regression) were employed to validate the findings and elucidate the underlying relationship between ADL and SI.

Background

SI poses significant challenges to the health and quality of life of middle-aged and older adults, increasing the demands on community-based and home care services. In the context of global aging, it is crucial to investigate the factors contributing to SI. While the role of ADL as a potential biomarker for SI remains unclear, this study aims to provide new evidence supporting ADL as an early predictor of SI through statistical analysis and machine learning validation.

Methods

Data were derived from the 2018 CHARLS national baseline survey, comprising 10,136 participants aged 45 and above. ADL was evaluated using the BI, and SI was assessed based on the CHARLS records of "Speech impediments." Statistical analyses, including independent sample t-tests, chi-square tests, Pearson and Spearman correlation tests, and hierarchical multiple linear regression, were conducted using SPSS 25.0. Machine learning algorithms, specifically Support Vector Machine (SVM), Decision Tree (DT), and Logistic Regression (LR), were implemented in Python 3.10.2.

Results

Analysis of demographic characteristics revealed that the average BI score in the "With Speech impediments" group was 49.46, significantly lower than the average score of 85.11 in the "Without Speech impediments" group. Pearson correlation analysis indicated a significant negative correlation between ADL and SI (r = -0.205, p < 0.001). Hierarchical multiple linear regression confirmed the robustness of this negative correlation across three models (B = -0.001, β = -0.168, t = -16.16, 95% CI = -0.001 to -0.001, p = 0.000). Machine learning algorithms validated the statistical findings, confirming the predictive accuracy of ADL for SI, with the area under the curve (AUC) scores of SVM-AUC = 0.648, DT-AUC = 0.931, and LR-AUC = 0.666. The inclusion of BI in the models improved the overall predictive performance, highlighting its positive impact on SI prediction.

Conclusion

The study employed various statistical methodologies to demonstrate a significant negative correlation between ADL and SI, a finding further corroborated by machine learning algorithms. Impairment in ADL increases the likelihood of SI occurrence, underscoring the importance of maintaining ADL in middle-aged and older populations to mitigate the risk of SI.

Self-inefficacy's impact on well-being indices in students self-identifying with cluttering characteristics

INTRODUCTION

Cluttering, a fluency disorder characterized by fast and irregular speech patterns, receives relatively limited research attention. Consequently, the association between cluttering and measures of well-being remains unexplored. In contrast, stuttering, another fluency disorder, has been associated with anxiety and depression. The present study examines whether an individual's experience of cluttering characteristics is related to alterations in both positive and negative measures of well-being. To achieve this, we assessed the relationship between Self-Identified Cluttering Characteristics (SICC) and measures of well-being in a sizeable sample of 1201 university students. Our main objective was to explore the potential impact of self-inefficacy on the association between SICC and well-being.

METHODS

Consistent with prior research, participants identified themselves as having cluttering characteristics (SICC) or no-cluttering characteristics (SINCC) based on a verbal and written explanation of the disorder. They also completed questionnaires on psychological well-being indices and self-inefficacy.

RESULTS

In total, 276 respondents identified themselves as having cluttering characteristics. In regression models, both SICC and self-inefficacy were predictive of greater negative well-being, increased depressive symptoms, and heightened psychosomatic symptoms. Interestingly, ADHD diagnosis was associated with less negative well-being. Positive well-being indicators (positive future orientation and subjective happiness) were solely predicted by self-inefficacy. Supporting these findings, supplementary regressions including only 56 SICC participants who reported being treated for cluttering yielded similar results. Utilizing Hayes's PROCESS computational procedures to test moderation revealed that self-inefficacy significantly moderated the association between SICC and negative well-being (depressive symptoms) as well as the association between SICC and positive well-being (positive future orientation).

CONCLUSIONS

The findings underscore alterations in well-being among individuals who identify themselves as experiencing cluttering characteristics. Primarily, heightened negative well-being was noted in those with SICC, yet individual self-inefficacy reports mitigated this effect. Overall, SICC exacerbates negative well-being rather than diminishing positive well-being. These findings point to the importance of integrating mental health assessment and intervention into clinical practice for individuals with cluttering symptoms and the potential benefits of interventions targeting self-inefficacy to improve overall well-being in this population.

Evaluating the association between developmental language disorder and depressive symptoms in preschool children

This study aims to investigate the association between developmental language disorder (DLD) and depressive symptoms in preschool-aged children, building upon previous research that has demonstrated emotional difficulties in children with DLD. Forty-one children with DLD or children at risk for DLD (DLD group) and 41 children with typical language development (TLD) were included in this study. Language development was evaluated using the TEDIL test which is a Turkish adaptation of the Test of Early Language Development-3. Auto acoustic Emissions Testing and Immittance-Metric Assessment were used to exclude children with hearing impairment. Developmental delays were excluded by Denver Developmental Screening Test II. Mothers filled out the Sociodemographic Data Form and the Child Depressive Symptoms Assessment Scale. The results demonstrate that children in DLD group scored significantly higher on the Child Depressive Symptoms Assessment Scale, manifesting increased levels of aggression, separation anxiety, impulsivity, hyperactivity, and encountering greater social adaptation difficulties and deterioration in cognitive processes than TLD. Multivariate regression analysis suggests that increased impulsivity and hyperactivity, alongside social and cognitive challenges, are predictors of DLD. The study concludes that depressive symptoms are more prevalent in children in DLD group than in their typically developing counterparts. These findings underscore the necessity for targeted psychiatric and pedagogical interventions, as well as individualized educational programs that cater to the socio-emotional and cognitive needs of children with DLD.

Developmental language disorder - a comprehensive study of more than 46,000 individuals

Developmental language disorder (DLD) is characterized by enduring low language abilities with a significant functional impact, in the absence of biomedical conditions in which language impairment is part of a complex of impairments. There is a lack of awareness of DLD even among healthcare professionals. Here we estimated the prevalence of DLD and its links to reading and learning difficulties and physical and mental health in the Danish Blood Donor Study (N = 46,547), where DLD-related information is based on questionnaires (self-report). We compared the questionnaire-derived DLD status with the relevant language-related diagnoses from hospital registers. We also investigated the genetic architecture of DLD in a subset of the cohort (N = 18,380). DLD was significantly associated with reading and learning difficulties and poorer mental and physical health. DLD prevalence was 3.36%-3.70% based on questionnaires, compared with 0.04% in hospital registers. Our genetic analyses identified one genome-wide significant locus, but not a significant heritability estimate. Our study shows that DLD has health-related implications that may last into adulthood, and that DLD may be undiagnosed in general healthcare. Furthermore, DLD is likely more genetically heterogeneous than narrower developmental language phenotypes. Our results emphasize the need to raise awareness of DLD and consider criteria for molecular studies of DLD to reduce case heterogeneity.