Prosociality from early adolescence to young adulthood: A longitudinal study of individuals with a history of language impairment

Social-Emotional Functioning and Quality of Life in Language Disorders: A Systematic Review of Development From Childhood to Adolescence

BACKGROUND

It is well-established that children and adolescents with developmental language disorder (DLD) have social-emotional difficulties. This is reflected in their behaviour, for instance, by (social) withdrawal, hyperactivity or difficulty with peer relations. Children with DLD are also known to have poorer quality of life (QoL). This is likely to be related to social-emotional difficulties, for both concern similar developmental domains but from a different point of view. Findings on the social-emotional abilities, QoL and predictors thereof in children with DLD are inconsistent across studies.

AIMS

This review investigates how social-emotional functioning (SEF) and QoL develop from childhood into early adulthood in children with DLD. These developments are then compared and predictors are identified.

METHODS & PROCEDURES

A systematic review of 128 articles, conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines in January 2024, yielded 34 articles for inclusion after qualitative assessment. Clinical populations were labelled differently (e.g., DLD, specific language impairment (SLI), language impairment (LI)) but adhered to inclusion criteria for language disorder (LD). The majority of the articles focused on SEF (n = 30 articles), while the remaining examined QoL (n = 4 articles).

MAIN CONTRIBUTION

This is the first review to simultaneously investigate SEF and QoL in children with LD. No single developmental pattern was found for SEF: a range of possible developmental trajectories exists. Interestingly, prosocial skills generally appear to improve over time, whereas children also experience increasing problems with peer relations. Few studies employed a longitudinal design regarding QoL, but those that did suggest that children with LD are likely to have poorer and declining QoL, at least between the ages of 4 and 9. The sole study examining SEF and QoL in the same sample found a predictive relationship between early SEF and later QoL. Linguistic abilities were predictive in less than half of the studies on SEF development and had little impact on QoL development. Findings on other predictors were inconsistent.

CONCLUSIONS

Despite their interrelatedness, SEF and QoL do not necessarily develop similarly in children with LD. Only one study examined SEF and QoL in the same children and found contrasting developmental trends. This could imply that SEF and QoL are not as intertwined as presumed. It also remains unclear what best predicts change over time in these two dimensions. More research is necessary to further examine the relationship between SEF and QoL, as well as to identify potential predictors.

WHAT THIS PAPER ADDS

What is already known on the subject Children with LD are more likely than their peers without LD to have lower SEF and poorer QoL. However, the development of these domains across childhood and adolescence remains unclear. The relationship between SEF and QoL is equally under-researched. What this paper adds to the existing knowledge This is the first review on those with LD that takes a longitudinal perspective on both SEF and QoL and looks at their relationship. It highlights that longitudinal research is valuable and necessary, specifically for QoL, where studies are scarce. Only one study examined SEF and QoL in the same group of children and found a predictive relationship between (aspects of) SEF and later QoL. What are the potential or actual clinical implications of this work? This study highlights the relevance of longitudinal research when aiming to comprehend development, particularly in heterogeneous populations such as language disorders (LD). Clinicians are advised to address social-emotional problems alongside language to potentially increase SEF and QoL. Future research should investigate SEF and QoL simultaneously to substantiate the preliminary evidence for this relationship between SEF and QoL. Additionally, future studies consider support and multilingualism as potential predictors of this development in children with LD.

Swedish Boys Were Almost Twice as Likely to be Referred for Suspected Language Difficulties Than Girls and at an Earlier Age

AIM

This study investigated gender differences in referrals to speech and language therapy (SLT) services in children 1.5-6.0 years of age and the distribution of children identified through universal language screening at 2.5-3.0 years within Swedish child health services.

METHODS

We conducted a population-based, cross-sectional study using register data from 53 595 children. Data were collected from eight Swedish regions between 1 May 2015 and 1 June 2023, including gender, referral details and screening outcomes.

RESULTS

Of all children, 9.60% (n = 5144) were referred. Boys were referred significantly more often than girls (12.26% vs. 6.79%), χ2(df = 1, N = 53 595) = 701.38, p < 0.001. The odds of referral were 1.94 times higher for boys (OR = 1.94, 95% CI 1.85 to 2.04). Boys were also referred at a younger median age (3.08 vs. 3.58 years). Among children who failed screening, boys were more likely to be referred within 3 months (17.2% vs. 13.5%), OR = 1.63, 95% CI 1.45 to 1.84.

CONCLUSION

Significant gender disparities exist in both screening and referral practices, with boys referred more frequently and at younger ages. Refining screening protocols is essential to ensure early and equitable intervention access for all children.

Comparing factors influencing wellbeing in young adults with aphasia and young adults with developmental language disorder

BACKGROUND

Understanding factors influencing wellbeing is crucial for the development of effective services. Aphasia in older individuals and developmental language disorder (DLD) in children significantly affect how people live and function. Despite the increasing stroke incidence in young adults and the growing recognition of DLD as a lifelong disorder, the literature lacks evidence on the wellbeing of young adults, aged between 18 and 40 years old, with these conditions.

AIMS

To identify factors influencing wellbeing in young adults with aphasia and DLD.

METHODS & PROCEDURES

This cross-sectional between-group study involved 78 young adults with aphasia, DLD and no language impairments, with mean (SD) age of 30.5 (6.38) years. A total of 12 measures were used to assess wellbeing, language, cognition, health, emotional distress, social functioning and psychological resources. Feasibility and acceptability were informed by a pilot-study. One-way-unrelated analysis of variance (ANOVA) and Kruskal-Wallis tests were used to compare groups on language, cognition and wellbeing, while correlation analyses identified factors influencing wellbeing in each group.

OUTCOMES & RESULTS

No significant differences were found between clinical groups in language and cognitive profiles, with both scoring lower than those with no language impairments. The wellbeing of individuals with aphasia and DLD was similar to that of adults with no language impairments. Health, emotional distress and social support were common drivers of wellbeing among all groups, with positive performance in those scales indicating better wellbeing. Language and self-esteem showed significant links with wellbeing for those with DLD, but not for the aphasia group. The higher the self-esteem level of people with DLD, the higher their wellbeing rating. Interestingly, language was negatively related to wellbeing in people with DLD, with higher language scores correlating with lower levels of wellbeing.

CONCLUSIONS & IMPLICATIONS

Aphasia and DLD share factors affecting wellbeing, but the different origins of the disorders seem to influence the overall nature of wellbeing. Wellbeing in DLD is primarily impacted by the language disorder, whereas in aphasia it is influenced by its secondary to the disorder characteristics and primarily emotional health. This study highlights the need for holistic therapy and ongoing psychosocial support to optimize services for young adults with these impairments.

WHAT THIS STUDY ADDS

What is already known on the subject Aphasia and DLD significantly impact social and emotional aspects of life. However, knowledge about wellbeing in young adults with these disorders remains limited. What this paper adds to the existing knowledge This research is the first to compare wellbeing in aphasia and DLD. It highlights the impact of several psychosocial factors and clinical characteristics including language on wellbeing, considering whether individuals developed language disorders during childhood or acquired them later in adult life. While there is a small amount of evidence on wellbeing in young adults with DLD, this is the first study to investigate wellbeing in young adults with aphasia. What are the potential or actual clinical implications of this work? The type of language disorder may influence wellbeing in diverse ways. Speech and language therapists must evaluate the impact of these disorders on young adults' wellbeing. Rehabilitation should consider both personal factors and external support systems, following appropriate care models. Our findings suggest that aphasia interventions might benefit from focusing on enhancing emotional wellbeing and social networks, particularly in young adults. For individuals with DLD, it appears that the emphasis should be on improving communication skills by addressing functional constraints in social interactions and considering their psychological resources. Further research is needed to confirm these potential intervention strategies. An interdisciplinary approach is essential for optimal outcomes.

Do parent-reported early indicators predict later developmental language disorder? A Raine Study investigation

BACKGROUND

Developmental language disorder (DLD) is one of the most common neurodevelopmental conditions. Due to variable rates of language growth in children under 5 years, the early identification of children with DLD is challenging. Early indicators are often outlined by speech pathology regulatory bodies and other developmental services as evidence to empower caregivers in the early identification of DLD.

AIMS

To test the predictive relationship between parent-reported early indicators and the likelihood of children meeting diagnostic criteria for DLD at 10 years of age as determined by standardized assessment measures in a population-based sample.

METHODS

Data were leveraged from the prospective Raine Study (n = 1626 second-generation children: n = 104 with DLD; n = 1522 without DLD). These data were transformed into 11 predictor variables that reflect well-established early indicators of DLD from birth to 3 years, including if the child does not smile or interact with others, does not babble, makes only a few sounds, does not understand what others say, says only a few words, says words that are not easily understood, and does not combine words or put words together to make sentences. Family history (mother and father) of speech and language difficulties were also included as variables. Regression analyses were planned to explore the predictive relationship between this set of early indicator variables and likelihood of meeting DLD diagnostic criteria at 10 years.

RESULTS

No single parent-reported indicator uniquely accounted for a significant proportion of children with DLD at 10 years of age. Further analyses, including bivariate analyses testing the predictive power of a cumulative risk index of combined predictors (odds ratio (OR) = 0.95, confidence interval (CI) = 0.85-1.09, p = 0.447) and the moderating effect of sex (OR = 0.89, CI = 0.59-1.32, p = 0.563) were also non-significant.

CONCLUSIONS

Parent reports of early indicators of DLD are well-intentioned and widely used. However, data from the Raine Study cohort suggest potential retrospective reporting bias in previous studies. We note that missing data for some indicators may have influenced the results. Implications for the impact of using early indicators as evidence to inform early identification of DLD are discussed.

WHAT THIS PAPER ADDS

What is already known on the subject DLD is a relatively common childhood condition; however, children with DLD are under-identified and under-served. Individual variability in early childhood makes identification of children at risk of DLD challenging. A range of 'red flags' in communication development are promoted through speech pathology regulatory bodies and developmental services to assist parents to identify if their child should access services. What this paper adds to the existing knowledge No one parent-reported early indicator, family history or a cumulation of indicators predicted DLD at 10 years in the Raine study. Sex (specifically, being male) did not moderate an increased risk of DLD at 10 years in the Raine study. Previous studies reporting on clinical samples may be at risk of retrospective reporting bias. What are the potential or actual clinical implications of this work? The broad dissemination and use of 'red flags' is well-intentioned; however, demonstrating 'red flags' alone may not reliably identify those who are at later risk of DLD. Findings from the literature suggest that parent concern may be complemented with assessment of linguistic behaviours to increase the likelihood of identifying those who at risk of DLD. Approaches to identification and assessment should be considered alongside evaluation of functional impact to inform participation-based interventions.

How do children with language disorder perceive their peer interactions? A qualitative investigation

Background and aims

Peer interaction difficulties are often elevated amongst children with language disorders, yet the mechanisms underlying these difficulties are unclear. Previous research indicates that poor conflict management, social withdrawal, emotion regulation difficulties, and reduced prosocial behavior may contribute to peer interaction difficulties. However, this research often uses adult perspectives, failing to acknowledge child perceptions of these experiences. The present study aimed to qualitatively investigate perceptions of peer interactions from the perspective of children with language disorders.

Methods

Seven participants aged between 7- and 10-years-old took part. All participants were diagnosed with a language disorder and had language as their primary area of difficulty. Participants were recruited from a specialist language school and via an online database. Semi-structured interviews were conducted, with participants given the choice to answer questions verbally or creatively, using toys or drawing materials. Interview transcripts were analyzed using interpretative phenomenological analysis.

Results

Participants valued play, conversation, and helping others. They felt that spending time with peers could alleviate loneliness. However, sometimes solitude was needed as social interaction could be overwhelming. Participants found conflict challenging and exhibited difficulties with regulating emotions. Participants relied on running away, retaliation, or asking an adult for help, to resolve conflict.

Conclusions and implications

The findings suggest that children with language disorders are socially motivated and have relative strengths in displaying prosocial behavior. However, children with language disorders require support to promote positive relationships. This support includes help with making deeper connections with peers, opportunities to spend time alone when needed, and providing adept conflict resolution and emotion regulation strategies.

Camouflaging in Developmental Language Disorder: The Views of Speech and Language Pathologists and Parents

The term camouflaging describes behaviors that cover up neurodivergent difficulties. While researched in autism, camouflaging has received no systematic study in other conditions affecting communication, including developmental language disorder (DLD). This study explored camouflaging in DLD, drawing on the experience and expertise of speech and language pathologists and parents of children with DLD. Using a qualitative descriptive design, we interviewed six speech and language pathologists and six parents of children with DLD. The inductive thematic analysis considered three broad topic areas: What camouflaging behaviors do children with DLD do, the impacts of camouflaging, and what factors are associated with camouflaging. Camouflaging took a range of forms, with eight common presentations identified. Camouflaging reportedly delayed recognition of children's language needs and affected interventions. Camouflaging reportedly impacted children's exhaustion, mental health, self-esteem, personality, friendships, and how others view them. Research characterizing camouflaging in DLD could help reduce the underdetection of children's language needs.

The Development of Mental Health Difficulties in Young People With and Without Developmental Language Disorder: A Gene-Environment Interplay Study Using Polygenic Scores

PURPOSE

Young people with developmental language disorder (DLD) have poorer mental health than those without DLD. However, not all young people with DLD are equally affected; some have more mental health difficulties than others. What explains these differences remains unclear.

METHOD

Data from a community cohort study, the Avon Longitudinal Study of Parents and Children, were analyzed to investigate genetic and environmental influences on the development of mental health difficulties at five time points from childhood (7 years) to adolescence (16 years) in 6,387 young people (8.7% with DLD). Regression and latent class models were fitted to the data.

RESULTS

Polygenic scores (PGSs), indices of genetic risk, for common psychiatric disorders (major depressive disorder, anxiety disorder, and attention deficit hyperactivity disorder) predicted mental health difficulties in both groups (with and without DLD). The presence of DLD, in some instances, amplified mental health difficulties for those with high genetic risk for common psychiatric disorders. Subgroups of children with similar developmental trajectories of mental health difficulties were identified. Young people with DLD were more likely than those without DLD to follow mental health subgroups characterized by consistently high levels of difficulties during development. PGSs, socioeconomic status, and the early home environment distinguished subgroups with low mental health difficulties from those characterized by high levels of difficulties, but these effects did not differ based on DLD status.

CONCLUSIONS

These findings suggest that, for the most part, both genetic and environmental risk affect the development of mental health difficulties in a cumulative way for young people with DLD (and those without). Some analysis did, however, suggest that genetic risk for common psychiatric disorders might manifest more strongly in those with DLD compared with those without DLD.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.22351012.

Children's vocabulary and friendships: A comparative study between children with and without Specific Learning Disorder and Attention Deficit Hyperactivity Disorder

Language skills are important in the formation and maintenance of friendships. Children with specific learning disorder (SLD) or attention-deficit/hyperactivity disorder (ADHD) experience difficulties with their relationships and have language-related problems. This study aims to examine how expressive and receptive vocabulary may relate to friendships of children with and without SLD or ADHD. Participants were 64 children with SLD, 64 children with ADHD, and 64 typically developing (TD) children, aged 8-12 years (M_age  = 9.77 years, SD = 1.22), attending Grades 3 to 6 in inclusive primary schools of Attica, Greece. The Greek versions of the Peabody Picture Vocabulary Test and the expressive vocabulary subscale of the WISC-III were administered along with the sociometric nominations of friends and the self-reports of best friendship duration. Results showed that children with SLD and ADHD reported best friendships of shorter duration and had significantly poorer receptive and expressive vocabulary. Children with ADHD had significantly fewer close and best friends than children with SLD, who in turn had significantly fewer close and best friends than the TD children. Children's vocabulary in all three groups was positively correlated with the duration of their best friendships and was found to moderately predict children's close friendships.

Developmental Language Disorder and Psychopathology: Disentangling Shared Genetic and Environmental Influences

There is considerable variability in the extent to which young people with developmental language disorder (DLD) experience mental health difficulties. What drives these individual differences remains unclear. In the current article, data from the Twin Early Development Study were used to investigate the genetic and environmental influences on psychopathology in children and adolescents with DLD (n = 325) and those without DLD (n = 865). Trivariate models were fitted to investigate etiological influences on DLD and psychopathology, and bivariate heterogeneity and homogeneity models were fitted and compared to investigate quantitative differences in etiological influences on psychopathology between those with and without DLD. The genetic correlation between DLD and internalizing problems in childhood was significant, suggesting that their co-occurrence is due to common genetic influences. Similar, but nonsignificant effects were observed for externalizing problems. In addition, genetic influences on internalizing problems, but not externalizing problems, appeared to be higher in young people with DLD than those without DLD, suggesting that the presence of DLD may exacerbate genetic risk for internalizing problems. These findings indicate that genetic influences on internalizing problems may also confer susceptibility to DLD (or vice versa) and that DLD serves as an additional risk factor for those with a genetic predisposition for internalizing problems.

Intelligence profiles and adaptive behaviors of high-functioning autism spectrum disorder and developmental speech and language disorders

OBJECTIVE

The present study was aimed at investigating the intelligence profiles and adaptive behaviors of children with high-functioning autism spectrum disorder (HFASD) and developmental speech and language disorders (DSLDs). We compared the similarities and differences of cognitive capabilities and adaptive functions and explored their correlations in the HFASD and DSLDs groups.

METHODS

128 patients with HFASD, 111 patients with DSLDs and 114 typically developing (TD) children were enrolled into our study. Wechsler Intelligence Scale for Children-IV (WISC-IV) and Adaptive Behavior Assessment System-II (ABAS-II) were respectively applied to evaluate intelligence profiles and adaptive behaviors. Intelligence quotient (IQ) scores and adaptive functioning scores among the HFASD, DSLDs and TD groups were compared through one-way ANOVA. Pearson correlation coefficient was applied to examine the relationships between WISC indices and ABAS domains.

RESULTS

Outcomes showed significantly poorer intelligence profiles and adaptive behaviors in HFASD and DSLDs groups. Both children with HFASD and DSLDs demonstrated impairments in verbal comprehension and executive functions. Processing speed and working memory were the predominant defects of children with HFASD and DSLDs in the field of executive functions, respectively. Whereas perceptual reasoning was a relative strength for them. Children with DSLDs had balanced scores of all the domains in ABAS-II; nevertheless, HFASD individuals demonstrated striking impairments in Social domain. Correlation analysis showed IQs of children with HFASD were positively correlated with all the domains and General Adaptive Composite (GAC) of ABAS-II. Additionally, IQs were positively correlated with Conceptual domain and GAC for children with DSLDs. Compared with DSLDs group, intelligence displayed stronger correlations with adaptive behaviors in HFASD group.

CONCLUSION

Our study expanded insights regarding intelligence profiles and adaptive behaviors of children with HFASD and DSLDs. Moreover, this study made breakthroughs in discovering positive correlations between IQs and adaptive functions in the two neurodevelopmental disorders.

Developing Preschool Language Surveillance Models - Cumulative and Clustering Patterns of Early Life Factors in the Early Language in Victoria Study Cohort

BACKGROUND

Screening and surveillance of development are integral to ensuring effective early identification and intervention strategies for children with vulnerabilities. However, not all developmental skills have reliable screening processes, such as early language ability.

METHOD

We describe how a set of early life factors used in a large, prospective community cohort from Australia are associated with language abilities across the preschool years, and determine if either an accumulation of risk factors or a clustering of risk factors provide a feasible approach to surveillance of language development in preschool children.

RESULTS

There were 1,208 children with a 7-year language outcome. The accumulation of early life factors increased the likelihood of children having low language skills at 7-years. Over a third of children with typical language skills (36.6%) had ≤ two risks and half of the children with low language (50%) had six or more risks. As the number of factors increases the risk of having low language at 7-years increases, for example, children with six or more risks had 17 times greater risk, compared to those with ≤ two risks. Data collected from 1,910 children at 8- to 12-months were used in the latent class modeling. Four profile classes (or groups) were identified. The largest group was developmentally enabled with a supportive home learning environment (56.2%, n = 1,073). The second group was vulnerable, both developmentally and in their home learning environment (31.2%, n = 596); the third group was socially disadvantaged with a vulnerable home learning environment (7.4%, n = 142); the final group featured maternal mental health problems and vulnerable child socio-emotional adjustment (5.2%, n = 99). Compared to developmentally enabled children, the risk of low language at 7-years was greater for children in the three other groups.

CONCLUSION

The cumulative and cluster risk analyses demonstrate the potential to use developmental surveillance to identify children within the first years of life who are at risk of language difficulties. Importantly, parent-child interaction and the home learning environment emerged as a consistent cluster. We recommend they be adopted as the common focus for early intervention and universal language promotion programs.

Young Adults With Developmental Language Disorder: A Systematic Review of Education, Employment, and Independent Living Outcomes

Purpose Research on developmental language disorder (DLD) in adulthood has increased rapidly in recent years. However, to date, there has been no systematic literature review on this topic, thereby limiting the possibility to have a comprehensive overview of publications in this field. Method Following Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines, we conducted a systematic literature review. A literature search was undertaken in four databases, from 2005 to 2018. We selected articles with original data related to life outcomes of young adults with and without DLD, all aged between 18 and 34 years, in three life areas: education, employment, and independent living. Methodological characteristics of the studies were analyzed. Results Fifteen articles were selected with longitudinal designs. In every life area, young adults with DLD were compared to their typically developing peers to identify their strengths and weaknesses. The predictive role of language abilities was also examined. Conclusions Outcomes within each life area are heterogeneous. Nevertheless, similarly to young children and adolescents, young adults with DLD face numerous challenges. Although language abilities partly predict some of these outcomes, much of the variance remains unaccounted for and some outcomes are unrelated to this predictor. This systematic literature review has implications for researchers and practitioners to identify promising avenues for research, interventions, and policy development. Supplemental Material https://doi.org/10.23641/asha.13022552.

How We Fail Children With Developmental Language Disorder

Purpose For over two decades, we have known that children with developmental language disorder (DLD) are underserved. We have also known that DLD does not attract the research attention that it merits given its prevalence and impact. The purposes of this clinical focus article are to present evidence that these failures continue, explore the reasons behind these failures, and propose solutions. Method I reviewed the literature and applied bibliometric analysis procedures from Bishop (2010) to quantify research efforts aimed at DLD compared to other neurodevelopmental disorders. Results The percentage of children who are deemed eligible for clinical services because of DLD continues to fall well short of estimates based on the prevalence of DLD in community samples. The amount of research conducted on DLD relative to other neurodevelopmental disorders remains low. Contributing factors include a lack of awareness of DLD, the hidden nature of DLD, entrenched policies, and the dissonance created when speech-language pathologists must diagnose DLD in school settings. Conclusions Expanded approaches to supporting children with DLD are required. These might include engagement in advocacy and awareness campaigns; clearer communication with the families we serve and enhanced collaborations with classroom teachers; the implementation of school-based language screenings; participation in policymaking; and the development of service delivery models that operate alongside those that exist in our schools and complement their function. Supplemental Material https://doi.org/10.23641/asha.12743273.

Play and prosociality are associated with fewer externalizing problems in children with developmental language disorder: The role of early language and communication environment

BACKGROUND

Children with developmental language disorder (DLD) are at higher risk of poorer mental health compared with children without DLD. There are, however, considerable individual differences that need to be interpreted, including the identification of protective factors.

AIMS

Pathways from the early language and communication environment (ELCE, 1-2 years) to internalizing (peer and emotional problems) and externalizing (conduct problems and hyperactivity) problems in middle childhood (11 years) were mapped using structural equation modelling. Specifically, the role of indirect pathways via social skills (friendships, play and prosociality) in childhood (7-9 years) was investigated.

METHODS & PROCEDURES

Secondary analysis of existing data from the Avon Longitudinal Study of Parents and Children (ALSPAC) was undertaken. The study sample consisted of 6531 children (394 with DLD).

OUTCOMES & RESULTS

The pathways from the ELCE to internalizing and externalizing problems were similar for children with and without DLD. For both groups, a positive ELCE was associated with more competent social play and higher levels of prosociality in childhood, which in turn were associated with fewer externalizing problems in middle childhood. Furthermore, better friendships and higher levels of prosociality in childhood were both associated with fewer internalizing problems in middle childhood.

CONCLUSIONS & IMPLICATIONS

A child's ELCE is potentially important not only for the development of language but also for social development. Furthermore, in the absence of adequate language ability, play and prosocial behaviours may allow children with DLD to deploy, practise and learn key social skills, thus protecting against externalizing problems. We suggest that consideration be given to play- and prosociality-based educational and therapeutic services for children with DLD. What this paper adds What is already known on this subject On the whole, children with DLD tend to have poorer mental health compared with their unaffected peers. There are, however, considerable differences and poor outcomes are not inevitable. What this study adds to the existing knowledge We demonstrate that children's ECLE is important for the development of social play behaviours and prosociality. Whilst children with DLD tend to have less competent social play and lower levels of prosociality compared with their unaffected peers, those with more competent social play and higher levels of prosociality are likely to have fewer externalizing problems later in childhood. We speculate that in the absence of adequate structural language ability, play and prosocial behaviours allow children with DLD to deploy, practise and learn key relationship skills, alongside behavioural and emotional regulation skills, thus protecting against externalizing problems. What are the potential or actual clinical implications of this work? Understanding the relationships among play, prosociality and externalizing problems may pave the way for play- and prosociality-based interventions in children with DLD. This may be particularly appealing for practitioners as such interventions capitalize on one of the most intuitive means of learning in childhood: play with friends. The likelihood of acceptability and engagement with such interventions may be higher in children than for traditional adult-led, paper-and-pencil activities.

Trajectories of prosociality from early to middle childhood in children at risk of Developmental Language Disorder

Longitudinal research into the development of prosociality during childhood contributes to our understanding of individual differences in social and emotional outcomes. There is a dearth of literature on the development of prosociality in children with Developmental Language Disorder (DLD). Data from the UK based Millennium Cohort Study was used to investigate prosociality from age 5 to 11 years in 738 children at risk of Developmental Language Disorder (r-DLD) and 12,972 children in a general population (GP) comparison group. Multilevel mixed effects regression models were run to investigate the mean change in prosociality and latent class growth analysis was used to identify heterogeneous groups of children who shared similar patterns of development. Overall, children at risk of DLD were less prosocial at age 5 and, although they did become more prosocial by the age of 11, they did not reach the same levels of prosociality as those in the GP group. Subsequent sub group analysis revealed four distinct developmental trajectories: stable high (19 %), stable slightly low (36 %), decreasing to slightly low (5 %), and increasing to high (40 %). Children at risk of DLD were less likely than those in the GP group to be in the stable high class and more likely to be in the stable slightly low class. For children at risk of DLD, being prosocial was protective against concurrent social and emotional difficulties. But being prosocial in early childhood was not protective against later social and emotional difficulties nor did the absence of prosociality in early childhood make social and emotional difficulties in middle childhood inevitable. Rather, the presence of prosociality in middle childhood was the key protective factor, regardless of prosociality in early childhood. Prosociality is not a key area of concern for children at risk of DLD. Instead, it is an area of relative strength, which can be nurtured to mitigate social and emotional difficulties in children at risk of DLD, particularly in middle childhood.

Using Polygenic Profiles to Predict Variation in Language and Psychosocial Outcomes in Early and Middle Childhood

Purpose Children with poor language tend to have worse psychosocial outcomes compared to their typically developing peers. The most common explanations for such adversities focus on developmental psychological processes whereby poor language triggers psychosocial difficulties. Here, we investigate the possibility of shared biological effects by considering whether the same genetic variants, which are thought to influence language development, are also predictors of elevated psychosocial difficulties during childhood. Method Using data from the U.K.-based Avon Longitudinal Study of Parents and Children, we created a number of multi-single-nucleotide polymorphism polygenic profile scores, based on language and reading candidate genes (ATP2C2, CMIP, CNTNAP2, DCDC2, FOXP2, and KIAA0319, 1,229 single-nucleotide polymorphisms) in a sample of 5,435 children. Results A polygenic profile score for expressive language (8 years) that was created in a discovery sample (n = 2,718) predicted not only expressive language (8 years) but also peer problems (11 years) in a replication sample (n = 2,717). Conclusions These findings provide a proof of concept for the use of such a polygenic approach in child language research when larger data sets become available. Our indicative findings suggest consideration should be given to concurrent intervention targeting both linguistic and psychosocial development as early language interventions may not stave off later psychosocial difficulties in children.

Friendship Quality and Gender Differences in Association With Cyberbullying Involvement and Psychological Well-Being

Current literature has documented the detrimental effects of cyberbullying which include a range of internalizing and externalizing problems for those involved. Although critical, this research can sometimes ignore social-ecological aspects of a child's life that can potentially 'buffer' the negative psychological effects of such involvement. With this in mind, this cross-sectional investigation of 12-16 year olds [M(SD): 13.5(1) years] in Ireland focused on the role of friendship quality and gender in association with cyberbullying involvement and psychological well-being (N = 2410). The Cyberbullying and Online Aggression Scale was used to measure cyber perpetration and victimization. A modified version of the Cambridge Friendship Questionnaire was included to investigate peer friendship quality. Finally, the Moods and Feeling Questionnaire and the Strengths and Difficulties Questionnaire were chosen to provide a measurement of psychological well-being. Prevalence rates for various types of cyberbullying roles (cyber bullies, victims and bully/victims) are presented, as well as differences for psychological well-being, friendship quality and cyberbullying involvement. In addition, regression models were used to determine the associations between gender, age, friendship quality and involvement in cyberbullying with psychological well-being. The results are considered in terms of the current literature and directions for future research are suggested.

The Prevalence and Psychopathological Correlates of Sibling Bullying in Children with and without Autism Spectrum Disorder

Using data from a prospective population based study, the prevalence and psychopathological correlates of sibling bullying in children with and without autism spectrum disorder (ASD) were estimated. There were 475 children with ASD and 13,702 children without ASD aged 11 years. Children with ASD were more likely to be bullied by their siblings compared to those without ASD. They were also more likely than those without ASD to both bully and be bullied by their siblings, which was associated with lower prosocial skills as well as more internalizing and externalizing problems compared to those not involved in any sibling bullying. Interventions to improve social and emotional outcomes in children with ASD should focus on both the affected and the unaffected sibling.

Identifying Children With Clinical Language Disorder: An Application of Machine-Learning Classification

In this study, we identified child- and family-level characteristics most strongly associated with clinical identification of language disorder for preschool-aged children. We used machine learning to identify variables that best classified children receiving therapy for language disorder among a sample of 483 3- to 5-year-old children (54% affected). Using a dichotomous outcome based on receipt of language therapy, we applied the least absolute shrinkage and selection operator (LASSO) classification approach to a range of background data available on the children, including teacher and caregiver ratings of communication and social skills. The sample was randomly split into a training (67% of children) and test sample (33% of children) to examine out-of-sample classification accuracy. The full model had excellent classification accuracy based on area under the curve (AUC) of .87 and .85 on the training and test sets, respectively, when utilizing all available background data. Variables most strongly contributing to accurate classification of language-therapy receipt were cognitive impairment, age, gender, and teacher- and parent-reported communication, social, and literacy skills. Use of machine-learning approaches to classify children receiving language services in school settings may provide a valuable approach for identifying those factors that best differentiate children with and without language disorders from a clinical perspective.

Do emotional difficulties and peer problems occur together from childhood to adolescence? The case of children with a history of developmental language disorder (DLD)

Children and adolescents with developmental language disorder (DLD) are, overall, vulnerable to difficulties in emotional adjustment and in peer relations. However, previous research has shown that different subgroups follow different trajectories in respect to the quality of peer relations. Less is known about the trajectories of emotional development. We consider here the possibility that development in these two domains is interrelated: that is, the trajectories of emotional and peer problems will proceed in parallel. We conducted longitudinal joint trajectories analyses of emotional and peer relations in a sample of young people identified as having DLD at the age of 7 years and seen at intervals up to 16 years. Potential influences on joint trajectory group membership were examined. Findings revealed five distinct joint trajectories. Emotional and peer difficulties do occur together from childhood to adolescence for just over half of the sample, but not all. The variables most clearly associated with group membership were pragmatic language ability, prosociality and parental mental health. This is the first study to examine joint longitudinal trajectories of emotional and peer difficulties in individuals with DLD. We demonstrate that development in individuals with DLD is heterogeneous and identify three key variables associated with personal and social adjustment from childhood to adolescence. Theoretical and clinical implications of these findings are discussed.

Emotional and behavioural needs in children with specific language impairment and in children with autism spectrum disorder: The importance of pragmatic language impairment

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.

Associations between Prosocial and Problem Behavior from Early to Late Adolescence

Though recent research has highlighted prosocial behavior as negatively associated with problem behavior during adolescence, we know little about how these variables might be associated longitudinally, whether there are bidirectional effects, and whether there might be different patterns of co-occurrence of behaviors for different individuals. Thus, the current study examined relations between prosocial and problem behaviors in three different ways in an attempt to better understand these associations. Participants included 500 adolescents recruited from a Northwestern state in the USA who took part in the study every year from age 12 to 18 (50% female, 67% European American). Growth curve analyses suggested that change in prosocial behavior was negatively associated with change in aggression and delinquency over time. A longitudinal panel model suggested that prosocial behavior and aggression were negatively associated bidirectionally, and that prosocial behavior was negatively associated with delinquency over time. Finally, mixture modeling conducted at ages 12, 15, and 18 revealed heterogeneity in the ways in which prosocial and problem behaviors co-occur. The discussion focuses on the complexity of interrelations between prosocial behavior and problem behavior across adolescence.

What Factors Influence Language Impairment? Considering Resilience as well as Risk

The considerable variation observed in the profiles of children with language impairment (LI) raises challenges for the diagnosis, treatment and prevention of language difficulties, in particular since LI can present substantial issues calling for the investment of clinical, educational and public health resources. In this review paper, we examine biological, psychological and environmental factors that appear to influence the developmental course of LI. In this review paper we are interested not only in examining deficits and risk factors but also in identifying strengths of children with LI that can act as protective factors providing the child with a scaffold for more positive development and better outcomes.