Family and Community Predictors of Comorbid Language, Socioemotional and Behavior Problems at School Entry.

Nathan Hughes,Emma Sciberras,Sharon Goldfeld,Valsamma Eapen

doi:10.1371/journal.pone.0158802

Abstract

ObjectivesTo identify the prevalence and family and community-level predictors of comorbid speech-language difficulties and socioemotional and behavioral (SEB) difficulties across a population of children at school entry.MethodsThe School Entry Health Questionnaire is a parent survey of children’s health and wellbeing, completed by all children starting school in Victoria, Australia (N = 53256). It includes parental report of speech-language difficulties, the Strengths and Difficulties Questionnaire (behavior), and numerous family and community variables. Following univariate analysis, family and community risk characteristics were entered into a multinomial logistic regression model to identify the associated relative risk of comorbid speech/language and SEB needs. The influence of experiencing multiple risk factors was also examined.Results20.4% (n = 10,868) began school with either speech-language or SEB difficulties, with 3.1% (n = 1670) experiencing comorbid needs. Five factors predicted comorbidity: the child having witnessed violence; a history of parent mental illness; living in more deprived communities; and the educational attainment of each parent (independently). The relative risk of comorbidity was 6.1 (95% Confidence Interval: 3.9, 9.7) when a child experienced four or more risk factors, compared to those with no risk factors.ConclusionsThe risk of comorbidity in early childhood is associated with a range of family and community factors, and elevated by the presence of multiple factors. Children growing up in families experiencing multiple, complex needs are therefore at heightened risk of the early development of difficulties likely to impact upon schooling. Early identification of these children offers opportunities for appropriate and timely health and education intervention.

Highlights

Socioemotional and behavioural (SEB) and speech-language difficulties each affect up to 20% [1,2,3,4] of children aged 3–5 years
Very little is known about how common comorbid SEB and speech-language difficulties are at school entry, a critical transition period for young children, nor the family/community level factors associated with this common comorbidity
Close to 9% (8.8%; n = 4873) of young people were defined as having SEB difficulties using the total Strengths and Difficulties Questionnaire (SDQ) score

Summary

Introduction

Socioemotional and behavioural (SEB) and speech-language difficulties each affect up to 20% [1,2,3,4] of children aged 3–5 years. Theoretical explanations emphasise the role of child and parent-child interaction factors in explaining the comorbidity between SEB and speech-language difficulties [8,9]. Child-specific factors include poor emotional regulation, negative temperament, and working memory deficits, while parent-child interaction factors implicate poor parental responsiveness or reduced social-linguistic interaction [8,9]. Shared neurobiological factors, such as genetics and brain structure, function and connectivity, are likely to play an important role in explaining the overlap between SEB and speech-language difficulties [10]

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