“I’m a man of few words”: Children's perspectives on living with developmental language disorder

Event Abstract Back to Event High rates of language impairment in vulnerable populations: the case for improving cross-sector awareness of Developmental Language Disorder. Hannah M. Hobson1* and Geoffrey Bird2, 3 1 University of Greenwich, United Kingdom 2 University of Oxford, United Kingdom 3 Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, United Kingdom Developmental Language Disorder (DLD) is a neurodevelopmental condition in which children do not achieve typical levels of language skill. These children may experience difficulties with structural aspects (i.e. syntactic, lexical and phonological problems) as well as pragmatic aspects of language. The prevalence rate of DLD is approximately 7.5% (Norbury et al., 2016). Thus, in a typical UK classroom of 30 students, we can expect on average two children to have DLD. Despite its relative prevalence compared to more widely known conditions such as autism (which has an estimated prevalence of around 1%; Baird et al., 2006), DLD is not well known. This is partly due to a historic lack of agreement on the criteria and terminology for DLD; recent efforts have been made to reach consensus on these issues (Bishop et al., 2016). However, the goal of increased awareness of DLD is not yet reached, and in the meantime, poor awareness of DLD has implications for children’s wellbeing and long-term outcomes. It is unsurprising, given the oral language and literacy demands of most education systems, that children with DLD show poorer academic outcomes compared to typically developing children (Johnson, Beitchman, & Brownlie, 2010). However, children with DLD may also face problems with their attendance: children who are school-refusers have poorer language skills overall, and a higher incidence of language impairments (Naylor, Staskowsi, Kenney & King, 1994). Language problems are also associated with exclusions from school; excluded children show higher rates of expressive language difficulties (Ripley & Yuill, 2005), and studies of mainstream secondary school pupils facing exclusion suggest that two thirds have language problems, with one third showing severe language problems (Clegg, Stackhouse, Finch, Murphy, & Nicholls, 2009). Of the 15 children assessed for this study, only one had received speech and language therapy (for a stammer); none of the other children had been assessed by a speech and language therapist. All children had been excluded three or more times, and were at risk of being permanently excluded from school. Language impairment is also elevated in mental health services. The high rate of language problems in children and adolescents accessing support for emotional and behavioural problems has been summarised in a meta-analysis of 22 studies (Hollo, Wehby, & Oliver, 2014): approximately 81% of children accessing help for an emotional-behavioural disorder have below-average language proficiency, and that 47% of children show moderate to severe language problems. None of the children in the studies had previously been assessed for speech or language problems. As yet, there is no data to indicate whether the high rate of language problems in these services has an impact on progress in psychological therapy. Language problems also show relationships to involvement with the criminal justice system. Language-impaired youth have higher rates of arrests and convictions (Brownlie et al., 2004), and the rate of language impairment in young offender institutions is elevated (see Anderson, Hawes, & Snow, 2016 for a systematic review). A recent study found that 47% of the 93 young offenders assessed showed language skills significantly below what would be expected for their age, and 20% would have met the criteria for language impairment (Hughes et al., 2017). The majority of those identified as having a language impairment had not previously worked with a speech and language therapist. It is thus clear that in a variety of different vulnerable populations we see higher rates of language impairment than would be expected given the prevalence in the general population, and that many of these cases go undetected. It is important to emphasise that many children with DLD go on to have good outcomes, and that language impairment is not deterministic of the problems discussed here (see Johnson et al, 2010). This is important, as it suggests firstly that there are factors that moderate the relationship between language problems and wellbeing, and secondly because it offers hope that, with appropriate identification and support, children with DLD can have good outcomes. Nonetheless, a pertinent question is why are rates of DLD increased across these different settings? There are number of plausible reasons. Firstly, some of the risk factors for poor language development and emotional and behavioural problems are overlapping, such as social disadvantage (Horwitz et al., 2003; Olak et al., 2009; Singh & Ghandour, 2012). Secondly, language problems themselves may contribute to social and psychological difficulties that increase the risk of emotional and behaviour problems. Specifically, language problems may lead children to experience social isolation, reducing opportunities for acquiring good social skills and increasing the risk of poor self-esteem and poor emotional outcomes (Craig, 1993; Redmound & Rice, 1998; Wadman, Durkin, & Conti-Ramsden, 2008). Children with language problems are also at increased risk of being bullied (Redmond, 2011), and of having poorer emotion regulation (Fujiki, Brinton & Clarke, 2002). Finally, and of relevance to an array of different professions, when their language problems are not recognised, the behaviours of children and young people with DLD may be interpreted by the adults in their environment in a way that increases the likelihood of poor outcomes. In the context of forensic interviewing, Snow and Powell (2012) argue that the presentation of language problems in young offenders may lead professionals to assume that the young person is rude, or incoherent with their account of events (and therefore likely guilty). One account given by a young person in prison stated that when asked by a judge if he was remorseful of his crime, he said no: he had never heard the word “remorseful” before, and had no idea what it meant (Talbot, 2007). If such an experience is representative of young people with communication disorders’ interactions with the criminal justice system, it is perhaps not surprising that the rate of language problems is so high in young offender institutions. Extrapolating this to the headteacher’s office or the psychiatrist’s chair, we may predict that children with DLD are similarly judged as being uncooperative, unapologetic or reticent. It would be naïve to assume that untrained professionals will readily detect language problems in their cohorts. Rather, language impairments will not always be obvious to people interacting with a person with DLD; adults have a tendency to assume that children understand more of what is being said to them than is actually the case (Sattler, Feldman, & Bohanan, 1985), and children may engage in masking behaviours that cover their language problems (Evans & Macwhinney, 1999). Indeed, teachers have quite poor sensitivity and specificity to children’s oral language impairments (Antoniazzi, Snow & Dickson-Swift, 2010). Even in settings where we might expect educational staff to have a higher level of knowledge regarding language problems, this is not necessarily the case: in a special school for children with emotional and behavioural difficulties in which the prevalence of language impairment was 74%, less than half of these children had been identified as impaired (Stringer & Lozano, 2007). Speech problems may be the most detectable issue, but children with pure speech problems actually do not show adverse outcomes, compared to typical children (Johnson et al., 2010). Possibly this is because speech problems do not affect children’s social and emotional development in the same way that a language problem does. Alternatively, perhaps a child with a speech problem is far more likely to be identified and supported than a child who has a language impairment but whose speech does not sound unusual. What happens to these children and young people if their language problems are not recognised? The increased rates of language impairment in children facing exclusion from school and in the criminal justice system paint a gloomy picture. DLD is considered a lifelong condition, and while children’s language skills may improve, they require input from specialists to help them acquire skills and strategies to compensate for their language problems (Perkins, 2001). Clearly there are many children who finish schooling and enter services aiming to remediate mental health problems or criminal behaviours without their language problems having been detected. It is therefore important that awareness of DLD is sufficient in professions that are very likely to interact with children with DLD, including mental health and forensic professionals. Acknowledgements Geoff Bird was supported by the Baily Thomas Charitable Trust. References Anderson, S. A. S., Hawes, D. J., & Snow, P. C. (2016). Language impairments among youth offenders: A systematic review. 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H., Escobar, M., Young, A., Atkinson, L., Johnson, C., ... & Douglas, L. (2004). Early language impairment and young adult delinquent and aggressive behavior. Journal of abnormal child psychology, 32(4), 453-467. Clegg, J., Stackhouse, J., Finch, K., Murphy, C., & Nicholls, S. (2009). Language abilities of secondary age pupils at risk of schoolClegg, J., Stackhouse, J., Finch, K., Murphy, C., & Nicholls, S. (2009). Language abilities of secondary age pupils at risk of school exclusion: A preliminary report. Child Language Teaching and Therapy, 25(1), 123–139. http://doi.org/10.1177/0265659008098664 Craig, H. K. (1993). Social skills of children with specific language impairment: Peer relationships. Language, Speech, and Hearing Services in Schools, 24(4), 206-215. Evans, J. L., & MacWhinney, B. (1999). Sentence processing strategies in children with expressive and expressive-receptive specific language impairments. International Journal of Language & Communication Disorders, 34(2), 117-134. Fujiki, M., Brinton, B., & Clarke, D. (2002). Emotion regulation in children with specific language impairment. Language, Speech, and Hearing Services in Schools, 33(2), 102-111. Hollo, A., Wehby, J. H., & Oliver, R. M. (2014). Unidentified language deficits in children with emotional and behavioral disorders: A meta-analysis. Exceptional Children, 80(2), 169–186. http://doi.org/10.1177/001440291408000203 Horwitz, S. M. C., Irwin, J. R., Briggs-Gowan, M. J., Bosson Heenan, J. M., Mendoza, J., & Carter, A. S. (2003). Language delay in a community cohort of young children. Journal of the American Academy of Child and Adolescent Psychiatry, 42(8), 932–940. http://doi.org/10.1097/01.CHI.0000046889.27264.5E Hughes, N., Chitsabesan, P., Bryan, K., Borschmann, R., Swain, N., Lennox, C., & Shaw, J. (2017). Language impairment and comorbid vulnerabilities among young people in custody. Journal of Child Psychology and Psychiatry and Allied Disciplines, 58(10), 1106–1113. http://doi.org/10.1111/jcpp.12791 Johnson, C. J., Beitchman, J. H., & Brownlie, E. B. (2010). Twenty-year follow-up of children with and without speech-language impairments: Family, educational, occupational, and quality of life outcomes. American Journal of Speech-Language Pathology, 19(1), 51–65. http://doi.org/10.1044/1058-0360(2009/08-0083) Naylor, M. W., Staskowski, M., Kenney, M. C., & King, C. A. (1994). Language disorders and learning disabilities in school-refusing adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 33(9), 1331-1337. Norbury, C. F., Gooch, D., Wray, C., Baird, G., Charman, T., Simonoff, E., … Pickles, A. (2016). The impact of nonverbal ability on prevalence and clinical presentation of language disorder: evidence from a population study. Journal of Child Psychology and Psychiatry and Allied Disciplines, 57(11), 1247–1257. http://doi.org/10.1111/jcpp.12573 Amone-P’Olak, K., Burger, H., Ormel, J., Huisman, M., Verhulst, F. C., & Oldehinkel, A. J. (2009). Socioeconomic position and mental health problems in pre-and early-adolescents. Social psychiatry and psychiatric epidemiology, 44(3), 231-238. Perkins, M. R. (2001). Compensatory strategies in SLI. Clinical Linguistics and Phonetics, 15(1–2), 67–71. http://doi.org/10.1080/026992001461334 Redmond, S. M. (2011). Peer victimization among students with specific language impairment, attention-deficit/hyperactivity disorder, and typical development. Language, Speech, and Hearing Services in Schools, 42(4), 520-535. Redmond, S. M., & Rice, M. L. (1998). The socioemotional behaviors of children with SLI: Social adaptation or social deviance?. Journal of Speech, Language, and Hearing Research, 41(3), 688-700. Ripley, K., & Yuill, N. (2005). Patterns of language impairment and behaviour in boys excluded from school. The British Journal of Educational Psychology, 75(Pt 1), 37–50. http://doi.org/10.1348/000709905X27696 Sattler, J. M., Feldman, J., & Bohanan, A. L. (1985). Parental estimates of children’s receptive vocabulary. Psychology in the Schools, 22(3), 303–307. http://doi.org/10.1002/1520-6807(198507)22:3<303::AID-PITS2310220312>3.0.CO;2-J Singh, G. K., & Ghandour, R. M. (2012). Impact of neighborhood social conditions and household socioeconomic status on behavioral problems among US children. Maternal and Child Health Journal, 16(SUPPL. 1), 158–169. http://doi.org/10.1007/s10995-012-1005-z Snow, P., & Powell, M. (2012). Youth (in) justice: Oral language competence in early life and risk for engagement in antisocial behaviour in adolescence. Trends and Issues in Crime and Criminal Justice, 435, 1-6. Stringer, H., & Lozano, S. (2007). Under identification of speech and language impairment in children attending a special school for children with emotional and behavioural disorders. Educational & Child Psychology, 24(4), 9–19. Talbot, J. (2007) No One Knows: Identifying and Supporting Prisoners with Learning Difficulties and Learning Disabilities. The Views of Prison Staff. London: Prison Reform Trust Wadman, R., Durkin, K., & Conti-Ramsden, G. (2008). Self-esteem, shyness, and sociability in adolescents with specific language impairment (SLI). Journal of Speech, Language, and Hearing Research, 51(4), 938-952. Keywords: developmental language disorder (DLD), Language, vulnerable population group, Mental Health, Policy & disabilities Conference: 4th International Conference on Educational Neuroscience, Abu Dhabi, United Arab Emirates, 10 Mar - 11 Mar, 2019. Presentation Type: Oral Presentation (invited speakers only) Topic: Educational Neuroscience Citation: Hobson HM and Bird G (2019). High rates of language impairment in vulnerable populations: the case for improving cross-sector awareness of Developmental Language Disorder.. Conference Abstract: 4th International Conference on Educational Neuroscience. doi: 10.3389/conf.fnhum.2019.229.00002 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 08 Feb 2019; Published Online: 27 Sep 2019. * Correspondence: Dr. Hannah M Hobson, University of Greenwich, Greenwich, London, SE10 9LS, United Kingdom, H.Hobson@greenwich.ac.uk Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Hannah M Hobson Geoffrey Bird Google Hannah M Hobson Geoffrey Bird Google Scholar Hannah M Hobson Geoffrey Bird PubMed Hannah M Hobson Geoffrey Bird Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.

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

Background and Aim.Children with Developmental Language Disorder (DLD) are at an increased risk to develop behaviors associated with Autism Spectrum Disorder (ASD). The relationship between early language difficulties and the occurrence of ASD-related behaviors in DLD is poorly understood. One factor that may hinder progress in understanding this relationship is the etiological heterogeneity of DLD. We therefore study this relationship in an etiologically homogeneous group of children, who share phenotypic characteristics with children with DLD: children with the 22q11.2 Deletion Syndrome (22q11DS). We compare children with 22q11DS, to children with DLD and age-matched typically developing children (TD).Method44 children with 22q11DS, 65 children with DLD and 81 TD children, between 3.0–6.5 years old, participated in a longitudinal cohort study that included a baseline measure and a follow-up measure with a 1-year interval. A parental questionnaire (SRS-2) was used to measure the incidence of behaviors in two key behavioral domains associated with ASD: Social Communication and Interaction and Restricted Repetitive Behaviors and Interests. At baseline, we assessed children's expressive and receptive language abilities as well as their intellectual functioning with standardized tests. We compared the distribution of ASD-related behaviors between the three groups. We used regression analyses to investigate whether language abilities at baseline predict ASD-related behavior at follow-up, accounting for ASD-related behavior at baseline, demographic variables and intellectual functioning.ResultsBoth the children with 22q11DS and the children with DLD displayed significantly more ASD-related behaviors than the TD children. Over 30% of children in both clinical groups had scores exceeding the subclinical threshold for ASD in both behavioral domains. Both in 22q11DS and DLD, baseline receptive language scores were negatively correlated with ASD-related behaviors 1 year later, when controlling for baseline SRS-scores. However, this association was statistically significant only in children with 22q11DS, even when controlled for IQ-scores, and it was significantly stronger as than in the TD group. The strength of the association did not differ significantly between 22q11DS and DLD.ConclusionBoth children with 22q11DS and children with DLD present with elevated rates of ASD-related behaviors at a preschool-age. Only in children with 22q11DS we observed that weaker receptive language skills were related to increased behavioral problems in the domain of social communication and interaction one year later.ImplicationsOur findings indicate that relations between early language impairment and other behavioral phenotypes may be more feasible to detect in a subgroup of children with a homogeneous etiology, than in a group of children with a heterogeneous etiology (such as children with DLD). Our results in 22q11DS reveal that receptive language is especially important in predicting the occurrence of ASD-related behaviors. Future research is needed to determine to what extent receptive language predicts the occurrence of ASD-related behaviors in children with DLD, especially among those children with DLD with the weakest receptive language. Clinically, screening for ASD-related behaviors in children with developmental language difficulties is recommended from a young age, especially among children with receptive language difficulties.

Public awareness of Developmental Language Disorder (DLD) is lower than other neurodevelopmental disorders, despite its high prevalence of 7.6%. This lower awareness means recruitment for DLD research studies is difficult. DLD is both underfunded and under-researched, resulting in relatively limited research investigating individuals with DLD. Engage with Developmental Language Disorder (E-DLD) is a response to these considerations. E-DLD is the first international participant database of those affected by DLD. Parents of children with DLD under 16 and young people and adults over 16 from anywhere in the world can sign up to be a part of the E-DLD. This paper aims to describe the families of children with DLD and adults with DLD in the database thus far. E-DLD members sign up via our website, reporting demographic characteristics as part of this procedure. We request all E-DLD members subsequently fill in a yearly survey. The content of the yearly survey changes dependent on the age of the child, while the yearly survey for adults remains consistent. We measure a wide range of domains, such as speech and language therapy (SLT) support, school support, socialisation skills, and early developmental milestones for our youngest members, and health care support and mental well-being measurements for our adults. We also collect parent and self-reported reflections on strengths and challenges for the person with DLD using open-ended questions and the Strengths and Difficulties Questionnaire. The database currently consists of 196 parents of children with DLD and 20 individuals over the age of 16 with DLD or suspected DLD across a range of socioeconomic status (SES) backgrounds. Our initial results confirm that E-DLD members meet the linguistic profile of DLD in relation to self- or parent-rated language difficulties. Both children and adults show increased rates of psychosocial difficulties compared to established norms, consistent with past research on clinical samples of people with DLD. The findings indicate that a participant database for DLD research is feasible and useful. The rates of emotional, behavioural and sleep difficulties among the child probands are higher than reported rates amongst typically developing children. Initial data indicate that adults with DLD have poorer well-being than their peers. The E-DLD is a useful collection of data on those affected by DLD and is a promising method for connecting people with DLD with academic researchers. What is already known on this subject Developmental Language Disorder (DLD) is characterised by expressive and/or receptive language difficulties in the absence of another biomedical condition that could explain these difficulties. It is critically under-researched and underfunded. As such, there is a lack of public awareness and difficulty recruiting sufficient sample sizes for DLD research studies. What this paper adds to existing knowledge Engage with Developmental Language Disorder (E-DLD) is the first international participant database of individuals with DLD. This paper provides a preliminary report on the profile of linguistic and psychosocial skills among the individuals on the database, adding to current understanding of DLD across age groups. What are the potential or actual clinical implications of this work? Our aim is that the E-DLD will provide much-needed facilitation of research into DLD. E-DLD will enable those with DLD and their families more readily to shape research agendas and to participate in studies that interest them. Families may be recruited into research that could directly translate to better clinical treatment of DLD. We also believe that the E-DLD yearly survey holds potential to provide key information on the development and longitudinal experience of children and adults with DLD.

To investigate: (a) language difficulties in children with developmental coordination disorder (DCD), and (b) motor difficulties in children with developmental language disorder (DLD). In this systematic review, PubMed, CINAHL, PsycINFO, and Embase were searched to identify peer-reviewed studies. Two researchers independently identified, screened and evaluated the methodological quality of the included studies following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). For objective (a), we combined the terms: "developmental coordination disorder" AND "language skills" AND "children". For objective (b) we combined the terms: "developmental language disorder" AND "motor skills" AND "children". Ten studies on language skills in children with DCD and 34 studies on motor skills in children with DLD are included, most with relatively good methodological quality. The results for language comprehension and production in children with DCD are contradictory, but there is evidence that children with DCD have communication and phonological problems. Evidence for general motor problems in children with DLD is consistent. Studies report problems in balance, locomotor, and fine motor skills in children with DLD. Evidence for aiming and catching skills is inconsistent. The findings of this systematic review highlight the co-occurrence of language impairments in children with DCD and motor impairments in children with DLD. Healthcare professionals involved in the assessment and diagnosis of children with DCD or DLD should be attentive to this co-occurrence. In doing so, children with DCD and DLD can receive optimal interventions to minimize problems in their daily life.

Background: Delayed verbal communication and vocabulary development can significantly impact children&amp;apos;s emotional well-being, social interactions, and overall psychological development. This systematic review aims to synthesize existing research on the psychological effects associated with these delays, focusing on how they affect children&amp;apos;s emotional health, social skills, and cognitive functioning. Methodology: This review systematically analyzed studies that investigated the psychological consequences of delayed verbal communication and vocabulary development in children. The studies included were diverse in design, including cross-sectional, longitudinal, and mixed-method approaches. Key measures across studies included assessments of depressive and anxiety symptoms, social-emotional functioning, language skills, and cognitive abilities. The analysis synthesized findings from a range of populations, including children with developmental language disorders (DLD), specific language impairment (SLI), and autistic spectrum disorders (ASD). Results: The review found that children with delayed verbal communication and vocabulary development are at increased risk for a variety of psychological issues. These include higher levels of anxiety and depression, difficulties in social interactions, and cognitive challenges. Specifically, children with DLD and SLI were more likely to experience emotional difficulties, such as depressive symptoms and anxiety, compared to their peers. Pragmatic language difficulties were found to be particularly associated with later psychotic experiences and depressive symptoms. Peer problems, bullying, and socioemotional challenges were prominent among youth with language impairments. Additionally, deficits in higher-order language skills and cognitive abilities were linked to greater emotional and social difficulties. Conclusion: The psychological impacts of delayed verbal communication and vocabulary development are profound, affecting children&amp;apos;s emotional well-being, social interactions, and cognitive development. Interventions should address both language difficulties and associated emotional and social challenges.

A heated debate has been ongoing regarding the potential overlap in language disorders exhibited by children with developmental language disorder (DLD) and those with autism spectrum disorder plus language impairment (ALI). This study compared the production of Chinese negative structures by these two populations, alongside typically developing age-matched (TDA) children. Nineteen children with DLD, thirty-two children with ALI and twenty-eight TDA children participated in a video task and a game task on two Chinese negative structures (Structure B: V-bu-C; Structure M: mei-V-C). The results reflected a general resemblance between the two groups (DLD vs. ALI) in their most prevalent non-target responses in the two structures. However, children with ALI evinced impairment in both structures, while children with DLD only presented significantly lower-than-TDA performance in Structure M. Moreover, only the ALI group performed better in the game task than in the video task when producing Structure B, and the DLD and ALI groups produced some distinctive non-target responses. The findings indicate that the DLD group’s poor performance may be related to the impairment in the assignment of negative scope and the ALI’s difficulties may be attributed to the deficits in pragmatics. This study supports the idea that while children with DLD and children with ALI share some common symptoms in language, their language difficulties may result from different impairments. Labels should not be attached to children without an in-depth analysis of children’s responses in language assessments.

Interventions for Developmental Language Disorder (DLD) span explicit and implicit approaches, yet Matching-to-Sample (MTS) protocols, a well-established method for fostering equivalence-based learning, remain unexamined in this population. The partly incidental and implicit nature of these protocols may align more closely with the way language skills are acquired in everyday contexts. To assess their potential for use in individuals with DLD, we conducted a scoping review of MTS-based language interventions in individuals with language impairments. Following the PRISMA-ScR guidelines and using Web of Science and PsycINFO, sixteen studies (N = 81, primarily children and adolescents) met inclusion criteria, the key requirement being evidence of language difficulties. In most studies, these difficulties co-occurred with diagnoses of autism spectrum disorder or intellectual disability. The review revealed that most interventions targeted foundational receptive and expressive skills and reliably produced untrained (derived) stimulus relations, underscoring the efficacy of implicit learning mechanisms. However, small sample sizes, varied MTS formats, and a dearth of long-term follow-up constrain generalizability. Our findings position MTS as a promising framework for DLD but highlight the need for controlled trials with standardized protocols, larger and DLD-specific cohorts, and measures of sustained, functional language gains. What is already known on the subject Matching-to-sample (MTS) training protocols have been successfully applied to teach a wide range of skills across diverse populations. However, systematic reviews specifically evaluating the potential of MTS-based language interventions for individuals with language impairments, and for Developmental Language Disorder (DLD) in particular, are lacking. What this study adds to existing knowledge This scoping review identified a relatively small number of studies involving individuals with language difficulties, most of whom also presented with co-occurring neurocognitive conditions. No studies were found that focused specifically on individuals with DLD. Across the available studies, outcomes were generally positive, with evidence not only for gains in explicitly trained language skills but also for the emergence of untrained foundational language skills. What are the potential or actual clinical implications of this study? If positive findings are replicated in larger, well-controlled trials that also address more advanced language abilities, MTS-based language interventions may represent a promising approach for the sustained improvement of language skills in individuals with DLD.

Developmental language disorder (DLD) is an underidentified neurodevelopmental disorder that affects, on average, one out of 11 kindergarten-age children (ages 4-6 years). Children with DLD can face academic, behavioral, psychiatric, emotional, and social challenges. Universal screening is seen as an effective way for public school districts to increase DLD identification rates. However, little is known about factors impacting implementation of school-based universal screenings for DLD. We partnered with a large suburban school district in the Intermountain West region of the United States to gather detailed perspectives from school personnel regarding the barriers and facilitators to the implementation of universal screening in their district. Using a two-phase mixed-methods design, we first conducted focus groups to identify potential barriers and facilitators to universal screening. We then used the qualitative data from the first phase to develop a 20-item survey to assess agreement with the focus group results among a wider group of district speech-language pathologists and kindergarten teachers from the school district. Our survey showed moderate levels of agreement with our focus group results. In particular, school personnel showed high levels of support for universal screening for DLD, with interesting interplay across various factors: (a) the negative impact of unmanageable workload on personnel under both referral- and universal-based identification formats, (b) the preference for paraprofessionals to administer screenings, (c) the role that Response to Intervention programs may play in offsetting workloads associated with universal screenings, and (d) the need for increased awareness and education about child language development and impairment among general education teachers and the public. Recommendations for incorporating these factors into more useful and applicable collaborative research-based efforts are presented. https://doi.org/10.23641/asha.23661876.

ABSTRACTObjectivesParticipation in organised extracurricular social activities (OESAs) can provide wide‐ranging positive developmental benefits for children. This study investigated whether participation and experiences differ for children aged 4‐ to 12‐years with a developmental language disorder (DLD) compared to their typical language developing (TLD) peers.MethodsParents of children with DLD (n = 18) and those of TLD peers (n = 21) reflected on their child's participation and experiences in OESAs.ResultsResults demonstrated that parents of children with DLD reported engagement in a similar number of OESAs and for a similar length of time on a weekly basis compared to parents of TLD children. Additionally, when evaluating factors that facilitated positive participation experiences— such as their child's abilities and behaviour, features of the OESA, and the social environment —parents of children with DLD provided ratings mostly comparable to those of TLD parents. However, when children disengaged from an OESA, ability‐related factors, such as communication, motor, and social skills, were more likely to be reported to influence the participation experience for children with DLD.ConclusionsThese findings underscore the importance of fostering accessible and positive OESA experiences to support meaningful participation and access to the developmental benefits of OESAs for children with DLD.WHAT THIS PAPER ADDSWhat is already known on this subjectChildren with developmental disabilities often experience reduced participation in organised extracurricular social activities (OESAs), limiting their access to important developmental opportunities. For children with developmental language disorder (DLD), research has focused primarily on academic challenges, with limited understanding of their participation and experiences in non‐academic, socially orientated activities. Previous studies have generally assumed participation barriers dominate the experiences of children with disabilities, potentially overlooking strengths, facilitators, and positive developmental contexts like OESAs.What this study adds to existing knowledgeThis study provides the first comprehensive comparison of OESA participation and experiences between children with DLD and their typically developing peers. Findings suggest that children with DLD participate at similar rates, intensities, and breadths and generally have positive experiences. Ability‐related factors such as communication and motor skills influenced disengagement but did not preclude participation. By applying a biopsychosocial framework, this study moves beyond a deficit‐based view and highlights the potential for inclusive OESA environments to support social development for children with DLD.What are the potential or actual clinical implications of this study?OESAs offer developmentally rich contexts that may support social engagement and psychosocial well‐being for children with DLD. Clinicians and educators should encourage participation in OESAs while being mindful of subtle ability‐related challenges that may affect sustained engagement. Targeted support strategies—such as facilitating beginner‐friendly entry points and fostering inclusive peer environments — could optimise participation. These findings highlight the importance of advocating for accessible, socially supportive community programmes as part of holistic developmental support plans for children with DLD.

This study aims to understand the difficulties young Kurdish language learners face with developmental language disorder in bilingual settings and to evaluate their impact on English as a foreign language acquisition. Underscoring the significance of this research, the study’s primary objective is to determine the characteristics of developmental language disorder in this context and their implications for academic assimilation. The Clinical Evaluation of Language Fundamentals assessment was selected to achieve this primary objective due to its suitability for assessing the British population’s linguistic characteristics and age group. Seven subtests were chosen to comprehensively evaluate various aspects of language proficiency, allowing for a thorough evaluation of the participants’ language skills. This research expands its significance. These initiatives include more extensive investigations, innovative participant recruitment methods, exploration of cultural influences, longitudinal studies to discover long-term effects, critical analysis of intervention strategies, examination of the complex relationship between emotional regulation and language development, investigation of genetic and environmental factors contributing to developmental language disorder, and evaluation of the far-reaching consequences. Upon analysis of the collected data, several significant findings shed light on the efficacy of individualised approaches in mitigating communication and academic difficulties in individuals with developmental language disorders.

A Brain Marker for Developmental Speech Disorders

Posterior fossa tumours (PFT) are the most common childhood brain tumours, and children treated for these tumours are at increased risk of persistent speech, language and/or communication difficulties. Such difficulties have often been described in association with the postoperative complication cerebellar mutism syndrome (CMS), but can also occur in children without a period of mutism. Speech and language difficulties may affect communication, participation and social relationships. However, little is known about how children themselves experience communication in everyday life following PFT surgery. This study aimed to describe children's experiences of communication in their everyday lives following PFT surgery. An inductive qualitative content analysis was conducted based on semi-structured interviews with 10 children, aged 6 to 18 years at the time of the interview, carried out at least 1 year after PFT surgery. Interviews were adapted to the children's communicative abilities, using augmentative and alternative communication (AAC) when needed, and a flexible, child-centred approach was used to capture their experiences. Two overarching themes were identified: The theme A thin line between belonging and not belonging captured children's experiences of inclusion and exclusion through everyday communicative events; The theme Navigating reality towards normality captured how children expressed who they were and managed how they were perceived. While speech, language and/or communication difficulties were not explicitly mentioned, the children's descriptions reflected how the consequences of such difficulties shaped everyday communication and participation. Small, everyday moments could affirm or undermine belonging, and familiar friendships provided continuity during a time of change. Children also expressed needs, set boundaries and protected their identity while adapting to new circumstances. The findings underline the importance of listening to children and planning support that is flexible, responsive and grounded in their perspectives. What is already known on the subject Previous studies have described speech, language and/or communication difficulties following posterior fossa tumour surgery. In children with speech and language impairments, such difficulties have been linked to fewer peer interactions, social withdrawal and difficulties maintaining friendships and participating in group activities. What this paper adds to existing knowledge This study offers a unique insight into children's own experiences of communication after PFT surgery. These experiences have not previously been described from the children's perspective. The study captures how children experience everyday communication, showing how it can support or disrupt a sense of belonging depending on how communication unfolds in different contexts. What are the potential or actual clinical implications of this work? The findings of this study have implications for healthcare providers, school health services and educational settings. Professionals should not rely solely on observation but actively invite children to share their experiences. Supporting pre-existing friendships and informing classmates may contribute to more understanding and positive responses.

Developmental Language Disorder (DLD) impacts various aspects of children's language abilities, including the processing of inflectional morphology. Prior research suggests that children with DLD exhibit deficits in processing speed and sensitivity to grammatical inflections, yet the relationship between these deficits remains unclear. This study aimed to investigate the relationship between processing speed and sensitivity to inflectional morphology in children with DLD, focusing on their real-time processing abilities in response to regular past tense, third person singular, and regular plural inflections at different rates of sentence articulation. Eighteen children with DLD and 18 age-matched controls underwent word monitoring tasks that assessed sensitivity to grammaticality of inflections in sentences presented at normal and slow rates of articulation. At a normal rate of articulation, children with DLD demonstrated slower response times and reduced sensitivity to grammaticality across all inflections compared to controls. When the articulation rate was slowed, children with DLD showed improved sensitivity, particularly to regular plural and third person singular inflections, although deficits in processing the regular past tense persisted. The findings suggest a significant relationship between processing speed and inflectional morphology sensitivity in children with DLD. Slower articulation rates improved grammatical sensitivity for certain inflections, highlighting the potential of tailored interventions that consider processing speed limitations. Persistent difficulties with the regular past tense inflection indicate the need for targeted support for children with DLD in this area. What is already known on this subject Children with Developmental Language Disorder (DLD) have a wide range of language difficulties, but deficits in inflectional morphology are regarded as a 'hallmark' of the disorder. Children with DLD are also very likely to show deficits in speed of processing, although it is not known if a 'slowness to process' can causally explain the language difficulties these children experience. What this study adds to existing knowledge When grammatical sensitivity was measured using an online real-time task, children with DLD showed widespread inflectional deficits when sentences were spoken at a normal conversational rate. When sentence articulation rate was slowed down, children with DLD were faster, more accurate and more sensitive to the grammaticality of constructions. However, deficits in the regular past tense remained persistent, even in this slow-rate condition. What are the clinical implications of this work? This study has implications for clinical and educational practices that work with children with DLD to improve their language skills. The findings of this study show that when children with DLD are given more time to process incoming information, their grammatical skills significantly improve. This study also shows that deficits in the regular past tense are persistent, and children are likely need extensive and intensive support with this particular grammatical feature.

Longitudinal perspective on nonverbal intelligence development in young children with developmental language disorder.