Systematically Identifying Communication Deficits in Youth Under Psychiatric Care Through a Self-Report Scale

Abstract

Background: Communication disorders are associated with psychopathology and social distress in adolescents, yet moderate or less severe deficits often go undiagnosed. Data from a quality improvement initiative was analyzed from the Communication Perception Estimate Scale (CoPES), a self-report scale for receptive-expressive and pragmatic language deficits in youth receiving mental health services. Objective: To identify the frequency of communication deficits (CDs) among youth in psychiatric care and identify patterns of self-reported symptoms. The scale may be used as a clinical screening tool for Language disorder and Social (Pragmatic) communication disorder. Methods: CoPES is a 31-item scale administered to 318 adolescents 11-18 years old, asking questions about receptive-expressive and pragmatic CDs. In the first 12 items, subjects identified the frequency of communication disorder symptoms using a forced-choice scale; in the following items, frustration with CDs, yes or no for earlier intervention, and current interest in getting help for CDs. Respondents are from five representative clinical services. Results: Patients were divided into self-identified groups: 14.5% significant Receptive-Expressive deficits only (R-ED); 6.6% significant Pragmatic deficits only (PD); 29.9% Both significant Receptive-Expressive and Pragmatic deficits (BCD); and 49.1% with limited or no deficits (NCD). The R-ED group expressed high rates of frustration and requests for help with Receptive-Expressive deficits. The PD group reported elevated rates of frustration in both areas. The BCD group indicated significantly more frustration and requests for help with both language areas compared to the NCD group. Conclusion: This data supports the need for greater awareness and consideration of communication disorders in youth presenting for psychiatric care.