The Relationship Between Pragmatic Language Skills and Emotional-Behavioral Characteristics in Children with Vocabulary Delay Focusing on Conversational Abilities

A scoping review of sex/gender differences in pragmatic language and friendship characteristics in autistic children and adolescents

Introduction: Developmental language disorder (DLD) is a neurodevelopmental disorder that affects the learning, expression and comprehension of language. Children diagnosed with DLD may experience difficulties in peer relationships, display behavioral problems, or encounter challenges in social-emotional development due to inadequacies in their pragmatic language skills. This study aims to evaluate the emotion regulation and pragmatic language skills of 60- to 72-month-old children with DLD those with Typical Language Development (TLD), and to examine the relationship between these two skills. Method: Seventeen (1 girl; 16 boys) children diagnosed with DLD and 26 (15 girls, 11 boys) children with TLD aged 60-72 months were included in the study. Data were collected face-to-face using the “Participant Information Form”, “Preschool Emotion Regulation Scale (PERS)” and “Pragmatic Language Skills Inventory Turkish Version (PDBE-TV)”. The data were analyzed using IBM SPSS 27.0 for Windows. Findings: It was found that children diagnosed with TLD had lower performance in emotion regulation (p = .000) and pragmatic language skills (p = .000) compared to children with TLD. No significant correlation was found between emotion regulation and pragmatic language skills in the group diagnosed with DLD (r = -.083, p = .753) or in the group with TLD (r = .081, p = .694). Discussion: No significant relationship was found between emotion regulation and pragmatic language skills in children with DLD and TLD. Although this result is consistent with some previous studies, the absence of a direct link between language skills and emotion regulation may be due to various factors. These may include unmeasured mediating variables, limitations in the sensitivity of the assessment tools, or the sample size and demographic characteristics. Conclusion and Recommendations: Children with DLD performed significantly lower than their TLD peers in both emotion regulation and pragmatic language skills. However, no significant relationship was found between these two skills in either group. This finding suggests that various cognitive, social, and environmental factors may contribute to the development of emotion regulation and pragmatic abilities. Future studies should consider potential mediating variables such as executive functions, social environmental influences, and parental attitudes to better understand possible indirect associations between these domains. Furthermore, the development of individualized and multicomponent intervention programs for children with DLD may provide a comprehensive approach to support both their language and emotional-behavioral development.

Editorial: The well‐being of children: empirical findings and implications for prevention and intervention

It remains unclear whether pragmatic language skills and core language skills (grammar and vocabulary) are distinct language domains. The present work aimed to tease apart these domains using a novel online assessment battery administered to almost 400 children aged 7 to 13 years. Confirmatory factor analysis indicated that pragmatic and core language domains could be measured separately, but that both domains were highly related (r = .79). However, zero-order correlations between pragmatic tests were quite small, indicating that task-specific skills played an important role in performance, and follow-up exploratory factor analysis suggested that pragmatics might be best understood as a family of skills rather than a domain. This means that these different pragmatic skills may have different cognitive underpinnings and also need to be assessed separately. However, our overall results supported the idea that pragmatic and core aspects of language are closely related during development, with one area scaffolding development in the other.

The SARS-CoV-2 pandemic has significantly impacted children and adolescents, leading to mental health challenges. Knowledge on their resources and difficulties is crucial and there is a need for valid instruments to assess their psychosocial condition especially in this exceptional situation. We assessed psychopathological symptoms using the SDQ during the pandemic, comparing to pre-pandemic data. Our study aims to understand adolescents' strengths and difficulties amidst COVID-19, evaluating the SDQ's utility in crisis settings. Within the German school-based surveillance study ("B-Fast"), we assessed behavioral strengths and difficulties in 664 adolescents aged 11-17 years during the peak of the German COVID-19 pandemic using the validated Strengths and Difficulties Questionnaire (SDQ) for both external and self-assessed data collection. Data were collected between November 2020 and April 2021. We compared self-assessed SDQ-scores to pre-pandemic data from a comparable sample and examined adolescent classification as "normal" or "borderline/abnormal" based on both external and self-assessed SDQ subscale scores using established cut-off values. Additionally, we conducted sex and rater-based score comparisons. In our study, we observed a significant worsening of "Emotional Symptoms" compared to pre-pandemic levels, while "Conduct Problems" and "Prosocial Behavior" showed improvement. Variations in classification to "normal" and "abnormal" emerged when applying German versus British cut-off values. Females scored higher on "Emotional Symptoms" while males scored higher on "Hyperactivity Symptoms." Correlations between external and self-assessed SDQ ratings ranged from 0.43 (p < 0.001) for "Prosocial Behavior" among girls to 0.62 (p < 0.001) for "Peer Problems" among boys, indicating moderate to high consistency. Our study contributes to understanding the psychosocial impact of the COVID-19 pandemic on German adolescents. Compared to other symptoms, we observed a particular worsening in "Emotional Symptoms" based on our data. Despite the moderate correlation between parental and self-reported evaluations, there appears to be a certain discrepancy in the perception of adolescent quality of life. Therefore, it seems prudent to assess both the external and self-reported evaluations and amalgamate the results from both parties to obtain a comprehensive problem profile of the individual. These findings underscore the importance of using country-specific cutoff values and reaffirm the utility of the SDQ as a valuable assessment tool, even within the unique circumstances posed by a pandemic.

Considerable evidence supports the association between language learning difficulties and behaviour in young children and this is likely to be particularly true of children raised in social disadvantage. Less is known about the way that different aspects of language, specifically pragmatics, interact with behaviour. This study examines the extent to which pragmatic language skills mediate the relationship between structural language skills and parent report of behaviour. It was carried out with 138 community ascertained monolingual English speaking primary school children raised in an area of marked social disadvantage. We found that pragmatic skills substantially mediate the relationship between language and behaviour in this group of children. Further analyses suggest that the mediational relationship holds for hyperactivity, peer related problems and overall impact score but not for emotional problems, conduct problems or pro-social behaviour. Pragmatic language skills underpin the relationship between language and behaviour in low SES (socio-economic status) children. This is specifically true for children exhibited signs of hyperactivity, peer problems and the perceived impact that these may have on the classroom teacher, parents and other children. These findings need to be replicated in both comparable and different populations but, if the relationship holds, it is likely to have considerable implications for the development of valid and effective interventions in this area. Furthermore they may lead to a more differentiated approach to behavioural difficulties.

Objective Attention Deficit and Hyperactivity Disorder (ADHD) is associated with significant pragmatic language impairment and theory of mind deficits, but there are only a handful of studies have investigated the relationship between them in these conditions. This study aimed that investigate two different aspects of Theory of Mind (ToM) (ToM decoding and reasoning), pragmatic language impairment, and emotion regulation in patients with ADHD. Method Seventy adolescents with ADHD were compared to matched 64 healthy controls. We administered Social Responsiveness Scale-2 (SRS-2), Difficulties in Emotion Regulation Scale (DERS), Kiddie-SADS, Conners Parent Rating Scale, Children’s Communication Checklist-2 (CCC-2), Faux Pas, Comprehension Test, and Reading Mind in the Eyes Test (RMET) to all study participants. Results The CCC-2 scores were found to be statistically significantly higher in the ADHD group than in healthy controls. ADHD group had lower performance in the Faces Test and RMET compared to healthy controls, which did not survive from false discovery rate correction. We also found that CCC-2 performance and Conners scores were significant predictors of social responsiveness. Conclusion Our results point to widespread impairment in pragmatic language use and communication from many perspectives. These results might be important to understand the difficulties in social functioning and interpersonal relationship in adolescents with ADHD. Key points ADHD is associated with significant impairment in pragmatic language use and social cognitive functions. ToM-Decoding (RMET) is impaired much more than ToM-Reasoning (Faux Pas) in ADHD. Pragmatic language skills and severity of ADHD may be significant predictors of social responsiveness. Emotion regulation problems may affect communication and pragmatic language use.

Aims and Objectives: The present study is an attempt to study strengths-difficulties, and experiences of loneliness in below poverty line (BPL) and above poverty line (APL) children and compared the same between two groups. Materials and Methods: The total sample consisted of 120 participants (age range 10–13 years), 60 BPL and 60 APL children. Each group further consisted of 25 females and 35 males. The samples were drawn using convenience sampling method. Strengths and difficulties questionnaire (SDQ) and loneliness and social dissatisfaction scale were the tools used. Results: In BPL children, peer problems were found to be the highest (i.e. 25% in abnormal and 55% in borderline range). Significant difference was found between BPL and APL children on emotional symptoms (P = 0.003), peer problems (P = 0.02), and prosocial behavior (P = 0.03), on SDQ, and experiences of loneliness (P = 0.04) on loneliness and social dissatisfaction questionnaire. The significant negative correlation was found between loneliness score and emotional symptoms score (P = 0.03), loneliness score and hyperactivity score (P = 0.002), and between loneliness score and peer problems score (P = 0.001). The significant positive correlation was found between experiences of loneliness score and prosocial behavior score (P = 0.03). Conclusions: In BPL children, peer problems were found to be the highest. BPL children have more emotional symptoms, peer problems, and feeling more lonely compared to APL children. APL children have low prosocial behavior. Children with more emotional symptoms, peer problems, and hyperactivity are feeling lonely. Children with low prosocial behavior are feeling lonely.

Objectives: Children with ADHD obtain lower scores than their peers on standardized language measures but less is known about their conversational language skills. We tested the ability of children with and without ADHD to monitor and repair their language during a conversation (social discourse) with a young adult. Methods: Forty-nine 9- to 14-year-old children previously diagnosed with ADHD (17 in partial remission) and an age and sex-matched sample of typically developing (TD) children engaged in a conversation with a young adult. Their conversations were recorded, transcribed, and coded for structural and pragmatic language use. Language error and correction rates were compared across the two groups, for the whole sample and for those meeting full criteria for ADHD. Results: The ADHD group made significantly more structural language errors, specifically morphosyntactic mistakes and word repetitions. In their pragmatic language use, children with ADHD were more likely to make unrelated utterances and were less successful in repairing dysfluent responses. The adult conversational partners made more attempts to keep TD participants engaged in conversation and rated them as more likable. Conclusions: Subtle differences were identified in the structural and pragmatic language use of children with and without ADHD during social discourse. Conversation partners were more engaged in their interactions with TD children and appeared to experience these interactions more positively. The language skills of children with ADHD, including their conversation skills, should be monitored and considered as targets for intervention.

Peer’s pragmatic language outcomes following a peer-mediated intervention for children with autism: A randomised controlled trial

This study examined the early pragmatic language skills in typically developing (TD) preschool-age children, children with language impairment (LI) and children with autism spectrum disorder (ASD). Two hundred and sixty-two TD children, 73 children with LI, and 16 children with ASD were compared on early pragmatics through direct assessment (DA). Post hoc analysis revealed that children in two clinical groups displayed significant pragmatic language deficits. Children in the ASD group who were older exhibited comparable degree of impairments as their LI peers, suggesting a relatively stagnant development of pragmatic language skills in children with ASD. Findings also supported the use of DA in identifying pragmatic language deficits, which have implications for the adoption of this assessment approach in clinical settings.

Introduction: There is increasing evidence that major depressive disorder (MDD) is associated with significant pragmatic language impairments. However, there is a lack of studies that use standardized tools and simultaneously investigate all pragmatic language skills among MDD patients. The aim of this study was to propose a more thorough investigation of all pragmatic language skills in patients with MDD. Methods: Twenty adults (aged 22–65) with a DSM-5 diagnosis of MDD were assessed using BLED Santa Lucia (Batteria sul Linguaggio dell’Emisfero Destro Santa Lucia), a battery designed to evaluate pragmatic language skills (comprehension of inferences, of picture and written metaphors, of indirect requests, of humoristic expressions, and of prosody). The performance of the MDD participants on all BLED Santa Lucia subscales was compared to 20 healthy control subjects (aged 20–60) matched for gender, age, years of education, and employment status. Results: MDD patients performed poorer than controls in comprehension of inferences (p < 0.01), picture metaphors (p < 0.001), written metaphors (p < 0.001), indirect requests (p < 0.01), humoristic expression (p < 0.05), and prosody (p < 0.05). Conclusions: All pragmatic language skills can be significantly impaired in MDD patients. A valid assessment of all pragmatic language skills can allow, for each patient, the definition of a specific profile of risk and protective factors before and during psychotherapy.

This paper provides a review of relevant research concerning the development and use of spoken pragmatic language skills by people with intellectual disabilities. The development of pragmatic language skills in childhood, the use of such skills in adulthood, and links between pragmatic language use and quality of life are discussed. Despite the variety of participants and methodologies used, research findings are broadly consistent. First, people with intellectual disabilities can and do acquire basic pragmatic language skills, although more subtle aspects of conversational competence are less commonly displayed. Second, the communicative environments of children and adults with intellectual disabilities appear to inhibit the acquisition and display of pragmatic language skills. Third, different service settings can have an impact on the pragmatic skills of people with intellectual disabilities. Fourth, intervention programs can improve the pragmatic language skills of people with intellectual disabilities, although maintenance and generalisation of such skills is uncommon. Fifth, the quantity and quality of conversations between people with and without intellectual disabilities has an impact on the broader quality of life of people with intellectual disabilities. The implications of these findings for further research are discussed.

Background: Adolescents often struggle with social, emotional, and behavioral difficulties that can lead to functional impairment later in life. School-going children are at risk of bullying victimization at school, which can lead to social, emotional, and behavioral difficulties (SEBD). This study aimed to estimate the burden of SEBD, evaluate possible risk factors, and explore the correlation between bullying victimization and SEBD. Methods: A cross-sectional study was done among 9th to 12th class students from July 2021 to June 2022. Strengths and Difficulties Questionnaire (SDQ) was utilized to evaluate SEBD. Bullying victimization was assessed by “Adolescent peer relation instrument” (APRI). Chi square test, t-test, pearson correlation, and logistic regression was used. Results: Out of 391 participants, 35.3% faced peer problems, 22.2% conduct problems, 16.4% hyperactivity, and 15.6% emotional symptoms. Prosocial behavior was present in only 12.7% of adolescents. 70.8% bullied others and 62.9% were victims in the past 1 year. The victims were at increased risk for emotional symptoms, conduct problems, hyperactivity, and peer problems. Social perpetrators were at risk for emotional symptoms, conduct problems, hyperactivity, and peer problems; verbal and physical perpetrators were prone to conduct problems and hyperactivity. Higher emotional problems and prosocial behavior were reported among girls; higher conduct problems, peer problems, and hyperactivity were reported among boys. Hyperactivity was significantly more prevalent in students with poor performance. Emotional symptoms, conduct problems, hyperactivity, and peer problems were positively correlated with bullying and victimization, but negatively correlated to prosocial behavior. Conclusions: The burden of SEBD and bullying is high among school-going adolescents. Bullying and gender are significant risk factors for social, emotional, and behavioral difficulties. It also impacts the academic performance of the student. Anti-bullying interventional programs, cognitive behavior therapy, and parent management training programs for parents at school should be implemented universally at school to control these problems effectively.

The relationship between mental health, behaviour and language development is widely recognized in the literature. Recent advances in assessment tools allows one to consider the role of pragmatic language skills in this co-occurrence. This pilot study aimed to investigate (1) the level of association between pragmatic language difficulties and emotional/behavioural difficulties; and (2) what explanations there might there be for any such association. The roles of language, word decoding, and non-verbal cognitive ability and also socio-demographic factors are considered. Seventeen participants aged 7-11 years were identified from Educational Psychologist caseloads as having behaviour that is causing concern at school. Comparisons were made with 16 age- and sex-matched controls. Participants' language, literacy and non-verbal cognitive ability were assessed at school. Parents and teachers completed questionnaires investigating communication skills, behaviour and emotional wellbeing. No significant difference was found between the groups for non-verbal cognitive ability. However, children in the referred group were significantly more likely to have structural language, word decoding and pragmatic language difficulties and mothers with no further education beyond school. Taking a broad view of language skills to include structural language, pragmatic language and word decoding, 94% (n = 15) of referred children had significant difficulties with at least one of these three factors. The only factor not found on its own was structural language difficulties, indicating that on their own they are perhaps not associated with emotional/behavioural difficulties. The results of this pilot study have implications for how we view language and behaviour difficulties in primary schools. Future larger-scale research should consider the role of parenting factors, pragmatic language skills and literacy ability in the high co-existence rate of emotional/behavioural difficulties and language/communication needs.