My child is having emotional and behavioural problems at school. Should I get his language development checked?

Yes, and as soon as practicable.

Why?

1. Children with undiagnosed and untreated language disorders are at risk both academically and socially

For over 30 years, we’ve known that language disorders can have long term negative effects on reading, academic performance and employment outcomes (e.g. Aram et al., 1984; Tomblin et al., 2000, Caspi et al., 1998). But less well known is the devastating emotional and social impact language disorders can inflict – especially if the language disorder is not picked up early.

Consider these research findings:

Children who exhibit antisocial behaviours are 10 times more likely to have a language deficit than children without a language disorder (Donahue et al., 1994, Warren et al., 1994);
Up to 40% of children with emotional or social disorders are thought to have undiagnosed language disorders that go undiagnosed and untreated (Cohen et al., 1998);
Receptive language deficits frequently go undetected (Cantwell & Baker, 1991); and
Language disorders often have devastating effects on relationships with peers, family members, and partners, including problems starting and keeping relationships (e.g. Redmond & Rice, 1998).

2. Parents, teachers and other students may perceive your child negatively

Cohen et al., (1993) tells us that:

Children with unsuspected receptive language (comprehension) deficits are rated as the most delinquent and depressed by parents and as the most aggressive by teachers.
Children with expressive language disorders are rated by others as more socially withdrawn and anxious.

3. Some antisocial behaviours may be caused by your child’s language disorder

An undiagnosed language disorder may not fully (or even partly) explain your child’s challenging behaviours. But:

children rated as “aggressive” tend to use less verbal communication and more direct physical actions to solve interpersonal problems, often due to limited language skills (Gallagher, 1999);
children prone to “noncompliance” may have receptive language deficits that limit their ability to understand and comply with warnings or verbal cues (e.g. Fujiki et al., 1999); and
children with language problems may misinterpret communications, become frustrated and develop antisocial behaviour (e.g., Ruhl, 1992).

4. Language disorders and emotional/behavioural disorders occur together more often than not

In 2002, Dr Gregory Benner and colleagues conducted a systematic literature review looking at the language skills of children with emotional and behavioural issues diagnosed by special education teachers and/or psychologists (see below). They reviewed 26 studies looking, collectively, at almost 3,000 children. Their key findings were shocking:

almost three-quarters (71%) of children diagnosed with emotional and behavioural issues had clinically significant language deficits; and
over half (57%) of children with language deficits had emotional and behavioural issues.

The study had some limitations, mainly due to flaws in the underlying studies they reviewed. For example, the data couldn’t explain the direction of the relationship (e.g. “Does a language disorder cause social and emotional problems or do they just happen together a lot?”), or the size of the relationship (e.g. “Are serious antisocial behaviours related to the severity of the language disorder?”). Nor was the sample necessarily reflective of the wider population. But, even taking these factors into account, the study presents a compelling argument for universal language screening of children diagnosed with emotional and behavioural problems.

5. Clinical bottom line

If your child has been diagnosed with emotional and/or behavioural issues, it is likely that they have a language deficit, which should be assessed by a speech pathologist as soon as practicable.
If your child has been diagnosed with a language disorder, it is probable that they may be perceived by others (including parents, teachers and other students) as exhibiting challenging behaviours or emotional problems.

All children with emotional and social problems should be screened for language deficits. For those children diagnosed with language disorders, early language intervention and additional support is highly recommended.

Principal source: Benner, G.J., Nelson, J.R., & Epstein, M.H. (2002). Language Skills of Children with EBD: A Literature Review. Journal of Educational and Behavioral Disorders, 10, 1, 43-59.

Image: http://bit.ly/1X4QgSw

Hi there, I’m David Kinnane.

Principal Speech Pathologist, Banter Speech & Language

Our talented team of certified practising speech pathologists provide unhurried, personalised and evidence-based speech pathology care to children and adults in the Inner West of Sydney and beyond, both in our clinic and via telehealth.