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Unsuspected language impairments

Dorothy V. M. Bishop

Studies of child psychiatry outpatients

288 child psychiatry outpatients, 4-12 yr Given routine screening with language tests 111 had previously identified language

impairment 99 had unsuspected language impairment –

nearly always involving receptive language Many with ADHD, externalising problems

Cohen NJ et al. 1993. Unsuspected language impairment in psychiatrically disturbed children: prevalence and language and behavioral characteristics. Journal of the American Academy of Child and Adolescent Psychiatry 32:595-

603.

Language problems are not always obvious

• Language difficulties may underlie problem behaviour such as:• Bad behaviour in class/failure to obey instructions• Inattention• Anxiety in social situations• Problems with peer group• Academic problems (esp. poor reading/writing)

• Failure to use inner speech to self-regulate behaviour

Cohen, N. J. (1996). Unsuspected language impairments in psychiatrically disturbed children: developmental issues and associated conditions. In J. H. Beitchman, et al (Eds.), Language, Learning, and Behavior Disorders (pp. 105-127). Cambridge: Cambridge University Press.

Things that get missed

Poor receptive language Weak vocabulary Over-literal interpretation Difficulties with talking about the future

“Don’t you think you owe it to your mum to take responsibility for your behaviour?”

Professionals often use language that is too complex!

• Abstract words: “responsibility”

• Complex syntax – multiple levels of embedding! “Don’t you think [you owe it to your mum [to take responsibility for your behaviour?]]”

• Figurative language: “owe”

• Talk about future/hypothetical situations

Sources of comprehension difficulty

Better…..

“How did your mum feel when you broke your toys?”

• Concrete vocabulary• Stay in the here and now• Simple sentences• Questions should be open-ended, not yes/no• Don’t rush! Speak slowly and give time for reply• May need visual support• Comprehension check – can child tell you (or a toy) what you’ve

agreed?

General rules for communication

• Language and reading problems often run in families• Some parents may have problems in comprehending

complex language• Some may have literacy problems

• General message– Key skill for professionals is to communicate

effectively without being patronising

Professionals may also talk over the heads of parents!

Blog post by Pamela Snow

Also need to consider verbal skills of offenders in youth justice system

http://bit.ly/1kSF88H

For further readingsee reference list on:

http://www.slideshare.net/RALLICampaign/unsuspectedLIrefs