Speech, language and communication difficulties can have
a profound and lasting effect on children's lives. For a small percentage of children their disability cannot be prevented, but early intervention is just as vital as for those with less severe difficulties to help give a child the best possible support that they need. The impact
of these difficulties will vary according to the severity
of the problem, the support the child receives, the child's
confidence and the demands of the child's environment. This
page pulls together research findings on the consequences
of speech and language impairment for children and young
people in order to highlight the seriousness of the issue overall. References are listed at the end.
- Young children with speech and language impairments
are at risk for continued communication problems, as
well as for associated cognitive, academic, behavioural,
social and psychiatric difficulties (Bashir & Scavuzzo,
1992).
- The initial pattern of speech and/or language deficits
is related to overall prognosis. Children whose impairments
involve only articulation/phonology generally fare better
than those whose impairments involve language [processing]
(Beitchman et al., 1994)
- Children with specific language impairment (SLI) have
been reported to experience concurrent difficulties
in the area of social and behavioral development (Redmond
& Rice, 1998). This has often been thought to arise
from such factors as frustration, peer rejection, and
lack of confidence in the face of poor linguistic skills.
- Studies have shown that substantial proportions of
children with SLI experience social and behavioural
problems as they reach high school age and that these
problems increase over time (Redmond & Rice, 2002).
Withdrawn behaviour
- Many children with SLI appear to show withdrawn social
interaction styles. This may include being less likely
to initiate conversation, playing alone, and being liked
less by others in the class (Coster, Goorhuis-Brouwer,
Nakken, & Spelberg, 1999).
- Paul and Kellogg (1997) found that children with slow
expressive development at 2 years of age were rated as
shyer and less outgoing than peers when followed up at
6 years of age.
- Poor interaction and increased withdrawal may also lead
to poor self-esteem, as some studies have found this to
be a feature of older but not younger children with language
difficulties (Jerome, Fujiki, Brinton, & James, 2002).
- Children with early language impairment have significantly
higher rates of anxiety disorder in young adulthood compared
with non-impaired children. The majority of participants
with anxiety disorders had a diagnosis of social phobia
(Beitchman et al, 2001).
Aggressive behaviour
- Behavioral difficulties of an aggressive nature have
been reported as showing increased prevalence in young
children with speech and language impairment (Carson,
Klee, Perry, Muskina, & Donaghy, 1998).
- In the epidemiological study by Beitchman and colleagues
(1996), nearly half of the 5-year-old speech-language-impaired
group was found to have behavioural disorders, of which
attention-hyperactivity difficulties were the main source.
Difficulty relating to others
- Even in a preschool setting, children with language
difficulties are less likely than peers to be chosen as
friendship partners (Gertner, Rice, and Hadley, 1994).
- Language impaired children are at risk of being the
target of bullies at school (Conti-Ramsden and Botting,
2004).
- Comprehension difficulties make children very vulnerable
in relation to education (Hooper et al 2003)
- Early language impairment (rather than speech impairment)
is clearly associated with continued academic difficulties
into adulthood. (Young et al, 2002)
- Tomblin, Zhang, Buckwalter, and Catts (2000) found that
children with language impairment were at risk of both
reading and behavioral problems and, furthermore, that
the behavioral difficulties were associated with the reading
impairments. Levels of frustration, misunderstanding,
and inability to access the curriculum could result in
subsequent aggressive behaviour, as could failure to understand
other children and adults.
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"Literacy difficulties in adolescents tend to
contribute to language disorders as adolescents get
a lot of higher language development input from what
they read: if they read little, they also tend to
not develop language as fast as their more literate
peers. Consequently, even children who appear to have
normal language development can have literacy difficulties
and develop language impairments as they grow older."
- Helen Stringer, School of Education, Communication
& Language Sciences, Newcastle University
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- High levels of speech, language and communication difficulties
are found among the young offender population (Bryan,
2004).
- Low education and speech and literacy difficulties are
risk factors for offending (Tomblin, 2000).
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"There are thousands of children and young people
effectively disabled by speech, language and communication
impairments.There's a progression between this "hidden
disability", exclusion from school and young adults
ending up in trouble, and it starts early. We need
to spot and offer provision for these impairments
as early as possible."
- Linda Lascelles, Chief Executive, Afasic
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- Speech and language impairment identified at age five
has long-lasting effects. In one study more than 72% of
children who had SLI at age 5 remained impaired at age
12. (Beitchman et al, 1994)
- Social and behavioral difficulties are not a short-term
problem for children with speech and language impairment.
To the contrary, social difficulties appear to increase.
A large cohort of 242 children who had been attending
infant language units at 7 years of age was followed up
when the children were in their final year of primary
school (aged 11). More than half of the children were
showing clinical-level difficulties. (Conti-Ramsden and
Botting, 2004)
- A study of young adults who were initially identified
as having SLI at age 5 and subsequently followed at ages
12 and 19 found: (a) high rates of continued communication
difficulties in those with a history of impairment; (b)
considerable stability in language performance over time;
(c) better long-term outcomes for those with initial speech
impairments than for those with language impairments;
and (d) more favourable prognoses for those with specific
language impairments than for those with impairments secondary
to sensory, structural, neurological, or cognitive deficits
(Johnson et al 1999).
Bashir, Anthony S., & Scavuzzo,
Annebelle. (1992). Children with language disorders: Natural
history and academic success. Journal of Learning Disabilities,
25 (1), 53-65.
Beitchman, J. H., Brownlie,
E. B., Inglis, A., Wild, J., Matthews, R., Schachter, D.,
et al. (1994). Seven-year follow-up of speech/language impaired
and control children: Speech/language stability and outcome.
Journal of the American Academy of Child and Adolescent
Psychiatry, 33, 1322-1330.
Beitchman, J. H., Wilson,
B., Brownlie, E. B., Walters, H., Inglis, A., & Lancee,
W. (1996). Long-term consistency in speech/language profiles:
II. behavioural, emotional and social outcomes. Journal
of the American Academy of Child and Adolescent Psychiatry,
35(6), 815-825.
Beitchman, J. H., Wilson,
B., Johnson, C. J., Atkinson, L., Young, A., Adlaf, E.,
et al. (2001). Fourteen year follow-up of speech/language
impaired children and control children: psychiatric outcome.
Journal of the American Academy of Child and Adolescent
Psychiatry, 40(1), 75-82.
Bryan, K. (2004) Preliminary
study of the prelance of speech and language difficulties
in young offenders. International Journal of Language
and Communication Disorders; 39:3, 391-400.
Carson, D. K., Klee, T.,
Perry, C. K., Muskina, G., & Donaghy, T. (1998). Comparisons
of children with delayed and normal language at 24 months
of age on measures of behavioral difficulties, social and
cognitive development. Infant Mental Health Journal,
19, 59-75.
Conti-Ramsden, G., & Botting,
N. (2004). Social difficulties and victimisation in children
with SLI at 11 years of age. Journal of Speech, Language
and Hearing Research, 47(1), 145-172.
Coster, F.W, Goorhuis-Brouwer,
S.M, Nakken, H, Lutje Spelberg H.C. (1999) Specific Language
Impairments and Behavioural Problems. Folia Phoniatrica
et Logopaedica, 51:99-107.
Gertner, B.L., Rice, M.L.,
& Hadley, P.A. (1994). Influence of communicative competence
on peer preferences in a preschool classroom. Journal
of Speech and Hearing Research, 37, 913-923.
Hooper, S J, Roberts J E,
Zeisel, SA, and Poe, M. (2003). Core language predictors
of behavioural functioning in early elementary school children:
Concurrent and longitudinal findings. Behavioral Disorders,
29(1), 10-21.
Jerome AC, Fujiki M, Brinton
B, James SL. (2002). Self-esteem in children with specific
language impairment, Journal of Speech Language and Hearing
Research Aug; 45(4): 700-14.
Johnson, C., Beitchman, J.
H., Young, A. R., Escobar, M., Atkinson, L., Wilson, B.,
et al. (1999). Fourteen-year follow-up of children with
and without speech/language impairments: Speech/language
stability and outcomes. Journal of Speech, Language and
Hearing Research, 42, 744-760.
Paul, R. & Kellogg, L. Temperament
in late talkers. Journal of Child Psychology and Psychiatry,
38, (1997): 803-810.
Redmond, S.M. & Rice M.L.
(1998) The socio-emotional behaviours of children with Speech
and Language Impairment: Social adaption or social deviance?
Journal of Speech, Language and Hearing Research,
41, 688-700
Redmond, S.M. & Rice, M.L.
(2002). Stability of behavioral ratings of children with
specific language impairment. Journal of Speech, Language,
and Hearing Research, 45, 190-201.
Tomblin, J. B., Zhang, X.,
Buckwalter, P., & Catts, H. (2000). The association of reading
disability, behavioural disorders and language impairment
among second-grade children. Journal of child psychology
and psychiatry, 41(4), 473-482.
Young, A. R., Beitchman,
J. H., Johnson, C., Douglas, L., Atkinson, L., Escobar,
M., et al. (2002). Young adult academic outcomes in a longitudinal
sample of early identified language impaired and control
children. Journal of Child Psychology and Psychiatry,
43(5), 635-645.
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