ACQ_Vol_11_no_3

134

ACQ

Volume 11, Number 3 2009

ACQ

uiring knowledge in speech, language and hearing

•

What is the role of emotions, motivation, and self-esteem

in this child’s daily life?

•

How does this child think and learn best?

Each of these considerations is designed to provide

information in order to develop intervention goals that

aim to equip children and adolescents with the skills and

confidence to participate effectively in classroom contexts.

These include goals that target meta-linguistic development

and discourse skills that are commonly used during

academic problem-solving activities and social interactions.

Investigating this area of development is particularly

important considering the lack of information on these higher

level language skills provided by traditional norm-referenced

assessments (e.g.,

Clinical Evaluation of Language

Fundamentals

(4th ed.): CELF-4; Semel, Wiig, & Secord,

2003). Developing intervention goals based on a profile of

children’s higher level language skills may reduce the risk

of negative outcomes reported in the literature for children

and adolescents experiencing communication impairments

and behaviour problems. These negative outcomes include

social withdrawal, academic failure, anti-social, and criminal

behaviour. Specifically, these intervention goals should aim to

(Prizant, Audet, Burke, & Hummel, 1990):

•

enhance basic and higher level language skills and

communicative competence;

•

promote positive social relationships with peers, family,

and adults; and

•

develop cognitive and academic skills.

There is also a clear need for research into the role of

speech pathology in improving behaviour, social, and

academic outcomes for children and adolescents with

communication impairments. This research must determine

effective ways to:

•

identify children with communication impairments who are

at risk of behaviour problems;

•

identify children and adolescents with behaviour problems

and unidentified communication impairments; and

•

provide support for developing communication, social

and academic skills and reducing behaviour problems.

Summary

This review has summarised a large body of evidence for the

relationship between communication impairments and

behaviour problems in children and adolescents. This

relationship is not surprising considering the critical role of

speech and language skills during social interactions and

academic experiences. The potential for positive long-term

outcomes for children with behaviour and communication

difficulties may be increased if speech pathologists work

closely with the child, their family, professionals and

researchers, towards intervention goals based on accurate

communication and behaviour evaluations. However, further

research is needed to identify specifically how speech

pathologists can best contribute to this area of practice.

References

Arkkila, E., Räsänen, P., Roine, R. P., & Vilkman, E. (2008).

Specific language impairment in childhood is associated with

impaired mental and social well-being in adulthood.

Logopedics Phoniatrics Vocology

, 179–189.

Benner, G. J., Nelson, J. R., & Epstein, M. H. (2002).

Language skills of children with EBD: A literature review.

Journal of Emotional and Behavioral Disorders

, 43–56.

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 and control children: Psychiatric

between child and adolescent behaviour problems, and

underlying deficits in language comprehension and/or

expression. This evidence has highlighted that children who

experience communication impairments are at increased

risk of behaviour problems and that some young people with

behaviour problems are likely to present with unidentified

communication impairments. The following section outlines

the role of speech pathologists in this area of practice.

The role of speech pathology in

managing clients

Historically, children with behaviour problems and adolescents

generally have received minimal input from speech

pathologists (Larson & McKinley, 2003). For example, Ruhl et

al. (1992) identified 30 school-aged students (8 females and

22 males aged 9;4 – 16;2) from a Pennsylvania school

district with mild/moderate social skill disorders and IQs

within the typical range. Although all participants performed

at least one standard deviation below the mean on both

receptive and expressive language measures, the

researchers reported that no speech pathology services had

been provided for these students. Similarly, Camarata et al.’s

(1988) study summarised above identified only 2 out of 38

school-aged children with behaviour disorders as receiving

services from speech pathologists. This was despite 97% of

the participants demonstrating significant difficulties on one

or more subtests of a standardised language test. More

recently, Snow and Powell (2008) noted a subgroup of

young offenders (n = 16) with language impairment

experiencing early intervention such as reading recovery;

however, no speech pathology input was reported.

Considering the evidence of the relationship between

communication impairments and behaviour problems,

speech pathologists have a role to play in identifying and

supporting children with behaviour problems (Snow &

Powell, 2004). However, speech pathologists are generally

not qualified to diagnose behaviour or social problems.

Therefore speech pathologists should work together with

developmental and educational psychologists and behaviour

specialists, parents, families, and children during the

evaluation and intervention process.

Speech pathologists also have significant capacity

to increase professional understanding of social and

behaviour disorders by providing insight and advice on

children’s linguistic strengths and weaknesses (Ruhl et al.,

1992). Input from speech pathologists will contribute to

the development of appropriate communication, social,

academic, and psychological profiles, which can then be

used to determine functional intervention goals across

domains and environments (Hummel & Prizant, 1993).

Speech pathologists will also be able to provide insight into

the appropriateness of assessment tools. For example,

many psychological assessment tools require competent

language skills in order to formulate appropriate responses

to questions. Therefore children and adolescents with

underlying language impairments are at risk of poor

performance on these assessments. When called upon to

evaluate a child or adolescent with behaviour problems a

number of assessment considerations are recommended

(see Brinton & Fujiki, 1993; Larson & McKinley, 2003):

•

What is the status of this child’s higher level language

skills (e.g., ability to draw inferences)?

•

What is the impact of this child’s language abilities on

their social interactions and relationships with peers and

adults?