Play and prosociality are associated with fewer externalizing problems in children with developmental language disorder: The role of early language and communication environment
Play and prosociality are associated with fewer externalizing problems in children with developmental language disorder: The role of early language and communication environment
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DOI：
10.1111/1460-6984.12541
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发表时间：
2020-06-04
影响因子：
2.4
通讯作者：
Conti-Ramsden, Gina
中科院分区：
文献类型：
--
作者：
Toseeb, Umar;Gibson, Jenny L.;Conti-Ramsden, Gina
背景 与没有发展性语言障碍 (DLD) 的儿童相比，患有发展性语言障碍 (DLD) 的儿童心理健康状况较差的风险更高。然而，存在相当大的个体差异需要解释，包括保护因素的识别。 目的 使用结构方程模型绘制从早期语言和交流环境（ELCE，1-2 岁）到童年中期（11 岁）内化（同伴和情绪问题）和外化（品行问题和多动）问题的路径。具体而言，研究了童年（7-9 岁）通过社交技能（友谊、游戏和亲社会）的间接途径的作用。方法和程序对雅芳父母和儿童纵向研究 (ALSPAC) 的现有数据进行了二次分析。研究样本包括 6531 名儿童（其中 394 名患有 DLD）。结果与结果 对于患有和不患有 DLD 的儿童，从 ELCE 到内化和外化问题的途径是相似的。对于这两个群体来说，积极的 ELCE 与童年时期更有能力的社交游戏和更高水平的亲社会性有关，而这反过来又与童年中期较少的外化问题有关。此外，童年时期更好的友谊和更高水平的亲社会性都与童年中期较少的内化问题有关。结论与含义儿童的 ELCE 不仅对于语言发展而且对于社会发展也具有潜在的重要意义。此外，在缺乏足够的语言能力的情况下，玩耍和亲社会行为可能会让患有 DLD 的儿童部署、练习和学习关键的社交技能，从而防止外化问题。我们建议考虑为患有 DLD 的儿童提供基于游戏和亲社会性的教育和治疗服务。本文增加了什么？这项研究对现有知识的补充是什么？关于这个主题的已知内容是什么？这项工作的潜在或实际临床意义是什么？总体而言，与未受影响的同龄人相比，患有 DLD 的儿童往往心理健康状况较差。然而，存在相当大的差异，不良结果并非不可避免。我们证明儿童的 ECLE 对于社交游戏行为和亲社会性的发展非常重要。与未受影响的同龄人相比，患有 DLD 的儿童的社交游戏能力和亲社会性水平往往较低，而那些社交游戏能力较强和亲社会性水平较高的儿童在童年后期可能会出现较少的外化问题。我们推测，在缺乏足够的结构性语言能力的情况下，游戏和亲社会行为可以让 DLD 儿童部署、练习和学习关键的关系技能，以及行为和情绪调节技能，从而防止外化问题。了解游戏、亲社会性和外化问题之间的关系可能为 DLD 儿童基于游戏和亲社会的干预措施铺平道路。这对于从业者来说可能特别有吸引力，因为此类干预措施利用了童年最直观的学习方式之一：与朋友一起玩耍。与成人主导的传统纸笔活动相比，儿童接受和参与此类干预的可能性可能更高。
Background Children with developmental language disorder (DLD) are at higher risk of poorer mental health compared with children without DLD. There are, however, considerable individual differences that need to be interpreted, including the identification of protective factors.Aims Pathways from the early language and communication environment (ELCE, 1-2 years) to internalizing (peer and emotional problems) and externalizing (conduct problems and hyperactivity) problems in middle childhood (11 years) were mapped using structural equation modelling. Specifically, the role of indirect pathways via social skills (friendships, play and prosociality) in childhood (7-9 years) was investigated.Methods & Procedures Secondary analysis of existing data from the Avon Longitudinal Study of Parents and Children (ALSPAC) was undertaken. The study sample consisted of 6531 children (394 with DLD).Outcomes & Results The pathways from the ELCE to internalizing and externalizing problems were similar for children with and without DLD. For both groups, a positive ELCE was associated with more competent social play and higher levels of prosociality in childhood, which in turn were associated with fewer externalizing problems in middle childhood. Furthermore, better friendships and higher levels of prosociality in childhood were both associated with fewer internalizing problems in middle childhood.Conclusions & Implications A child's ELCE is potentially important not only for the development of language but also for social development. Furthermore, in the absence of adequate language ability, play and prosocial behaviours may allow children with DLD to deploy, practise and learn key social skills, thus protecting against externalizing problems. We suggest that consideration be given to play- and prosociality-based educational and therapeutic services for children with DLD.What this paper adds What this study adds to the existing knowledgeWhat is already known on this subjectWhat are the potential or actual clinical implications of this work?On the whole, children with DLD tend to have poorer mental health compared with their unaffected peers. There are, however, considerable differences and poor outcomes are not inevitable.We demonstrate that children's ECLE is important for the development of social play behaviours and prosociality. Whilst children with DLD tend to have less competent social play and lower levels of prosociality compared with their unaffected peers, those with more competent social play and higher levels of prosociality are likely to have fewer externalizing problems later in childhood. We speculate that in the absence of adequate structural language ability, play and prosocial behaviours allow children with DLD to deploy, practise and learn key relationship skills, alongside behavioural and emotional regulation skills, thus protecting against externalizing problems.Understanding the relationships among play, prosociality and externalizing problems may pave the way for play- and prosociality-based interventions in children with DLD. This may be particularly appealing for practitioners as such interventions capitalize on one of the most intuitive means of learning in childhood: play with friends. The likelihood of acceptability and engagement with such interventions may be higher in children than for traditional adult-led, paper-and-pencil activities.