Predictive Relationships between Language and Social, Emotional and Mental Health

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Two children in every primary school classroom start school with difficulties understanding others and expressing themselves appropriately. These children are often diagnosed with developmental language disorder (DLD). Research has consistently demonstrated that children with DLD are much more likely than peers with typical language development to experience social, emotional, and mental health (SEMH) problems, especially when they reach adolescence. Our project aims to better understand why children with DLD are at increased risk for SEMH concern, and whether we can improve our ability to predict which children presenting with DLD early in their school careers are most likely to have SEMH problems when they get to secondary school.Language is a critical skill that predicts school success, facilitates positive peer interactions and is important for developing 'self-talk' used to control behaviour and regulate emotions. Many researchers, teachers and clinicians (including psychologists and speech-language therapists) have therefore suggested that children with DLD develop SEMH concerns because they are more likely to struggle at school, have problems communicating with peers and developing friendships, and/or can't use language to express their feelings or calm themselves down, leading to behavioural outbursts. However, no one has systematically tested these possibilities. Our project will test these possibilities with a view to identifying more specific intervention targets for children with DLD.Our project builds on an existing study, the Surrey Communication and Language in Education Study (SCALES). This study involved over 180 primary schools in south-east England and included in-depth assessment of 590 children at reception (ages 4-5 years), Year 1 (5-6 years) and Year 3 (7-8 years). The cohort is unlike any other study because it includes children with a wide range of language abilities, including children with typical development, DLD and a variety of existing developmental conditions, such as autism or Down syndrome. The cohort is also unique in that measures of SEMH, non-verbal reasoning skills and educational experience and achievement are available at every time point.Our project will assess these children again at two further points in time: in Year 6 (10-11 years) and Year 8 (12-13 years). This is an important period because children are moving from primary to secondary school, a time when support for children with language disorders tends to diminish while the social and academic demands of school increase substantially and likely require more sophisticated language to help with this transition.It is also the period in which most children will experience puberty. It is well known that the biological changes that accompany this period of development, in combination with changes to social experience, give rise to increasing rates of SEMH concern. It is therefore an ideal period to assess how language influences SEMH at this time. In addition to assessing language and SEMH, we will assess how children use language to communicate with peers and regulate their own emotions. We will consider how school experience contributes to SEMH, for example, in children's experience of school success or special support such as speech-language therapy or special educational placement.During this project we will also create improved test norms that will help other research groups and clinicians identify language and SEMH problems; a 'risk index' that will identify the combination of factors that best predict later SEMH concern; evidence-based guidelines for early identification for parents, teachers and therapists; and knowledge about the role of language in supporting SEMH. Such knowledge should identify specific skills to target in education or therapy that will improve SEMH outcomes for children with language disorder.