Predictive Relationships between Language and Social, Emotional and Mental Health

每个小学教室里都有两个孩子，他们在理解他人和适当表达自己方面存在困难。这些儿童经常被诊断为发育性语言障碍(DLD)。研究一直表明，与具有典型语言发展的同龄人相比，患有DLD的儿童更有可能经历社交、情感和心理健康(SEMH)问题，特别是当他们进入青春期时。我们的项目旨在更好地了解为什么患有DLD的儿童患SEMH的风险增加，以及我们是否能够提高我们的能力，预测哪些在学校生涯早期出现DLD的儿童在进入中学后最有可能出现SEMH问题。语言是一项关键技能，可以预测学校的成功，促进积极的同伴互动，并对发展用于控制行为和调节情绪的“自我对话”非常重要。因此，许多研究人员、教师和临床医生(包括心理学家和言语语言治疗师)提出，患有DLD的儿童患上SEMH担忧是因为他们更有可能在学校遇到困难，在与同龄人沟通和发展友谊方面存在问题，和/或无法用语言表达自己的感受或让自己平静下来，从而导致行为爆发。然而，还没有人系统地测试过这些可能性。我们的项目将测试这些可能性，以期为患有DLD的儿童确定更具体的干预目标。我们的项目建立在现有研究--萨里沟通与语言教育研究(SCALE)的基础上。这项研究涉及英格兰东南部的180多所小学，包括对590名接受教育的儿童(4-5岁)、一年级(5-6岁)和三年级(7-8岁)的深入评估。这一队列不同于任何其他研究，因为它包括了具有广泛语言能力的儿童，包括具有典型发育、DLD和各种现有发育状况的儿童，如自闭症或唐氏综合症。这组儿童的独特之处还在于，在每个时间点都可以获得SEMH、非语言推理技能以及教育经验和成就的测量。我们的项目将在另外两个时间点再次评估这些儿童：第六年(10-11岁)和第八年(12-13岁)。这是一个重要的时期，因为儿童正从小学进入中学，在这一时期，对语言障碍儿童的支持趋于减少，而学校的社会和学术要求大幅增加，可能需要更复杂的语言来帮助这一过渡。这也是大多数儿童将经历青春期的时期。众所周知，伴随着这一发育期的生物学变化，再加上社会经验的变化，引起了对SEMH的日益关注。因此，现在是评估语言对SEMH的影响的理想时期。除了评估语言和SEMH，我们还将评估儿童如何使用语言与同龄人交流和调节自己的情绪。我们将考虑在校经历如何有助于SEMH，例如，在儿童的学校成功经历或特殊支持，如语言治疗或特殊教育安置。在这个项目中，我们还将创建改进的测试规范，以帮助其他研究小组和临床医生识别语言和SEMH问题；确定最佳预测未来SEMH担忧的因素组合；为家长、教师和治疗师提供早期识别的循证指南；以及关于语言在支持SEMH中的作用的知识。这些知识应该确定在教育或治疗中有针对性的具体技能，以改善语言障碍儿童的SEMH结果。

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.