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of poor psychosocial outcome. Beitchman et al. (2001) reported adolescents with communication impairments being at increased risk of psychiatric problems. In a prospective longitudinal design, the researchers tracked the psychiatric profile of children from age 5 to 19 according to three categories: 1) speech disorder only (n = 38); 2) language impairment with and without speech impairment (n = 77); or 3) typical development (n = 129). At age 19, adolescents with childhood language impairments at age 5 were more likely to experience anxiety disorders, particularly social phobia, compared to children with speech disorder only, and children experiencing typical development. Brownlie et al. (2004) investigated behaviour disorders within the same group of children. They used parental reports to identify higher levels of delinquent behaviour (e.g., lying, cheating, stealing) among 19-year-old males with a language impairment compared to males and females with speech impairments or typically developing language. Clegg et al. (2005) compared the psychosocial outcomes of 17 adults with a history of severe developmental language disorder with their siblings and a group matched on intelligence. The adults with a language difficulty experienced higher levels of social difficulties and emotional disturbance. Four adults with language difficulty also reported clinically relevant mental health disorders (e.g., anxiety related disorders). In a Finnish study using a health-related quality of life questionnaire, researchers reported higher levels of distress and lower levels of cognitive functioning among 33 adults who experienced childhood SLI compared to an age-and-gender matched control group (Arkkila et al., 2008). All these studies The influence of poor language skills on adolescents’ behaviour and social experiences is also evident by the language and literacy difficulties experienced by adolescents in the juvenile justice system (Bryan, 2004; Putninš, 1999; Snow & Powell, 2008). A study by Putninš reported young offenders (aged 13–18 years) in secure care facilities in South Australia as demonstrating poor literacy and numeracy skills compared to age-matched controls. background may have contributed to the group differences. Similarly, linguistic profiles for 30 young offenders (aged 18–21 years) in a Scottish institution highlighted that 73% of young offenders performed below the normative range on an expressive syntactic task (Bryan, 2004). Half of the participants also performed poorly on picture description and naming tasks. In a recent Australian study, Snow and Powell (2008) compared the language and social skills of 50 juvenile offenders (mean age 15;8) with a control group matched on age, IQ, gender, and socioeconomic background. The performance of juvenile offenders was significantly poorer than the control group on both social skills and language assessments, and 26 of these offenders (52%) were noted as having language impairment. These findings provide further support for the link between language, literacy and social communication skills and low academic achievement (including learning and attention difficulties) and anti-social behaviour for many young offenders. In summary, a considerable body of evidence has developed over the past 30 years to identify a relationship However, uncontrolled group differences such as socioeconomic background, gender, and cultural highlight a link between childhood communication impairments and behaviour problems later in life. Communication impairments and juvenile offenders

and Difficulties Questionnaire; Goodman, 1997) during a longitudinal study of behaviour and social skills among 242 children with SLI. At age 7, this group was overrepresented in the areas of conduct difficulties (e.g., bullying other children) and hyperactivity. However, by age 11, this overrepresentation was not evident. Rather, at age 11 these children presented with social difficulties such as withdrawn social style and were the recipients of higher levels of bullying compared to children without SLI. School-aged children with written language impairments can also demonstrate a range of behavioural and psychiatric problems (Carroll, Maughan, Goodman, & Meltzer, 2005; Willcutt & Pennington, 2000). High levels of Attention Deficit Hyperactivity Disorder (ADHD), depression, aggression, and conduct and anxiety disorders were reported among a cohort of twins aged 8 to 18 years experiencing reading disability (Willcutt & Pennington, 2000). Male participants were more likely to display aggressive behaviour, and female participants demonstrated higher levels of depression and anxiety. Somatic complaints and depression correlated strongly with reading disability after controlling for ADHD and additional behaviour disorders (Willcutt & Pennington, 2000). Carroll et al. (2005) reported a similar pattern of findings among a large national sample of British children aged 9–15 years (n = 289) with reading disorder. The presence of ADHD mediated the link between reading disability and disruptive behaviour, and conduct disorder; however, reading disability was directly linked with anxiety. Given that children with histories of SLI are at risk of reading problems (e.g., Catts & Hogan, 2003), it could be that studies investigating school-aged children with written language impairments have among them children with histories of spoken language impairment. This would suggest the importance of investigating both spoken and written language skills in school-aged children suspected of or diagnosed with behavioural problems. Adolescents with behaviour or psychiatric problems often present with undiagnosed communication impairments. Sanger, Hux, and Belau (1997) investigated the oral language skills of female juvenile delinquents (aged 14;1 to 17;11) who had no history of language impairments. Comparison was made with an age-matched control group with no history of special education needs. The juvenile delinquent group demonstrated difficulty in the domains of syntax, semantics, and morphology. Similarly, Camarata, Hughes, and Ruhl (1988) examined the language skills of 38 children aged 8 to 13 years with mild to moderate behaviour disorders enrolled in special education programs within regular schools. Students were identified with a behaviour disorder based on the authors’ criteria which included non-compliant behaviour and attention problems. They reported 37 out of 38 subjects performing at least one standard deviation below the mean on one or more subtests of a broad-spectrum standardised language test. Furthermore, 27 subjects scored 2 standard deviations or greater below the mean on at least one subtest. Older adolescents and adults The psychosocial effects of childhood language impairment often persist into adolescence and beyond (Arkkila, Räsänen, Roine, Sinoten, & Vilkman, 2008; Brinton, Fujiki, & Robinson, 2005; Clegg et al., 2005). Brinton et al. (2005) presented a longitudinal case study of a child (Cody) identified with SLI at age 4 through to age 19. Across his development, Cody experienced persistently high levels of anxiety and poor quality social relationships which the authors linked to his significant and ongoing language difficulties. Larger comparison studies also present evidence

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ACQ Volume 11, Number 3 2009

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