Language and social/emotional problems identified at a universal developmental assessment at 30 months

BMC Pediatrics

Philip Wilson²  Christopher Gillberg⁶  Michelle Affleck⁴  Susan Macmillan⁵  James Law¹  Lucy Thompson²  John O’Dowd³  Fiona Sim⁵ 

[1] Communication & Language Sciences, University of Newcastle, Newcastle, UK;Centre for Rural Health, University of Aberdeen, Centre for Health Sciences, Old Perth Rd, Inverness, IV2 3JH, Scotland;Public Health, NHS GG&C, Glasgow, UK;NHS GG&C, Glasgow, UK;Institute of Health and Wellbeing, College of Medical, Veterinary and Health Sciences, University of Glasgow, Caledonia House, Royal Hospital for Sick Children, Glasgow, Yorkhill, G3 8SJ, UK;Child & Adolescent Psychiatry, University of Gothenburg, Gothenburg, Sweden

关键词: Child psychiatry;    Child health surveillance;    Preschool assessment;    Screening;    Socio-emotional development;    Language delay;    Child development;   

Others  :  1144101
DOI  :  10.1186/1471-2431-13-206

 received in 2012-12-04, accepted in 2013-12-10,  发布年份 2013

【 摘 要 】

Background

Preschool language and neurodevelopmental problems often persist and impede learning. The aims of the current study are to assess the uptake of a new universal 30 month health visitor contact and to quantify the prevalence of language delay and social/emotional difficulties.

Methods

All families of 30 month old children in four Glasgow localities were offered a visit from their health visitor. Structured data were collected relating to language, social and emotional development using three instruments; The Strengths and Difficulties Questionnaire (SDQ), the abbreviated Sure Start Language Measure and a two-item language screen.

Results

From an eligible population of 543 children, there was a 90% return rate of contact forms from the health visitors, and assessments were completed on 78% of eligible children. Visit completion rates did not differ significantly by socio-economic status. 3-8% of children were reported to have language delay depending on the method of assessment. 8.8% of children scored in the “abnormal” range of SDQ total difficulties scores and 31.1% had an abnormality in at least one subscale. There was substantial overlap between language delay and abnormal scores on the SDQ.

Conclusions

Universal assessment of neurodevelopmental function at 30 months identified a significant proportion of children, including those previously considered at low risk, with both language and social/emotional difficulties. Further work is required to assess the precise nature of these difficulties and to assess the potential impact on services.

【 授权许可】

   
2013 Sim et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Gillberg C: The ESSENCE in child psychiatry: early symptomatic syndromes eliciting neurodevelopmental clinical examinations. Res Dev Disabil 2010, 31(6):1543-1551.
• [2]Caspi A, Moffitt TE, Newman DL, Silva PA: Behavioral observations at Age 3 years predict adult psychiatric disorders: longitudinal evidence from a birth cohort. Arch Gen Psychiatry 1996, 53(11):1033-1039.
• [3]Arseneault L, Moffitt TE, Caspi A, Taylor PJ, Silva PA: Mental disorders and violence in a total birth cohort: results from the Dunedin study. Arch Gen Psychiatry 2000, 57(10):979-986.
• [4]Odgers CL, Caspi A, Broadbent JM, Dickson N, Hancox RJ, Harrington H, Poulton R, Sears M, Thomson M, Moffitt TE: Prediction of differential adult health burden by conduct problem subtypes in males. Arch Gen Psychiatry 2007, 64(4):476-484.
• [5]Billstedt E, Gillberg C, Gillberg C: Autism after adolescence: population-based 13- to 22-year follow-up study of 120 individuals with autism diagnosed in childhood. J Autism Dev Disord 2005, 35(3):351-360.
• [6]Dodge KA, Pettit GS, Bates JE: How the experience of early physical abuse leads children to become chronically aggressive. In Developmental Perspectives on Trauma: Theory, Research, and Intervention.Rochester Symposium on Developmental Psychology, Volume 8. Edited by Cicchetti D, Toth SL. Rochester, NY, US: University of Rochester Press; 1997:263-288.
• [7]Scottish Executive: Health for all Children 4 - Guidance to Implementation in Scotland 2005. Edinburgh: HMSO; 2005. http://www.scotland.gov.uk/Publications/2005/04/15161325/13443 webcite
• [8]Cohen NJ, Davine M, Horodezky N, Lipsett L: Unsuspected language impairment in psychiatrically disturbed children: prevalence and language and behavioural characteristics. J Am Acad Child Adolesc Psychiatry 1993, 39:595-603.
• [9]Cohen NJ, Barwick MA, Horodezky N, Vallance DD, Im N: Language, achievement and cognitive processing in psychiatrically disturbed children with previously identified and unsuspected language impairments. J Child Psychol Psychiatr 1998, 39:865-877.
• [10]Cohen NJ, Menna R, Vallance DD, Barwick MA, Im N, Horodezky N: Language, social cognitive processing, and behavioural characteristics of psychiatrically disturbed children with previously identified and unsuspected language impairments. J Child Psychol Psychiatr 1998, 39:853-864.
• [11]Nelson JR, Benner GJ, Cheney D: An investigation of the language skills of students with emotional disturbance served in public school settings. J Spec Educ 2005, 39:97-105.
• [12]Ripley K, Yuill N: Patterns of language impairment and behaviour in boys excluded from school. Br J Educ Psychol 2005, 75(1):37-50.
• [13]Rescorla L, Ross GS, McClure S: Language delay and behavioural/emotional problems in toddlers: findings from Two developmental clinics. J Speech Lang Hear Res 2007, 50(4):1063-1078.
• [14]Aram DH, Nation JE: Preschool language disorders and subsequent language and academic difficulties. J Commun Disord 1980, 13:159-198.
• [15]Ellis Weismer S: Typical Talkers, Late Talkers, and Children with Specific Language Impairment: a Language Endowment Spectrum? In Language Disorders from a Developmental Perspective:Essays in honor of Robin S. Chapman. Edited by Paul R. Mahwah, NJ: Erlbaum; 2007:83-102.
• [16]Rescorla L: Do late talking toddlers turn out to have languages and reading difficulties a decade later? Ann Dyslexia 2000, 50:87-102.
• [17]Rescorla L: Language and reading outcomes to age 9 in late-talking toddlers. J Speech Lang Hear Res 2002, 46:360-371.
• [18]Rescorla L, Lee EC: Language impairments in young children. In Handbook of Early Language Impairment in Children. Edited by Layton T, Watson L. New York: Delmar; 2000:1-38. [Nature, Volume I]
• [19]Rice M, Taylor C, Zubrick S: Language outcomes of 7-year-old children with or without a history of late language emergence at 24 months. J Speech Lang Hear Res 2008, 51:394-407.
• [20]Conti-Ramsden G, Botting N, Simkin Z, Knox E: Follow-up of children attending infant language units: outcomes at 11 years of age. Int J Lang Commun Disord 2001, 36(2):207-220.
• [21]Johnson CJ, Beitchman JH, Young A, Escobar M, Atkinson L, Wilson B, Brownlie EB, Douglas L, Taback N, Lam I, Wang M: Fourteen-year follow-up study of children with and without speech/language impairments: speech/language stability and outcomes. J Speech Lang Hear Res 1999, 42(3):744-760.
• [22]Aram DH, Ekelman BL, Nation JE: Preschoolers with language disorders: 10 years later. J Speech Lang Hear Res 1984, 27:232-244.
• [23]Stothard SE, Snowling MJ, Bishop DVM, Chipchase BB, Kaplan CA: Language-impaired preschoolers: a follow-up into adolescence. J Speech Lang Res 1998, 41(2):407-418.
• [24]Clegg J, Hollis C, Mawhood L, et al.: Developmental language disorders: a follow-up in later adult life; cognitive, language, and psychosocial outcomes. J Child Psychol Psychiatr 2005, 46(2):128-149.
• [25]Beitchman JH, Jiang H, Koyama E, Johnson CJ, Escobar M, Atkinson EB, Vida R: Models and determinants of vocabulary growth from kindergarten to adulthood. J Child Psychol Psychiatr 2008, 49(6):626-634.
• [26]Richards M, Power C, Sacker A: Paths to literacy and numeracy problems: evidence from two British birth cohorts. J Epidemiol Community Health 2009, 63(3):239-244.
• [27]Wilson P, Minnis H, Puckering C, Gillberg C: Should we aspire to screen preschool children for conduct disorder? Arch Dis Child 2009, 94:812-816. doi:10.1136/adc.2009.158535
• [28]Tickell C: The Early Years: Foundations for Life, Health and Learning: An Independent Report on the Early Years Foundation Stage to Her Majesty’s Government. London: HMSO; 2011.
• [29]Ellis Weismer S: Intervention for Children with Developmental Language Delay. In Speech and Language Impairments in Children: Causes, Characteristics, Intervention Andoutcome. Edited by Bishop D, Leonard L. Philadelphia: Taylor and Francis; 2000:157-176.
• [30]Law J, Boyle J, Harris F, Harkness A, Nye C: Screening for primary speech and language delay: a systematic review of the literature. Int J Lang Commun Disord 1998, 33:Suppl-3.
• [31]Laing GJ, Law J, Levin A, Logan S: Evaluation of a structured test and a parent led method for screening for speech and language problems: prospective population based study. BMJ 2002, 325(7373):1152.
• [32]Hall DMB, Elliman D: Health for all Children Revised Fourth Edition. Oxford: OUP; 2006.
• [33]Jenkins S, Bax M, Hart H: Behaviour problems in preschool children. J Child Psychol Psychiatr 1980, 21:5-18.
• [34]Miniscalco Mattson C, Mårild S, Pehrsonn NG: Evaluation of a language-screening programme for 2.5-Year-olds at child health centres in Sweden. Acta Paediatr 2001, 90:339-344.
• [35]Nelson HD, Nygren P, Walker M, Panoscha R: Screening for speech and language delay in preschool children: systematic evidence review for the US preventive services task force. Pediatrics 2006, 117(2):e298-e319.
• [36]Thompson L, McConnachie A, Wilson P: A universal 30-month child health assessment focussed on social and emotional development. J Nurs Educ Pract 2012. In press
• [37]Deprivation measures: Guidance for ISD analysts http://www.isdscotland.org/Products-andServices/Deprivation/Deprivation_Measures_Guidance.pdf?1 webcite
• [38]Identifying Need and Targeting Support. Edinburgh: HMSO: Scottish Executive: Health for all Children 4 - Guidance to Implementation in Scotland 2005; 2005. http://www.scotland.gov.uk/Publications/2005/04/15161325/13443 webcite
• [39]Crofts DJ, Bowns IR, Williams TS, Rigby AS, Haining RP, Hall DMB: Hitting the target: the equitable distribution of health visitors across caseloads. J Public Health 2000, 22(3):295-301.
• [40]Goodman R: Psychometric properties of the strengths and difficulties questionnaire. J Am Acad Child Adolesc Psychiatry 2001, 40(11):1337-1345.
• [41]Goodman R: The strengths and difficulties questionnaire: a research note. J Child Psychol Psychiatr 1997, 38(5):581-586.
• [42]Goodman R: Assessing preschool children’s emotional and behavioural adjustment: a report to the department of health on two projects involving the development and well-being assessment. 2012. Downloadable from http://www.dawba.info/EarlyYears webcite accessed 17/7/2012
• [43]Angold A, Egger H, Erkanli A: Reliability and screening properties of the SDQ in preschoolers. Jan 2010. In Press
• [44]Miniscalco C, Nygren G, Hagberg B, Kadesjo B, Gillberg C: Neuropsychiatric and neurodevelopmental outcome of children at age 6 and 7 years who screened positive for language problems at 30 months. Dev Med Child Neurol 2006, 48(5):361-366.
• [45]Turner E, Mears P, Houston AM: Implementation of the sure start language measure. Community Pract 2004, 77(5):185-189.
• [46]Fenson L, Dale PS, Reznick JS, Thal D, Bates E, Hartung JP, Pethick S, Reilly JS: The MacArthur Communicative Development Inventories: User’s Guide and Technical Manual. San Diego: Singular Publishing Group; 1993.
• [47]Law J, Roy P: Parental report of infant language skills: a review of the development and application of the communicative development inventories. Child Adolesc Ment Health 2008, 13(4):198-206.
• [48]Harris F, Law J, Roy P: The Third Implementation of the Sure Start Language Measure. Nottingham: DFES, Sure Start; 2005. https://www.education.gov.uk/publications/standard/publicationDetail/Page1/SSU/2005/FR/014 webcite accessed 17/7/2012
• [49]Roy P, Kersley H, Law J: The sure start language measure standardisation study, july 2004 - March 2005. 2005. http://www.literacytrust.org.uk/talk_to_your_baby/policy_research/1540_research_sure_start_language_measure_standardisation_study_july_2004-march_2005 webcite, accessed 17/7/2012
• [50]Bradshaw P, Tipping S: Growing Up In Scotland: Children’s Social, Emotional and Behavioural Characteristics at Entry to Primary School. Edinburgh: Scottish Government; 2010. http://www.scotland.gov.uk/Publications/2010/04/26102809/0 webcite accessed 17/7/2012
• [51]Wilson P, Bradshaw P, Tipping S, Henderson M, Der G, Minnis H: What predicts persistent early conduct problems? Evidence from the growing up in Scotland cohort. J Epidemiol Community Health 2013, 67:76-80.
• [52]Marryatt L, Thompson L, McGranachan M, Sim F, White J, Wilson P: Annual Report: Evaluation of Glasgow City Parenting Support Framework. 2012. http://www.gla.ac.uk/researchinstitutes/healthwellbeing/research/mentalhealth/projects/psf/reportsandpublishedpapers/ webcite
• [53]Ek U, Norrelgen F, Westerlund J, Dahlman A, Hultby E, Fernell E: Teenage outcomes after speech and language impairment at preschool age. Neuropsychiatr Dis Treat 2012, 8:221-227.
• [54]Blair M, Hall D: From health surveillance to health promotion: the changing focus in preventive children’s services. Arch Dis Child 2006, 91(9):730-735.
• [55]Bellman M, Vijeratnam S: From child health surveillance to child health promotion, and onwards: a tale of babies and bathwater. Arch Dis Child 2011.