This course will review the link between psychiatric diagnoses and language deficits, and discuss how behavior can impact both areas. We will review the literature, and discuss specific behavioral strategies and treatment considerations for different psychiatric diagnoses.
Terminology
Some of the journal articles that we've reviewed are authored by different disciplines, and so some of the terminology is used interchangeably. In our presentation, you might see these terms used interchangeably.
- Mental Health Disorders and Diagnoses
- Psychiatric Disorders and Diagnoses
- Emotional-Behavioral Disorders (EBD)
- Emotional Disturbance (ED)
The DSM-5 is a Diagnostic and Statistical Manual of Mental Disorders, 5th edition. This is a standard classification of mental disorders used by mental health professionals in the United States, and contains a listing of diagnostic criteria for every psychiatric disorder recognized by the US health care system.
Review of the Literature
First, I wanted to start with a meta-analysis that was conducted in 2014. This examined 22 studies of children, ages five through 13, with an emotional-behavioral diagnosis, without any history of developmental, neurological, or language disorders. The researchers found that 81% of the participants in those studies had below average language skills. The study also found that the average comprehensive language score was around 76 as the standard score for core language.
In another systematic review conducted in 2002, they found that over 70% of children diagnosed with emotional-behavioral disturbances had significant language deficits. They analyzed 26 studies of children with emotional-behavioral difficulties, and again, they exhibited significant language deficits. In fact, one out of two children diagnosed with a language impairment also had emotional-behavioral disturbances.
Nelson and his colleagues conducted a study where they randomly selected 166 students (K-12) with emotional disturbance. They found that 68% had moderate to severe language deficits. Furthermore, they found that externalizing behavior problems were directly related to receptive and expressive language skills, whereas internalizing behaviors were not statistically significantly related to language.
With regard to the next few studies, children in treatment for speech and language disorders were evaluated to see what the co-occurrence of mental health disorders were. In the first study, they conducted a review that showed that 50 to 80% of children with language disorders later ended up having a co-occurring mental health disorder, or emotional-behavioral disorder. Between one-third and two-thirds of children referred for psychiatric testing, specifically for conduct, also showed a strong prevalence of language disorders.
Specifically, in the study of pragmatic language difficulties, it was found that two-thirds of children with conduct disorders had pragmatic language deficits independent of IQ. For children with whom conduct, rather than language, had been the major concern, managing their social and communicative skill deficits could have prevented some of their disruptive behavior. The relationship between language deficits and conduct disorders is an important finding for which we need to raise awareness.
