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      Language growth in children with heterogeneous language disorders: a population study

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          Abstract

          Background

          Language development has been characterised by significant individual stability from school entry. However, the extent to which trajectories of language growth vary in children with language disorder as a function of co‐occurring developmental challenges is a question of theoretical import, with implications for service provision.

          Methods

          SCALES employed a population‐based survey design with sample weighting procedures to estimate growth in core language skills over the first three years of school. A stratified sample ( n = 529) received comprehensive assessment of language, nonverbal IQ, and social, emotional and behavioural difficulties at 5–6 years of age and 95% of the sample ( n = 499) were assessed again at ages 7–8. Language growth was measured using both raw and standard scores in children with typical development, children with language disorder of unknown origin, and children with language disorders associated with a known clinical condition and/or intellectual disability.

          Results

          Overall, language was stable at the individual level (estimated ICC = 0.95) over the first three years of school. Linear mixed effects models highlighted steady growth in language raw scores across all three groups, including those with multiple developmental challenges. There was little evidence, however, that children with language disorders were narrowing the gap with peers ( z‐scores). Adjusted models indicated that while nonverbal ability, socioeconomic status and social, emotional and behavioural deficits predicted initial language score (intercept), none predicted language growth (slope).

          Conclusions

          These findings corroborate previous studies suggesting stable language trajectories after ages 5–6 years, but add considerably to previous work by demonstrating similar developmental patterns in children with additional nonverbal cognitive deficits, social, emotional, and behavioural challenges, social disadvantage or clinical diagnoses.

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          Most cited references38

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          Smoothing reference centile curves: the LMS method and penalized likelihood.

          Refence centile curves show the distribution of a measurement as it changes according to some covariate, often age. The LMS method summarizes the changing distribution by three curves representing the median, coefficient of variation and skewness, the latter expressed as a Box-Cox power. Using penalized likelihood the three curves can be fitted as cubic splines by non-linear regression, and the extent of smoothing required can be expressed in terms of smoothing parameters or equivalent degrees of freedom. The method is illustrated with data on triceps skinfold in Gambian girls and women, and body weight in U.S.A. girls.
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            Heterogeneity and plasticity in the development of language: a 17-year follow-up of children referred early for possible autism.

            Delayed, abnormal language is a common feature of autism and language therapy often a significant component of recommended treatment. However, as with other disorders with a language component, we know surprisingly little about the language trajectories and how varied these might be across different children. Thus, we know little about how and when language problems might resolve, whether there are periods of relative stability or lack of change and what periods might offer more favourable circumstances for intervention.
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              Language ability predicts the development of behavior problems in children.

              Prior studies have suggested, but not fully established, that language ability is important for regulating attention and behavior. Language ability may have implications for understanding attention-deficit hyperactivity disorder (ADHD) and conduct disorders, as well as subclinical problems. This article reports findings from two longitudinal studies to test (a) whether language ability has an independent effect on behavior problems, and (b) the direction of effect between language ability and behavior problems. In Study 1 (N = 585), language ability was measured annually from ages 7 to 13 years by language subtests of standardized academic achievement tests administered at the children's schools. Inattentive-hyperactive (I-H) and externalizing (EXT) problems were reported annually by teachers and mothers. In Study 2 (N = 11,506), language ability (receptive vocabulary) and mother-rated I-H and EXT problems were measured biannually from ages 4 to 12 years. Analyses in both studies showed that language ability predicted within-individual variability in the development of I-H and EXT problems over and above the effects of sex, ethnicity, socioeconomic status (SES), and performance in other academic and intellectual domains (e.g., math, reading comprehension, reading recognition, and short-term memory [STM]). Even after controls for prior levels of behavior problems, language ability predicted later behavior problems more strongly than behavior problems predicted later language ability, suggesting that the direction of effect may be from language ability to behavior problems. The findings suggest that language ability may be a useful target for the prevention or even treatment of attention deficits and EXT problems in children.
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                Author and article information

                Contributors
                c.norbury@ucl.ac.uk
                Journal
                J Child Psychol Psychiatry
                J Child Psychol Psychiatry
                10.1111/(ISSN)1469-7610
                JCPP
                Journal of Child Psychology and Psychiatry, and Allied Disciplines
                John Wiley and Sons Inc. (Hoboken )
                0021-9630
                1469-7610
                18 September 2017
                October 2017
                : 58
                : 10 , Developmental Language Disorders ( doiID: 10.1111/jcpp.2017.58.issue-10 )
                : 1092-1105
                Affiliations
                [ 1 ] Psychology and Language Sciences University College London London UK
                [ 2 ] Department of Psychology Royal Holloway, University of London London UK
                [ 3 ] Department of Biostatistics Institute of Psychology, Psychiatry and Neuroscience Kings College London London UK
                [ 4 ] Newcomen Centre Guy's and St Thomas’ NHS Trust London UK
                [ 5 ] Department of Psychology Institute of Psychology, Psychiatry and Neuroscience Kings College London London UK
                [ 6 ] Department of Child & Adolescent Psychiatry Institute of Psychology, Psychiatry and Neuroscience Kings College London London UK
                Author notes
                [*] [* ] Correspondence

                Courtenay Frazier Norbury, Psychology and Language Sciences, University College London, Chandler House, 2 Wakefield Street, London, WC1N 1PF, UK; Email: c.norbury@ 123456ucl.ac.uk .

                Article
                JCPP12793
                10.1111/jcpp.12793
                5639364
                28921543
                0d38be3a-62e3-4adb-a5ef-ad402836ed9a
                © 2017 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.

                This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 05 July 2017
                Page count
                Figures: 2, Tables: 6, Pages: 14, Words: 10579
                Funding
                Funded by: The Wellcome Trust
                Award ID: WT094836AIA
                Funded by: National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                jcpp12793
                October 2017
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.2.1 mode:remove_FC converted:13.10.2017

                Clinical Psychology & Psychiatry
                language disorder,language trajectories,longitudinal study,comorbidity

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