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      Education and employment outcomes of young adults with a history of developmental language disorder

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          Abstract

          Background

          Developmental language disorder (DLD) presents a considerable barrier for young adults to engage in further education and training. Early studies with young adults with DLD revealed poor educational achievement and lack of opportunities to progress in education. More recent studies have provided more positive findings. Relatively sparse data exist, however, on current cohorts and the factors that predict outcomes.

          Aims

          To examine educational and employment outcomes in young adulthood in a sample of people with histories of DLD compared with an age‐matched peer group without DLD. We ask: How do educational pathways and early jobs compare between those with and without DLD? Are young adults with DLD receiving similar levels of income as their peers? To what extent are language and literacy abilities associated with outcomes?

          Methods & Procedures

          Participants included 84 individuals with DLD (67% males) and 88 age‐matched peers without DLD (56% males). Participants were on average 24 years of age. They completed a battery of psycholinguistic, literacy and nonverbal skills assessments. Data were also collected on educational qualifications, current educational status, extent of educational support received, employment status, history and support, as well as current income.

          Outcomes & Results

          Those with DLD obtained lower academic and vocational qualifications. Higher educational/vocational qualifications were associated with better language, better reading and higher performance IQ (PIQ). There were few differences between the two groups in terms of engagement with education, but the mean age at leaving education was significantly earlier in the participants with DLD. Substantially more participants with DLD reported receiving support or dispensation from their educational institution. There was no significant difference between groups in the proportion of young people currently employed, though a higher proportion of the age‐matched peers was in work full time. Participants with DLD were much more likely to be in non‐professional occupations. However, when examining pay in relation to types of occupation, the groups’ incomes were broadly comparable.

          Conclusions & Implications

          At the group level, young people with a history of DLD more commonly have less skilled employment and more rarely achieve professional roles. At the individual level there is considerable variation with smaller but not trivial proportions of young adults with a history of DLD showing good educational and employment outcomes. There are positive aspects to early adult outcomes for some young people with a history of DLD.

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          The impact of nonverbal ability on prevalence and clinical presentation of language disorder: evidence from a population study

          Background Diagnosis of ‘specific’ language impairment traditionally required nonverbal IQ to be within normal limits, often resulting in restricted access to clinical services for children with lower NVIQ. Changes to DSM‐5 criteria for language disorder removed this NVIQ requirement. This study sought to delineate the impact of varying NVIQ criteria on prevalence, clinical presentation and functional impact of language disorder in the first UK population study of language impairment at school entry. Methods A population‐based survey design with sample weighting procedures was used to estimate population prevalence. We surveyed state‐maintained reception classrooms (n = 161 or 61% of eligible schools) in Surrey, England. From a total population of 12,398 children (ages 4–5 years), 7,267 (59%) were screened. A stratified subsample (n = 529) received comprehensive assessment of language, NVIQ, social, emotional and behavioural problems, and academic attainment. Results The total population prevalence estimate of language disorder was 9.92% (95% CI 7.38, 13.20). The prevalence of language disorder of unknown origin was estimated to be 7.58% (95% CI 5.33, 10.66), while the prevalence of language impairment associated with intellectual disability and/or existing medical diagnosis was 2.34% (95% CI 1.40, 3.91). Children with language disorder displayed elevated symptoms of social, emotional and behavioural problems relative to peers, F(1, 466) = 7.88, p = .05, and 88% did not make expected academic progress. There were no differences between those with average and low‐average NVIQ scores in severity of language deficit, social, emotional and behavioural problems, or educational attainment. In contrast, children with language impairments associated with known medical diagnosis and/or intellectual disability displayed more severe deficits on multiple measures. Conclusions At school entry, approximately two children in every class of 30 pupils will experience language disorder severe enough to hinder academic progress. Access to specialist clinical services should not depend on NVIQ.
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            Children with Specific Language Impairment

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              Developmental language disorders--a follow-up in later adult life. Cognitive, language and psychosocial outcomes.

              Little is known on the adult outcome and longitudinal trajectory of childhood developmental language disorders (DLD) and on the prognostic predictors. Seventeen men with a severe receptive DLD in childhood, reassessed in middle childhood and early adult life, were studied again in their mid-thirties with tests of intelligence (IQ), language, literacy, theory of mind and memory together with assessments of psychosocial outcome. They were compared with the non language disordered siblings of the DLD cohort to control for shared family background, adults matched to the DLD cohort on age and performance IQ (IQM group) and a cohort from the National Child Development Study (NCDS) matched to the DLD cohort on childhood IQ and social class. The DLD men had normal intelligence with higher performance IQ than verbal IQ, a severe and persisting language disorder, severe literacy impairments and significant deficits in theory of mind and phonological processing. Within the DLD cohort higher childhood intelligence and language were associated with superior cognitive and language ability at final adult outcome. In their mid-thirties, the DLD cohort had significantly worse social adaptation (with prolonged unemployment and a paucity of close friendships and love relationships) compared with both their siblings and NCDS controls. Self-reports showed a higher rate of schizotypal features but not affective disorder. Four DLD adults had serious mental health problems (two had developed schizophrenia). A receptive developmental language disorder involves significant deficits in theory of mind, verbal short-term memory and phonological processing, together with substantial social adaptation difficulties and increased risk of psychiatric disorder in adult life. The theoretical and clinical implications of the findings are discussed.
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                Author and article information

                Contributors
                gina.conti-ramsden@manchester.ac.uk
                Journal
                Int J Lang Commun Disord
                Int J Lang Commun Disord
                10.1111/(ISSN)1460-6984
                JLCD
                International Journal of Language & Communication Disorders
                John Wiley and Sons Inc. (Hoboken )
                1368-2822
                1460-6984
                15 November 2017
                Mar-Apr 2018
                : 53
                : 2 ( doiID: 10.1111/1460-6984.2018.53.issue-2 )
                : 237-255
                Affiliations
                [ 1 ] School of Health Sciences The University of Manchester and Manchester Academic Health Sciences Centre (MAHSC) Manchester UK
                [ 2 ] School of Psychological Sciences and Health University of Strathclyde Glasgow UK
                [ 3 ] Department of Psychology Manchester Metropolitan University Manchester UK
                [ 4 ] Language and Communication Science City University London UK
                [ 5 ] Department of Biostatistics, Institute of Psychiatry King's College London London UK
                Author notes
                [*] [* ]Address correspondence to: Gina Conti‐Ramsden, School of Health Sciences, The University of Manchester and Manchester Academic Health Science Centre (MAHSC), Ellen Wilkinson Building, Oxford Road, Manchester M13 9PL, UK; email: gina.conti-ramsden@ 123456manchester.ac.uk
                Article
                JLCD12338
                10.1111/1460-6984.12338
                5873379
                29139196
                6d70b236-83c8-46fc-b360-d3ee35abc802
                © 2017 The Authors International Journal of Language & Communication Disorders published by John Wiley & Sons Ltd on behalf of Royal College of Speech and Language Therapists

                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
                : 13 December 2016
                : 06 July 2017
                : 17 July 2017
                Page count
                Figures: 1, Tables: 10, Pages: 19, Words: 13652
                Funding
                Funded by: Economic and Social Research Council
                Award ID: RES‐062‐23‐2745
                Funded by: Nuffield Foundation
                Award ID: EDU‐8366
                Award ID: EDU‐32083
                Funded by: Wellcome Trust
                Award ID: 060774
                Funded by: Medical Research Council
                Award ID: G0802307
                Categories
                Research Report
                Research Reports
                Custom metadata
                2.0
                jlcd12338
                March–April 2018
                Converter:WILEY_ML3GV2_TO_NLMPMC version:version=5.3.3 mode:remove_FC converted:28.03.2018

                Neurosciences
                developmental language disorder,education,employment,young adulthood
                Neurosciences
                developmental language disorder, education, employment, young adulthood

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