Communication Skills and the Child with EBD: A pilot study investigating child abilities and demogra

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Communication Skills and the Child with EBD A
pilot study investigating child abilities and
demographic factors

• Leila Mackie
• Research SLT

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Introduction

• CIHR Pump Priming
• Me!
• SLT clinical experience
• Psychology background
• Overview
• Arriving at the questions
• Methodology
• Results
• Discussion
• Implications for practice

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Background

• Interaction between mental health, behaviour and
  language development is widely recognised in the
  literature
• (e.g. Benner, 2002, Beitchman et al 1996, 2001,
  etc Cohen et al 1993, 1998)
• Still dont know how other factors beyond
  language skills interact with this association
• Need for consideration of pragmatic language
  skills
• CCC-2 allows more standardised measurement of
  pragmatics that previously available
• Gilmour et als study (2004)

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Research questions

• What is the level of association between
  pragmatic language difficulties and EBD?
• What explanations might there be for any such
  association?
• Language skills?
• Non-verbal IQ?
• Word decoding?
• Socio-demographic factors?

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Methodology

• Recruitment
• via Educational Psychologists
• behaviour that is causing concern at school
• mainstream school
• aged 7 to 11
• Exclusions
• ASD, EAL, evidence of sensori-neural hearing loss
  or neurological impairment

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Assessment battery
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Socio-economic Status (1)

• Scottish Index of Multiple Deprivation (SIMD)

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Socio-Economic Status (2)
Maternal education of children in the Referred
and Control groups.
Significantly more mothers in the referred group
have a low level of education Fishers exact test
(p0.031)
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Risk of EBD Diagnosis (SDQ)

• 94 (n15) of referred children at high risk of a
  diagnosis in SDQ
• 87 at risk of diagnosis of behavioural disorder

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Non-verbal IQ (Ravens Matrices)

• No significant difference between groups
• Mann Whitney test (U122.5, p0.637)

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Language Skills (ACE)

• Median overall score significantly lower for
  referred group (U72.50, p0.021, two tailed)
• 38 (n6) of referred group scored at or below
  10th percentile
• Greater range of scores in referred group

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Word decoding (MIRA)

• Significantly more children in the referred group
  were below average in word decoding
• Chi square ?²(1)-2.332 p0.041

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Pragmatic Language Skills (CCC-2)

• 5 sub-scales designed to assess pragmatic
  language
• Coherence
• Inappropriate initiation
• Stereotyped language
• Use of context
• non-verbal
• Referred group scored significantly lower on all

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Features of ASD

• 2 sub-scales to assess difficulties indicative of
  autism
• Social relations
• Interests
• Referred group scored significantly lower on both

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Discussion

• Small numbers but
• High level of association between pragmatic
  language difficulties and EBD. Majority (64) had
  both
• Replicates Gilmour et al study (2004)
• Supports their argument for a causal link
• Nearly all (91) had impairment in at least one
  of
• Pragmatic language skills
• Word decoding
• Language skills (LI)
• More mothers with low levels of education in
  referred group

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Discussion (2)

• Those without pragmatic language difficulties had
  word decoding difficulties (27)
• alternative causal link with EBD?
• No child had LI without accompanying word
  decoding and/ or pragmatic language difficulties
• How much of a role does it play in the EBD-LI
  link???

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Implications for Practice

• All too often a child is seen as having either a
  language difficulty OR a behavioural difficulty
  but all too often they have BOTH
• Needs to be more awareness of the overlap and our
  services need to reflect this
• These children have complex individual
  presentations that would benefit from
• Combined expertise of integrated services
• Multidisciplinary team working
• EP, SLT, teaching staff, Learning Assistants and
  also role for SLT within CAMHS
• tailor made programmes of intensive input for
  each individual child
• We need to continue to develop our services in
  order to do this.

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Future research

• My PhD
• Larger scale study
• regression analysis
• Bigger focus on parental factors
• measure of parental stress
• Wider at risk group
• Including children primarily identified with LI
• Case studies

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Thank you!

• lmackie_at_qmu.ac.uk