Using Measurement Invariance to Study Social Withdrawal in Children With Developmental Language Disorders.

Purpose Teacher ratings were used to compare children with developmental language disorders (DLD) and their typically developing peers on 2 subtypes of social withdrawal (shyness and unsociability). Measurement invariance analysis was utilized to determine if teachers rated the 2 groups using the same underlying construct for each of the rating scale items that have been designed to assess withdrawn behavior. Method The Teacher Behavior Rating Scale (TBRS; C. H. Hart & Robinson, 1996 ) was administered to the teachers of 173 children with DLD and 182 typically developing children (age range: 5;0-12;11 years;months) to compare 2 subtypes of withdrawal, shyness and unsociability. Measurement invariance analysis was used to establish an appropriate basis for comparing the latent group means and other structural parameters, and partial invariance models were used to compare the groups. Results For the TBRS, shyness and unsociability were measured by 4 and 5 items, respectively. The measurement invariance analysis indicated that classroom teachers approached 1 item on each of these scales using a different underlying construct when rating the 2 groups of children. Taking this into account, the groups were compared. Teachers rated children with DLD as significantly more withdrawn on both shyness and unsociability in comparison with typically developing children. Age and gender were not significant factors. Conclusions When conducting assessments, it should not be assumed that teachers or other raters approach even commonly used rating scale items using the same underlying perception for typically developing children and children with disorders. However, the analysis of invariant items on the TBRS reconfirmed that children with DLD are at risk for social withdrawal as operationalized by assessments of both shyness and unsociability. Supplemental Material https://doi.org/10.23641/asha.7789472.

The Ability of Children With Language Impairment to Dissemble Emotions in Hypothetical Scenarios and Natural Situations.

PURPOSE: This study examined the ability of children with language impairment (LI) to dissemble (hide) emotional reactions when socially appropriate to do so. METHOD: Twenty-two children with LI and their typically developing peers (7;1-10;11 [years;months]) participated in two tasks. First, participants were presented with hypothetical scenarios in which the main character was exposed to situations that would require dissembling an emotional reaction for social purposes (e.g., receiving a disappointing gift from a grandparent). In the second task, children were presented with four naturally occurring opportunities to dissemble emotion (e.g., receiving a disappointing reward for taking part in the study). RESULTS: Although the ability to dissemble emotion was still emerging in children in both groups, typically developing children judged that dissemblance was appropriate significantly more often than did children with LI in the hypothetical scenarios. In naturalistic scenarios, there was little difference between groups in low-cost scenarios (those in which the child had nothing to lose by hiding emotion). In the high-cost scenario (hiding emotion meant accepting a disappointing prize), more typically developing children concealed their disappointment than did children with LI. These differences neared statistical significance (p = .058). CONCLUSION: Children with typically developing language showed a greater ability to dissemble in hypothetical scenarios. In naturalistic scenarios, performance was more nuanced. In low-cost scenarios, there was little difference between groups. In the high-cost scenario, typically developing children tended to dissemble more often than did children with LI.

A social communication intervention to increase validating comments by children with language impairment.

PURPOSE: Four children identified with language impairment (LI) participated in a social communication intervention to increase the production of validating comments, including making positive statements, sharing information, and asking peers questions about themselves. METHOD: A case study design was used. Baseline measures were collected from 3 cooperative learning sessions for each participant. The intervention lasted 10 weeks, with 40 (15-min) sessions for 3 of the children and 20 (30-min) sessions for the remaining child. Each week, participants took part in sessions of group instruction, novel peer play, and review with the clinician. Data monitoring the production of validating comments were taken from the novel peer play interactions. RESULTS: One child produced a notable increase in validating comments during intervention, and 2 other participants produced more modest improvement. All 3 maintained these gains in the follow-up sessions. The remaining participant produced little change from baseline during the intervention. With respect to social outcomes, changes were not noted in peer acceptance and friendship. Teachers reported notable improvement in the sociable behavior of 2 of the children. CONCLUSION: The 4 participants showed varied increases in the production of validating comments. Possible factors influencing the successful application of the intervention are discussed.

Language use in social interactions of school-age children with language impairments: an evidence-based systematic review of treatment.

INTRODUCTION: Pragmatic models were first applied to the treatment of children with language impairment in the late 1970s. Since that time, the study of language use has had considerable impact on language assessment and treatment. Despite the need to address pragmatic language skills clinically, there has been no systematic examination of the efficacy of treatments developed for this purpose. METHOD: In accordance with the evidence-based practice policy agenda, the American Speech-Language-Hearing Association (ASHA) convened an ad hoc committee on language use in social interactions in school-age children. The committee's charge was to develop an evidence-based systematic review of treatment for disorders of language use in social interactions. This charge was conducted in collaboration with ASHA's National Center for Evidence-Based Practice in Communication Disorders. RESULTS: This systematic review provided preliminary support for the feasibility of various treatment procedures addressing social communication behaviors. Gains were reported in topic management skills, narrative production, and repairs of inadequate or ambiguous comments. CONCLUSION: Because further investigation of these treatments is warranted, the committee is unable to make empirically supported recommendations for changes in standard clinical practice based solely on this review. More research is needed to examine the feasibility of interventions that focus on children's language use.

The trajectory of language impairment into adolescence: what four young women can teach us.

Five girls who were identified with language impairment in elementary school were reevaluated 8 years later to investigate the trajectory of language and social development. At the time of follow-up, one participant had recently been expelled from school due to violent behavior and was not available for assessment. Aspects of the language, academic, social, and behavioral status of the remaining four participants were evaluated. One participant scored within typical limits on a standardized test of language, and three scored at least one standard deviation below the mean and were receiving special services in school. The four young women evaluated presented with a variety of language, academic, social, and behavioral difficulties. According to parent, teacher, or participant report, all demonstrated externalizing and/or internalizing behaviors and experienced some degree of social isolation. The follow-up suggested that although each young woman presented a unique developmental profile, language difficulties and associated academic, social, and emotional challenges persisted. At a time when intervention opportunities were narrowing, these young women seemed particularly at risk.

Ability of children with language impairment to understand emotion conveyed by prosody in a narrative passage.

BACKGROUND: Several recent studies have indicated that children with language impairment experience difficulty with various aspects of emotion understanding. Because emotion understanding skills are critical to successful social interaction, it is possible that these deficits play a role in the social problems frequently experienced by children with language difficulties. AIMS: To explore further the emotion understanding skills of children with language impairment, the investigation examined the ability of these children to understand emotion conveyed by prosody in a narrative passage. METHODS & PROCEDURES: Nineteen children with language impairment and their chronological age-matched peers served as participants. Children were sampled from the age range of 8-10; 10 years. These children were presented with a seven-sentence narrative read by actors to express happiness, anger, sadness, and fear. They were then asked to indicate what emotion the speaker expressed. OUTCOMES & RESULTS: Children with language impairment performed significantly more poorly than their typical peers in identifying the emotion expressed in the passage. There were also differences between emotions, with happiness being the easiest emotion to identify and fear the most difficult. The interaction between group and emotion type was not statistically significant. CONCLUSIONS: The results provide additional evidence that children with language impairment may have impairments in emotion understanding. If these findings are replicated, interventions designed to facilitate emotion understanding as an aspect of social communication should be considered for some children with language impairment.

What should chris say? The ability of children with specific language impairment to recognize the need to dissemble emotions in social situations.

PURPOSE: In this study, the authors examined the ability of children with specific language impairment (SLI) and their typical peers to judge when an experienced emotion should be dissembled (hidden) in accord with social display rules. METHOD: Participants included 19 children with SLI and19 children with typical language skills, both groups ranging in age from 7;9 (years;months) to 10;10, with a mean age of 9;1. Children were presented with 10 hypothetical social situations in which a character, Chris, experienced an emotion that should be dissembled for social purposes. The participants' responses were categorized as to whether or not they dissembled or displayed the emotion. RESULTS: Although the task was difficult for many participants, children with SLI indicated that the experienced emotion should be dissembled significantly less often than did their typical peers. Children in the 2 groups did not significantly differ in their judgments of the social display rules governing these situations. CONCLUSION: These results suggested that the children with SLI did not understand the impact of displaying emotion on relationships in the same way as did their typical peers. In this respect, they seemed to lag behind the typical children in their developing emotion knowledge.

Understanding emotions in context: the effects of language impairment on children's ability to infer emotional reactions.

BACKGROUND: Research indicates children with language impairment (LI) may experience social deficits extending beyond those expected due to their language deficits. In particular, it has been found that children with LI have difficulty with various aspects of emotional competence. One aspect of emotional competence is emotion understanding, which includes the ability to infer the emotions of oneself and others from social context. AIMS: To examine the ability of children with LI to infer the emotions elicited by specific social situations. METHODS & PROCEDURES: Participants were presented with short scenarios in which the main character, Chris, was exposed to a situation that would be expected to elicit anger, fear, happiness or sadness. Children were then asked to indicate what emotion Chris experienced. Following selected scenarios, children were asked to talk about the emotions they associated with some of the scenarios. They were first asked why the character would feel a particular emotion (e.g. Why did Chris feel happy?) and then asked for a description of how the particular emotion would feel (e.g. How does it feel inside to be happy?). OUTCOMES & RESULTS: Both groups of children identified happiness most accurately, followed by sadness, fear and anger. Older children were significantly more accurate than younger children, and typically developing children were significantly more accurate than children with LI. Children with LI were less sophisticated in their descriptions of emotion than were typical children. CONCLUSIONS: It is suggested that clinical interventions for children with LI should include activities designed to enrich children's emotion understanding, giving them opportunities to develop skills they may not acquire otherwise.

Social competence in children with language impairment: making connections.

Children with language problems frequently experience social difficulty. This is the case not only for children diagnosed as having impairments such as autism spectrum disorder, Asperger syndrome (AS), or mental retardation but also for children falling into diagnostic categories traditionally considered to be primarily language based (e.g., language impairment, learning disability). In considering what interventions might be most effective, it is important to consider how various aspects of development are connected. This article describes causal networks in which various factors influence the relationship between language deficits and social difficulties. Case descriptions of Joseph, an adolescent with language impairment, and Cari, a 6-year-old diagnosed with AS, illustrate the complexity of this relationship and demonstrate how intervention might be designed to facilitate positive social communication outcomes.

Description of a Program for Social Language Intervention: If You Can Have a Conversation, You Can Have a Relationship.

Adolescents with impaired language comprehension and formulation skills often experience difficulty keeping up with the linguistic and social demands of peer interaction. This clinical exchange describes an individualized treatment program designed to increase the conversational skill of an adolescent male with language impairment. Treatment focused on increasing awareness of the listener's needs and on balancing the exchange of conversational turns. Clinical performance, parent report, and client report were used to assess outcomes.

Description of a program for social language intervention: "if you can have a conversation, you can have a relationship".

Adolescents with impaired language comprehension and formulation skills often experience difficulty keeping up with the linguistic and social demands of peer interaction. This clinical exchange describes an individualized treatment program designed to increase the conversational skill of an adolescent male with language impairment. Treatment focused on increasing awareness of the listener's needs and on balancing the exchange of conversational turns. Clinical performance, parent report, and client report were used to assess outcomes.

The relationship of language and emotion regulation skills to reticence in children with specific language impairment.

This study examined the relationship between emotion regulation, language ability, and reticent behavior in children with specific language impairment (SLI) and their typical peers. Participants included 43 children with SLI and 43 typically developing children, for a total sample of 86 participants. Children were selected from 2 age ranges: 5-8 years and 9-12 years. The Emotion Regulation Checklist (ERC; A. Shields and D. Cicchetti, 1997, 1998) and the Teacher Behavior Rating Scale (TBRS; C. H. Hart and C. C. Robinson, 1996) were completed by each child's teacher to provide measures of emotion regulation and reticence, respectively. The Comprehensive Assessment of Spoken Language (CASL; E. Carrow-Woodfolk, 1999) was administered to provide a measure of language ability. A regression analysis including all participants indicated that the emotion regulation scores and the CASL scores were significant predictors of the reticence scores, accounting for 43% of the variance. Group-specific analyses were then conducted to determine whether the 2 predictor scales differentially predicted reticence based on language and age groups. None of the tests exceeded the.05 level, indicating that there was no significant difference in predictive power on the 2 factors in question.

The relationship between social behavior and severity of language impairment.

The Teacher Behavior Rating Scale (C. H. Hart and C. C. Robinson, 1996) was used to compare the withdrawn and sociable behaviors of 41 children with specific language impairment (SLI) and 41 typically developing peers. Three subtypes of withdrawal (reticence, solitary-active, solitary-passive) and 2 subtypes of sociable behavior (prosocial, impulse control/likeability) were examined. Teachers rated children with SLI as exhibiting higher levels of reticence and solitary-passive withdrawal than typical children. Teachers also rated the children with SLI as demonstrating lower levels of both types of sociable behavior than typical children. The group with SLI was then separated into subgroups of children having more severe and less severe language impairment. These groupings did not differ on comparisons involving withdrawn behavior, except that girls with more severe receptive problems demonstrated higher levels of solitary-passive withdrawal than did girls with less severe language problems. Children with less severe receptive language impairment demonstrated higher levels of proficiency on both types of sociable behavior than their peers with more severe impairment. Children with more severe expressive problems also demonstrated poorer prosocial behavior--but not poorer impulse control/likeability--than children with less severe expressive problems.

Blending quantitative and qualitative methods in language research and intervention.

Best practice in speech-language pathology should be informed by current research findings. Traditional research methods are not always geared to address some of the complex, individual questions that arise in clinical intervention, however. Qualitative research methods may provide useful tools for bridging the gap from research to practice. Combinations of qualitative and quantitative procedures may be particularly helpful in sorting out some of the important issues surrounding language intervention in both clinical and research contexts. Examples of research blending qualitative and quantitative methods, as well as the case study of Sid, an 11-year-old boy with specific language impairment, are presented to illustrate how a combination of procedures can be used to enhance language research and intervention.

Self-esteem in children with specific language impairment.

The purpose of this preliminary study was to probe the self-perceptions of a group of children with specific language impairment (SLI) and their typically developing peers. A measure of self-esteem was administered to 46 children between the ages of 6 and 9 years old and 34 children between the ages 10 and 13. In the younger group, there were no statistically significant differences between children with SLI and typically developing children in the way they perceived themselves across domains of competence and acceptance. In the older group, children with SLI perceived themselves more negatively in scholastic competence, social acceptance, and behavioral conduct than did children with typical language development. Differences were evident in areas that were most affected by language impairment.

Emotion Regulation in Children With Specific Language Impairment.

PURPOSE: The purpose of this preliminary study was to determine if emotion regulation warrants investigation as a factor influencing social outcomes in children with specific language impairment (SLI). Emotion regulation was evaluated in children with SLI and their typically developing peers. METHOD: Teachers were asked to rate the emotion regulation behaviors of 41 children with SLI and 41 typical peers using the "Emotion Regulation Checklist" (ERC, Shields & Cicchetti, 1997; 1998). Children were sampled from two age levels (6-9 years and 10-13 years). At each age level, equal numbers of boys and girls were sampled. RESULTS: As a group, children with SLI received significantly lower ratings than typical children. In addition, girls produced higher scores than boys. None of the other interactions was significant. Scores on the two subscales of the ERC, labeled as lability/negativity and emotion regulation, were then examined to further delineate performance. Boys with SLI had notably lower ratings than all the other groups on the emotion regulation subscale. CLINICAL IMPLICATIONS: Emotion regulation warrants further research to determine if it is associated with specific social outcomes in children with SLI.

Social Behaviors of Children With Language Impairment on the Playground: A Pilot Study.

PURPOSE: This pilot study examined the social behaviors of children with language impairment (LI) and their typical peers on the playground. METHOD: Eight children with LI and their age-matched peers were videotape recorded for 45 minutes during morning and lunch recesses. Samples were divided into 5-second segments and coded according to the child's behavior occurring during the segment. The behavior displayed during each interval was then coded into one of 37 subcategories. These subcategories were grouped into six general categories of (a) peer interaction, (b) adult interaction, (c) withdrawal, (d) aggression, (e) victimization, and (f) other. RESULTS: Significant differences were observed in the categories of peer interaction and withdrawal. Typical children spent significantly more time interacting with peers than did children with LI. Conversely, children with LI demonstrated significantly more withdrawn behaviors than did their typical peers. Analyses of effect size using ω2 indicated that group membership accounted for approximately 30% of the variability in both of these types of playground behavior. No other significant differences were observed. These findings support the conclusions of researchers using teacher interview procedures, indicating that children with LI are more withdrawn than their typical peers at school. CLINICAL IMPLICATIONS: Specific intervention targeting social language skills in playground contexts may be warranted to include children with LI in social interactions at recess.

Children With Language Impairment in Cooperative Work Groups: A Pilot Study.

PURPOSE: This pilot study examined the manner in which the individual social-behavioral profiles of children with language impairment (LI) influenced their ability to work within cooperative groups. METHOD: Six children with LI each participated in four different cooperative work groups. In each of these groups, the child with LI interacted with two typically developing children (for a total of 48 different typical children). Groups were structured to make it possible for the child with LI to play a meaningful role in the interactions (e.g., assignment of specific roles). The success of each of these interactions was evaluated to determine the extent to which all of the children participated and worked together toward a joint goal. Social profiles of each of the children with LI were obtained using the Teacher Behavioral Rating Scale (TBRS, Hart & Robinson, 1996). The success of the collaborative work of each triad was then considered in light of the child's social profile. RESULTS: The success of the individual interactions was highly variable from child to child. However, the social profile of the child with LI appeared to be a good predictor of the child's ability to work with other members of the triad toward a joint goal. CLINICAL IMPLICATIONS: In facilitating cooperative groups, teachers and speech-language pathologists need to consider the social profiles, as well as the language levels, of children with LI who participate. Children who show withdrawn behaviors may need support to help them become more responsive to their partners. Children with LI who show withdrawn as well as aggressive behaviors may need a variety of accommodations, including specific intervention designed to help them understand the value of working with others.

Withdrawn and Sociable Behavior of Children With Language Impairment.

This study examined the dimensions of withdrawal and sociability in children with language impairment (LI) and their typically developing chronological age-matched peers. Classroom teachers rated the withdrawn and sociable behaviors of 41 children with LI and 41 typically developing peers using the Teacher Behavioral Rating Scale (TBRS, Hart & Robinson, 1996). Children were sampled from the age ranges of 5 to 8 years and 10 to 13 years. Subtypes of both withdrawn (solitary-passive withdrawal, solitary-active withdrawal, reticence) and sociable (impulse control/likability, prosocial) behavior were examined. Teachers rated children with LI as displaying higher levels of reticent behavior than typically developing children. Teachers also rated boys with LI as displaying significantly higher levels of solitary-active withdrawal than girls with LI or typically developing children of either gender. The groups did not differ on solitary-passive withdrawal, although boys were rated higher than girls. In the dimension of sociable behavior, children with LI were rated significantly below typical peers on subtypes of impulse control/likability and prosocial behavior. The relationship between language impairment and withdrawn and sociable behavior is complex. Although language impairment is an important factor in social difficulty, the current results suggest that language impairment is not the sole factor leading to social problems in children with LI. Assessment and intervention procedures for children with language and social problems should take the complex nature of this relationship into account.