Narrative skills, cognitive profiles and neuropsychiatric disorders in 7-8-year-old children with late developing language

• Published in: International journal of language & communication disorders 2007-11, Vol.42 (6), p.665-681
• Main Authors: Miniscalco, Carmela, Hagberg, Bibbi, Kadesjö, Björn, Westerlund, Monica, Gillberg, Christopher
• Format: Article
• Language: English
• Subjects: Attention Deficit Disorder with Hyperactivity; Attention Deficit Disorder with Hyperactivity - complications; Attention Deficit Disorder with Hyperactivity - psychology; Attention Deficit Disorders; Attention deficit disorders. Hyperactivity; attention deficit/hyperactivity disorder (ADHD); autism; Autistic Disorder; Autistic Disorder - complications; Autistic Disorder - psychology; Biological and medical sciences; Child; Child clinical studies; Child Language; Children; Cognition; Cognitive Ability; Cognitive Processes; cognitive profile; Complications; Correlation; Delayed Speech; Developmental disorders; Diagnosis; Etiology; Follow-Up Studies; Foreign Countries; High Risk Students; Humans; Hyperactivity; Infantile autism; Intelligence; Intervention; Language Acquisition; Language and communication disorders; language delay; Language Development Disorders; Language Development Disorders - diagnosis; Language Development Disorders - etiology; Language Development Disorders - psychology; Language Impairments; Mass Screening; Mass Screening - methods; Medical sciences; MEDICIN; MEDICINE; Mental Disorders; Mental Disorders - complications; Mental Disorders - diagnosis; Mental Disorders - psychology; Methods; Narration; narrative skill; Neuropsychology; Pervasive Developmental Disorders; Psychiatric Status Rating Scales; Psychiatry; Psychology; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psykiatri; Speech Skills; Sweden
• ISSN: 1368-2822; 1460-6984; 1460-6984
• DOI: 10.1080/13682820601084428

Background: A community-representative sample of screened and clinically examined children with language delay at 2.5 years of age was followed up at school age when their language development was again examined and the occurrence of neuropsychiatric neurodevelopmental disorder (attention deficit hyperactivity disorder (ADHD) and or autism spectrum disorder (ASD)) was documented. Aims: (1) To determine whether these 7-8-year-old children with a history of language delay have deficits in narrative skills compared with the age norms of standardized tests; and (2) to analyse if there is a relationship between narrative outcome, cognitive profile, and neuropsychiatric diagnosis. Methods & Procedures: Twenty-one children recruited from a community sample and with a history of language delay underwent an in-depth multidisciplinary examination at 7-8 years of age. Their narrative and cognitive skills were examined using the Bus Story Test, the Narrative Memory Subtest from the Developmental Neuropsychological Assessment (NEPSY), and The Wechsler Intelligence Scale for Children III (WISC-III). Outcomes & Results: The three measures of the Bus Story Test (information, sentence length, and subordinate clauses) were below age norms for all 21 children, of whom 13 also had a neuropsychiatric diagnosis, i.e. ADHD and or ASD. Half of the children with language delay had problems on Bus Story Test Information and on the Narrative Memory subtest independently of co-occurrence of neuropsychiatric disorder. The only difference across the children with language delay pure and those who had language delay plus ADHD or language delay plus ASD was on Freedom from Distractibility, where children with ADHD and ASD scored low. In addition, children with ASD had a much lower overall cognitive level (FSIQ) and poorer results on Processing Speed. Conclusions: Swedish children with late developing language at 2.5 years of age have persisting difficulties with oral narrative skills at age 7-8 years. However, almost none of the children with language delay had problems when responding to story-related questions - irrespective of whether or not they had an additional diagnosis of ADHD or ASD. Thus, asking story-related questions may be a good intervention strategy when working with these children. Because narrative difficulties are a reflection of linguistic, cognitive and or pragmatic social difficulties, it is important for clinicians of different specialities to work in close collabor