2024
Two children in every classroom have a developmental language disorder
Dr. Pauline Frizelle from the Department of Speech and Hearing Sciences at the School of Clinical Therapies shares her research goals aimed at enhancing the effectiveness of intervention strategies to support children’s language and communication skills.
Research in Focus: Children with or at risk of Developmental Language Disorder
What is the challenge in society that your research is focused on?
Two children in every classroom have a development language disorder. Language is the medium through which people form and maintain relationships, learn and develop, and create and define a sense of identity. It is the primary tool with which we navigate the world of work, community and our wider society. Although children’s acquisition of oral language can appear effortless, approximately 8 % of children have a developmental language disorder and so do not develop this crucial skill at the expected rate. It is also problematic that children’s language needs often go unrecognised, or are only identified, when children develop other difficulties such as with literacy, youth offending or mental health, and so we miss important opportunities to provide preventative interventions.
My research is about developing equitable and cost-effective public health models of intervention to promote robust language development for all children and prevent the negative lifelong consequences for those with or at risk of DLD.
What are the striking findings in your research?
The prevalence of language difficulties is reported to be up to 40 % in more disadvantaged populations. These children are at a substantially increased risk of poor long-term outcomes with respect to social-emotional wellbeing, literacy, mental health, employment, health literacy, social anxiety and isolation. Hence, child language difficulties can be seen as both a cause and a consequence of social disadvantage. Families living with social disadvantage are much less likely to seek support and have fewer resources, making adverse consequences much more likely.
We are currently carrying out a randomised control trial on the Happy Talk programme (a €1.3m Health Research Board Definitive Intervention and Feasibility Award). This trial addresses these service delivery challenges by mobilising the necessary assets within the community and taking a public health approach to the delivery of speech language and communication services. This work has the potential to change how we deliver services and educate people living in social disadvantage into the future.
5.8 million children in Europe have a language disorder, making it the least recognised, funded and studied neurodevelopmental disorder, at a cost of €15bn to Europe in lost productivity and health and welfare access.
What are common signs of language disorder that a child might exhibit?
Signs of a language disorder are dependent on the age of the child. For young children we might note for example a difficulty understanding simple commands, limited use of gesture and a lack of imitation. However, the literature indicates significant variation in what is considered ‘normal development’, and we do not recommend diagnosing DLD before 4 years of age. In preschool years, indicators might include limited vocabulary, difficulty following directions and poor phonological awareness. As children start to progress through school, we see difficulties understanding and using complex sentences, frequent grammatical errors, literacy difficulties, and difficulty organising their thoughts.
If I have a child, and I am worried about their language development, what should I do?
A speech and language therapist (SLT) is the primary professional who can diagnose a language disorder. You can access SLT through the HSE and you can get a referral from your GP. However, public service waiting lists are very long (currently the longest of any health care service provision in Ireland and the UK), so you might want to explore private therapy options, as early intervention is key. An SLT assessment will typically involve a series of tests and observations to determine the nature and severity of the language difficulties. This may include assessing vocabulary, grammar, comprehension, and expressive language. If your child does get a diagnosis, it would be important to inform your child’s school. Schools are required to make accommodations for children with DLD. Your child may also be entitled to additional support through an Individual Education Plan or a School Support Plan.
You recently received the largest ever research funding award in Ireland, in this area. How is that work going?
Yes, we received a €2.5m Health Research Board Applied Programme Award, the largest award ever to be given in this field. This work will ensure that interventions to support children's language and communication will deliver maximum benefit, through the development of a set of internationally accepted reporting guidelines. In a series of connected studies, we will develop internationally agreed standards of language intervention reporting and a validated training programme to sustain future implementation. The provision of effective interventions to mitigate the negative consequences of (D)LD is a clear priority for health and educational services world-wide, for the many children whose early development has been affected by COVID-19 restrictions and for the 97,000 children affected in Ireland.
The acceleration of research and clinical impact is core to the aims of this research programme. Our research will enable effective interventions to be delivered precisely and efficiently for children, and for international collaboration and meta-analyses to accelerate scientific progress to address research gaps.
Finally, children and families may recognise you on YouTube. Tell us more!
For many years I have been an ambassador for the use of key word signing in special and mainstream schools. Lámh is the key word signing system used in Ireland to support language and communication in people with communication difficulties. Within the world of intellectual disability (ID), I am ‘Lamheen’, the presenter of the Lámh-a-Song DVD series, developed to help children with ID, and their communicative partners, to learn Lámh. In collaboration with Down Syndrome Ireland, and UCC researchers Dr Eva McMullan and Dr Ciara O’Toole, we developed the language through music intervention, which uses key word sign to promote vocabulary development in children with Down Syndrome. We are currently planning to build on this work with a larger intervention project – watch this space!
Interview was conducted with Dr Trevor Carey