Developmental Language Disorder (DLD) in Young People Leaving Care in England: A Study Profiling the Language, Literacy and Communication Abilities of Young People Transitioning from Care to Independence
Abstract
:1. Introduction
1.1. Children and Young People in Care
1.2. Language, Literacy and Communication Profiles of Children and Young People in Care
1.3. Current Study: Aims and Research Questions
- What is the language, literacy and communication profile as measured by standardised assessments of care leavers aged between 16 and 25 years?
- How do care leavers report their own language and communication abilities and does this align with the profile of language and communication ability described by the assessments?
- Can key staff working with care leavers describe their language and communication abilities and does this align with the profile of language and communication ability described by the assessments?
- How do key staff perceive and experience the language and communication abilities of care leavers?
2. Materials and Methods
2.1. Study Design
2.2. Participants
2.3. Measures
2.3.1. The Clinical Evaluation of Language Fundamentals (CELF-5 UK)
Formulating Sentences (FS)
Recalling Sentences (RS)
Understanding Spoken Paragraphs (USP)
Semantic Relationships (SR)
2.3.2. Test of Word Reading Efficiency 2 (TOWRE-2)
2.3.3. Communication Checklist Adult Self Report Scale (CC-SR) and Adult Report Scale (CC-A)
2.3.4. Demographic Questionnaire
2.3.5. Survey
2.4. Procedure
2.5. Analysis
3. Results
3.1. Participant Demographic Data
3.1.1. Living Circumstances
3.1.2. Experience of Looked after Provision
3.1.3. English as an Additional Language (EAL)
3.1.4. Education and Vocational Circumstances
3.1.5. Special Educational Needs
3.1.6. Health Circumstances
3.1.7. Experience of the Criminal Justice System
3.2. Language
3.3. Literacy
3.4. Communication Checklists
3.4.1. Communication Checklist—Self Report (CC-SR)
3.4.2. Communication Checklist—Adult Report (CC-A)
3.4.3. Comparison of CC-SR and CC-A Data
3.5. Profile of Participants with CELF-5 UK Scores in the Very Low/Severe Range
3.6. Survey Findings
4. Discussion
4.1. Summary of Findings
4.2. Methodological Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A
Survey Completed by PAs
- Staff find it hard to communicate with the young person which impacts on the overall management of the young person
- The young person finds it difficult to engage in verbally mediated interventions offered to support him/her
- The young person is more likely to give inappropriate communicative responses and/or behave in a socially inappropriate way which can have negative consequences for the young person
- The young person finds it difficult to express/regulate their emotions in respect to leaving care which may impede communication
- The young person finds it difficult to access and understand information about the service offered.
Appendix B
English as an additional language (EAL) (n = 44) | Yes 5 (11.4%) mean age 19.80 (SD 1.30) range 18–21 | No 39 (88.6%) mean age 20.15 (SD 2.29) range 16–26 | |||
Current Vocation (n = 44) | In Education 10 (22.7%) mean age 20.44 (SD 1.9) range 17–24 | In Paid Employment 9 (20.5%) mean age 20.00 (SD 1.94) range 18–25 | Not in Education, Employment or Training (NEET) 23 (52.3%) mean age 19.90 (SD 2.47) range 16–26 | Volunteering 2 (4.5%) mean age 21.50 (SD 2.12) range 20–23 | |
Current Living Circumstances (n = 44) | Independent 23 (52.3%) mean age 20.74 (SD 1.89 range 18–25 | Supported 7 (15.9%) mean age 19.14 (SD 3.4) range 16–26 | Current Care Placement Foster 6 (13.6%) mean age 18.83 (SD 0.75) range 18–20 Residential 0 (0%) | Other (n = 4; 9%) Hostel: 2 mean age 18.50 (SD 3.6) range 16–21 Safe house: 1; 21 years Homeless: 1; 18 years | |
Experience of care (n = 44) | Yes 44 (100%) Foster care: 40 (91%) Residential: 4 (9%) | No 0 (0%) | |||
Care placements (n = 44) | Number of placements ever (n = 34) mean 4.56 (SD 3.98) range 1–18 Not able to remember: (n = 10) | Mean age entered care (n = 42) mean age 10.90 (SD 4.48) range 2–18 | Mean age left care (n = 29) mean age 17.62 (SD 0.82) range 15–19 | Still in care N = 15 | |
Qualifications (highest ever) (n = 41) | NVQ 18 (40.9%) | GCSE 16 (36.3%) | A level 1 (2.3%) | BTEC 5 (11.4%) | Higher Education 0 (0%) |
Physical health diagnoses (n = 44) | Yes 10 (22.7%) | No 34 (77.3%) | Not sure/can’t remember/prefer not to say 0 (0%) | Physical Health Hearing Difficulties 3 Epilepsy 1 Mobility 4 Cardiac 2 | |
Mental health diagnoses (n = 44) | Yes 29 (65.9%) | No 13 (29.5%) | Not sure/can’t remember/prefer not to say 2 (4.5%) | Type of mental health difficulties self-reported Depression 13 (29.5%) Anxiety 15 (34.1%) Bi-polar 1 (2.3%) Conduct disorder 1 (2.3%) Obsessive Compulsive Disorder 2 (4.5%) Borderline Personality Disorder 2 (4.5%) Post Traumatic Stress Disorder 1 (2.3%) | |
Developmental disorders (n = 44) | Yes 14 (31.8%) | No 30 (68.2%) | Not sure/can’t remember/prefer not to say 0 (0%) | Type of developmental disorders self-reported Attention Deficit Hyperactivity Disorder (ADHD) 8 (18.2%) Autism Spectrum Disorders (ASD) 5 (11.4%) Learning Difficulties 4 (9.1%) Dyslexia 4 (9.1%) Dyspraxia 1 (2.3%) | |
Statement of SEN/EHCP (n = 44) | Yes 19 (43.2%) | No 22 (50.0%) | Support received but status not known 1 (2.3%) | Not sure 2 (4.5%) | |
Reason for Statement of SEN/EHCP | Learning Difficulties 3 (13.6%) | SEMH Difficulties 1 (4.5%) | Reading/Dyslexia 2 (9.1%) | Physical/Mobility/Hearing 1 (4.5%) | Other Unable to report 12 |
Criminal Convictions | Yes 15 (34.1%) | No 29 (65.9) | Type of sentence Referral/community order 4 (28.6%) Secure/YOI 4 (28.6%) Not sure 1 Prefer not to say 6 (42.9%) |
Appendix C
Participant | Age in Years | Gender | EAL | CC-SR 6 or Below | CC-A 6 or Below | SEN/EHCP | Reason for SEN/EHCP | Developmental Disorder | Mental Health |
---|---|---|---|---|---|---|---|---|---|
1. | 23 | Female | No | No | Yes | Yes | Not sure | Learning Difficulties | Anxiety Depression |
2. | 19 | Male | No | No | No | No | NA | No | No |
3. | 21 | Male | No | No | Yes | No Received support at school | Reading/dyslexia | Dyslexia | Anxiety |
4. | 21 | Female | No | Yes | NC | Yes | Not sure | ASD Learning difficulties | Anxiety Depression |
5. | 20 | Male | No | Yes | Yes | Yes | Not sure | Dyslexia | Depression |
6. | 16 | Male | No | No | Yes | Yes | SEMH | ADHD Conduct Disorder | Conduct Disorder |
7. | 21 | Male | No | Yes | NC | Yes | Learning Difficulties | Dyslexia ADHD | No |
8. | 18 | Female | No | No | NC | No | NA | No | No |
9. | 20 | Male | No | No | NC | Yes | Learning Difficulties | ADHD | Obsessive Compulsive Disorder (OCD) |
10. | 19 | Male | No | Yes | Yes | Yes | Not sure | Learning difficulties ADHD | No |
11. | 21 | Female | No | No | No | No | No | No | Anxiety Depression OCD Borderline Personality Disorder (BPD) |
12. | 19 | Male | Yes | No | Yes | No | No | No | No |
13. | 19 | Female | No | Yes | No | No | No | No | No |
14. | 16 | Female | No | No | No | Yes | Not sure | No | Anxiety Depression |
15. | 25 | Female | No | Yes | NC | Yes | Not sure | Dyslexia | Anxiety Depression BPD |
16. | 17 | Male | No | No | NC | No | No | No | No |
17. | 18 | Male | Yes | No | NC | No | No | No | No |
18. | 20 | Male | No | Yes | Yes | No | No | No | Depression Post Traumatic Stress Disorder (PTSD) |
19. | 20 | Male | Yes | No | No | No | No | No | No |
20. | 21 | Male | Yes | Yes | No | No | No | No | No |
21. | 20 | Male | No | No | No | Yes | Not sure | No | No |
22. | 21 | Female | Yes | Yes | No | No | No | No | No |
23. | 20 | Female | No | Yes | NC | Not sure | Not sure | No | Anxiety Depression |
24. | 20 | Male | No | Yes | NC | No | No | No | No |
25. | 19 | Male | No | No | NC | Yes | Not sure | ASD | No |
26. | 21 | Male | No | No | NC | No | No | No | No |
References
- Department for Education. Children Looked After in England (including Adoption) Year Ending 31 March 2018; Department for Education: London, UK, 2018.
- Ford, T.; Vostranis, P.; Meltzer, M.; Goodman, R. Psychiatric disorder among British children looked after by local authorities: Comparison with children living in private households. Br. J. Psychiatry 2007, 190, 319–325. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Meltzer, H.; Corbin, T.; Gatward, R.; Goodman, R.; Ford, T. The Mental Health of Young People Looked after by Local Authorities in England; Office of National Statistics: London, UK, 2003.
- Viner, R.M.; Taylor, B. Adult health and social outcomes of children who have been in public care: Population-based study. Pediatrics 2005, 115, 894–899. [Google Scholar] [CrossRef] [PubMed]
- Snow, P.; McLean, E.; Frederico, M. The language, literacy and mental health profiles of adolescents in out-of-home care: An Australian sample. Child Lang. Teach. Ther. 2020, 36, 151–163. [Google Scholar] [CrossRef]
- Trout, A.L.; Huscroft-D’Angelo, J.; DeSalvo, C.; Gehringer, R. The language functioning of youth at entry to residential treatment. Resid. Treat. Child. Youth 2011, 28, 269–282. [Google Scholar] [CrossRef]
- McCool, S.; Stevens, I.C. Identifying speech, language and communication needs among children and young people in residential care. Int. J. Lang. Commun. Disord. 2011, 46, 665–674. [Google Scholar] [CrossRef] [PubMed]
- Bishop, D.V.M. Children’s Communication Checklist-2 (CCC-2); The Psychological Corporation: London, UK, 2003. [Google Scholar]
- Sylvestre, A.; Merette, C. Language delay in severely neglected children: A cumulative or specific effect of risk factors. Child Abus. Negl. 2010, 34, 414–428. [Google Scholar] [CrossRef] [PubMed]
- Lum, J.A.G.; Powell, M.; Timms, L.; Sow, P. A meta-analysis of cross sectional studies investigating language in maltreated children. J. Speech Lang. Hear. Res. 2015, 58, 961–976. [Google Scholar] [CrossRef] [PubMed]
- Allen, R.E.; Oliver, J.M. The effects of child maltreatment on language development. Child Abus. Negl. 1982, 6, 299–305. [Google Scholar] [CrossRef]
- Culp, R.E.; Watkins, R.V.; Lawrence, H.; Letts, D.; Kelly, D.J.; Rice, M. Maltreated children’s language and speech development: Abused, neglected and abused and neglected. First Lang. 1991, 11, 377–398. [Google Scholar] [CrossRef]
- Eigsti, I.M.; Cicchetti, D. The impact of child maltreatment on expressive syntax at 60 months. Dev. Sci. 2004, 7, 88–102. [Google Scholar] [CrossRef] [PubMed]
- Bishop, D.V.M.; Snowling, M.J.; Thompson, P.A.; Greenhalgh, T.; Catalise Consortium. Phase 2 of CATALISE: A multi-national and multi-disciplinary Delphi consensus study of problems with language development terminology. J. Child Psychol. Psychiatry 2017, 58, 1068–1080. [Google Scholar] [CrossRef] [PubMed]
- Yew, S.G.; O’Kearney, R. Emotional and behavioural outcomes in later childhood and adolescence for children with specific language impairments: Meta-analyses of controlled prospective studies. J. Child Psychol. Psychiatry 2013, 54, 516–524. [Google Scholar] [CrossRef] [PubMed]
- Van Dahl, J.; Verhoven, L.; van Balkom, H. Behaviour problems in children with language impairment. J. Child Psychol. Psychiatry 2007, 48, 1139–1147. [Google Scholar] [CrossRef] [PubMed]
- St Clair, M.C.; Pickles, A.; Durkin, K.; Conti-Ramsden, G. A longitudinal study of behavioral, emotional and social difficulties in individuals with a history of specific language impairment (SLI). J. Commun. Disord. 2011, 44, 186–199. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Hentges, R.F.; Devereux, C.; Graham, S.A.; Madigan, S. Child language difficulties and internalizing and externalizing symptoms: A meta-analysis. Child Dev. 2021. online ahead of print. [Google Scholar] [CrossRef] [PubMed]
- Thornton, E.; Patalay, P.; Matthews, D.; Bannard, C. Does early child language predict internalizing symptoms in adolescence? An investigation in two birth cohorts born 30 years apart. Child Dev. 2020, in press. [Google Scholar] [CrossRef]
- Clegg, J.; Law, J.; Rush, R.; Peters, T.; Roulstone, S. The contribution of children’s early language development to children’s emotional and behavioural functioning at 6 years: An analysis of the children in focus sample from the ALSPAC birth cohort. J. Child Psychol. Psychiatry 2015, 56, 67–75. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Semel, E.; Wiig, E.H.; Secord, W. Clinical Evaluation of Language Fundamentals—Fifth Edition (CELF-5 UK); Pearson: London, UK, 2017. [Google Scholar]
- Wagner, R.; Torgesen, J.K.; Rashotte, C. Test of Word Reading Efficiency—Second Edition (TOWRE-2); Pearson: London, UK, 2011. [Google Scholar]
- Bishop, D.; Whitehouse, A.; Sharp, M. Communication Checklist—Self Report (CC-SR); Pearson: London, UK, 2009. [Google Scholar]
- Whitehouse, A.; Bishop, D. Communication Checklist-Adult Report (CC-AR); Pearson: London, UK, 2009. [Google Scholar]
- Winstanley, M.; Webb, R.T.; Conti-Ramsden, G. Developmental Language Disorders and risk of recidivism among young offenders. J. Child Psychol. Psychiatry 2020, 62, 396–403. [Google Scholar] [CrossRef] [PubMed]
- Hopkins, T.; Clegg, J.; Stackhouse, J. Examining the association between language, expository discourse and offending behaviour: An investigation of direction, strength and independence. Int. J. Lang. Commun. Disord. 2018, 53, 113–129. [Google Scholar] [CrossRef] [PubMed]
- Prison Reform Trust. In Care, Out of Trouble. An Independent review chaired by Lord Laming; Prison Reform Trust: London, UK, 2016.
Number of Participants (n = 42) | Test Scaled Score | Category of Ability | Relationship to Mean | |
---|---|---|---|---|
Core Language Score (CLS) Median 67.00 (IQR 21) Range 40–111 | 1 (2.4%) | Above average | +1 SD and above | |
3 (7.1%) | Average | Within + or −1 SD | ||
6 (14.3%) | Marginal/below average/mild | Within −1 to 1.5 SD | ||
6 (14.3%) | Low range/moderate | Within −1.5 to −2 SD | ||
26 (61.9%) | Very low range/severe | −2 SD and below | ||
CELF-Formulating Sentences (FS) Median scaled score 5.00 (IQR 5) Range 1–13 | 2 (4.8%) | 13+ and above | Above average | +1 SD and above |
7 (16.7%) | 8 to 12 | Average | Within and or −1 SD | |
33 (75.0%) | 7 and below | Below average | −1 SD and below | |
CELF-Recalling Sentences (RS) Median scaled score 5.00 (IQR 4) Range 1–12 | 0 | 13+ and above | Above average | +1 SD and above |
7 (16.7%) | 8 to 12 | Average | Within and or −1 SD | |
35 (83.3%) | 7 and below | Below average | −1 SD and below | |
CELF-Understanding Spoken Paragraphs (USP) Median scaled score 3.00 (IQR 5) Range 1–16 | 1 (2.4%) | 13+ and above | Above average | +1 SD and above |
4 (9.5%) | 8 to 12 | Average | Within and or −1 SD | |
37 (88.1%) | 7 and below | Below average | −1 SD and below | |
CELF-5 Semantic Relationships (SR) Median scaled score 4.00 (IQR 4) Range 1–13 | 2 (4.8%) | 13+ and above | Above average | +1 SD and above |
3 (7.1%) | 8 to 12 | Average | Within and or −1 SD | |
37 (88.1) | 7 and below | e | −1 SD and below |
TOWRE-2 | Raw Scores Mean (S.D) Range | Percentiles | Scaled Scores Mean (S.D) Range | |
---|---|---|---|---|
Sight Word (n = 39) | 70.59 (22.98) 20–104 | 31.12 (27.27) 1–89 | 84.69 (17.91) 55–118 | |
Phonemic Decoding (n = 39) | 39.15 (18.0) 7–63 | 40.32 (31/08) 1–94 | 89.90 (18.53) 57–123 | |
Sum of scaled scores (n = 39) | 174.67 (35.0) 112–234 | |||
Overall total scaled score (n = 39) | 86.62 (18.45) 54–118 | Above average 3 (6.8%) Average 14 (31.8%) Below average 6 (13.6%) Poor 6 (3.6%) Very poor 10 (22.7%) |
CC-SR | Raw Score | Scaled Score | Z Score | Percentile |
---|---|---|---|---|
Language Structure (n = 44) | 17.89 (10.74) 1–45 | 7.18 (3.6) 1–15 | −1.17 (3.11) −19.9 to 1.8 | 31.01 (29.03) 0.1 to 96.4 |
Pragmatic Skills (n = 44) | 19.61 (13.48) 0–47 | 7.50 (3.8) 0–17 | −0.71 (1.34) −4.3 to 2.5 | 34.93 (30.42) 0.3 to 99.4 |
Social Engagement (n = 44) | 28.27 (10.52) 5–46 | 6.84 (3.7) 0–15 | −0.88 (1.21) −3.5 to 1.7 | 30.50 (28.25) 0.3 to 95.5 |
CC-SR Mean totals | 21.92 (28.19) 8–120 | 7.17 (9.15) 2–44 | −1.98 (1.45) −19.9 to −2.5 | 32.14 0.3 to 99.4 |
CC-A | ||||
Language Structure (n−21) | 10.33 (10.38) 0–43 | 6.62 (3.7) 0–14 | −1.40 (1.10) −4.0 to 0.1 | 12.93 (14.62) 0–42 |
Pragmatic Skills (n = 21) | 11.90 (12.69) 0–50 | 7.71 (4.4) 0–14 | −1.09 (1.30) −4.0 to 0.4 | 8.99 (13.5) 0–50 |
Social Engagement (n = 21) | 31.48 (17.11) 2–64 | 4.14 (3.8) 0–10 | −2.26 (1.45) −4.0 to 0. 2 | 6.14 (11.03) 0–42 |
CC-A Mean totals | 17.90 (34.80) 3–157 | 6.16 (10.10) 1–38 | −1.79 (1.32) −4.0 to 0.4 | 5.51 (6.12) 0–18 |
Language Structure | Pragmatic Skills | Social Engagement | Mean Totals | |||||
---|---|---|---|---|---|---|---|---|
CC-SR | CC-A | CC-SR | CC-A | CC-SR | CC-A | CC-SR | CC-A | |
Raw Score SD Range | 16.29 (8.22) 8–38 | 10.33 (10.38) 0–43 | 16.67 (10.83) 17–48 | 11.90 * (12.69) 0–50 | 29.29 (9.08) 17–48 | 31.48 (7.11) 2–64 | 62.24 (21.11) 38–103 | 53.71 (34.80) 3–157 |
CELF-5 UK Core Language Score | TOWRE Total Score | CC-SR | CC-A | |
---|---|---|---|---|
Monolingual participants (n = 21) | median 61.00 IQR 32 range 40–72 n = 21 | mean 82.39 (SD 17.57) range 54–110 n = 18 | mean 7.40 (2.98) range 2.6–12.0 n = 21 | mean 6.55 (SD 2.77) range 3–11.3 n = 9 |
Participants with EAL (n = 5) | median 54.00 IQR 27 Range 40–67 n = 5 | mean 76.80 (SD 11.82) range 57–88 n = 5 | mean 6.60 (SD 2.40) range 2–9.66 n = 5 | mean 8.33 (SD 3.18) range 5–11.33 n = 3 |
Question 5 Response Options | Median Rank |
---|---|
Attending and listening to others (n = 20) | 1.00 |
Understanding/processing what others say (n = 20) | 2.00 |
Being able to communicate with others in a socially appropriate way (n = 20) | 2.00 |
Reading and writing difficulties (n = 20) | 2.50 |
Using appropriate vocabulary in their talking (n = 20) | 3.00 |
Using appropriate grammar in their talking (n = 20) | 4.00 |
Speech difficulties where speech is difficult to understand (n = 20) | 5.00 |
Stammering/stuttering (n = 20) | 6.50 |
Hearing difficulties (n = 20) | 6.50 |
Question 8 Response Options | Median Rank |
---|---|
The young person is more likely to give inappropriate communicative responses and/or behave in a socially inappropriate way which can have negative consequences for the young person (n = 16) | 2.00 |
Staff find it hard to communicate with the young person which impacts on the overall management of the young person (n = 18) | 3.00 |
The young person finds it difficult to express/regulate their emotions in respect to leaving care which may impede communication (n = 19) | 3.00 |
The young person finds it difficult to access and understand information about the service offered (n = 17). | 3.00 |
The young person finds it difficult to engage in verbally mediated interventions offered to support him/her (n = 18) | 4.00 |
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Share and Cite
Clegg, J.; Crawford, E.; Spencer, S.; Matthews, D. Developmental Language Disorder (DLD) in Young People Leaving Care in England: A Study Profiling the Language, Literacy and Communication Abilities of Young People Transitioning from Care to Independence. Int. J. Environ. Res. Public Health 2021, 18, 4107. https://doi.org/10.3390/ijerph18084107
Clegg J, Crawford E, Spencer S, Matthews D. Developmental Language Disorder (DLD) in Young People Leaving Care in England: A Study Profiling the Language, Literacy and Communication Abilities of Young People Transitioning from Care to Independence. International Journal of Environmental Research and Public Health. 2021; 18(8):4107. https://doi.org/10.3390/ijerph18084107
Chicago/Turabian StyleClegg, Judy, Ellen Crawford, Sarah Spencer, and Danielle Matthews. 2021. "Developmental Language Disorder (DLD) in Young People Leaving Care in England: A Study Profiling the Language, Literacy and Communication Abilities of Young People Transitioning from Care to Independence" International Journal of Environmental Research and Public Health 18, no. 8: 4107. https://doi.org/10.3390/ijerph18084107