The link between Social Emotional and Behavioural Difficulties
There is a continuous interest in the emerging body of literature to investigating the link between social, emotional and behaviour difficulties (SEBD) and speech, language and communication difficulties (SLCN).
SEBD in children with SLCN is determined as a concern area of enquiry in recent years. The literature covers ‘Education’, ‘Health’ and ‘Social Disadvantage’ as its three major perspectives. This essay centers on primary school children with SEBD and SLCN, from an education perspective and it covers certain facts, co morbidities, and the causes from the literature in understanding the link between SEBD and SLCN. Finally, it highlights the need for further study (on this topic) by diverse professionals.
The word ‘Social’ has been introduced to Emotional, Behavioural difficulties (EBD) in the year 1998. Nevertheless, children experiencing SEBD are considered with Special Educational Needs (SEN) by the ‘Code of Practice, (2001)’.
Social, Emotional and Behavioural Difficulties (SEBD): refers to the three potential areas of developmental difficulty of a child: to understand, express, engage and acknowledge in a given context.
Speech Language and Communication Needs (SLCN): refer mainly to ‘Expressive’ (use of words and sentences, vocabulary and grammar broadly), ‘Receptive’ (understanding the language and processing the information) and ‘Pragmatic’ ( usage of language in a social context) language difficulties.
Population study of children with SEBD and Communication Difficulties
Nearly 71% of the children with SEBD are identified of having communication difficulties (Benner et al 2002). These studies were based on 26 papers on the link between SEBD and communication difficulties. In one of their studies, the overall mean of prevalence rate was found to be 63% in children with speech problems previously diagnosed in speech clinics and 46 % in children served in a variety of settings in general population.
The research indicates the current estimation of prevalence in children with communication difficulties in England and Wales is nearly 10% and also children with SEBD are inclined towards having communication difficulties (Law et al 2000). Children with receptive language impairments are at greater risk for developing SEBD (Beitchman et al., 1996).
Approximately 3% of school children are having severe form of Attention Deficit Hyperacctive Disorder (ADHD) and are at high risk of anti-social behaviour as well as poor conduct. At least 10% of school age children are affected by motor or vocal tics, or a combination of both. Recent population studies estimate that at least 1% of general population of school age children are affected by a clinically handicapping ‘Tourett’s syndrome’. Obsessive Compulsive Disorder affects (1%) of school age children. They display obsessions and compulsions, which are considered as a ‘neuropsychiatric disorder’ states Gillberg (2005).
The study from the literature strongly indicates that the language impairment and social, emotional and behavioural difficulties are interlinked. (Cross, 2004).
Co- morbidity of language impairment and SEBD
Studies show that children with SEBD have been studied for the co-occurrence of language difficulties where Benner (2002) finds 71% of the children being experiencing language difficulties significantly and other authors argue if it is due to a core neurological deficit.
Botting and Conti-Ramsden (2000), has identified 40% of children with combined expressive and receptive language problems are most likely to experience behavioural problems and antisocial problems. Also Ripley and Yuill (2005) reported that expressive difficulties were linked to high level of emotional symptoms and tend to increase with the age of the child.
Psychiatric Comorbidity: It is noticed that 42% of children who had speech or language difficulties at the age 5 had psychiatric disorder when diagnosed (Beitchman et al 1996).
30% of seven to eight year olds were determined as having difficulties of specific language impairments, on the total scale of the teacher completed ‘Strengths and Difficulties Questionnaire’ from both the special and mainstream schools (Lindsay and Dockrell, 2000).
The ascertained percentage of children referring child psychiatric services for behavioural and emotional problems having unsuspected language impairment is 33% (Cohen et al, 1993). The prevalence from other studies also suggests that learning difficulties can account for high percentage of language problems in children with SEBD (Cross 2004).
‘Estimation of concomitant prevalence of language deficits in children who exhibit anti-social behaviour is 10 times that of the general population’ (Donahue et al, 1994), also the strengths of relationship between language disorders and anti-social behaviour may increase throughout the life (Cantwell 1991).Henceforth, it is an established fact that a child with language difficulties is bound to have emotional and behavioural difficulties which further on have a tendency to rise.
Children identified with SLCN may encounter and experience problems such as usage of vocabulary, understanding and recalling information, processing information, maintaining attention, following instructions by listening, taking part actively in various activities or joining in group discussions, relating to peers , memorizing specific vocabulary (SENCo Newsletter, 2010).
Children with SEBD are more likely to be disruptive and disturbing, (they could be hyperactive, lack concentration, poor or immature social skills or personality disorders and quite a few exhibit challenging behaviours, mainly due to other complex special needs). This could be temporary or permanent which can become as a barrier towards their ability to learn as they experience restlessness, social withdrawal, poor attention and isolation according to Teacher Training Agency’s National SEN Specialist Standards in 1999.
Also these children are subjected towards low levels of self esteem, they lack in
Regulating their emotions ‘emotion regulation is a form of mental – control’ states Parrot (2001).
Developing social cognition which can lead on to failure in learning at school, as a result of emotional damage (Saarni, 1999).
The fact is neither are they very different from their peers, nor do they fall particularly under a homogenous group; rather they can be considered on a continuum.
In general, the disorders are based on DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Association, 1994). These disorders can be broadly divided as behavioural, emotional and developmental disorders. Other disorders include Developmental Disorders (like Autism seen as a Pervasive Developmental Disorder) and Reactive Attachment Disorder, Schizophrenia, eating disorder and Post-traumatic Stress Disorder (Cross 2004).
Heneker, (2005) postulates an interesting way when making a distinction of these disorders. First, the less-obvious disorders such as anxiety, school phobia, prolonged stress (due to various reasons such as transitions, communication difficulties, depression). Secondly, the well-known disorders such as, conduct disorders, hyperkinetic disorders. However, it is also possible that these disorders cover a wide range of abilities, including SLCN and some of the learning difficulties.
Some of the causes and risk factors: Earlier, children experiencing difficulties with social interactions, bad conduct disorders, children exhibiting high levels of frustrations due to peer- rejections/maladjusted, aggressive behaviour or inappropriate behaviour in adjusting to school environment were regarded as ‘abnormal’ and ‘immature’ social cognition (Happe and Frith 1996).
‘It is not what we think or feel but what we do that makes us maladjusted….continued severity anxiety may get the better of people and induce them to take desperate ill-considered action which is against their interest but it is the action and not the anxiety which ranks as maladjusted.’ (Scott, 1982).
Fortin and Bigras (1994) claims that any of these below mentioned risk factors occur in isolation, addressing the complex interaction of the factors associated with SEBD. The main factors being - predisposing factor, child-based factors, contextual risk factors and also family-centered risk factors. They concluded that the accumulation of these factors increases the probability that a child may develop SEBD.
Within primary schools, there has been a growing emphasis on interventions that can enable to bring difference in children identified with SEBD and also SLCN, with the aim of promoting the child’s learning and development and level of school achievement.
By introducing the storytelling intervention program called ‘The Big Book of Storysharing’ by Peacey (2009), has demonstrated in bringing up a positive change while prioritizing on communication and sharing personal stories amongst primary school children from both mainstream and special schools. The purpose of this project is to develop social skills, language and communication skills.
It has promoted positive attitudes and narrative skills. Children from special school were able to use words or signs, gaze eye contact while speaking, joining in narration by listening and telling stories, whereas the children from mainstream perceived to be more confident and gained pleasure in narrating stories which shows the effectiveness of the project.
PALS – ‘a program to develop Social Skills for children’. It emphasis and aims towards building confidence in children and participate actively in social contexts. The main purpose of this program is to teach social skills such as listening, sharing, taking turns, dealing with feelings of fear, coping up with frustration, dealing with emotions effectively, etc. It is accepted by early childhood psychologists and NSW (New South Wales, Australia) that it reduces the problem behaviour and increases social skills significantly in children. It also indicates that children with internal behavioural difficulties (withdrawn, shyness, anxiousness, passivity) lack in communication skills which again has a significant effect in developing their social skills at schools and finally has an impact of low level of school achievement (Cooper, 2002).
Henker (2005) proposed an individualized intervention for the children at a pre referral unit (PRU) who are identified for a specific communication need to ameliorate their skills such as: vocabulary, social skills and speech, grammar. It has been noticed that children were able to show improvement in one or more area, where they were attending this speech and language therapy weekly or twice a week. Evaluating staff questionnaires suggests that improvement has been obtained by the children with communication needs.
Explanations of Intervention Programs:
Peacey (2009) conceives that this project can demonstrate well if a named person from each school takes in charge to mediate with other members of the staff to motivate and repeat or retell the stories for the children. The second factor is to assure the age group of children has to be well chosen. Also this project did not demonstrate to be an effective one in measuring children’s specific difference in their usage of language on the standardized assessments for the children who were at the early stage of language development and have showed only minor improvements as they were experiencing learning difficulties. However, it consists of certain drawbacks. When the children were assessed in the areas such as, attention, impulse control and flexibility; it fails to identify and explain the gain of attention at both mainstream as well as special schools and it could not control impulses of all the children. It is time consuming (for the preparation of the project towards discussing objectives with the members for their participation and affirmation).
Overall, the project has been identified for a positive outcome of making progress with the story telling skills where children enjoyed and valued their experiences and also it has established the concept of inclusion in both of the school cultures.
The graph of the success rate indicates that PALS effectiveness is more on the age group ranging preschool children when compared to primary school aged group of children. Cooper (2002), states that social skills interventions work less effective for primary school aged children and on the other hand it works more effectively for preschoolers.
Explanation from literature:
Today in United Kingdom the government is providing the opportunity to the primary school teachers in various ways to provide better services to the children. For example, a SENCO training enables a class room teacher in understanding the different areas of difficulties experiencing by a child can play a vital role with the support of specific frameworks. There are other professionals from the local authorities to liaise with in supporting children with special needs including children with social, emotional behavioural difficulties as well as speech, language and communication needs.
A large portion of children (with 50 % or more) are entering primary schools with low language levels and 5-7% of children from general population are identified with SLCN. Limited usage of language can oppose making relationships with peers at school and which can also lead to behavioural problems in the future (SENCo Newsletter, 2010).
Evaluations and limitations:
There are certain limitations to study the link between SEBD and SLCN. It is not always possible to identify language difficulties in children with other learning difficulties as research suggests that children with language difficulties may have underlying cognitive processing delays (Beitchman et al 1998; Torgeson, 1998). Instruments currently available for measuring underlying cognitive process are less technically adequate than instruments designed to assess language development or academic achievement (Beitchman, et al 1998).
Often a communication difficulty can be interpreted differently as a behavioural difficulty in some cases (for example, a child who is unable to convey a message to his friend while playing can behave in a noncompliant and aggressive way). In contrast a behavioural difficulty can be interpreted differently when the other person is aware of the communication difficulty or need of that particular child.
Language difficulties lead on to substantially high risk of anti-social behaviour. Receptive language difficulties not only go undetected but have adverse negative behaviour and have a profound affect on vital relationships throughout one’s life span. Benner (2000). These children tend to face a significant or high risk in attaining school achievement.
On the other hand, most of the parents are unwilling to accept the fact that they are in need of help with regards to their children’s behavioural problems and look for help when they find and realize the situation, at a high risk. It is true that the response towards intervention programs is less when the behavioural problems are at an advanced stage. Parow (2009).
Previous reviews of literature examined that relation between on wide range of antisocial behaviour and communication difficulties but very little of previous study or reviews focused specifically on Language skills of children identified with emotional, behavioural difficulties. This suggest the need for investigation in understanding the link between SEBD and SLCN by diverse participants.
The Special Educational Needs (SEN) graph in England indicates the percentage level of children with SEBD inclines gradually with their age from primary school, whereas the SLCN tends to decline as the child grows. (Cross, 2009).
There are substantial amounts of documented associations between behavioural difficulties and language and a large ratio of children with BESD have an underlying language problem. Expressive language difficulties are very apparent, but other language impairments can be harder to detect; a receptive language difficulty could easily be missed as it most often gets considered as a learning difficulty.
Nevertheless the relationship is unclear in identifying the primary difficulty in decision - making clinically and it is not appropriate for the population of children where language difficulties are unidentified / unsuspected previously. The need to find how language structure emerges through varied time frames is crucial for the current researchers.
Therefore, the research indicates the need to encourage diverse participants for further research. In addition to public sectors of educational, health and social service or charity organizations rather include clinical psychologists, community developers, epidemiologists, medics, etc. should be involved.
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