Developmental Language Disorder: A secondary analysis investigating risk and resilience for mental health difficulties

Fradley, Kathryn (2020) Developmental Language Disorder: A secondary analysis investigating risk and resilience for mental health difficulties. Doctoral thesis (PhD), Manchester Metropolitan University.

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Abstract

Young people diagnosed with Developmental Language Disorder (DLD) are more likely to experience worse mental health difficulties (i.e. poorer internalising and externalising problems), compared to their typically developing peers. DLD is diagnosed when an individual experiences severe and persisting language difficulties with no known biomedical cause. Mental health difficulties broadly refer to when an individual may not be adequately functioning (socially, emotionally, or behaviourally) in their everyday life. Nonetheless, some young people diagnosed with DLD do demonstrate resilience and can overcome the negative effects of risk exposure. The current project aimed to provide a deeper insight into risk factors for mental health difficulties, as well as to identify any possible factors that promote resilience for mental health difficulties, in young people diagnosed with DLD. To achieve the project aims, secondary analysis of the data collected by the Millennium Cohort Study was performed. A longitudinal approach was adopted to detect changes to the development of mental health difficulties, in those selected as at risk of DLD (rDLD). In relation to the inclusion criteria, scores on the Naming Vocabulary subtest was used to select through rDLD. Also, mental health difficulties were indicated by scores on the parentreported Strengths and Difficulties Questionnaire when the young person was fourteen years old. The first investigation revealed that young people rDLD were more likely to experience worse mental health difficulties at age fourteen, compared to their typically developing peers. The second investigation identified early risk factors (up to age five) for general mental health difficulties, internalising problems, and externalising problems at age fourteen, within young people rDLD. Internalising problems are broadly described as mental health difficulties that are expressed internally; and externalising problems are expressed externally. Early risk factors for general mental health difficulties, included high levels of parent-child conflict and harsh discipline practices. For internalising problems, the early risk factors were high levels of parent-child conflict and being female, and for externalising problems, high levels of iv parent-child conflict, harsh discipline practice, and exposure to second-hand smoke. The third investigation revealed that the identified early risk factors operated in a cumulative fashion, within young people rDLD. This means that as the number of exposed risks (up to age five) increased, there was a greater severity of general mental health difficulties, internalising problems, and externalising problems at age fourteen. The final investigation identified school-age factors (between seven and fourteen years) that encourage resilience for general mental health difficulties, internalising problems, and externalising problems, at age fourteen. High levels of prosocial behaviour, better problem-solving ability, and fewer sleep disruptions significantly predicted less severe general mental health difficulties at age fourteen. These factors also predicted less severe externalising problems at age fourteen. Finally, high prosocial behaviour predicted less severe internalising problems, at age fourteen. These factors increase the likelihood of resilience for mental health difficulties through compensating for early risk exposure. The findings drawn from the present project were discussed in relation to the Ecological and Developmental Perspective for understanding risk and resilience for mental health difficulties. Therefore, the project provides a unique contribution to our current understanding of this dynamic process in young people diagnosed with DLD.