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Language impairment is consistently associated with poor academic performance in childhood and adolescence. Clinically-referred language-impaired children and youth have, on average, poorer academic performance than children in the general population;17,18,19 these results have been corroborated by prospective epidemiological studies.20,21,22,23 Children with language impairments at age five were about eight times more likely to have learning disabilities at age 19 than children without language impairments.21 Recent research indicates that children with language impairment differ from typical language children in cognitive development and information processing, including short-term memory and auditory processing.24,25,26

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children with language impairment may experience …

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Studies have produced compelling evidence that the child and adolescent psychosocial outcomes of language impairment are disproportionately problematic; some disadvantages persist into adulthood. These outcomes include continued disadvantage in speech and language competence, intellectual functioning, and educational adjustment and achievement, psychosocial difficulties, and increased probability of psychiatric disorder. Key insights from the studies highlighted in this fact sheet imply a need for early identification of language problems and effective intervention addressing language problems and related cognitive, academic, behavioural and psychosocial concerns, and prevention of victimization in this population. Support for children and adolescents who have language impairment is particularly important in the school context.

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Language is central to social life; speech and language development is a cornerstone for successful outcomes later in life. Speech and language competency does not progress normally for a sizeable number of children, however, and research shows that these children are at greater risk for later psychosocial problems than children who do not have speech or language impairments.

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At the same time, increases in well-being from age 19 to age 25, despite continuing language deficits, suggests that differences in social contexts may play an important role in the psychosocial difficulties of language impaired youth. In particular, the demands of school environments may constitute stressors that exacerbate the problems of youth with language impairments. For example, children with language impairment may experience bullying in school,14 and many youth with language impairment report fear of speaking in front of others.35 Unlike youth completing compulsory education, adults with language impairment are able to select vocations consistent with their strengths that rely less on verbal skills.16,31 These results suggest the need for strong support systems for language- impaired youth in school and attention to all aspects of their school environments. Gender also needs to be taken into account in interventions for youth with language impairment. In particular, prevention of victimization needs to be incorporated into work with language-impaired youth, particularly girls. Children with a history of speech and language impairments are more likely to have multiple problems than their non-impaired counterparts, and as such may benefit most from early intervention. This demonstrates the urgency of early identification of language impairments and the development and maintenance of proven treatment programs that address the multiplicity of adversity facing these at-risk children, while supporting their resilience and adaptation.

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Some of the key questions posed by the OLS have been: Do language impairments persist? Are language impairments associated with behavioural problems in childhood, adolescence or adulthood? Do language impairments predict academic achievement, educational attainment or vocational outcomes? Are childhood language impairments associated with greater frequency of psychiatric disorders across the lifespan? Are psychosocial outcomes of language impairment different for girls versus boys?

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Research on the outcomes of speech and language impairments is incomplete. First, many studies reporting long-term outcomes of speech and language impairments have used clinic-referred rather than community-based samples. These studies do not represent the spectrum of speech and language impairments. Individuals referred for treatment tend to be more severely impaired and/or have more noticeable impairments than those who are not referred. They are also more likely to have associated problems, especially behaviour problems, that attract attention and motivate referral,27 while those with more subtle problems, often girls, may be overlooked.27,28 Second, most studies of adult outcomes of childhood speech/language impairment are retrospective, and have had difficulty securing objective data on language history. Third, very few studies of non-referred samples have published outcomes beyond adolescence, into adulthood. Fourth, some studies on the adult outcomes of language-impaired samples have not employed matched control groups, severely limiting inferences that can be made. Fifth, available studies seldom include measurement of outcomes across multiple domains of functioning. This is a crucial shortcoming because problems in other domains of psychosocial function may persist even if speech and language difficulties resolve. Broad assessments can also identify areas of strength, and similarities between language-impaired and typical language individuals. Finally, greater attention to social contexts in relation to outcomes of speech/language impairment is needed.28,29 For instance, few studies have directly addressed gender in relation to the outcomes of language impairments; most that have done so focus on young children.15,30