Is There a Relationship between Language Delays and Behavior and Socialization Problems in Toddlers

Abstract

Introduction There is a large literature indicating that language delay is associated with academic and behavior/emotional problems at school age (e.g., Beitchman, Wilson, Brownlie, Walters, & Lancee, 1996; Benasich, Curtiss, & Tallal, 1993; Cohen, Barwick, Horodezky, Vallance, & Im, 1998; Redmond & Rice, 1998; Rescorla & Schwartz, 1990; Scarborough, 2001; Silva, Williams, & McGee, 1987; Stevenson, Richman & Graham, 1985; Tomblin, Zhang, & Buckwalter, 2000). These problems include reading disorders, attention-deficit hyperactivity disorders, poor socialization skills, and psychiatric problems (Baker & Cantwell, 1987; Beitchman et al., 2001; Cohen et al., 1998; Redmond & Rice, 1998; Tomblin et al., 2000). A significant relationship also has been noted between language delay and concurrent behavior problems and socialization difficulties in preschool aged children (between 3 and 5 years old). Generally, studies with preschool children have reported a positive relationship between language delay and behavior problems, such as social withdrawal, inattention, negativity and psychiatric disorders (e.g., Carson, Klee, Perry, Muskina, & Donaghy, 1998; Caulfield, Fischel, DeBaryshe, & Whitehurst, 1989; Cross, 1998; Stevenson & Richman, 1978; Tallal, Dukette, & Curtiss, 1989). With the establishment of Early Intervention Programs to evaluate children who are suspected of having developmental delays, there has been increasing interest in whether the relationships between language delays and behavior problems that are reported in older children can be found even in toddlers (children between 18 months and 3-years-old). Some studies have documented such a relationship, although others have not. Irwin, Carter, and Briggs-Gowan (2002) found that 14 children with expressive language delays were significantly more likely to be rated as socially withdrawn and to have difficulties in social relatedness on social/emotional rating scales than 14 children with normal language development. However, a review of that study suggested that children with Pervasive Developmental Disorder (PDD), a disorder defined by both language deficits and impaired socialization skills, may have been included in the sample. Inclusion of children with PDD, therefore, could have accounted for the difference between children with language delays and those with normal language skills (Fitzgerald, 2003). Studying thirty-four 2-year-olds with delayed expressive language, Caulfield et al. (1989) found that their mothers reported the children to be more fearful or shy in new situations. Furthermore, in a play situation, the children showed higher levels of negative behaviors (e.g., crying, hitting, throwing) and non-involved behaviors (e.g., quietly standing or sitting) than normal controls. Carson et al. (1998) found that 2-year-olds with language delays were significantly more likely to have higher Total Problems scores on the Child Behavior Checklist (CBCL; Achenbach & Rescorla, 2000), but those scores were attributed to sleep problems and behaviors, rather than to withdrawal, shyness, inattentiveness, or other behavioral syndromes that are most often associated with language delays in older groups. In another study of twenty-one 24-34 month olds, Paul, Spangle- Looney, and Dahm (1991) showed a positive relationship between late talking (10 or fewer words at