Abstract
Language disorder is associated with anxiety and with social problems in childhood and adolescence. However, the relation between language disorder and adult social anxiety is not well known. This study examines social anxiety in early adulthood in a 26-year prospective longitudinal study following individuals identified with a communication disorder at age 5 and a control group. Social anxiety diagnoses and subthreshold symptoms were examined at ages 19, 25, and 31 using a structured diagnostic interview; social anxiety symptoms related to social interaction and social performance were also assessed dimensionally at age 31. Multiple imputation was used to address attrition. Compared to controls, participants with childhood language disorder had higher rates of subthreshold social phobia at ages 19 and 25 and endorsed higher levels of social interaction anxiety symptoms at age 31, with particular difficulty talking to others and asserting their perspectives. Childhood language disorder is a specific risk factor for a circumscribed set of social anxiety symptoms in adulthood, which are likely associated with communication challenges.
Similar content being viewed by others
References
American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd ed.). Washington: American Psychiatric Association.
Bao, L., Brownlie, E. B., & Beitchman, J. H. (2015). Mental health trajectories from adolescence to adulthood: Language disorder and other childhood and adolescent risk factors. Development and Psychopathology (in press).
Beidel, D. C., Turner, S. M., & Morris, T. L. (1999). Psychopathology of childhood social phobia. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 643–650.
Beitchman, J. H., & Brownlie, E. (2014). Language disorders in children and adolescents. Boston, MA: Hogrefe Publishing.
Beitchman, J. H., Nair, R., Clegg, M., & Patel, P. G. (1986). Prevalence of speech and language disorders in 5-year-old kindergarten children in the Ottawa-carleton region. Journal of Speech and Hearing Disorders, 51, 98–110.
Beitchman, J. H., Peterson, M., & Clegg, M. (1988). Speech and language impairment and psychiatric disorder: the relevance of family demographic variables. Child Psychiatry and Human Development, 18, 191–207.
Beitchman, J. H., Brownlie, E. B., Inglis, A., Wild, J., Ferguson, B., Schachter, D., & Matthews, R. (1996). Seven-year follow-up of speech/language impaired and control children: psychiatric outcome. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 37, 961–970.
Beitchman, J. H., Wilson, B., Johnson, C. J., Atkinson, L., Young, A., Adlaf, E., & Douglas, L. (2001). Fourteen-year follow-up of speech/language-impaired and control children: psychiatric outcome. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 75–82.
Beitchman, J. H., Brownlie, E. B., & Bao, L. (2014). Age 31 mental health outcomes of childhood language and speech disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 53, 1102.e8–1110.e8.
Blishen, B. R., Carroll, W. K., & Moore, C. (1987). The 1981 socioeconomic index for occupations in Canada. Canadian Review of Sociology/Revue Canadienne De Sociologie, 24, 465–488.
Botting, N., & Conti-Ramsden, G. (2008). The role of language, social cognition, and social skill in the functional social outcomes of young adolescents with and without a history of SLI. British Journal of Developmental Psychology, 26, 281–300.
Brinton, B., Fujiki, M., & McKee, L. (1998). Negotiation skills of children with specific language impairment. Journal of Speech Language and Hearing Research, 41, 927–940.
Brown, E. J., Turovsky, J., Heimberg, R. G., Juster, H. R., Brown, T. A., & Barlow, D. H. (1997). Validation of the social interaction anxiety scale and the social phobia scale across the anxiety disorders. Psychological Assessment, 9, 21–27.
Carpenter, J. R., Kenward, M. G., & White, I. R. (2007). Sensitivity analysis after multiple imputation under missing at random: a weighting approach. Statistical Methods in Medical Research, 16, 259–275.
Clark, D. M., & Wells, A. (1995). A cognitive model of social phobia. In R. B. Heimberg (Ed.), Social phobia: Diagnosis, assessment and treatment (pp. 69–93). New York: The Guildford Press.
Clegg, J., Hollis, C., Mawhood, L., & Rutter, M. (2005). Developmental language disorders – a follow‐up in later adult life: cognitive, language and psychosocial outcomes. Journal of Child Psychology and Psychiatry, 46, 128–149.
Cohen, N. J., Menna, R., Vallance, D. D., Barwick, M. A., Im, N., & Horodezky, N. B. (1998). Language, social cognitive processing, and behavioral characteristics of psychiatrically disturbed children with previously identified and unsuspected language impairments. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 39, 853–864.
Conti-Ramsden, G., & Botting, N. (2004). Social difficulties and victimization in children with SLI at 11 years of age. Journal of Speech Language and Hearing Research, 47, 145–161.
Conti-Ramsden, G., & Botting, N. (2008). Emotional health in adolescents with and without a history of specific language impairment (SLI). Journal of Child Psychology and Psychiatry, 49, 516–525.
Crome, E., Baillie, A., Slade, T., & Ruscio, A. M. (2010). Social phobia: further evidence of dimensional structure. Australian and New Zealand Journal of Psychiatry, 44, 1012–1020.
DeThorne, L. S., & Watkins, R. V. (2001). Listeners’ perceptions of language use in children. Language, Speech, and Hearing Services in Schools, 32, 142–148.
Dunn, L. M., & Dunn, L. M. (1981). Peabody picture vocabulary test – revised. Circle Pines: American Guidance Service.
Durkin, K., & Conti-Ramsden, G. (2007). Language, social behavior, and the quality of friendships in adolescents with and without a history of specific language impairment. Child Development, 78, 1441–1457.
Endicott, J., Spitzer, R. L., Fleiss, J. L., & Cohen, J. (1976). The global assessment scale: a procedure for measuring overall severity of psychiatric disturbance. Archives of General Psychiatry, 33, 766–771.
Fehm, L., Beesdo, K., Jacobi, F., & Fiedler, A. (2008). Social anxiety disorder above and below the diagnostic threshold: prevalence, comorbidity and impairment in the general population. Social Psychiatry and Psychiatric Epidemiology, 43, 257–265.
Fryers, T., Melzer, D., & Jenkins, R. (2003). Social inequalities and the common mental disorders: a systematic review of the evidence. Social Psychiatry and Psychiatric Epidemiology, 38, 229–237.
Goldman, R., Fristoe, M., & Woodcock, R. W. (1974). Goldman-Fristoe-Woodcock auditory memory tests. Circle Pines: American Guidance Service Inc.
Graham, J. W. (2009). Missing data analysis: making it work in the real world. Annual Review of Psychology, 60, 549–576.
Guralnick, M. J., Connor, R. T., Hammond, M. A., Gottman, J. M., & Kinnish, K. (1996). The peer relations of preschool children with communication disorders. Child Development, 67, 471–489.
Hadley, P. A., & Rice, M. L. (1991). Conversational responsiveness of speech- and language-impaired preschoolers. Journal of Speech and Hearing Research, 34, 1308–1317.
Hart, K. I., Fujiki, M., Brinton, B., & Hart, C. H. (2004). The relationship between social behavior and severity of language impairment. Journal of Speech Language and Hearing Research, 47, 647–662.
Héraud-Bousquet, V., Larsen, C., Carpenter, J., Desenclos, J., & Le Strat, Y. (2012). Practical considerations for sensitivity analysis after multiple imputation applied to epidemiological studies with incomplete data. BMC Medical Research Methodology, 12, 73.
Hoff, E. (2006). How social contexts support and shape language development. Developmental Review, 26, 55–88.
Hollo, A., Wehby, J. H., & Oliver, R. M. (2014). Unidentified language deficits in children with emotional and behavioral disorders: a meta-analysis. Exceptional Children, 80(2), 169–186.
Iverach, L., & Rapee, R. M. (2014). Social anxiety disorder and stuttering: current status and future directions. Journal of Fluency Disorders, 40, 69–82.
Iza, M., Wall, M. M., Heimberg, R. G., Rodebaugh, T. L., Schneier, F. R., Liu, S., & Blanco, C. (2014). Latent structure of social fears and social anxiety disorders. Psychological Medicine, 44, 361–370.
Johnson, C. J., Beitchman, J. H., Young, A., Escobar, M., Atkinson, L., Wilson, B., & Wang, M. (1999). Fourteen-year follow-up of children with and without speech/language impairments: speech/language stability and outcomes. Journal of Speech Language and Hearing Research, 42, 744–760.
Johnson, C. J., Beitchman, J. H., & Brownlie, E. B. (2010). Twenty-year follow-up of children with and without speech-language impairments: family, educational, occupational, and quality of life outcomes. American Journal of Speech-Language Pathology / American Speech-Language-Hearing Association, 19, 51–65.
Kessler, R. C., Wittchen, H., Abelson, J. M., Mcgonagle, K., Schwarz, N., Kendler, K. S., & Zhao, S. (1998). Methodological studies of the composite international diagnostic interview (CIDI) in the US national comorbidity survey (NCS). International Journal of Methods in Psychiatric Research, 7, 33–55.
Kristensen, H., & Torgersen, S. (2008). Is social anxiety disorder in childhood associated with developmental deficit/delay? European Child & Adolescent Psychiatry, 17(2), 99–107.
Liiva, C. A., & Cleave, P. L. (2005). Roles of initiation and responsiveness in access and participation for children with specific language impairment. Journal of Speech Language and Hearing Research, 48, 868–883.
Lindsay, G. L., Dockrell, J. E., & Mackie, C. (2008). Vulnerability to bullying in children with a history of specific speech and language difficulties. European Journal of Special Needs Education, 23, 1–16.
Lindsay, G. L., Dockrell, J. E., & Palikara, O. (2010). Self-esteem of adolescents with specific language impairment as they move from compulsory education. International Journal of Language & Communication Disorders, 45, 561–571.
Maggio, V., Grañana, N. E., Richaudeau, A., Torres, S., Giannotti, A., & Suburo, A. M. (2014). Behavior problems in children with specific language impairment. Journal of Child Neurology, 29, 194–202.
Marton, K., Abramoff, B., & Rosenzweig, S. (2005). Social cognition and language in children with specific language impairment (SLI). Journal of Communication Disorders, 38, 143–162.
Mattick, R. P., & Clarke, J. C. (1998). Development and validation of measures of social phobia scrutiny fear and social interaction anxiety. Behaviour Research and Therapy, 36, 455–470.
Merikangas, K. R., Avenevoli, S., Acharyya, S., Zhang, H., & Angst, J. (2002). The spectrum of social phobia in the zurich cohort study of young adults. Biological Psychiatry, 51, 81–91.
Mok, P. L. H., Pickles, A., Durkin, K., & Conti‐Ramsden, G. (2014). Longitudinal trajectories of peer relations in children with specific language impairment. Journal of Child Psychology and Psychiatry, 55, 516–527.
Montgomery, J. W., Magimairaj, B. M., & Finney, M. C. (2010). Working memory and specific language impairment: an update on the relation and perspectives on assessment and treatment. American Journal of Speech-Language Pathology / American Speech-Language-Hearing Association, 19, 78–94.
Newcomer, P. L., & Hammill, D. D. (1977). The test of language development (TOLD). Austin: Empiric Press.
Ollendick, T. H., & Ishikawa, S.-i. (2013). Interpersonal and social factors in the treatment of child and adolescent anxiety disorders. In C. A. Essau & T. H. Ollendick (Eds.), The Wiley-Blackwell handbook of the treatment of childhood and adolescent anxiety. Chichester: Wiley.
Rapee, R. M., & Spence, S. H. (2004). The etiology of social phobia: empirical evidence and an initial model. Clinical Psychology Review, 24, 737–767.
Redmond, S. M. (2011). Peer victimization among students with specific language impairment, attention-deficit/hyperactivity disorder, and typical development. Language, Speech, and Hearing Services in Schools, 42, 520–535.
Redmond, S. M., & Rice, M. L. (1998). The socioemotional behaviors of children with SLI: social adaptation or social deviance? Journal of Speech Language and Hearing Research, 41, 688–700.
Rice, M. L., Hadley, P. A., & Alexander, A. L. (1993). Social biases toward children with speech and language impairments: a correlative causal model of language limitations. Applied PsychoLinguistics, 14, 445–471.
Ruscio, A. M. (2010). The latent structure of social anxiety disorder: consequences of shifting to a dimensional diagnosis. Journal of Abnormal Psychology, 119, 662–671.
Schoon, I., Parsons, S., Rush, R., & Law, J. (2010). Children’s language ability and psychosocial development: a 29-year follow-up study. Pediatrics, 126, e73–e80.
Sentenac, M., Arnaud, C., Gavin, A., Molcho, M., Gabhainn, S. N., & Godeau, E. (2012). Peer victimization among school-aged children with chronic conditions. Epidemiologic Reviews, 34, 120–128.
Simkin, Z., & Conti-Ramsden, G. (2009). ‘I went to a language unit’: adolescents’ views on specialist educational provision and their language difficulties. Child Language Teaching and Therapy, 25, 103–122.
Snowling, M. J., Bishop, D. V. M., Stothard, S. E., Chipchase, B., & Kaplan, C. (2006). Psychosocial outcomes at 15 years of children with a preschool history of speech‐language impairment. Journal of Child Psychology and Psychiatry, 47, 759–765.
Spence, S. H., Donovan, C., & Brechman-Toussaint, M. (1999). Social skills, social outcomes, and cognitive features of childhood social phobia. Journal of Abnormal Psychology, 108, 211–221.
Stothard, S. E., Snowling, M. J., Bishop, D. V. M., Chipchase, B. C., & Kaplan, C. A. (1998). Language-imparied preschoolers: a follow-up into adolescence. Journal of Speech Language and Hearing Research, 41, 407–418.
Vallance, D. D., Im, N., & Cohen, N. J. (1999). Discourse deficits associated with psychiatric disorders and with language impairments in children. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 40, 693–704.
Voci, S. C., Beitchman, J. H., Brownlie, E. B., & Wilson, B. (2006). Social anxiety in late adolescence: the importance of early childhood language impairment. Journal of Anxiety Disorders, 20, 915–930.
Wadman, R., Botting, N., Durkin, K., & Conti-Ramsden, G. (2011a). Changes in emotional health symptoms in adolescents with specific language impairment. International Journal of Language & Communication Disorders, 46, 641–656.
Wadman, R., Durkin, K., & Conti-Ramsden, G. (2011b). Social stress in young people with specific language impairment. Journal of Adolescence, 34, 421–431.
Wechsler, D. (1967). Manual for the Wechsler preschool and primary scale of intelligence. New York: The Psychological Corporation.
Whitehouse, A. J. O., Watt, H. J., Line, E. A., & Bishop, D. V. M. (2009). Adult psychosocial outcomes of children with specific language impairment, pragmatic language impairment and autism. International Journal of Language & Communication Disorders, 44, 511–528.
Young, A. R., Beitchman, J. H., Johnson, C., Douglas, L., Atkinson, L., Escobar, M., & Wilson, B. (2002). Young adult academic outcomes in a longitudinal sample of early identified language impaired and control children. Journal of Child Psychology and Psychiatry, 43, 635–645.
Acknowledgments
This research was funded by Health Canada (6606-5639-102) and the Canadian Institutes for Health Research (MOP 49512 and MOP 84421). We thank Brenda Cavanagh and Shelly-Anne Li, Centre for Addiction and Mental Health, for their assistance with interviewing and coding, and the participants and families whose ongoing involvement made this research possible.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
The authors declare that they have no conflict of interest.
Electronic supplementary material
Below is the link to the electronic supplementary material.
ESM 1
(DOCX 46 kb)
Rights and permissions
About this article
Cite this article
Brownlie, E.B., Bao, L. & Beitchman, J. Childhood Language Disorder and Social Anxiety in Early Adulthood. J Abnorm Child Psychol 44, 1061–1070 (2016). https://doi.org/10.1007/s10802-015-0097-5
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10802-015-0097-5