Mental health needs of young people with language disorder are being neglected, researchers say

There is an urgent need to address inequality in health services, especially mental health provision, for young people with developmental language disorder (DLD), according to a team led by UCL researchers.

DLD is a lifelong condition that affects around 7.5% of children in the U.K. It causes difficulties with talking and understanding what other people say—which can create barriers to communication.

Difficulties with speaking might manifest as delayed early language milestones, saying less overall, and use of simple sentences with reduced vocabulary. Problems with understanding may look like not paying attention or not following instructions because the child can't figure out or remember what they are being asked to do.

In a new Comment article for The Lancet Child & Adolescent Health, researchers highlight the mental health problems experienced by children and young people with the condition, and explain that children identified as having DLD are around twice as likely to experience poor mental health by adolescence compared with their peers.

Meanwhile, a very high proportion (between 40% and 66%) of young people referred to CAMHS have language difficulties.

The team, led by Professor Courtenay Norbury (UCL Psychology & Language Sciences), said, "Many young people with DLD experience increasing anxiety as they approach adolescence, due to the increasing language demands of the school curriculum and peer relationships.

"They describe the constant struggle associated with trying to keep up with lessons and conversation, often try to mask their difficulties by nodding and agreeing even when they don't understand, or withdraw from social situations in which they might be exposed, including school."

There is a need for a more joined up approach to care.

The researchers argue that speech-language therapists are unable to address the mental health needs of their clients, due to professional boundaries. Meanwhile, many clinical psychologists feel ill-equipped to deal with the language needs of their patients.

As a result, the team have made several recommendations, including:

• Raising awareness of DLD among all health-care professionals so they can refer children who are not developing as expected for further evaluation by speech-language therapists.
• Language interventions that target language skills that specifically support social and emotional understanding.
• Language interventions that include support and guidance for conversation partners and significant others.
• Adaptations to existing mental health interventions, such as cognitive behavioral therapy, to make them more accessible to young people with DLD.

Professor Norbury writes, "There is an urgent need to address inequality in access to health services, especially mental health provision for young people with DLD.

"To overcome this gap, we must increase awareness of DLD, develop and test novel interventions, and amplify the voices of affected young people through international interventions."

Royal College of Speech and Language Therapists' Head of Research and Outcomes Amit Kulkarni said, "Given the prevalence of Developmental Language Disorder (DLD) and its potential impact on mental health, I'm delighted to see this important research. It highlights the scale and impact of DLD, prompts reflection on traditional talking therapies, and provides practical suggestions for improving multi-disciplinary working to ensure children and young people can access the best support possible."