Recent research in child psychiatry has demonstrated a high prevalence of speech, language, and communication disorders in children referred to psychiatric and mental health settings for emotional and behavioral problems. Conversely, children referred to speech and language clinics for communication disorders have been found to have a high rate of diagnosable psychiatric disorders. Most of the emerging knowledge regarding relationships between communication disorders and psychiatric disorders has been presented in the child psychiatric literature. Speech-language pathologists and audiologists also need to be familiar with this information; an understanding of the complex interrelationship between communication disorders and emotional and behavioral disorders is important for diagnosis, assessment, and treatment. The purpose of this article is to review recent research and discuss clinical implications for professionals in speech-language pathology and audiology working with children and adolescents who have, or who are at risk for, developing emotional and behavioral disorders. Issues to be addressed include differential diagnosis, prevention, intervention, and the role of speech-language pathologists serving these children and adolescents.
Quantitative and qualitative procedures were used in this pilot study to develop and evaluate the effectiveness of a language and literacy instruction model for meeting the needs of children with impairments, delays, and differences in regular Head Start classrooms. Although the project addresses a variety of literacy domains, this article focuses on rhyming and letter naming. In the instruction model, children were exposed to motivating examples of rhyme and letter targets in different activity structures embedded across the curriculum. A crossover design compared two classrooms of children trained on letter and rhyme targets in a different order. Results of an analysis of variance revealed a significant Condition (rhyme first vs. letter first) x Task (rhyme generation vs. letter generation) x Time (Posttest 1 vs. Posttest 2) interaction. At the first posttest, children in the rhyme-first condition performed better than those in the letter-first condition on rhyme generation, whereas children in the letter first condition performed better on letter generation. At the second posttest, after the groups had experienced instruction in both areas, the children performed comparably on both tasks. In addition to the quantitative analyses, qualitative analyses were also conducted. A qualitative examination of children's participation revealed their affective involvement and engagement in instructional activities. Changes in the children's awareness of their capacity to rhyme and changes in their displayed abilities to participate in rhyming activities were also documented.
In a federally funded early literacy project, various instructional activities were embedded into an array of classroom contexts to provide supplemental literacy instruction and to contrast children's engagement and participation in different contexts and participant structures. The study was conducted with English- and Spanish-speaking children from four Head Start classrooms. In a crossover project design, children were trained on similar sets of rhyme and letter targets at different times. Three-way ANOVAs with rhyme and letter difference scores as the dependent variables revealed a significant time-of-test effect for rhyming and significant Time × Order × Set interactions for rhyme and letter generation. Children performed better on trained than untrained targets. Observations of children revealed growth in performance and spontaneity of rhyme skills in classroom contexts. Qualitative analyses documented high levels of engagement, illustrating the value of varying activities and contexts for instruction. Both groups demonstrated their ability to gain from concrete instruction and interactive participation.
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