Contribution of speech/language difficulties to health-related quality-of-life in Australian children: a longitudinal analysis

Abstract

Speech and/or language difficulties (SaLD) are among the most frequently observed developmental problems affecting children. Research points to the impact of childhood SaLD on literacy/educational achievement, behaviour and self-esteem; however, there has been limited attention paid to the impact of SaLD, directly or indirectly, on health-related qualityof-life (HRQoL). HRQoL is the impact a particular health condition (or intervention) has on an individual. HRQoL comprises numerous distinct dimensions ('domains', commonly physical, psychological and social). Very few studies have examined associations between HRQoL, SaLD, and other child and family factors and none have been undertaken in Australia. This research will explore these associations using data from a sample of children aged 4 to 9 years, extracted from the Longitudinal Study of Australian Children (LSAC), a nationally representative longitudinal study of childhood development. The rich data available in the LSAC afforded an opportunity to investigate various child and family factors that may be related to children's HRQoL and hence was well suited to exploratory research.Use of LSAC data also enabled tracking of children's outcomes over six years. The Disability-Stress-Coping (DSC) model (which examines physical health, mental health and social functioning in children with chronic illness) formed the basis for variable selection.This thesis comprises two studies, the first cross-sectional, and the second longitudinal. The cross-sectional study provided an exploration of the LSAC data and elicited variables which were appropriate for further analysis in the subsequent longitudinal investigation. Further, this study component enabled examination of relationships between HRQoL and SaLD while accounting for fine and gross motor skills which could not be examined in the longitudinal study component as there were no appropriate motor skills measures at Waves 4 and 5. The cross-sectional study involved analysis of data from the baby cohort (children aged 4-5 years) of the LSAC (n=4, 386). For this study, three domains of HRQoL were examined, assessed by the physical, emotional and social functioning subscales of the Pediatric Quality of Life Inventory (PedsQL TM ). SaLD was assessed in two ways: (1) parent concern about speech/language (Parents' Evaluation of Developmental Status) and (2) receptive vocabulary ability (adapted Peabody Picture Vocabulary Test-III).Multiple regression analyses were used to examine relationships at the cross-sectional level between HRQoL, SaLD, and various other explanatory variables including child specific factors (e.g., gender, ethnicity, temperament) and family characteristics (social-ecological considerations and psychosocial stressors).ii The longitudinal study examined the trajectory of HRQoL for children aged from 4 to 9 years and its relationship with SaLD. Generalised linear latent and mixed modelling (GLLAMM) was used to analyse data from Waves 3, 4 and 5 of the LSAC to understand HRQoL trajectories, asses...

Quality of life in children with developmental language disorder

“…More detailed analysis of complex risk factor models may provide a better understanding of impacts of social–emotional behaviour, family and environmental factors on the QoL of children with DLD over time (Feeney et al . ). For example, we recommend future studies examine modalities of DLD which are known to vary in response to intervention (e.g., expressive versus receptive) and a more comprehensive set of child, family and environmental factors, including how protective factors, such as family support, home learning environments, and good peer relationships modify impacts of DLD on QoL.…”

“…We know that child (e.g., gender, general health), family (e.g., maternal education and mental health), and environmental factors (e.g., socioeconomic status, parents' engagement in work) contribute to both language and social-emotional development (Bayer et al 2012, Reilly et al 2010) and children's QoL when parents have concerns regarding their child's speech and language development (Feeney et al 2017). Children also need adequate language skills to develop their social relationships, to engage with school learning, and to learn how to manage and self-regulate their behaviour , Conti-Ramsden et al 2013).…”

“…) and children's QoL when parents have concerns regarding their child's speech and language development (Feeney et al . ). Children also need adequate language skills to develop their social relationships, to engage with school learning, and to learn how to manage and self‐regulate their behaviour (Snowling et al .…”

Health‐related quality of life of children with low language from early childhood to adolescence: results from an Australian longitudinal population‐based study

“…Socioeconomic status was determined by the census-derived Socio-Economic Indexes for Areas (SEIFA) disadvantage score based on the family's home postcode (Australian Bureau of Statistics, 2009). These characteristics were specified a priori based on the literature (Feeney et al, 2017;van Agt et al, 2010;Vella et al, 2015) and used as confounders in both the multivariable linear regression and mixed effect models. As we were interested in the association of child HRQoL and LL regardless of aetiology, we did not intend to delineate the effects of LL from cognitive abilities or other comorbidities by including these factors as confounders.…”

Health-related quality of life in children with autism spectrum disorders and children with developmental language disorders

“…Recent studies have explored constructs such as well-being and HRQoL in children with DLD and ASD. Feeney, Desha Kahn, and Ziviani (2017) indicated that parental reports of concern about receptive language, for children aged 4–9, were negatively associated with HRQoL across all domains. They suggested that DLD is associated with reduced HRQoL, concluding that typically developing speech and language skills is a protective factor for HRQoL in children.…”