Pragmatic Language Intervention for Children with Language and Emotional/behavioral Disorders

Article excerpt

Children diagnosed with emotional/behavioral disorders experience expressive and pragmatic language disorders that can negatively affect educational success. This article describes a classroom-based pragmatic language intervention program that was conducted with children diagnosed as having an emotional/ behavioral disorder. Results of the program suggested that the classroom-based pragmatic language intervention may have positively influenced the ability of the participants to employ pragmatic skills, such as providing sufficient and detailed information, stating opinions, and using verbal language to negotiate with others.


Over the past 20 years, considerable research has been completed suggesting that 50% to 80% of children with language disorders have co-occurring psychiatric or emotional/ behavioral disorders (E/BD; Audet & Hummel, 1990; Baker & Cantwell, 1987; Camarata, Hughes, & Ruhl, 1988; Cantwell & Mattison, 1979; Donahue, Cole, & Hartas, 1994a, 1994b; Gallagher, 1999; Mattison, Cantwell, & Baker, 1980a, 1980b). Additional studies indicated that children with E/BD have difficulties in all language areas (Audet & Hummel, 1990; Camarata et al., 1988; Griffith, Rogers-Adkinson, & Cusick, 1997; Warr-Leeper, Wright, & Mack, 1994). Most pointedly, expressive and pragmatic difficulties experienced by children with E/BD have the potential to increase the risk of developing or maintaining current social-emotional and behavioral problems (Gallagher, 1999; Prutting & Kirchner, 1983; Rice, 1993), as well as the potential to affect educational success (Baltaxe & Simmons, 1988; Hummel & Prizant, 1993; Rinaldi, in press; Sanger, Maag, & Shapera, 1994). Consequently, children with E/BD have fewer opportunities to interact and fewer communicative tools to appropriately participate in interactions, potentially resulting in less language input from their environment and delayed language development (Westby, 1998). This article focuses on describing a pragmatic language intervention program conducted with a classroom of children diagnosed as having E/BD.


Historically, researchers have focused on three similar yet distinct populations when reviewing the occurrence of language delays in children with emotional difficulties. Those populations include children with a current language diagnosis who also displayed E/BD, those with diagnosed psychiatric disorders who also displayed language disorders, and children labeled by the public schools as emotionally or behaviorally disordered who displayed language disorders (Donahue, Cole, & Hartas, 1999).

The seminal explorations originated within the speech-language pathology clinic. Children currently receiving speech-language services for a diagnosed language or articulation disorder were evaluated for secondary psychiatric disorders according to the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III; American Psychiatric Association, 1987). Results of these early studies showed that there was a high co-occurrence of language disorders and E/BD. The results of these early works are best illustrated by Baker and Cantwell (1987), in which 50% of 600 participants were determined to be "psychiatrically ill" according to their scores on the Child Behavior Checklist (Achenbach & Edelbrock, 1981) and standard clinical interviewing to determine emotional status. The determination of "psychiatrically ill" was based on the child meeting criteria for any disorder (e.g., depression and attention-deficit/hyperactivity disorder [ADHD]) within the DSM-Ill as assessed by a qualified mental health professional.

The inverse relationship was then explored to determine whether language disorders could also be observed in children either with a diagnosed psychiatric disorder or in school-based populations as determined by the federal definition of emotional disturbance specified in the Individuals with Disabilities Education Act of 1990. …