NANCY J. COHEN Language Impairment and Psychopathology in Infants, Children, and Adolescents Thousand Oaks, CA: Sage Publications, 2001, 230 pages (ISBN 0-7619-2025-0, us$32.95, Softcover)
Reviewed by JEREMY I. CARPENDALE and ARLENE R.YOUNG
Approximately half of the children referred to mental health clinics for social-emotional problems have, on testing, been shown to have co-occurring language impairment. Conversely, about the same percentage of children originally seen for difficulties with language are later diagnosed with social-emotional problems. It is this overlap that Nancy Cohen explores in this concise and immensely readable book.
In the first two chapters, essential terminology and features of normal and disordered speech and language development and child psychopathology are provided. Once this essential groundwork is established, Cohen goes on to review a diverse array of potential contributors to the overlap between language impairment and psychopathology across development. Cohen outlines, for example, how difficulties in interacting with others and understanding social interaction can delay language development by restricting relevant experience. Conversely, communication problems and difficulties in understanding others can lead to improvised social interaction, which in turn could result in abnormal social emotional development. The direction of these relations is controversial and is likely to be bidirectional.
This book does the field a great service in integrating an impressive range of research and theory. Cohen draws extensively on developmental research and theory and draws out the connections with psychopathology. In doing so, she provides a good example of developmental psychopathology, that is, work in the intersection of developmental psychology and psychopathology. In particular, Cohen takes a developmental perspective in charting the changing relations between language and social competence, and describing possible transactional cycles between language and social understanding.
The subtle and clearly complex interplay between language and various aspects of development is a recurrent theme throughout the book. In one section, for example, research is described showing that deaf children with hearing parents are delayed in their development of social understanding. Cohen notes, however, that this is not the case for deaf children with deaf parents, who are skilled in sign language. Thus, it appears that the delay is the result of a lack of access to complex language. This example illustrates the importance of access to complex talk about the social world in children's development of social understanding.
In adolescence, language may be important for presenting arguments to hold one's ground and negotiate. If adolescents are not competent in using language, they may either withdraw from social interaction or resort to negative behaviours. Also in adolescence the use of figurative speech, metaphor, irony, and sarcasm increases, and if adolescents cannot understand their peers they are likely to be rejected.
The final two chapters of the book attempt to draw the reviewed research findings into the clinical arena by focusing on approaches to assessment and treatment. Cohen advocates extending the standardized assessment model to include multiple domains of development, including pragmatics and theory of mind. Similarly, after summarizing major approaches to intervention, the treatment chapter points to the need to develop treatments specifically geared for children with co-occurring language and socialemotional difficulties.
Now that we have praised this book and encouraged researchers and clinicians to read it, we wish briefly to consider the question of why we need a book like this. What led us to this situation in which we need to have it pointed out that language and social understanding are intimately interrelated? Once Cohen has pointed this out it seems immediately obvious. …