“He doesn’t follow directions”, “She prefers to play by herself ”, or “He constantly hits other children.” Have you ever heard these comments from teachers? I have. Per the teachers’ comments, these students show obvious behavior concerns. It has been my experience that if I was to ask the teachers to describe the students’ communication skills, they might say “They’re good.” But, during targeted questioning to gather additional information about the students’ communication skills, teachers’ responses often reveal issues that point to possible language problems. Unfortunately, they do not link the behaviors to an underlying language impairment. This is an indication that training to identify language problems in students, particularly those with behavior problems, continues to be an area of need for some teachers. According to Cross (2004), language impairments in students with behavior problems often go undetected. When language problems are not properly identified, appropriate referrals for evaluations and necessary supports cannot be implemented.
Language impairments and behavior problems may not exist in a vacuum. Language impaired children may show a variety of challenging behaviors, such as withdrawal, aggression, mood disturbances, irritability, noncompliance, poor social skills, and relationship problems with peers and adults. While the link between language, emotions, and behavior is not easily explained, a variety of research indicates students with communication impairments are often at risk for academic problems, along with social and emotional-behavioral problems which threaten school success (Benner et al., 2002; Cross, 2004; Hay et al., 2007). Cross (2004) stated that language and emotional development occur together and affect each other powerfully. Difficulties in one domain can influence the development of the other.
Behavior problems in children range in manifestation, but also in severity. Unfortunately, negative attitudes often develop toward students with significant behavior problems even though language impairment may be an underlying factor. When functional communication deficits exist, academic achievement may also suffer as a result. In the same way that behavior problems in children vary in severity and manifestation, language problems do the same. While some language problems are glaring, some may be subtle. Subtle problems could go undetected or be misunderstood. For instance, consider a student who shows work avoidance. If the student has a language problem that hinders comprehension of key concepts or vocabulary in the material, it would be difficult for him to complete the work independently. In addition, sometimes when students don’t have the oral language ability to ask appropriate questions regarding their comprehension needs, their solution is to just sit or do some other task unrelated to the assignment.
So how do we get teachers to be more cognizant of this link between language impairment and problem behaviors so that appropriate referrals are completed? Unfortunately, the question is not easily answered. Training is important and probably the easiest part of the task. As school-based SLPs, we are tasked to help school staff, particularly classroom teachers, build awareness of the link between disordered behavior and language impairment so that problem behaviors at school aren’t automatically misconstrued as “pure” behavior issues. It is important for them to understand that some language problems are subtle. For example, language deficits may underlie issues such as slower processing of oral information, word-finding problems, or aggression. However, despite any efforts to increase knowledge through proper training, there are barriers (e.g. more paperwork) that may be a hindrance to getting teachers to follow through with referrals.
Since undetected language impairments in students with behavior problems is an on-going issue in schools, teachers will play the most important role in identifying them. The need for assessment and other supports, such as instruction, is dependent upon appropriate identification. It is possible for students with behavior problems to be successful in the classroom and other settings across the school environment when appropriate assessments, behavioral supports and language instruction are effectively implemented. The purposes of assessment are to determine a student’s specific abilities and needs and to identify strategies and supports to efficiently address the learning and behavioral problems. Best practice dictates the use of formal and informal assessment tools across a variety of settings, contexts, and communication partners to obtain a comprehensive picture of a student’s level of communication performance. It is appropriate to use a combination of direct and indirect instruction methods. Direct instruction could involve work on specific skill deficits related to receptive-expressive language, emotional language, vocabulary, and social skills. Collaboration with the classroom teacher on how to facilitate a student’s functional communication in the classroom is one means of indirect instruction.
In summary, proper identification of language impairments in students with behavior problems is an area of need in the school setting. Some teachers do not show awareness of the link between problem classroom behaviors and language impairment. As SLPs, we should continue to provide training to increase their awareness of this connection, because they play an important role in identifying students who have communication needs. When language impairments in behavior disordered students are identified, appropriate evaluation referrals and necessary interventions can be implemented so that they can experience success at school.
Author: Colleen H. Williams, SLP.D, CCC-SLP
Benner, G.J., Nelson, J.R., & Epstein, M.H. (2002). Language skills of children with EBD: A literature review. Journal of Emotional and Behavioral Disorders, 10, 43-59.
Cross, M. (2004). Children with emotional and behavioral difficulties and communication problems: There is always a reason. London, England: Kingsley.
Hay, I., Elias, G., Fielding-Barnsley, R., Homel, R., & Freiberg, K. (2007). Language delays, reading delays, and learning difficulties: Interactive elements requiring multidimensional programming. Journal of Learning Disabilities, 40, 400-409.