Australian girls are as likely to have language disorders as boys, but get referred less to treatment clinicians.
A study published in the Journal of Paediatrics and Child Health has found that roughly six percent of its cohort of 10-year-old children had developmental language disorders (DLDs), but there was no significant sex difference.
“Developmental language disorders are a condition where kids have difficulty understanding and using language compared to kids their own age,” explains lead author Dr Sam Calder, a speech pathologist at Curtin University’s School of Allied Health.
“This could look like using fewer words than kids their own age, it could be difficulty following instruction in the classroom or from parents, or it could look like a hesitancy interacting.”
The onset of DLD is usually before four years of age, and it’s a lifelong condition.
“There’s no cure for it, and these kids tend to never really catch up to their peers,” says Calder.
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The researchers drew on data from the Raine Study which has been tracking the health and development of nearly 3000 West Australian children, born between 1989 and 1992.
They examined the language data from the participants at 10 years of age, a total of 1626 children, 104 of whom were assessed as having DLD.
The gender balance in children with DLD was roughly even, which sits in stark contrast to children who get referred for language difficulties.
“What we tend to find clinically is we have a lot more boys show up for services. Some studies have found a five to one ratio of boys to girls accessing clinical services. But population-based studies like this one show that there’s actually no sex difference between boys and girls presenting with DLD,” says Calder.
This suggests there’s a “referral bias” towards boys with language difficulties. What could have caused this disparity? Does DLD present differently in boys compared to girls?
“That’s the million dollar question,” says Calder.
The researchers have a hypothesis, but they don’t yet think there’s enough evidence to count it as fact.
“What we hypothesise is that boys tend to demonstrate more externalising behaviours – so they might be a little bit more frustrated with their difficulty communicating. They might appear to be a little bit naughty in classrooms, they might even get to the point where they act aggressively towards their peers because they can’t be understood.
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“Whereas girls tend to demonstrate more internalised behaviours, so they kind of mask their difficulties a little bit more with passivity, reluctance to initiate, and they tend to just fly under the radar a little bit more,” says Calder.
“There’s some evidence to support this hypothesis, but it’s definitely something that we need further research into.”
While sex differences weren’t apparent, the researchers did find some links between DLDs and other health or lifestyle factors.
“The study showed a higher proportion of 10-year-old children meeting the criteria for DLD were born preterm, exposed to smoking in pregnancy, had a father that did not live at home, and were read to less than once per week as a three-year-old,” says co-author Dr Lizz Hill, also from the Curtin School of Allied Health.
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Calder says that language disorders are better diagnosed and treated when speech pathologists work in schools.
“Speechies are often seen as the experts in managing speech and language difficulties, but what we know from emerging research – and any speech pathologist would attest to this – is there are better outcomes associated with collaboration between clinicians, teachers and families.
“Also, outcomes are better when the difficulties are addressed in context – so for our kids, usually the classroom is where they have the most difficulties.”
As well as helping with treatment, school-based speech pathologists can speed up referral processes and spot more diagnoses, according to Calder.
“Having the speech pathologist in school would benefit every child in school by collaborating with educators to create a really stimulating and language rich environment.”