Emotional And Behavioural Difficulties: Communication Problems

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Social, emotional and behavioural difficulties generally co-occur with language and communication problems. The aim of this paper is to analyse and discuss this relationship whit the relevant literature. First of all, language and communication skills will be discussed. Then, language, emotional, social development, links between these development areas and communication problems will be discussed respectively. Finally, after discussing assessment and support methods, conclusion will be present.

Language and Communication Skills

It is essential to identify the necessary skills for communication in order to understand how language develops. Communication and language are complex processes to observe and understand because they happen without awareness (Berstein and Tiegerman, 1993; Dockrell and Messer,1999). On the other hand, they are everywhere; we use language to communicate with other people, to share our feelings, to learn and to think. Besides, as much as language, non-verbal features, for instance, facial expression and intonation are other important communication ways (Dockrell and Messer,1999). Nevertheless, language is the most significant piece in human communication(Becker-Bryant, 2001).

According to Buck (1986, cited from Barden and Williams), language is not a cognitive output. Powerful emotional and motivational factors get involved in learning process and strengthen it. Furthermore, language is not just a cognitive skill, in addition, it is a creative skill that includes imagination and emotions. Language has a close relationship with reasoning. They are both related to feeling and thinking with symbols and also with creativity and imagination.

Form, Content and Use are the major skills of language which is necessary for every communication (Brandone et.al, 2006). In order to express ourselves and understand others, we need to understand we use the form, content and use in conversation.

Form

The form can be described as the structure of communication, it is essential to understand and use the form correctly in order to communicate effectively(Becker-Bryant, 2001).Besides, it refers to the logical array of sounds to make words in spoken language. The grammar of any language is also a part of the form. To put the words in a right order is important in order to make sense.(Bloom and Lahey,1978)

Content

The content can be described as the meaning of communication. Even you have a full knowledge of a language, you have to understand the meaning and deliver it for effective communication (Becker-Bryant, 2001). In order to deliver the meaning, vocabulary knowledge is important. On the other hand, it is not easy to understand to content as learning the vocabulary or grammar because people can transfer the meaning with phrases such as idiomatic and abstract (Fenson et al., 1994).

Use

For effective communication, knowledge, and understanding the social context that the language is used in is as necessary as the knowledge of form and content. In addition, this skill is the basic tool of interaction and children start to improve it before gaining spoken language (Sachs, 2001). For an efficient language usage, spoken and non-verbalized communication skills such as eye contact and facial expression are important as well as being aware of other people’s interest, their responses, what they are talking about (Becker-Bryant,2001).

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Language Development

When they are in mother’s womb, babies can perceive mother’s speech and after birth, babies start to be interested in language and to communicate. For this reason, babies choose people’s talk to attend right after birth. During the first year, infants start to give their attention when someone talks to them. Apart from that, they begin to play with sounds and tones as experiments in order to gain language (Paul, 2001). When they are between 6 and 12 months, infants are now capable of distinguish meaningful speech sounds from the sounds that are not part of the language spoken around them. In other words, this is the period that they start to learn their mother tongue. They start to apply sounds from the language they hear from around when they are babbling ant ten months. Besides this, between eight and ten months they begin to comprehend words, however, they still need to identify the right meaning of words from possible alternatives (Chapman, 2000). Additionally, first patterns of communication acts such as vocal and gestural acts are began to develop from ten to fifteen months (Bernstein, 1993). At the age of one, first words come out, then children start to correlate words and their meanings’ at two years (Bates et al., 1992). Moreover, they can speak with a growing vocabulary of fifty or more words because they can gain nine new words for every day. Grammatical rules are acquired at around age of two(Fenson et al. 1994). Additionally, during age of two, different groups of words such as comprehensions, words for describing feelings or what you think and abstracts are acquired as well. Words for mental states are used in order to mention themselves and then to refer others. At school ages, children can know around 20 thousand words. They have comprehensible speech. Moreover, they are capable of making little stories with well-formed sentences. In addition, that they are capable of using language in more complex ways such as naming, categorizing and thinking or for different reasons like teasing, giving or hiding information, making fun and comforting. When they start school, they learn synonyms and figurative meanings. In addition, they continue to gain new words nearly eight words for a day (Paul, 2001).

How does Language Develop

Children acquire the language by being exposed to their mother tongue in their environment. In other words, if a child is isolated or cannot have enough experience with language, they may not begin to speak. When considering the ability of learning language, it is difficult to decide the extent of both innate side of language and the environmental effect. On the other hand, it is clear that both of them have impact on language learning. However, it is clear that social context is essential to learn how to use language (Gleason, 1997).

Child Direct Speech

Child direct speech (CDS) refers to adults’ modification of language to the child’s understanding of speech (Snow, 1986). Adults prefer to use sort, simple sentences and lots of repetitions. Infants tent to show more interest to CDS if they receive more positive emotions (Sing, Morgan and Best 2002). Additionally, children play an active role in gaining language by selecting which speech that they give response (Garton 1992).

With the help of CDS, children learn to identify when a speech is directed to them. Moreover, it can help children to understand when their turn to speak comes because of the changes in intonation. Children can hear the gaps between words by CDS and this helps to improve language development (Thiessen et al., 2005).

Responsive Interaction

Responsive interactions are important because it is an important factor in language development. Responsive interaction refers to the easy emotional availability of another person who will give significant interactions. During a responsive interaction, adults realise and give responses to the cues and signals that a baby gives out. If babies receive positive responses to their attempts to interaction and vocalise, they will do it more. It means that they realise they have an effect on people. Thus, they will have wish to share their thoughts and feelings (Pressman et al., 1999).

According to Bruner (1983), to learn language process, interaction has a critical importance. Children can learn language in social context. Interaction causes cognitive development and language development. Babies or children are active in responsive interaction. Babies can use a range of sounds in order to communicate and express emotions (Papaeliou et al., 2002). When they reach their first year, children actively try to share their feelings with others. This is important because, if children have more socially oriented early language learning, they can learn words for emotions easily.

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Good responsive interaction means that caregiver is emotionally available and this is an important factor for language development (Kaiser et al., 1996). Vocabulary and grammar development depends on suitable responsiveness and interactive communication between child and mother.

Emotional Development

Emotions can function as a guide to understand others, ourselves and to decide our behaviours and how others may act in the future. According to Bretherton et al. (1986), emotions help humankind to survive and this explains why they developed. As it happens in language development, both genetic and environmental factors have impact on emotional development.

Primary feelings such as happiness, anger, sadness and fear always develop firstly. Even newborn babies can differentiate expressions of happiness, sadness and surprise from each other and can try to copy them. Their mother’s facial gestures start to impress 11 weeks old babies. If mother expresses fear, they get shock or if mother shows a happy face they can be interested in it. When they reached three months, even they don’t understand what had told, they will respond to how the speech is said; if the speech is delivered in a positive way, they will react positively while the negative speech will be responded negatively (Fabes et al., 2001).

Two years old children are capable of speaking themselves and other people’s emotions. Beside this, they can try to manipulate emotional situations in order to change them. Moreover, it is the period that children start to realise the links between behaviours and feelings. For instance, if someone cries, they can understand that this person is sad. When they are five years old, they can start to understand that emotions can be affected by external factors such as losing a toy. On the other hand, they can find it difficult and confusing to understand if spoken and non-verbalized signals are interrelated or contradictory as the situations that if someone is sad but saying they are fine (Fabes et al., 2001).

How do Emotional Skills Develop

There are some important elements in emotional development. They are secure attachment, development of thinking abilities and also innate ability. Children can discover about feelings by doing observations about others, examine their feelings and talking about them.

Attachment

In order to survive, babies need and tend to develop strong emotional ties from after birth. This strong motivation to be in relation to the caregiver helps children to feel in secure as well as to improve language and emotional development. These ties serve to be in social interaction while serving to share our feelings and thoughts which make a contribution to development. If babies do not feel themselves in secure or cannot connect with the caregiver, anxiety increases. As a result of this, need for security, comfort and attachment rises. The caregiver’s reaction to these emotional needs has a critical role to the child’s emotional development. The responses which helps to reduce anxiety and stress lead the baby to calm down, to play and to learn about its surroundings. This is described as secure attachment (Ainsworth et al. 1978). Ainsworth et al. (1978) points out that secure attachment happens when caregivers respond to the children predictably, comforting and sensitively to the child’s communicational and emotional needs. When secure attachment occurs, the child feels in a safe environment. Thus the child starts to enjoy interaction and this satisfying feeling will lead to interact with other people.

On the other hand, negative feelings are also accepted by the caregiver and are responded warmly in secure attachment. This will help to the child to accept and tolerate them. Because of all these reasons it can be said that attachment leads a healthy emotional development by helping to the child to deal and to work out emotions. Because of learning their feelings in a positive way through adults’ responses, children become more capable of dealing with the stress that is increased by social contacts. As a result of this, securely attached children are more emphatic and social and also less hostile and anxious ( De Rosnay and Harris, 2002).

Beside this attachment has an effect on cognitive and language development as well. According to Murray and Yingling (2000), in secure attachment environment mothers stimulate children’s language skills. It is found that securely attached children have better and complex language skills (Gesten, 1986).

Emotional Coaches

Parents lead their children to learn their emotions, what others think and feel by responding to the child’s emotions with the right facial expression. This is called as emotional coaching. This helps child to regulate own feeling, to separate themselves from others and to improve language skills. According to Peterson and Slaughter (2003), children will understand correctly others and own thoughts and feelings, if their parents talk to children about them. Moreover, emotional coaching will lead to have a better theory of mind.

Social Development

To improve healthy relationships, to have social contacts and deal with social situations, children need to learn to communicate with peers and adults in a socially acceptable way. This will lead a healthy social development. Taking their parents as a model is a way to develop social skills. Additionally, parents’ interaction with their children will improve acceptable social skills as well. Moreover, social contacts will help language development. Vocabulary development can improve by social interactions. Infants can understand the speech directed them, if they are stimulated with rich non-verbal information sources. It means that social interaction helps children to learn to identify non-verbal referents of speech. On the other hand, some social routines such as sharing toys or other objects provides children a well-structured pattern in order to understand speech. Moreover, children become more capable of using contextual messages in order to understand the meaning of words when they become older (Dockrell and Messer, 1999).

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Language, Thinking and Emotional Development

While the importance of language for thinking and social interaction has already been known, the link between language and emotional mechanism was accepted in recent years. However, language is significant to show and organise internal states and this is a clear connection between language and emotion. Even though, we do not need words while thinking, we use words when we think about how we feel and share them (Dale, 1996). Bloom and Beckwit(1989) provide evidence in favour of integration of language and emotion. According to them, a child’s emotional state cam affect the child’s language development. They found that two-year-old children could show positive and negative emotions by laughing and crying directly. On the other hand, they could use words when they were in neutral emotional states.

Language, cognitive and emotional developments affect each other. According to Dixon and Smith (2000), language develops better when attention control and positive emotions occur. On the other hand, it is obvious that secured attached children have good thinking, attention and language skills (Robinson and Acevedo, 2001). Additionally, understanding emotions and verbal abilities are related with each other (Bastin, Burns and Nettelbeck, 2005).

Babies express emotions through behaviour and when they are three, symbolic representation of feeling and behaviour can be possible by the development of language. It means that language is a kind of hyperlink between experience of emotion and its expression (Greenberg et al. 1995). Children learn to identify and to name emotions. This process is the first steps of problem-solving. When children reach at six years old, they can think using words and consider emotions. Adolescents develop advance language, cognitive and emotional development skills. They can consider multiple perspectives very quickly (Eisenberg et al. 2004).

Brain Development

Brain development has a major impact on language, emotional and cognitive development. There are critical periods while brain grows in terms of language development. The critical period for language learning is before adolescence. It means that if children couldn’t develop language properly in childhood, they may have difficulties in the future. However, some studies show that if a brain damage occurs in the language area before ten years old, children can recover their language, but after the age of 12 proportion of recovering shows decrease. On the other hand, it is clear that language learning goes on during adolescence and adulthood (Nippold, 1993). It can be said that the brain has unlimited potential to develop.

It is clear that babies use their language processing areas that are in the brain to help them understand expressions on the faces (Tzourio-Mazoyer et al., 2002). This can explain the importance of focusing on the faces to learn language. In the early stages of development, areas in the brain which are responsible for understanding people and social interaction have close relationship whit the areas which are responsible from emotions (Grady and Keighyley, 2002). Because of this reason, early social interaction is essential for both emotional and language development. It is because environmental inputs and early interactions may affect brain structure and function (Gerhardt, 2004).

Cognitive Development

The most detailed and influential theory that explains cognitive development built by Jean Piaget (Richardson, 1998). According to Piaget’s cognitive development theory, the child is very active during the making sense of word in order to adapt to the environment. Cognitive development show progress through stabilised functioning of assimilation, accommodation and organisation. Assimilation is to associate new information with the previous structure of understanding. Accommodation is to change the old structure into new ones when a new information or problem occurs. These two functions work together in order to organise the structure of cognitions which are differentiated, integrated and flexible sets of ways to understand the world. (Meadows, 1986).

Communication and emotional skills are affected by cognitive skills. For instance, if the infant’s ability of sharing attention which means infant and caregiver both give their attention to the same thing at the same time develops well, it will make a contribution to early interactions. Shared attention develops with the early ability of the infant’s to identify eye direction, emotion and purpose, and that shared attention improves the development of theory of mind (Baron-Cohen and Belmonte, 2005). If problems take place with shared attention, interaction will probably be weakened as it happens in autism. Language and social understanding is impaired in children with autism because of having difficulties at shared attention.

Other necessary cognitive skills in order to develop language are memory and attention. Children should have enough ability to listen, to process and to gain the meaning what other people say in order to learn language. If babies have problem with processing the sounds, they will probably have communication problems (Benasich et al., 2006).

Theory of Mind

Theory of mind which refers to mental states required to understand beliefs, purposes, and wishs of yourself and others, is not just related to child language and cognitive development, also related to social interaction and communication. Theory of mind is the essential tool of interacting with others and affected by language development as well (Apperly, 2011).

Caregivers help to develop the theory of mind by responding children as they have feelings and intentions and focusing children’s feeling and thoughts. This will help children to recognise and regulate own feelings (Fonagy and Target 1997). In addition, describing thoughts, feelings and mental states with words will develop language as well. In other words, as theory of mind develops, the child’s understanding of mental states improves and they become capable of referring other’s mental states (Patnaik and Babu 2001).

Play and Interaction

Other essential tools of emotional and communication development are play and interaction. Moreover, these skills interact each other’s development. Play helps children to learn adult roles, to express emotions, to learn social patterns and to develop language. While children are playing, they learn to use symbols as it happens in language. Beside this, play gives children the opportunity to talk about their difficult emotions like fear and anger (Haight and Sachs 1995).

Links Between Emotional, Behavioural Difficulties and Communication Problems

Communication, emotion and behavioural problems can be seen together because of developing together and being intertwined the process. It means that if a problem occurs in one area, it will affect other.

Defining SEBD

Social, emotional and behavioural difficulties (SEBD) refers to the wide scale of behaviours ranging such as as aggression, non-compliant behaviour, vandalism, bullying which are called as acting out behaviours and also, social anxiety, depression, eating disorders and self-harm which are named as acting in behaviours. (Cooper and Tiknaz, 2007).

Mental Health Perspective

SEBD can be considered related to mental health. The Diagnostic and Statistical Manual of Mental Disorders (APA, 1994) classifies categories of disorders in the field of child psychiatry. Some of them are:

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1. Developmental Disorders

(a) Pervasive Developmental Disorder (PDD)

2. Behavioural Disorders

(a) Attention Deficit Hyperactivity Disorder (ADHD)

(b) Conduct Disorder.

3. Emotional Disorders

(a) Anxiety Disorder.

(b) Depression.

4.Selective Mutism

5.Schizophrenia

6.Post-traumatic Stress Disorder.

Educational Perspective

The Department of Education describes emotional, behavioural and social difficulties and underlines that this term covers a large range of special educational needs. The department identified:

• anti-social and aggressive behaviour

• ADHD

• somatic problems

• emotional problems. (Department for Education and Skills 2001b).

Children who have an emotional disorder have special educational needs more than children with no emotional disorders. It can be difficult to educate these children in normal classrooms without additional support. However, the idea that social and psychological factors can intensify emotional and behavioural difficulties began the center of interests. As a result of the term social, emotional and behavioural difficulties took a place in Special Educational Needs code of practice (Department for Education and Skills, 2001b).

Defining Communication Problems

There are a variety of definition and categorisation of communication problems and the DSM includes the most clear and the broad one. However, using broad categories may cause problems in finding relations between communication problems and SEBD (Cross, 2011).

There is much type of communication problems such as problems with larynx, with the muscles which produce speech, usage of the sound system of language, verbal dyspraxia which cause difficulty to ordinate the muscles for speech. Beside this, a communication problem can be described as a sing of atypical development because language problems and a disorder often occur together (Lees and Urwin, 1997).

On the other hand, difficulties related to the form, content and use of language can cause communication problems. Here are some examples of difficulties with form:

· Problems discriminating speech sounds

· Problems linking sentences

· Difficulty understanding complex sentences such as passives.

Difficulties with content:

· Difficulty learning new words.

· Problems with understanding idioms

· Limited vocabulary for emotion words.

Difficulties with use:

· Difficulty continuing eye contact.

· Difficulty understanding or responding to the listener.

· Problems with following conversation (Brandone et al., 2006).

SEBD Co-occur with Communication Difficulties

Frequently, emotional and behavioural problems co-occur with language and communication problems. Research show that almost half of children with emotional and behavioural problems also have communication problems (Baker and Cantwell 1987; Camarata, Hughes and Rhul 1988)

In their study, Cohen and Mendez(2009) found that preschool children with behavioural problems have problems understanding language and emotions. Similarly, Botti and Conti-Ramsden (2000) studied with over 200 children with communication problems and discovered that complex language problems co-occurred with clinical level behavioural difficulties. Additionally, it was demonstrated that adolescents with difficulties understanding language can feel frustrated and respond aggressively (Sigafoos, 2000). Other studies indicate that a group of children with communication problems showed firstly frustration then had more anxiety, lower self-esteem (Haynes and Naidoo, 1991; Rutter and Mawhood, 1991).

Why SEBD Co-occur with Communication Problems

Maybe there is not only one answer for this. There may be different ways which SEBD and communication problems can be linked. However, it is obvious that SEBD cause communication problems as well as communication problems cause SEBD. On the other hand, some factors such as attachment problems and attention deficit disorder cause both SEBD and communication problems. Additionally, environmental factors such as low SES, child abuse have impact on language and emotional development (Vaughn and Bos, 2002).

Do Communication Problems Cause SEBD

The comorbidity communication problems and SEBD is clear but the causal is not clear. It was found that children with communication problems also develop behavioural and psychiatric problems (Clegg, Hollis and Rutter 1999; Silva, Williams and McGee 1987; Lindsay et al. 2007; Snowling et al. 2006).Additionally, the six months old children with language deficits also develop mental heath problems at age 1 (Skovgaard et al. 2008). Moreover, if children have language problems at age 5, they can have social phobia in adolescence (Voci et al. 2006).

Do SEBD Cause Communication Problems

Social, emotional and behavioural difficulties can limit language development. However, there is little evidence for SEBD cause communication problems. On the other hand, in some psychiatric difficulties like selective mutism, autism, communication problems are part of diagnosis. Additionally, it seems that ADHD and communication problems are related (Lum, Conti-Ramsden, & Lindell, 2007)

Some SEBD Problems Which Co-occur with Communication Problems (ADHD, ASD, Conduct Disorder)

Autism, attention deficit disorder and conduct disorder are examples of SEBD which co-occur with communication problems. The symptoms of ADHD like poor attention, impulsiveness and hyperactivity cause significant impairment of social and academic functioning (DSM-IV, APA, 1994). Children with ADHD may have delayed language development, expressive language difficulties and understanding language as it happens in Specific Language Impairment(SLI) (Cardy et al., 2010). In addition, children with SLI are at risk for ADHD (McGrath et al., 2008).

Children with ASD have difficulties with communication, social interaction, empathising and show narrow interests (Baron-Cohen 2009).All children with ASD have language usage problems and communication difficulties (Lindgren et al. 2009; Tomblin et al. 2003).

Children with conduct disorder also experience problem with social usage of language such as understanding other people’s non-verbal cues, staying on topic (Audit and Ripich, 1994; Gilmour et al. 2004).

Undetected Communication Problems and Their Ä°mpact

Almost half of young people suffering from emotional and behavioural problems also develop communication problems. In addition, unfortunately many children who have emotional and behavioural problems and communication problems are not detected. Moreover, children with undetected communication problems can be misdiagnosed (Cross, 2011).

Undetected Communication Problems in Children with SEBD

It was found that many children with emotional and behavioural problems have unsuspected communication problems (Cohen and Lipsett 1991; Giddan, Milling and Campbell 1996; Jones and Chesson 2000). In their study Schultheis (2001) examined the 129 pre-school children and discovered that children with behaviour problems had undetected communication disorders. In addition, some researches indicate that the children who have emotional and behavioural problems in special education also have undetected language difficulties (Burgess and Bransby, 1990). On the other hand, it was found that children with undetected communication problems and emotional, behavioural problems were suspended from school (Law and Sivyer, 2003).

Children with undetected communication difficulties can have problems to follow routines, understand instructions and they often get negative feedback about their attention. As a result of this, these children can be called as ‘difficult’ (Law and Sivyer, 2003).

Why are Communication Problems Undetected

There are lots of reasons, but maybe the main reason for why communication problems are undetected lies in its complex nature. In other words, they can be unexpected and difficult to identify.

One of the reasons is lack of awareness and training. According to Toppelberg (2000), child psychiatrists should learn more about language development and problems in order to diagnose correctly. On the other hand comorbidity can make it difficult to identify. For instance, children with communication problems also have dyspraxia. Additionally, dyslexia can be seen together with Specific language impairment.

SEBD is often hidden and does not occur with obvious communication problems. Besides, communication problems can show itself as behaviour problems. It can be difficult to understand for children with SEBD what is waited from them and what to do. As a result of this, not adaptable behaviours can be seen.

Impact of Communication Problems

Social abilities and social learning can be affected badly by communication problems. Moreover, undetected communication problems may cause misdiagnosis which can aggravate their social, emotional and behavioural difficulties. Communication problems have an impact on a wide variety of areas of a child’s life. It affects educational and social life, emotional and behavioural development and cause misunderstanding.

Spoken language skills take an important place in school life. If a child has a problem with understanding spoken language or build sentences, they will also have a problem with understanding reading materials as well as writing. In addition, they may experience problems with associating letters to sound (Snowl

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