ARTICLES
Fourteen-Year Follow-up of Speech/Language-Impaired and Control Children: Psychiatric Outcome

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ABSTRACT

Objective

To examine the association between early childhood speech and language disorders and young adult psychiatric disorders.

Method

In a longitudinal community study conducted in the Ottawa-Carleton region of Ontario, Canada, interviewers administered structured psychiatric interviews to age 19 participants who were originally identified as speech-impaired only, language-impaired, or nonimpaired at age 5. The first stage of the study took place in 1982 when participants were 5 years old, and the latest stage of the study took place between 1995 and 1997 when participants had a mean age of 19 years. This report examines the association between early childhood speech/language status and young adult psychiatric outcome.

Results

Children with early language impairment had significantly higher rates of anxiety disorder in young adulthood compared with nonimpaired children. The majority of participants with anxiety disorders had a diagnosis of social phobia. Trends were found toward associations between language impairment and overall and antisocial personality disorder rates. Males from the language-impaired group had significantly higher rates of antisocial personality disorder compared with males from the control group. Age of onset and comorbidity did not differ by speech/language status. The majority of participants with a disorder had more than one.

Conclusions

Results support the association between early childhood speech and language functioning and young adult psychiatric disorder over a 14-year period. This association underscores the importance of effective and early interventions.

Section snippets

Sample and Design of Initial Study (1982) and First Follow-up Study (1989–1990)

In 1982, a one-in-three random sample of all 5-year-old English-speaking children in the Ottawa-Carleton region of Ontario, Canada (N = 1,655; 794 girls and 861 boys), was administered the first stage of a three-stage S/L screening procedure. Among the four school boards in the region, a grid was drawn on a map to contain geographical clusters of three schools in each segment with similar enrollment and smallest distance between schools. One school was randomly selected from each segment. This

Age 19 Rates of Psychiatric Disorder by Age 5 S/L Status

In Table 2, rates of age 19 psychiatric disorder by age 5 S/L status are shown. Odds ratios and 95% confidence intervals are reported for contrasts with α levels at or below the .05 level. Indicator contrasts showed that the language-impaired group had significantly higher rates of anxiety disorder compared with the control group. Most participants with an anxiety disorder had social phobia. Although rates of social phobia did not differ significantly by S/L group, they showed a pattern similar

Disorder Rates

Young adults with a history of early childhood language impairment have one of the highest rates of psychiatric disorder in the community. Using the UM-CIDI, the NCS and the OHS reported disorder rates of 37% for 18-to 24-year-olds (Kessler et al., 1994) and 26.6% for 18-to 20-year-olds, respectively (E. Lin, personal communication, March 5, 1998). Both studies found the highest rates of disorder among young adult cohorts. Unlike the NCS and the OHS, we included the GAF criterion, suggesting

Conclusions

These results reveal the long-term psychiatric outcome associated with early childhood S/L impairment. Language-impaired children were significantly more likely to develop anxiety disorders in young adulthood. Most participants with an anxiety disorder had a diagnosis of social phobia. Males from the language-impaired group had significantly higher ASP rates compared with males from the control group. That age 5 language impairment is associated with an increased risk of psychiatric disorder at

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