Purpose This study evaluated the pathways between developmental language disorder (DLD), psychosocial risk factors, and the development of emotional difficulties from ages 3 to 11 years within the Millennium Cohort Study. Method A total of 14,494 singletons (49.4% female) from the Millennium Cohort Study were evaluated within this study. Risk of DLD (rDLD) was defined as age 5 parent-reported language problems and/or −1.5 SD s on a Naming Vocabulary subtest at the age of 5 years. Children without rDLD formed the general population comparison group. Psychosocial risk factors included 9-month temperamental traits, parental psychological distress, and maternal attachment as well as age 3 emotional regulation abilities, parent–child relationship, and peer problems. The parent report Strengths and Difficulties Questionnaire Emotional Difficulty subscale at 3, 5, 7, and 11 years of age was the outcome variable. The trajectory of emotional difficulties was evaluated within a variable-centered approach and a person-centered approach, using growth mixture modeling. Results Children with rDLD ( n = 884) had increased levels of emotional problems when compared to the general population group ( n = 13,344). Psychosocial risk factors were increased in children with rDLD, fully mediated the increased emotional difficulties at 3 years, and partially mediated the increased emotional difficulties at 11 years. Children with rDLD were more likely to be included in emotional trajectory subgroups with an increasing pattern of emotional problems. rDLD was an additional risk factor for lower levels of emotional self-regulation and increased peer problems when controlling for the emotional difficulties trajectory subgroup. Conclusion This article indicates that the increased emotional difficulties found in children with rDLD are likely a function of early language difficulties influencing other domains of development, specifically social interactions (parent and peer) and emotional self-regulation abilities. Clinically, this reiterates the importance of early identification and treatment of children with language delays or clinical level language disorders. Supplemental Material https://doi.org/10.23641/asha.8323598

Background and aim Individuals with developmental language disorder have been found to exhibit increased emotional difficulties compared to their typically developed peers. However, the underlying pathways involved in this relationship are unclear. It may be that poor language leads to social exclusion, resulting in feelings of frustration and isolation. Additionally, previous research has focused on clinical samples or early childhood in population cohorts. Therefore, the current paper examines the mediating effect of childhood peer problems on poor emotional outcomes in adolescence using a population cohort. Methods Data from the Millennium Cohort Study were analysed at ages 5, 7 and 14. The risk of developmental language disorder group (children considered at risk of developing developmental language disorder based on parental report of difficulties or a score −1.5 standard deviation on Naming Vocabulary subtest at age 5) was compared to a general population group. A Sobel–Goodman test was used to examine the mediating effect of teacher-reported peer problems at age 7 on the association between language difficulties at age 5 and parent-reported emotional problems at age 7 and 14. Results Peer problems at age 7 accounted for approximately 14% of the effect of language difficulties at age 5 on emotional problems at age 7, and approximately 17% of the effect of language difficulties at age 5 on emotional problems at age 14. Conclusions This paper supports previous findings that children and adolescents with language difficulties are at increased risk for social and emotional problems as reported by their parents and teachers. Furthermore, the findings show that peer problems partially mediate the relationship between language difficulties and emotional problems, suggesting that better relationships with peers may offer some protection against poor mental health outcomes in adolescents at risk of developmental language disorder. Implications This paper adds to the literature that investigates the mechanisms involved in the relationship between developmental language disorder and increased emotional problems. Practitioners wishing to reduce risk of emotional difficulties in children with developmental language disorder may wish to reflect on what they can do to support a child to develop positive peer relationships.

BackgroundNon-adherence to secondary prevention medicines (SPMs) among patients with coronary artery disease (CAD) remains a challenge in clinical practice. This study attempted to identify actual and potential modifiable barriers to adherence that can be addressed in cardiology clinical practice.MethodsThis was a cross-sectional, postal survey-based study of the medicines-taking experience of patients with CAD treated at a secondary/tertiary care centre. All participants had been on SPM for ≥3 months.ResultsIn total, 696 eligible patients were sent the survey and 503 responded (72.3%). The median age was 70 years, and 403 (80.1%) were male; the median number of individual daily doses of all medicines was 6. The rate of non-adherence to at least one SPM was 43.5% (n=219), but 53.3% of reported non-adherence was to only one SPM. Statins contributed to 66.7% and aspirin to 61.7% of overall non-adherence identified by the Single Question (SQ) tool. In 30.8% of non-adherent patients (n=65), this was at least partly intentional. Barriers included forgetfulness (84.9%; n=186), worry that medicines will do more harm than good (33.8%; n=74), feeling hassled about medicines taking (18.7%; n=41), feeling worse when taking medicines (14.2%; n=31) and not being convinced of the benefit of medicines (9.1%; n=20). In a multivariate analysis, modifiable factors associated with overall non-adherence included being prescribed aspirin (OR: 2.22; 95% CI: 1.18 to 4.17), having specific concern about SPM (OR: 1.12; 95% CI: 1.07 to 1.18) and issues with repeat prescriptions (OR: 2.48; 95% CI: 1.26 to 4.90). Different factors were often associated with intentional versus unintentional non-adherence.ConclusionsUsing appropriate self-report tools, patients share actual and potential modifiable barriers to adherence that can be addressed in clinical practice. Non-adherence behaviour was selective. Most non-adherence was driven by forgetfulness, concern about the harm caused by SPM and practical barriers.

Purpose Adolescents with a history of language difficulties are at risk for increased social and emotional difficulties; however, the pathways involved are unclear. We examine the contribution of poor emotion regulation by comparing longitudinal data from children at risk of developmental language disorder (rDLD) and the general population. Method Data from the Millennium Cohort Study were analyzed at ages 3, 5, 7, 11, and 14 years. The rDLD group (children with parent-reported difficulties and/or a score of −1.5 SD s on the Naming Vocabulary subtest at age 5 years) was compared to a general population group on parent reports of emotion regulation, peer problems, and emotional problems. Results In line with the established literature, increased socioemotional problems in individuals with language difficulties were reported. Poor emotion regulation consistently predicted subsequent peer and emotional problems throughout development in both groups. Stronger cross-lag effects were found in the rDLD group for poor emotion regulation at age 3 years predicting age 5 years emotional problems and age 5 years emotional problems predicting age 7 years emotion regulation difficulties. Stronger reciprocal cross-lag effects were also observed in the rDLD group between peer and emotional problems at ages 3 and 5 years. No significant group differences were found in adolescence. Conclusions Poor emotion regulation makes a small but significant contribution to later peer and emotional difficulties, and this relationship is stronger in children at rDLD. Early reciprocal peer and emotional difficulties are also stronger in the rDLD group, but these effects dissipate in midchildhood. Nevertheless, the consistent relationship between early emotion regulation difficulties and socioemotional problems throughout development warrants further investigation in individuals with lower language skills. Supplemental Material https://doi.org/10.23641/asha.12142059