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Language Problems

Among Students with


Emotional and
Behavioral Disorders
Provides an overview of language problems
and the extent of their impact on and the implications
for youngsters with emotional and behavioral disorders

By Dixie Sanger,
John W . M a a g ,
a n d N a d i n e R. Shapera

Y
oungsters with emotional (Camarata, Hughes, & Ruhl, 1988; child can experience. Language prob-
and behavioral disorders Cantwell & Baker, 1985; Giddan, 1991; lems are commonly described within
(EBD) represent a very het- McDonough, 1989; Prizant et al., 1990; five areas: phonology, morphology,
erogeneous group. These Rosenthal & Simeonsson, 1991; Traut- syntax, semantics, and pragmatics.
children experience problems that in- man, Giddan, & Jurs, 1990). Awareness- The component of language that fo-
clude aggressive, disruptive, and anti- of-incidence figures strongly suggest cuses on rules governing the structure,
social behavior,- social rejection by that speech-language pathologists and distribution, and sequencing of speech
peers,- depression,- and inadequate aca- special educators need to collaborate sounds is phonology (Owens, 1992).
demic achievement (cf. Cullinan, Ep- and develop improved services for Morphology refers to units of language
stein, & Sabomie, 1992). One area in youngsters with concomitant behav- that convey the nuances of meaning—
particular that seems to represent a ioral, emotional, and language disor- such aspects as tense markers, plural-
central and persistent characteristic ders. Therefore, in this article we will ity, pronominalization, and case vari-
of youngsters with EBD is deficits in first provide an overview of language ation (Laughton & Hasenstab, 1986).
language. Rosenthal and Simeonsson disorders and their impact upon young- Syntax refers to the form and order of
(1991) found that the communication sters with EBD, the extent of language words,- semantics addresses the mean-
of adolescents with emotional distur- problems in these youngsters, and the ing component of language and words
bances was both less informative and implications of language impairments (e.g., antonyms, synonyms, analogies,
less effective than that of nondisturbed in this population. Recommendations nonliteral and literal meanings, mean-
peers. Because language and communi- for special educators will be presented ings of sentences). Finally, pragmatics
cation are essential components of to address the needs of these young- refers to how language is used for inter-
interpersonal relationships, children sters. personal communication. It describes
with EBD may experience difficulties a set of sociolinguistic rules used to
giving and receiving information from determine who says what to whom,
others. Consequently, language skills Language and its how, why, when, and in what situation
seem to impact upon children's so- Relation to EBD (Muma, 1978).
cial skills (McTear & Conti-Ramsden, In order to understand the impact Taken together, youngsters with lan-
1992; Rice, Sell, & Hadley, 1991). language difficulties have upon the guage problems experience a number
Recently, researchers have docu- emotional and behavioral disorders of of difficulties that include, but are not
mented the extent of language dif- youngsters, it is important to under- limited to, deficiencies in using tense
ficulties in youngsters with EBD stand the type of language problems a or plural markers in correct pronoun

INTERVENTION IN SCHOOL AND CLINIC VOLUME 30 NUMBER 2 NOVEMBER 1994 (PP. 103-108) 103
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usage, limited vocabulary, restricted more difficult. Neel and Cessna (1993) of disorders. For example, Costello
word meanings, problems with figura- developed an outcome guide and out- et al. (1988) found that community
tive language and jokes, poor compre- come analysis worksheet to assist in prevalence rates of between 12% and
hension and spoken language skills, this process. However, an area that 20% for emotional and behavioral dis-
difficulty understanding questions and could greatly enhance this process is orders were considered to constitute a
following directions, and problems par- an understanding of the language dif- major public health problem and, con-
ticipating effectively in conversations. ficulties many youngsters with EBD sequently, pediatricians in these com-
Specific examples of pragmatic behav- experience. Language disorders are munities were more likely to identify
ior could include the ability to main- much more prevalent in youngsters children for treatment. During the past
tain or stay on a topic, as opposed to with EBD than one may suspect. This 10 years, studies have reported preva-
irrelevant comments, unorganized nar- area is often ignored by educators work- lence rates of language problems among
ratives, inappropriate questions, or ing with these children. In fact, a quick youngsters with EBD ranging from
excessive interruptions. Of the five glance through textbooks dealing with moderate levels of 24% to a shock-
areas of language problems, pragmatics characteristics and interventions for ing 95% (Baker & Cantwell, 1982;
is particularly relevant to practitioners youngsters with EBD suggests that the Camarata et al., 1988; Fessler, Rosen-
working with youngsters with EBD be- topic of language problems is either berg, & Rosenberg, 1991; Ruhl, Hughes,
cause of its relation to interpersonal ignored completely or restricted to dis- & Camarata, 1992). Interestingly, these
competence. cussions of severe behavior disorders studies have addressed the strong co-
such as autism. existence of language problems (e.g.,
Unless the relatively high prevalence morphological, syntactical, semantic,
Understanding Pragmatics of language problems among young- and pragmatic) with youngsters who
Aspects of pragmatics include under- sters with EBD is acknowledged, the also have emotional or behavioral
standing context; changing language area of language seems destined to disorders.
according to the needs of a listener or remain solely within the purview of In summary, the research to date sug-
situation,- conveying intents; using lan- speech-language pathologists. This cir- gests that rates of language problems
guage for different purposes such as cumstance would indeed be unfortu- among youngsters with EBD are fairly
greetings, requests, or commands; and nate because special educators can use high but will vary, depending upon the
using rules for participating in con- many of the language techniques from age of the sample, the setting from
versations. The ability to initiate and the field of speech pathology to deter- which they were selected (e.g., clinical
maintain a topic, take turns, respond mine the functional relationship be- and psychiatric, resource classroom),
to requests for clarification, repair tween problem behavior and its intent. and the tests used to determine the
errors in conversation, actively partic- Therefore, a brief overview of the prev- presence of a language disorder.
ipate in a conversation, establish eye alence of language problems among
contact, use other nonverbal signals youngsters with EBD is necessary.
such as facial expressions, or provide These prevalence figures support addi- Implications
sufficient information are important tional collaborative efforts between Language disorders among young-
aspects of conversational management speech-language pathologists and spe- sters with EBD can have far-reaching
and social competence (Brinton & cial educators for more effective pro- implications. Within the academic
Fujiki, 1989; Gallagher, 1991; Kirchner gramming. domain, language impairments ad-
& Prutting, 1989; Laughton & Hasen- versely impact a youngster's auditory
stab, 1986). comprehension, written expression,
The importance of understanding Extent of Language Impairments reading comprehension, mathematics,
pragmatics has been addressed recently in Youngsters with EBD spelling, response to questions, basic
by Neel and Cessna (1993) in their de- Language disturbances in youngsters concept development, and participa-
scription of appropriate instructional with EBD have only recently been the tion in class discussions (Kamhi &
content for students with EBD. They topic of investigation; however, many Catts, 1989; Wallach & Liebergott,
gave the example of aggressive students of the interventions used with young- 1984; Wallach & Miller, 1988). Neel
who found that striking an intimi- sters with EBD rely on some type of and Cessna (1993) cogently described
dating pose or uttering a few well- language skill. For example, how effec- the relation between the intended pur-
chosen words allowed them to escape tive can we expect verbal mediation pose of inappropriate behavior and
an unpleasant spelling assignment. interventions such as self-instruction teaching appropriate replacement be-
This example reflects the students' training to be with youngsters who haviors that achieve the desired out-
communicative intent (e.g., Neel & lack adequate receptive and expressive come. Although determining the pur-
Billingsley, 1989). From this perspec- language skills? Similarly, the whole pose inappropriate behavior serves is
tive, problem behaviors are similar area of pragmatics described previously directly related to pragmatics, the im-
to their appropriate counterparts in has direct impact upon children acquir- pact language problems have upon the
that they have been determined by the ing and using social skills. Therefore, effectiveness of a broad range of inter-
youngster to be the most effective it is helpful to examine the extent ventions used with youngsters with
means of communicating their needs to which youngsters with EBD ex- EBD cannot be understated.
in a particular situation or setting. perience concomitant difficulties in
Although this explanation appears language. Intervention Implications. Almost
straightforward, the task of determin- Prevalence estimates have implica- every intervention used with young-
ing the intent of behavior is much tions for identification and treatment sters with EBD relies on some form of

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communication. Teachers communi- would be appropriate for use with a conspicuous lack of emphasis on the
cate to students whenever they imple- adults, such as Albert Ellis's rational role of children's language skills and
ment an intervention. The effective- emotive therapy (RET; Ellis, 1962), may their level of interpersonal function-
ness of the intervention also depends, not be fully understood by children. ing. For example, several researchers
to a large extent, upon the degree to This problem is exacerbated in chil- have developed models for organizing
which the student understands and is dren with language problems. In fact, assessment information to determine
able to apply it. Communication skills many counseling techniques in addi- the nature of performance deficits.
can impact upon the efficacy of behav- tion to RET, such as reality therapy, Gresham and Elliott (1984) categorized
ioral, cognitive-behavioral, and coun- transactional analysis, and gestalt ther- social skills problems into four general
seling techniques used with young- apy, that have been used with young- areas: skill deficits, performance defi-
sters with EBD. sters rely heavily on children's ability cits, self-control deficits, and self-
A wide variety of behavioral inter- to understand the practitioner and control performance deficits. Distinc-
ventions rely on the use of instructions express themselves adequately (e.g., tions among these four categories are
to prompt appropriate responses from Maag & Meinhold, 1985). based on whether or not youngsters
youngsters. Sulzer-Azaroff and Mayer know how to perform the skill in ques-
(1977) suggested that instructions be- tion and the existence of emotional
come discriminatory for specific re- arousal responses (e.g., anger, impul-
sponses in exactly the same manner sivity) that may interfere with perfor-
as do other stimuli such as physical mance. Hughes and Hall (1987) de-
prompts. Instructions can facilitate scribed a similar model by combining
behavioral change in several ways. For correct and incorrect social perceptions
example, they speed up the learning "Language disorders with the following strategic reper-
process and may help youngsters work are much more prevalent toires: 230 error, behavioral skill defi-
for delayed reinforcement (Ziegler, in youngsters with EBD cit, cognitive deficit, and cognitive-
1987). In addition, instructions repre- behavioral deficit Their models have
than one may expect/' greatly enhanced our knowledge of fac-
sent an integral component of social
skills training (Maag, 1990). Instruc- tors related to youngsters' poor inter-
tions are used when requiring students personal skills. However, they virtually
to imitate a model, rehearse skills, and ignore the role language skills play in
perform the skills during role-play sit- the acquisition and performance of
uations. However, many youngsters social skills.
with EBD fail to follow instructions Assessment Implications. Perhaps
properly. Most often this failure is in no other area is the impact of young-
attributed to the youngster exhibiting sters' language skills as relevant as in Recommendations
oppositional behavior. Consequently, the area of functional assessment for Research in the past 10 years has
elaborate token economy systems and social skills training. Functional as- not only addressed the extent of lan-
behavioral contracts have been used to sessment refers to the process of deter- guage problems in youngsters with
enhance compliance with instructions mining the reason or nature for a child's EBD, it has also suggested a larger role
(e.g., Axelrod, 1974; Rutherford & social skill performance deficit (Maag, with this population for the speech-
Polsgrove, 1981). However, it also is 1989). Deficits may be due to a variety language pathologist (Camarata et al.,
possible that youngsters either did not of factors: missing requisite skills, poor 1988; Giddan, 1991; Giddan, Trautman,
understand the instructions or lacked problem solving or impulse control, & Hurst, 1989; Prizant et al., 1990).
the language skills to ask for clarifi- deficient language skills, or environ- This role has stressed more involve-
cation. mental antecedents and consequences ment in both evaluation and interven-
Cognitive-behavioral interventions that militate against competent perfor- tion (Rosenthal & Simeonsson, 1991;
also rely heavily on the language skills mance. For example, a boy who lacks Ruhl et al., 1992; Trautman et al.,
of the teacher and student. For exam- requisite skills for initiating a conver- 1990). This expanded involvement is
ple, self-instruction training, problem- sation with a group of his peers would needed because of the impact language
solving training, self-management tech- benefit from behavioral social skills has on behavior, social skills, aca-
niques, attribution retraining, and training. Conversely, if the boy pos- demics, and learning. Valuable inter-
relaxation training all emphasize the sessed requisite skills for introduc- vention contributions could result
complex interaction among cognitive ing himself and initiating a conver- from more collaborative efforts among
events, processes, products, structures, sation but is nervous and subsequently the speech-language pathologist, edu-
affect, overt behavior, and environmen- fails to employ the behaviors, self- cational consultant, and special educa-
tal contexts and experiences (Braswell instruction training or relaxation train- tor to address problems in these areas.
& Kendall, 1988). The effectiveness ing would be advisable. The process There are a number of recommenda-
of cognitive approaches is dependent of linking assessment information to tions that can facilitate language skills
upon several factors, including the performance deficits is crucial for for children who have concomitant
child's verbal fluency, comprehension, maximizing the effectiveness of inter- language and emotional and behavioral
and capacity for conceptual reasoning. vention. disorders. However, a lengthy descrip-
These factors are directly related to the Although the idea of functional as- tion of these recommendations would
level of a child's language skills. There- sessment has gained support in the not do justice to the contextual condi-
fore, many cognitive strategies that social skills literature, there has been tions within the school and the com-

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plexity level of language as they affect Encourage Children to Practice 1990). It is important that children
youngsters' interactions. Contextual Conversational Skills know how to act and interact in the
support, regularities of daily school It is easy to take for granted young- classroom (e.g., when to be quiet, when
routine, nature of the listening en- sters' conversational skills. In fact, to ask a question, when to ask for help
vironment, and the overall language many teachers try to suppress young- from a peer, how to follow the teacher's
demands of the curriculum are task de- sters' conversation skills when they cues for special directions). Examining
mands that can affect ongoing inter- occur during a lesson. This practice is the subtle nuances of classroom rou-
actions. Nevertheless, there are several exemplified by the rule of "no talking tines and the teacher's cues will pro-
areas that should be considered when while working." However, it is impor- vide valuable information to help facil-
planning a language intervention. tant for youth to use conversational itate students' success in the classroom
Mismatches in communication skills within classroom contexts. Some (Creaghead, 1992; 1993). Recently,
among the language of the teacher, stu- conversational skills include appropri- Fuchs, Fernstrom, Scott, Fuchs, and
dent, curriculum, textbook, and ex- ately getting the teacher's attention, Vandermeer (1994) developed a class-
pectations regarding routines of the asking for clarification if information room ecological inventory for determin-
classroom might result in successful or is not understood, responding to re- ing expectations, rules, and teacher-
unsuccessful communication (Creag- quests for clarification, participating student behavior interaction patterns.
head & Tattershall, 1985; Nelson, in peer conversation, taking turns in
1985) and are important considera- conversations, maintaining a topic of
tions. Most appropriate suggestions conversation, initiating activities and Facilitate Language in
will be the result of evaluations that conversations, and solving problems Naturalistic Contexts
include classroom observations and (Brinton & Fujiki, 1989; Giddan, 1991; Naturalistic contexts could include
standardized as well as descriptive lan- Giddan etal., 1989; McDonough, 1989). the arrival at school, transition between
guage measures. The effectiveness of In this respect, it is important for teach- classes, and interactions occurring dur-
language program development and ers to foster interaction among chil- ing athletic activities and through a
implementation of the following rec- dren and provide opportunities for variety of classes in a regular school
ommendations will be facilitated when them to build relationships with peers day. Special educators could use these
the speech-language pathologist and and teachers. Unfortunately, many spe- contexts to allow children to provide
special educator work collaboratively. cial education classrooms are devised appropriate responses when asked ques-
The following recommendations are to curtail interaction. tions, to follow instructions, partici-
not intended to be inclusive; however, Neel (1988) described several steps pate in conversations, introduce a
they may be useful for special educa- for fostering interaction. For example, topic, change a topic appropriately,
tors in planning programs and develop- putting different children in charge of maintain a topic while adding new and
ing language-based intervention activi- particular materials and activities, and relevant information, respond to the
ties in the classroom. implementing cooperative learning speaker's request for clarification, or to
activities where students can work take turns while conversing. Through-
together, encourage social interac- out the school day there are a variety
Teach Vocabulary and Words tion. Similarly, management programs of classroom activities wherein lan-
Denoting Emotional Expression should be developed that facilitate guage skills could be facilitated through
Vocabulary variety, as well as words rather than prevent social interaction. theme-building activities and the use
that specifically help youngsters ver- Neel observed that students typically of scaffolding. Examples of these con-
balize frustrations associated with are rewarded for sitting quietly and texts where language could be facil-
complex language (e.g., sad, scared, only talking when they raise their itated include, but are not limited
embarrassed, confused, lonely, disap- hand, which, in turn, reduces opportu- to, learning poetry, role-playing sit-
pointed), could reduce the quantity and nities to reinforce social interaction. In uations, cooperating in games to solve
severity of classroom behavior prob- addition, it is difficult to enhance in- mysteries about literature, dialoging
lems. These types of words could be teractive problem solving when class- through class meetings, discussing lit-
acceptable replacements to help young- rooms are structured to the extent that erature, practicing peer interviews,
sters express themselves, rather than all obstacles are eliminated for stu- retelling stories using dialog journals,
using inappropriate adverse behaviors dents. writing narratives, brainstorming po-
such as sarcasm or verbal threats lite phrases, creating a list of conver-
(Giddan, 1991). Vocabulary develop- sational starters, using round-robin
ment could include learning alternate Use Clearly Presented Rules techniques for brainstorming, holding
words to describe concepts, learning a It is important for students to under- class meetings, and pantomiming feel-
network of related concepts, learning stand classroom rules for all classes, ings and situations. Special educators
words that have multiple meanings, including music, art, and special edu- should use the texts of the curriculum
and understanding figurative concepts cation. Assumptions cannot be made to build language skills.
(i.e., metaphors, idioms). Vocabulary that generalizations will occur across
development should be functionally settings or classes. Students with lan-
relevant and acceptable to a young- guage problems may have difficulty in Incorporate Whole Language
ster's desired outcome, and facilitated areas such as understanding expecta- Strategies
through whole language learning as tions, rules, and scripts. Teachers may Three principles can serve as guides
well as school- and other literature- find it helpful to use frequent repeti- to understanding whole language. First,
based texts. tion of rules and expectations (Stone, language is a whole, it is learned from

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whole to part, and written language is lescents with emotional and behavioral disorders. learning problems among students with behavior/
developed in parallel with oral lan- N a d i n e R. S h a p e r a is currently a graduate emotional disorders. Behavior Disorders, 16, 97-
student majoring in the area of communication dis- 106.
guage (Norris & Hoffman, 1993). Sec- orders at the University of Nebraska-Lincoln.
ond, whole language focuses on rele- Address: Dixie Sanger, 318 Barkley Memorial Fuchs, D., Fernstrom, P., Scott, S., Fuchs, L., & Van-
vant literacy and builds on existing Center, University of Nebraska-Lincoln, Lincoln, dermeer, L. (1994). Classroom ecological inven-
learning. Third, language should not be NE 68583-0731. tory: A process for mainstreaming. Teaching
decontextualized and fragmented into Exceptional Children, 26(2), 11-15.
isolated parts but rather learned as a
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NOTICES

Expanding Autism cedures; and (e) program descrip- Medical Center, 3901 Rainbow,
Journal Seeks tions. The journal will also publish Kansas City, KS 66160-7335; or
Manuscripts short manuscripts (2 to 10 pages) Dr. Dianne Berkell, Long Island
The bimonthly journal Focus in two areas: (1) teaching tips and University, C. W. Post Campus,
on Autistic Behavior will soon be (2) book reviews. Department of Special Education
superseded by a new, peer-reviewed Persons submitting papers for and Reading, Brookville, NY 11548.
quarterly journal, to be titled publication in Focus on Autism
Focus on Autism and Other and Other Developmental Disabili-
Developmental Disabilities. The ties should prepare their manu- The Orton Dyslexia
journal will continue to include scripts in accordance with the Pub- Society's Annual
articles related to persons with lication Manual of the American Outstanding Dissertation
autism but is being expanded to Psychological Association (4th ed., Award
address issues concerning persons 1994). An original of the com- Application guidelines for the
with other developmental disabil- plete manuscript and three high- Outstanding Dissertation Award
ities, such as mental retardation. quality copies (double-space all are available by contacting The
Editorial responsibilities for the manuscript pages, including tables, Orton Dyslexia Society. Deadline
new journal will be shared by figures, references, and headings) for submission to the committee
Dr. Richard Simpson, the cur- should be submitted; each manu- is March 1, 1995. The award will
rent editor of Focus on Autistic script should include a cover be presented at the society's 46th
Behavior and a professor of spe- sheet listing the names, affil- annual conference in Houston,
cial education at the University of iations, addresses, and phone Texas, November 1-4, 1995. The
Kansas, and Dr. Dianne Berkell, a numbers of all authors. All manu- recipient receives a $1,000 cash
professor of special education at scripts will be screened by one of award, plus $500 for travel expenses.
Long Island University, C. W. the coeditors for appropriateness Some recent winners include Brenda
Post Campus. of content and form and reviewed H. Stone, PhD, University of
The journal's editorial staff seeks by three peers (selected by the Rhode Island; Lois G. Dreyer, PhD,
manuscripts from diverse philo- coeditors on the basis of their Southern Connecticut State Uni-
sophical and theoretical positions. expertise in particular areas). versity,- and Margaret Semrud-
Five types of full-length manu- Authors typically will be notified Clikeman, PhD, University of
scripts (15 to 30 pages) will be con- of the disposition of their paper Washington. For a copy of the
sidered for publication: (a) original within 8 to 10 weeks of the time guidelines, write or phone: The
research reports,- (b) reviews and it is sent for peer review. Addi- Orton Dyslexia Society, The
interpretations of professional lit- tional details may be obtained by ODS Dissertation Award, Chester
erature; (c) theoretical papers, contacting either Dr. Richard L. Building/Suite 382, 8600 LaSalle
Simpson, Department of Special Road, Baltimore, MD 21286-2044;
conceptual statements, and posi-
Education, University of Kansas 410/296-0232.
tion papers; (d) intervention pro-

108 INTERVENTION IN SCHOOL AND CLINIC


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