Merely Misunderstood? Receptive, Expressive, and Pragmatic Language in Young Children With Disruptive Behavior Disorders

Abstract

Children with disruptive behavior disorders (DBDs) often seem to have poorer language skills compared to same-age peers; however, language as an early risk factor for DBD has received little empirical attention. The present study provides an empirical examination of associations between normal language variation and DBD by investigating receptive, expressive, and pragmatic language skills and preschool DBD symptoms. The sample consisted of 109 preschoolers ages 3 to 6 (M = 4.77 years, SD = 1.10, 59% boys; 73% with DBD, including oppositional defiant disorder [ODD] and attention-deficit/hyperactivity disorder [ADHD]) along with their primary caregivers, who completed a clinician-administered interview, symptom questionnaires, and a questionnaire measure of pragmatic language, and teacher and/or daycare providers completed symptom questionnaires. Children completed objective tests of receptive and expressive vocabulary. Preschoolers with DBD showed poorer receptive, expressive, and pragmatic skills compared to preschoolers without DBD. Preschoolers with ADHD-only or ADHD+ODD exhibited poorer language skills, compared to ODD and non-DBD groups. Specificity analyses suggested that parent-rated hyperactivity-impulsivity were particularly associated with poorer language skills. Thus, preschoolers with DBD exhibited poorer language skills compared to preschoolers without DBD, and preschoolers with increased hyperactivity-impulsivity exhibited particular problems with language skills. This work suggests the need for early assessment of language in preschoolers, particularly those with ADHD, as well as the possible utility of tailored interventions focused on improving language skills, particularly for those with high hyperactivity-impulsivity.

Notes

Note. ADHD = attention-deficit/hyperactivity disorder; ODD = oppositional defiant disorder; DBD = disruptive behavior disorder.

^a n = 18.

^b n = 18.

^c n = 43.

^d n = 30.

*Significant differences between DBD and non-DBD groups, p < .05. ^†Multiple modes (0 = annual income less than $20,000, 1 = between $20,000 and $40,000, 2 = between $40,000 and $60,000, 3 = between $60,000 and $80,000, 4 = between $80,000 and $100,000, and 5 = over $100,000 annually).

Note. Like subscripts denote significant differences between groups (p < .05). Receptive language was measured using the PPVT-4. Expressive language was measured using the EVT-2. Standard scores for receptive and expressive language are reported. Pragmatic language was measured via parent-report on the CELF-P-2 Descriptive Pragmatics Profile. Raw scores for pragmatic language are reported. ADHD = attention-deficit/hyperactivity disorder; ODD = oppositional defiant disorder; DBD = disruptive behavior disorder; DBRS = Disruptive Behavior Rating Scale; K-DBDS = Kiddie Disruptive Behavior Disorder Schedule; Sx = Symptoms.

^a n = 18.

^b n = 18.

^c n = 43.

^d n = 30.

Note. All unflagged correlations are significant at p < .01. PPVT = Peabody Picture Vocabulary Test-Fourth Edition; measure of receptive language. EVT = Expressive Vocabulary Test–Second Edition, measure of expressive language; DPP = Descriptive Pragmatics Profile of CELF = Clinical Evaluation of Language Fundamentals Preschool–Second Edition, measure of pragmatic language; P-Inattn = parent-rated inattention on DBRS; P-HI = parent-rated hyperactivity-impulsivity on DBRS; P-ODD = parent-rated ODD symptoms on DBRS; P-DBD = total parent-rated DBD symptoms on DBRS; T-Inattn = teacher-rated inattention on DBRS; T-HI = teacher-rated hyperactivity-impulsivity on DBRS; T-ODD = teacher-rated ODD symptoms on DBRS; T-DBD = total teacher-rated DBD symptoms on DBRS.

*p < .05.

Note. DBD = disruptive behavior disorder; ODD = oppositional defiant disorder; Sx = symptoms.