Girls under-referred for language problems

3 minute read

A new study shows no sex differences in children with developmental language disorder, yet boys are more likely to receive support.

Young girls experience developmental language disorder at the same rate as boys, yet are less likely to be referred for clinical treatment, according to a large Curtin University study.

Using data from Australia’s longest-running public health study (the Raine Study), involving more than 1600 10-year-olds, researchers found 6% met the criteria for developmental language disorder. This was a higher prevalence than other more well-known neurodevelopmental disorders such as autism and ADHD.

Among the 104 children with developmental language disorder, there were no significant differences in sex, with 49 girls and 55 boys experiencing the condition.

Researchers suggest that this finding might be surprising to some clinicians as previous studies have shown that boys are more likely to receive referrals for speech and language support services.

“A history of developmental language disorder is associated with lower academic and vocational qualifications. Males with developmental language disorder are four times more likely to engage in anti-social behaviour and females are three times more likely to be victims of sexual abuse.

“From an access-to-service standpoint, educators and health professionals should be vigilant when considering referrals for females who present with potential language and learning challenges,” the study authors wrote.

Psychiatrist, Professor Vaslamma Eapen told TMR that young girls presenting with language difficulties may be overlooked due to gendered assumptions about their behaviour, as well as their ability to mask their symptoms.

“If a young girl is not speaking, or if she has a language related speech issue, people might assume that she’s just shy or just behaves like that in social situations, so going to go seek help for these issues isn’t normally front of mind for parents.

“And even if parents were to seek help, the language disorder might get dismissed or be misdiagnosed as social anxiety. So, these expectations may overshadow whether language disorders are taken seriously in young girls, and then further comprehensive damage assessment probably isn’t happening for them,” said Professor Eapen, chair of faculty of infant and child & adolescent psychiatry at UNSW.

According to Professor Eapen, looking at overall development rather than a language disorder alone puts GPs in the best position to identify the signs of developmental language disorder in young children, particularly when they come in for unrelated matters.

“It’s one of those things that GPs could look out for when seeing kids for other things, for instance when they come in for vaccinations. Keeping an eye out and supporting children during their early years, and as a part of that picking up on any differences in development, that’s the way to go.”

We need to come around to understanding development in a much more comprehensive, universal way, so that every child gets their development looked at in a much more robust way than is currently happening,” she said.

The Curtin-led study was the first to establish the prevalence of developmental language disorder among Australian children, and one of few internationally to measure the condition in the middle childhood years.

“In Australia, much of our awareness of the prevalence and impact of developmental language disorder has been informed by international research. Consequently, there is limited evidence to guide the development of public health and education campaigns specific to the Australian context.

“These findings should inform education and public health priorities to raise awareness of developmental language disorder and establish the foundation for exploring effective interventions and service delivery models for these at-risk children,” the authors wrote.

Journal of Paediatrics and Child Health 2022, online 3 August

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