Social-Emotional Problems in Toddlers: Relationship with Language Development and Autism Risk

honors thesisCollege of HealthCommunication Sciences & DisordersStacy S. ManwaringPurpose:Children with language delays are at increased risk for persistent difficulties such as language disorder, learning disability, and autism spectrum disorder (ASD). Further, the presence of a language delay may also indicate risk for social-emotional problems. However, research examining social-emotional problems in young children is limited, and the relationship of these problems to language itself is not well understood. The purpose of this study was to examine the social- emotional problems of toddlers with language delays compared to toddlers with typical development, and to examine the associations between social-emotional problems and both language development and symptoms of ASD in toddlers with language delays. Measures: Participants included 28 toddlers with receptive and expressive language delay (mean age 18.7 months) and 61 typically developing toddlers (mean age 18.5 months). Social-emotional functioning was assessed using the Infant-Toddler Social and Emotional Assessment (ITSEA; Carter and Briggs-Gowan, 2006) a parent-report measure, at 18 and 24 months. The Mullen Scales of Early Learning (Mullen, 1995) was used to measure language at 18 and 24 months. Autism symptoms were measured using the Autism Diagnostic Observational Schedule-2 (Lord et al., 2012). Results:Toddlers with language delay were reported to have higher levels of social-emotional problems on the Internalizing, Externalizing, and Dysregulation domains of the ITSEA, and reduced Competence, when compared to typically developing toddlers at both 18 and 24 months . In the language-delayed group of toddlers, Dysregulation at 18 months was correlated with concurrent and later expressive language. While competence behaviors were correlated with receptive language at 18 and 24 months. Social-emotional problems related to ASD "red flags", as determined by the ITSEA, were reported in a majority of toddlers with language delay at 18 months, and were highly correlated with ASD symptoms at 24 months. Conclusions:This study found that toddlers with receptive and expressive language delay exhibit increased levels of social-emotional problems as early as 18 months when compared to typically developing children. Results of the study also indicate that the association between social-emotional behaviors and both language development and ASD symptoms can be detected from 18 months onward