It is nearly 30 years since the publication of the edited book by Rutter and Martin (1972), The child with delayed speech (London: Heinemann), which drew attention to the two-way relationship between language and behaviour. In the book the mechanisms whereby psychiatric disorders can have an involvement with language development were identified. Also, Mike Rutter suggested various ways in which delayed language development could impinge upon other aspects of psychological development. The current issue of the JCPP has a number of papers that examine the relationship between language development and aspects of cognition and behaviour. These include a long-term follow-up for a group of individuals with receptive language disorder who were first studied at about the time that the 1972 book was published.

There is an urgent need to pay attention to the mental health of children in developing countries. Professionals confronted with this task face a number of challenges. Services have to be planned in a rational way, keeping in mind the needs of local populations. These needs will often exceed the available resources, and it will be necessary to set priorities. Feasible and cost-effective models of service delivery then have to be developed to meet these needs. This annotation provides a framework within which mental health needs of children can be assessed, priorities established, and services organised. This is illustrated with examples of relevant activities undertaken in low-income developing countries over the last two decades.

In this paper we compare adult outcome in a group of young men with autism and a group with developmental receptive language disorders. The two groups were first assessed in early childhood, when aged 7 to 8 years of age. Although matched at that time for nonverbal IQ (mean 92–93) and expressive language ability, the Autism group was significantly more impaired on most measures of social and communication skills and stereotyped behaviours. A later follow-up, in mid-childhood, suggested that although the groups were still quite distinct, social and behavioural problems had become more apparent in the Language group. The current study was completed when the participants were aged, on average, 23 to 24 years. The findings indicated that verbal IQ and receptive language scores had improved significantly more in the Autism group than in the Language group over time. Moreover, although the Language group were less severely impaired in their social use of language, many showed a number of abnormal features in this domain. There were no differences between the groups on tests of reading or spelling. Discriminant function analysis, which had clearly distinguished between the groups as children, now showed much greater overlap between them. Regression analysis indicated that although early language ability appeared to be related to outcome in the Autism group, in the Language group there was little association between measures of childhood functioning and later progress. The implications of these findings for understanding the nature of the underlying deficit in autism and the relationship between the two disorders are discussed.

This paper focuses on general social functioning in two groups of young men, one with autism and one with developmental receptive language disorders, who were first assessed at the ages of 7–8 years. At that time, although matched for nonverbal IQ (mean 92–93) and expressive language, the Language group showed significantly fewer social and behavioural problems. At follow-up, when aged on average, 23 to 24 years, the Autism group continued to show significantly more impairments in terms of stereotyped behaviour patterns, social relationships, jobs, and independence. However, problems in all these areas were also common in the Language group. Many still lived with their parents, few had close friends or permanent jobs, and ratings of social interaction indicated abnormalities in a number of different areas. On a composite measure of social competence only 10% of the Language group was assessed as having severe social difficulties compared to 74% of the Autism group. Nevertheless, 65% were rated as having moderate social problems and only 25% were rated as being of near/normal social functioning. Two individuals in the Language group, but none in the Autism group, had also developed a florid paranoid psychosis in late adolescence.

As in the follow-up of cognitive and linguistic functioning (see Mawhood et al., 2000, this volume, pp. 547–559), discriminant function analysis, which had clearly distinguished between the groups as children, now showed much greater overlap between them. Regression analysis indicated that although early language ability appeared to be related to outcome in the Autism group, there was little association between any measures of childhood functioning and prognosis in the Language group. Theoretically, these findings have implications for our understanding of the nature of autism and other pervasive language disorders, and of the relationship between them. Practically, they demonstrate the very persistent problems experienced by individuals with developmental language disorders, and their need for much greater help and support than is presently available.

Objective: To determine the risk of the lesser variant (or PDD-like traits) in the biological and nonbiological second- and third-degree relatives of PDD probands using a screening questionnaire and to investigate the extent to which the risk of the lesser variant differs according to various characteristics of the proband. Method: The sample consists of a series of 34 nuclear families with 2 affected PDD children (multiplex, MPX), 44 families with a single PDD child (simplex, SPX), and 14 families who adopted a PDD child. Data on characteristics of the lesser variant in 1362 biological and 337 nonbiological second- and third-degree relatives were collected from parents by telephone interview and from several maternal and paternal relatives by questionnaire. Results: All components of the lesser variant were more common in biological relatives (BR) than nonbiological relatives (NBR), confirming the familial aggregation of the traits. Proband characteristics associated with an increased risk of the lesser variant in relatives were a higher level of functioning and coming from a MPX family. Conclusions: These findings on the familial aggregation of the lesser variant suggest that the genes for PDD also confer susceptibility to the lesser variant and that PDD may be a genetically heterogeneous disorder.

The literacy skills of 56 school leavers from the Bishop and Edmundson (1987) cohort of preschoolers with specific language impairment (SLI) were assessed at 15 years. The SLI group performed worse on tests of reading, spelling, and reading comprehension than age-matched controls and the literacy outcomes were particularly poor for those with Performance IQ less than 100. The rate of specific reading retardation in the SLI group had increased between the ages of 8½ and 15 years and there had been a substantial drop in reading accuracy, relative to age. However, over 35% had reading skills within the normal range and those who had had isolated impairments of expressive phonology had a particularly good outcome. Our findings highlight the limitations of discrepancy definitions of dyslexia that do not take account of the changing demands of reading over time. We argue that children's phonological difficulties place them at risk of literacy failure at the outset of reading and that later, impairments of other language skills compromise development to adult levels of fluency.

Deaf children frequently have trouble understanding other people's emotions. It has been suggested that an impaired theory of mind can account for this. This research focused on the spontaneous use of mental states in explaining other people's emotions by 6- and 10-year-old deaf children as compared to their hearing peers. Within both age-groups deaf children referred to others' beliefs as often as their hearing peers and their references to desires even exceeded those of hearing children. This relative priority for the expression of desires is discussed in terms of possible communicative patterns of deaf children. The specific problems that deaf children meet in their daily communication might explain their abundance of desire-references: plausibly, they give a high priority to stress their own desires and needs unambiguously.

Phonological awareness is important for reading development in hearing children, in whom it develops at the three consecutive levels of the syllable, rhyme, and phoneme. Deaf children typically have literacy difficulties, and previous research has been equivocal about whether deaf children can develop phonological awareness. Three experiments are presented that investigate the phonological skills of deaf children (mean age 11 years) at the three linguistic levels of syllable, rhyme, and phoneme. The first experiment showed that deaf children's syllable awareness can be equivalent to that of chronological age-matched hearing controls. In the second experiment, deaf children's ability to make rhyme judgements was above chance, but poorer than that of younger reading-matched hearing controls. The third experiment showed that deaf children could phonologically recode nonsense words at a level above chance, suggesting that they could draw on phonemic skills in certain conditions. We conclude that deaf children can develop phonological awareness, but that their phonological skills lag those of hearing children and may develop in different ways. Differences between our tasks and those used in other studies are discussed.

This study explored the links between the development of language and the development of social cognition. Measures of language, phonological short-term memory, social cognition, and social competence of two groups of children with specific language impairment (SLI), one group attending a special school, the other attending integrated educational placements, were compared with those of chronological and language age-matched normally developing peers (N = 8 in each group). Significant differences between the scores of normally developing children and the scores of the group of children with SLI who attended the special school were found for social cognition and ratings of social competence. Children with SLI from integrated placements did not differ significantly from other groups on these measures. Assessments of language development and phonological short-term memory were not related to social cognition and social competence. Models of the possible relationship between social cognition and language development in children with SLI are discussed.

Functional imaging studies of developmental dyslexia have reported reduced task-related neural activity in the temporal and inferior parietal cortices. To examine the possible contribution of subtle anatomic deviations to these reductions, volumes were measured for the major lobes of the brain, the subcortical nuclei, cerebellum, and lateral ventricles on magnetic resonance imaging (MRI) scans from 16 right-handed dyslexic men, ages 18 to 40, and 14 matched controls, most of whom had previously undergone PET imaging. A specific decrease in tissue volume was localized to the temporal lobes and was particularly prominent on the left (p < .01). An analysis of tissue composition revealed that this reduction was primarily attributable to decreased gray matter within the left temporal lobe (p < .002). Further segmentation of the temporal lobe showed that this reduction was not confined to the superior temporal gyrus, the primary location of primary auditory cortex. Reductions of temporal lobe gray matter may reflect a regional decrease in neuronal number or neuropil, which in turn may result in reading impairment.

The Development and Well-Being Assessment (DAWBA) is a novel package of questionnaires, interviews, and rating techniques designed to generate ICD-10 and DSM-IV psychiatric diagnoses on 5–16-year-olds. Nonclinical interviewers administer a structured interview to parents about psychiatric symptoms and resultant impact. When definite symptoms are identified by the structured questions, interviewers use open-ended questions and supplementary prompts to get parents to describe the problems in their own words. These descriptions are transcribed verbatim by the interviewers but are not rated by them. A similar interview is administered to 11–16-year-olds. Teachers complete a brief questionnaire covering the main conduct, emotional, and hyperactivity symptoms and any resultant impairment. The different sorts of information are brought together by a computer program that also predicts likely diagnoses. These computer-generated summary sheets and diagnoses form a convenient starting point for experienced clinical raters, who decide whether to accept or overturn the computer diagnosis (or lack of diagnosis) in the light of their review of all the data, including transcripts. In the present study, the DAWBA was administered to community (N = 491) and clinic (N = 39) samples. There was excellent discrimination between community and clinic samples in rates of diagnosed disorder. Within the community sample, subjects with and without diagnosed disorders differed markedly in external characteristics and prognosis. In the clinic sample, there was substantial agreement between DAWBA and case note diagnoses, though the DAWBA diagnosed more comorbid disorders. The use of screening questions and skip rules greatly reduced interview length by allowing many sections to be omitted with very little loss of positive information. Overall, the DAWBA successfully combined the cheapness and simplicity of respondent-based measures with the clinical persuasiveness of investigator-based diagnoses. The DAWBA has considerable potential as an epidemiological measure, and may prove to be of clinical value too.

Recent epidemiological studies suggest that both social anxiety and attention deficit hyperactivity disorder (ADHD) in childhood might predict levels of delinquent behavior in adolescence. The current study prospectively examines the influence of social phobia and ADHD symptom scale scores on the correlation in conduct disorder symptom scale scores over time. An epidemiologically selected sample of 776 young people living in Upstate New York received DSM-based psychiatric assessments in 1983, 1985, and 1992 using structured interviews. Correlations among conduct disorder scales over time were examined as a function of social phobia and ADHD ratings. Individuals with low scores on social phobia scales or high scores on ADHD scales exhibited the highest correlation in conduct disorder symptom scales over time. There was also a suggestion that low scores on social phobia scales predicted later risk for conduct disorder. Low scores on social phobia symptom scales or high scores on ADHD scales predict stronger across-time correlations in conduct disorder symptom scales. Various cognitive or biological factors might account for these moderating effects on conduct problems.

To Wamboldt, Schmitz, & Mrazek (1998). Genetic association between atopy and behavioural symptoms in middle childhood. Volume 39 (7), pp. 1007–1016.

Through Dr Emily Simonoff's re-analysis of our data (see article above, pp. 667–674) we found a slight model specification change which has now been corrected and which actually provides stronger results. Revised Tables 4–6 are available from the authors by request.

Correct covariance matrix for the DZ opposite-sex pairs for atopy and total problem score

1 2 3 4

1 0.710

2 0.352 2.393

3 0.213 0.044 0.825

4 0.025 1.717 0.137 2.980

Corrected last paragraph of the Results section

Additive genetic effects accounted for most of the correlation between atopy and the three CBCL scores: 77% of the correlation between atopy and internalising symptoms, 100% of the correlation between atopy and externalising symptoms, and 93% of the correlation between atopy and total problem scores. The genetic correlation (rG) between atopy and INT was .34 and the nonshared environmental correlation (rE) was .16; for atopy and EXT rG was .29 and there was no rE; for total problems and atopy rG was estimated at .37 and rE at .06. The parameter estimates obtained from the bivariate factor model (full model, or A & E) are as follows: for atopy, h2 = .72 and e2 = .28; for INT, h2 = .35, c2 = .28 and e2 = .37; for EXT, h2 = .55, c2 = .23 and e2 = .22; and for Total Problems, h2 = .34, c2 = .45 and e2 = .21.

As behavioral genetic strategies have become part of the arsenal of research in developmental psychopathology, a wide variety of genetic analyses are being applied to child psychiatric data. Multivariate genetic techniques have been used to explore comorbidity among traits or disorders and the main analysis undertaken has been to examine whether comorbidity is due to shared genetic and/or environmental factors. However, this model ignores other possible causes of comorbidity, which are reviewed. In particular, genetic analyses of comorbidity have only infrequently considered the model of phenotypic causality (one disorder directly influencing another), which provides an important alternative with potentially different implications for intervention strategies. Data from a recently published article by Wamboldt, Schmitz, and Mrazek (1998) are used to illustrate the potential difficulties of distinguishing between models of shared genetic/environmental risk and phenotypic causality. Given that the sample sizes required to distinguish between these models are often large, and frequently greater than those of the datasets available, it is argued that researchers should select the models that they test based on other lines of evidence that these models are plausible. Where convincing evidence does not exist, researchers should explore alternative models and determine their power to discriminate between these models.