Summary of coding schemes for behaviour observed during social interaction

The coding schemes described above are limited in the types of behaviours they detect (specific to their sample) and only one includes the observation of behaviours during

interaction with peers (potentially influenced by classroom and teacher dynamics). While they may indicate the types of behaviours that could be observed in children with poor social behaviour and communication, evidence is too limited to derive a strong hypothesis

predicting peer-to-peer interaction behaviour observed in children with BESD. It may be said that none of the coding schemes discussed above are entirely suitable for coding the

communicative interaction behaviours of children with BESD and typically developing children during peer interaction; including positive as well as problematic behaviours, verbal and non-verbal behaviours.

4.5 Literature Review 4: Reviewing Coding Schemes for Language and Communication Difficulties

In Chapter 3, observations of peer interaction behaviour were reviewed, and this included coding of some verbal and non-verbal behaviour of children. However, there remained the question of whether the social language of children with BESD differs from that of children with language and communication difficulties or disorders. Evidence reviewed so far in Chapter 3 has suggested pragmatic and structural language difficulties in children with BESD as well as children with language difficulties. There is a need to disentangle overlap between behaviour and language in terms of their applied operational impacts, especially in light of evidence for association between pragmatic language and social/externalising behaviour difficulties. It is also unclear whether difficulties that are highlighted in report measures are also observed in children’s social interaction. Such questions guided a fourth literature review exploring coded language and communication of children with behaviour or language

difficulties/disorders.

Literature review 4 was first carried out in 2010 at the start of the project. An updated search was carried out in November 2014 (searching 2010–2014) to update this and provide current data for comparison to the project findings. The same five databases presented in Chapter 3 were used in this literature search. Search terms included ‘communication’, ‘conversation’, ‘language characteristics’, ‘language observation’, ‘language coding’ ‘behaviour difficulties’, ‘behaviour disorder’, ‘externalising behaviour’, ‘ADHD’, ‘Conduct Disorder’, ‘language difficulties’, ‘language disorder’, ‘Specific Language Impairment’, and ‘Pragmatic Language

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Impairment’. Papers were included in the final literature review if they met the following inclusion criteria:

 Children recruited were of primary school age (4–11 years).

 Children were identified as having a primary behaviour difficulty/disorder or primary language difficulty/disorder.

 The paper reported upon distinct coding of children’s language and communication during social interaction or conversation.

 The paper was published within the previous ten years for the initial search, 2000–2010, and the previous four years for an updated search, 2010–2014 (to ensure the most recent findings were considered).

This resulted in 329 papers. Of these papers, seven met the full inclusion criteria. Three of these reported on the use of the same coding scheme within the same sample (Adams et al., 2005, 2006; Adams and Lloyd, 2007). The most recent of these will be included here as a main paper for review (leaving four papers in the final review). Key descriptive elements from each of these four papers are presented in Table 6.

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Study Sample (n) Age (mean), gender (M/F)

Coding scheme Key outcomes

Stroes, Albert and van der Meere (2003) ADHD 20 8.10 years (all male) Latency of speech responses, communicative speech, subject change, talk to self, duration and frequency of visual looks to the adult

ADHD group: more subject changes, longer duration of speech, slower responses, and interrupted less than TD group TD 19 9.1 years (all male) Ziatas (2003) ASD 12 8.3 years (10M, 2F)

SAT* Internal reports, attributions, explanations, identifications (objects/events), descriptions predicate events, judgement, procedurals

ASD children made fewer internal reports, explanations and descriptions. SLI made more internal reports and fewer assertions Asperger Syndrome 12 6.11 years (8 M, 4 F) SLI 24 8.2 years (10 M, 2 F) TD 12 5.8 years (10 M, 2 F) Redmond (2004) ADHD 10 6.9 years (9 M, 1 F) KLTD* Speaking rate, formulation and length, lexical diversity, morphosyntactic development (tense marking, grammar) ADHD group: difficulties with formulation, greater mean length speech. SLI group: difficulty with lexical diversity SLI 10 6.6 years (7 M, 3 F) TD 13 6.6 years (9 M, 4F) Adams and Lloyd (2007) PLI 6 7.10 years (all male)

ALICC* pre- and post- therapy. Conversational dominance, participation and loquacity High discourse participation, dominance and loquacity common characteristics Table 6: Key descriptive elements of four papers coding the language of children with behaviour or language disorders.

*SAT: Speech Act Taxonomy (Dore, 1986). KLT: Kansas Language Transcript Database (Howe, 1996). ALICC: Analysis of Language Impaired Children’s Conversation (Bishop et al., 2000).

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The four papers listed above all report on clinical samples of children with behaviour or language disorder. Only one includes observations of children who may present with co- occurring behaviour and language difficulties, those with ASD (Ziatas, 2003). Three studies include the use of existing coding schemes for coding various aspects of statemented or conversational spoken language. The ALICC codes pragmatic difficulties in language (in line with the characteristics of the PLI sample it has been applied to). The KAT codes structural aspects of language and the SAT codes both pragmatic and structural aspects of language. Noticeably, the KAT and SAT are both relatively dated in comparison to the ALICC. One paper includes a novel scheme which codes verbal (pragmatic) and non-verbal behaviour. Each of these four coding schemes was applied to the language and communication of children used during direct semi-structured conversational interaction with adults. Aspects of language and communication that are coded impact on the type of difficulties detected. Outcomes of these coding schemes, however, may be cross-referenced between behaviour or language impaired samples of children.

For those children with primary behaviour difficulty, outcomes of the studies by Stroes, Albert and van der Meere (2003) and Redmond (2004) suggest that while their

communicative speech may be longer in duration than that of typical children, the structural aspects of their language may be impaired. This is evidenced by reported difficulties with utterance formulation such as false starts, fillers, revisions and repetitions in speech. Outcomes also suggest that the coherence of their speech and conversation may also be impaired, evidenced by frequent subject changes and slower speech responses. This may be indicative of pragmatic language difficulties.

Reported language outcomes of children with primary language difficulty are also indicative of structural and pragmatic impairment, likely to be the result of different types of deficits. For children with SLI, evidence suggests less verbosity, shorter utterance lengths, less lexical diversity and less speech about others. Some of these qualities therefore indicate structural impairment, and some pragmatic impairment in language. Children with PLI are reported to be verbose and dominant in conversation, reflecting primary difficulties with pragmatic language. Additional language characteristics of children with PLI are reported in the two studies prior to Adams and Lloyd (2007) mentioned above, Adams et al. (2005) and Adams et al. (2006). Within these, responsiveness in conversation was also observed. Children with PLI were found to be less responsive and more likely to bring conversational topics back to their own preferred ones. Difficulties with conversational turn taking were also found, disrupting

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conversation. This suggests less engagement in conversation, egocentricity in speech and disruption to the coherence of conversation. Egocentricity in speech is also reported in children with SLI, noted above. Ziatas (2003) indicates that children with SLI make more internal reports and fewer reports about others. Disruption to coherence and flow of conversation is similar to disrupted coherence of utterance formulation (false starts, fillers, revisions and repetitions) reported above in relation to children with primary behaviour difficulties.

The Ziatas (2003) study also reports on children with ASD who have difficulties with social behaviour and language, indicating that this sample made fewer internal reports, explanations and descriptions than children with SLI or typically developing children, despite being matched on verbal mental age. This suggests children with ASD may use language less to engage with their external world or to report upon their inner thoughts and feelings. Children with Asperger Syndrome, however, made more internal reports and fewer assertions about others. This suggests greater egocentricity and may demonstrate difficulty with theory of mind, a common characteristic of children on the Autistic spectrum. Therefore, differential difficulties with behaviour that are coupled with or independent of, additional language difficulties may impact on how children use social language. This is supported by the studies above sampling children with ADHD (not reported to have any language difficulties), within which increased talkativeness and structural language difficulties are suggested.