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Relationships between concurrent language ability and mental health outcomes in a South African sample of 13-year-olds.

ABSTRACT: Children and adolescents with delayed or disordered language development are at increased risk of a number of negative outcomes, including social and emotional problems and mental health difficulties. Yet, in low- and middle- income countries, where risk factors for compromised language development are known to be prevalent, there is a lack of research on the association between child and adolescent language ability and mental health outcomes. This study evaluates data from a cross-sectional study in Khayelitsha, a semi-urban impoverished community near Cape Town, South Africa. To measure language ability, behaviour and mental health, adolescents aged 13 (n = 200) were assessed using the Riddles subtest of the Kaufman Assessment Battery for Children Version 2, the parent report Child Behaviour Checklist, and the self-report Moods and Feelings Questionnaire and the Self-Esteem Questionnaire. We conducted univariate and multivariate analyses to determine associations between language skills, self-esteem and mental health in this group of adolescents. Poor language ability was related to a range of concurrent adverse difficulties, such as attention deficits, self-esteem problems, social withdrawal, and depressive symptoms. Increased levels of language ability were related to better psychosocial profiles. In some cases, only individuals with a low level of language (bottom 10% of sample) were at increased risk of maladaptive outcomes. This study replicates the well-established relationship between language ability and poorer mental health found within high income countries in an upper middle-income country setting. Locally accessible support for children with reduced language ability is required, given the longer-term consequences of poorer mental health.

SUBMITTER: St Clair MC

PROVIDER: S-EPMC6728123 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Relationships between concurrent language ability and mental health outcomes in a South African sample of 13-year-olds.

St Clair Michelle C MC Skeen Sarah S Marlow Marguerite M Tomlinson Mark M

PloS one 20190905 9

Children and adolescents with delayed or disordered language development are at increased risk of a number of negative outcomes, including social and emotional problems and mental health difficulties. Yet, in low- and middle- income countries, where risk factors for compromised language development are known to be prevalent, there is a lack of research on the association between child and adolescent language ability and mental health outcomes. This study evaluates data from a cross-sectional stu ...[more]

PMID: 31487290

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Project description:Of children with mental health problems who access specialist help, 50% show reliable improvement on self-report measures at case closure and 10% reliable deterioration. To contextualise these figures it is necessary to consider rates of improvement for those in the general population. This study examined rates of reliable improvement/deterioration for children in a school sample over time. N = 9074 children (mean age 12; 52% female; 79% white) from 118 secondary schools across England provided self-report mental health (SDQ), quality of life and demographic data (age, ethnicity and free school meals (FSM) at baseline and 1 year and self-report data on access to mental health support at 1 year). Multinomial logistic regressions and classification trees were used to analyse the data. Of 2270 (25%) scoring above threshold for mental health problems at outset, 27% reliably improved and 9% reliably deteriorated at 1-year follow up. Of 6804 (75%) scoring below threshold, 4% reliably improved and 12% reliably deteriorated. Greater emotional difficulties at outset were associated with greater rates of reliable improvement for both groups (above threshold group: OR = 1.89, p < 0.001, 95% CI [1.64, 2.17], below threshold group: OR = 2.23, p < 0.001, 95% CI [1.93, 2.57]). For those above threshold, higher baseline quality of life was associated with greater likelihood of reliable improvement (OR = 1.28, p < 0.001, 95% CI [1.13, 1.46]), whilst being in receipt of FSM was associated with reduced likelihood of reliable improvement (OR = 0.68, p < 0.01, 95% CI [0.53, 0.88]). For the group below threshold, being female was associated with increased likelihood of reliable deterioration (OR = 1.20, p < 0.025, 95% CI [1.00, 1.42]), whereas being from a non-white ethnic background was associated with decreased likelihood of reliable deterioration (OR = 0.66, p < 0.001, 95% CI [0.54, 0.80]). For those above threshold, almost one in three children showed reliable improvement at 1 year. The extent of emotional difficulties at outset showed the highest associations with rates of reliable improvement.

Project description:Afrocentric paradigms reflect assumptions of the overarching importance of interconnectedness and social bonds in meaningful experiences. It is, however, not known if types of relatedness vary in importance as meaning sources in the subjective experiences of laypeople, or what the reasons are that they ascribe to the importance of relationships. The empirical and theoretical substantiation of philosophical assumptions is needed to provide a scientific basis for appropriate well-being interventions in African contexts. Therefore, this study aimed to empirically explore the relative importance of various types of relationships as sources of meaning and in particular why relationships are important to laypeople in relatively collectivist African contexts. Using a bottom-up qualitative approach with quantification of responses, this study explored how prominently relationships featured as meaning sources compared to other domains of life and then, in particular, the motivations for the importance of various types of relationships as found in four African samples: a Ghanaian urban group (n = 389), a South African multicultural, English-speaking urban group (n = 585), and two South African Setswana-speaking groups (n = 512 rural, n = 380 urban). Findings showed that the relational domains of life, namely, family, interpersonal relations, spirituality/religion, and community/society, made up a large proportion of responses on what provides meaning in life-in particular family and spirituality/religion with community/society occurring the least. The reasons for meaning experienced in various relationship types included domain-typical relational descriptors, such as contributions made or rewards received. However, many intrapersonal motives also emerged: inner well-being, happiness, joy, a sense of competence, and own growth. Material needs and harmony also surfaced as motivations for relational importance. Findings are aligned with African philosophical perspectives as far as the importance of relationships and the value attached to spirituality/religion are concerned, but contributed additionally by showing that different types of relationships vary in importance: close relationships are more important than community/societal relationships. Unearthing the reasons for the importance of relationships points toward a dialectic pattern of African individualism-collectivism in which independent and interdependent orientations flow together. Such knowledge is vital for the promotion of mental health and well-being in these contexts.

Project description:MethodologyThis paper uses regression adjustment and entropy matching to achieve an appropriate balance between the two groups. Having achieved this balance any difference in the overall performance between the two groups can then be attributed directly to the new language policy that has been implemented. Our results indicate, after matching, that a significant difference in performance between the two groups occurs with Black African Zulu home language speakers in particular not performing as well as students from the other race and language groups. The data came from the University of KwaZulu-Natal and the study has been approved by the University Ethics committee and Research committee.Results and conclusionsUsing a weighted mean of marks to measure performance, the ATT estimates that result indicate that students in the treated group would all perform significantly better had they been allowed instead to enrol in the non-treated group. Furthermore, Zulu home language speakers, who are not actually forced to take this course, are significantly underperforming whether they have chosen to take this course in Zulu or not. Surprisingly, their underperformance is worse in the treated group. Because one would expect them to be scoring a higher mark for Zulu in this treated group, forfeiting the chance to take another course in their chosen area of study is clearly affecting the type of mark they could be getting for their other courses had they chosen to remain in the non-treated group. With English being the medium of instruction at this university, should the university not also consider introducing a compulsory course in English for these Zulu home language speakers? Females are doing better than males in both groups. The effect being stronger in the treated group suggests that females appear to cope better with the learning of a new language. Significant college effects are also being observed, suggesting that this new language rule possibly needs to be adjusted for the college a student wants to study in.

Dataset Information

Relationships between concurrent language ability and mental health outcomes in a South African sample of 13-year-olds.

Publications

Relationships between concurrent language ability and mental health outcomes in a South African sample of 13-year-olds.

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