Investigating the role of play in protecting against mental health difficulties in children with Developmental Language Disorder

Supervisor: Dr Umar Toseeb

A) Rationale for the project

Developmental Language Disorder (DLD) is characterised by difficulties in the ability to use and learn spoken language (Conti-Ramsden, St Clair, Pickles, & Durkin, 2012). Affected children have problems putting words together to formulate sentences (expressive language) and/or understanding the words that are being said (receptive language). The prevalence of DLD is ~7% (Norbury et al., 2016).

We know that play with peers is important for the development and practice of social and communication skills (Howes, Droege, & Matheson, 1994; Pellis & Pellis, 2007). Social play with peers is a key context in which children deploy, practice and learn key relationship skills (Baines & Blatchford, 2010). On the whole, children with DLD have difficulties integrating into peer social play (Gibson, Adams, Lockton, & Green, 2013; Gibson, Hussain, Holsgrove, Adams, & Green, 2011). Furthermore, the social play behaviours of children with DLD have less sophistication and higher levels of atypicality, when compared to neurotypical peers (DeKroon, Kyte, & Johnson, 2002; Gibson et al., 2011). However, there are individual differences in this respect and some children with DLD do develop adequate play skills. Recent work has shown that in a sample of children with DLD, play is protective against subsequent psychosocial difficulties (Toseeb et al., in press). Much less attention has been focussed on which specific play behaviours are protective against mental health difficulties and why. An investigation into specific play behaviours will allow for the identification of the strengths and weaknesses in children with DLD. Once specific play behaviours have been identified, it will advance our understanding of the antecedents of mental health difficulties in children with DLD.

B) References that should be read (if you do not have access to these, please email

Baines, E., & Blatchford, P. (2010). Children’s Games and Playground Activities in School and Their Role in Development In P. Nathan & A. D. Pellegrini (Eds.), The Oxford Handbook of the Development of Play Oxford: Oxford Library of Psychology.

Conti-Ramsden, G., St Clair, M. C., Pickles, A., & Durkin, K. (2012). Developmental Trajectories of Verbal and Nonverbal Skills in Individuals With a History of Specific Language Impairment: From Childhood to Adolescence. Journal of Speech Language and Hearing Research, 55(6), 1716-1735. doi:10.1044/1092-4388(2012/10-0182)

DeKroon, D. M., Kyte, C. S., & Johnson, C. J. (2002). Partner Influences on the Social Pretend Play of Children With Language Impairments. Lang Speech Hear Serv Sch, 33(4), 253-267. doi:10.1044/0161-1461(2002/021)

Gibson, J., Adams, C., Lockton, E., & Green, J. (2013). Social communication disorder outside autism? A diagnostic classification approach to delineating pragmatic language impairment, high functioning autism and specific language impairment. J Child Psychol Psychiatry, 54(11), 1186-1197. doi:10.1111/jcpp.12079

Gibson, J., Hussain, J., Holsgrove, S., Adams, C., & Green, J. (2011). Quantifying peer interactions for research and clinical use: the Manchester Inventory for Playground Observation. Res Dev Disabil, 32(6), 2458-2466. doi:10.1016/j.ridd.2011.07.014

Howes, C., Droege, K., & Matheson, C. C. (1994). Play and communicative processes within long- and short-term friendship dyads. Journal of Social and Personal Relationships, 11(3), 401-410. doi:10.1177/0265407594113006

Norbury, C. F., Gooch, D., Wray, C., Baird, G., Charman, T., Simonoff, E., . . . Pickles, A. (2016). The impact of nonverbal ability on prevalence and clinical presentation of language disorder: evidence from a population study. Journal of Child Psychology and Psychiatry, 57(11), 1247-1257. doi:10.1111/jcpp.12573

Pellis, S. M., & Pellis, V. C. (2007). Rough-and-Tumble Play and the Development of the Social Brain. Current Directions in Psychological Science, 16(2), 95-98. doi:10.1111/j.1467-8721.2007.00483.x

C) Research aims / questions

  1. How do children with DLD compare to those without DLD on positive friendships and family relationships?
  2. How are these effects (1) different for children in primary and secondary school?
  3. To what extent are positive friendships and family relationships associated with better mental health outcomes in children with DLD?
  4. How are these effects (3) different for children with and without DLD?

D) Methods

Children with DLD and their parents (and those without as controls) will be recruited from schools and local support services.  Parents and children will be asked to complete questionnaires and/or take part in structured assessments about play, mental health, language and communication difficulties, and sociodemographic information.  Children will be observed in a play setting using observational methods.  The data will be analysed using quantitative analysis.