J Am Acad Child Adolesc Psychiatry. 1993 May;32(3):595-603.

Unsuspected language impairment in psychiatrically disturbed children: prevalence and language and behavioral characteristics.

Cohen NJ, Davine M, Horodezky N, Lipsett L, Isaacson L. C.M.

Hincks Treatment Centre/Institute, Toronto, Ontario, Canada.

OBJECTIVE: This study examined the prevalence of unsuspected language impairments in 4-12-year-old psychiatric outpatients. METHOD: Children (N = 399) were routinely screened with standardized language tests, and parents and teachers completed behavioral checklists. RESULTS: Results indicated that of 288 children referred solely for a psychiatric disorder, 99 (34.4%) had a language impairment that had not been suspected previously. These children had more subtle language impairments than did the 111 children referred with previously identified language impairments. Both children with unsuspected and previously identified language impairments had symptoms associated with attention-deficit hyperactivity disorder. Children with unsuspected language impairments had the most serious externalizing behavioral problems. CONCLUSIONS: Attention needs to be paid to screening children for language impairments and to helping adults understand how language disabilities impact on communication and behavior.