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Resilience to Adverse Mental Health Outcomes in Children with Language Impairment (LI) THIS OFFER IS NOW CLOSED

Vice-Chancellor PhD Scholarship



Children with Language Impairment (LI) have a higher risk of adverse mental health outcomes compared to children without LI.  However, mental health difficulties are not inevitable.  Using existing longitudinal data from ~18,000 children, this project will investigate why some children with LI are resilient to adverse mental health outcomes. 

Aims and objectives

Background and Importance

Language Impairment (LI) affects approximately 7% of children who start primary school in the UK every year, with an associated estimated cost of 2.5% of national GDP.  This cost encompasses extra help in school, speech and language therapy provision, and support associated with mental health difficulties (NHS) in child and adulthood.

LI is characterized by difficulties with using and understanding spoken language, in the absence of a sensory impairment, intellectual disability, or physical condition.  Children with LI have higher risks of worse mental health and educational outcomes compared to the general population [1-6].

However, adverse outcomes for those with LI are not inevitable. There is considerable heterogeneity in the impairment, which needs to be disaggregated in order to target the ever-shrinking government funding effectively to the most vulnerable children.  For example, in a sample of individuals with LI, approximately 44% did not have social difficulties by the time they left school [7].  Similarly, for 71% of young people with LI, their trajectories of prosocial behaviour from middle childhood to early adulthood were comparable to their peers without LI [8].  Understanding what makes some children resilient to adverse mental health outcomes will inform targeted early interventions to prevent adversity and improve the quality of life in the most vulnerable children.

Environmental risk indicators for LI are well-documented: family history, being male, low birth weight, socioeconomic status, low prosocial behaviour, and lack of shared book reading in the home, have all been implicated [9-12].  

Project Aim and Objectives

This project will investigate resilience to adverse mental health outcomes for children with LI.  The main objectives are to:

Objective 1.  Understand the contribution of environmental risk factors, during the first three years of life, to resilience to adverse mental health outcomes in later childhood.  From the population sample of ~18,000, 1,227 children have been identified as meeting the diagnostic criteria for LI.  Statistical modelling will allow for a “risk score” to be calculated for each of the 1,227 children.  The “risk score” will then be used to identify children who should have experienced adverse mental health outcomes but did not. 

The factors which influence resilience to adverse mental health outcomes in children with LI will be investigated using path analysis, a modern statistical technique, using data collected at 9 months, 3,5,7, 11, and 14 years.  Pathways from early life experiences to optimum mental health outcomes will be mapped for the mentally resilient group of children with LI.

Objective 2.  Understand how prosocial behaviour promotes resilience to adverse mental health outcomes.  Prosocial behaviour refers to behaviour that is intended to benefit another child without any direct benefit to the child him/herself.  Prosociality, specifically, is known to be protective against developing mental health difficulties in children with LI [8] but the mechanisms by which this happens remain elusive.  Data are available from parents (1,227 parents of children with LI) about the prosocial behaviour of their children at ages 3, 5, 7, 11 and 14 years. These data will be analyzed to understand the mechanisms and pathways from being prosocial to optimum mental health outcomes.    

Proposed Outputs and Impact. 

It is expected that at least two high quality publications will arise from this PhD studentship.  Each of them will be linked to the one of the two main objectives.  All supervisors have extensive experience of publishing in high impact periodicals.

This project will also have impact outside academia, where it will develop practitioners’ understanding of children’s resilience to adverse mental health outcomes and will have implications for service provision and practice.  


1. Wadman, R., et al., Changes in emotional health symptoms in adolescents with specific language impairment. International Journal of Language & Communication Disorders, 2011. 46(6): p. 641-656.

2. Brinton, B. and M. Fujiki, Social interactional behaviors of children with specific language impairment. Topics in Language Disorders, 1999. 19(2): p. 49-69.

3. St Clair, M.C., et al., A longitudinal study of behavioral, emotional and social difficulties in individuals with a history of specific language impairment (SLI). Journal of Communication Disorders, 2011. 44(2): p. 186-199.

4. Yew, S.G. and R. O'Kearney, Emotional and behavioural outcomes later in childhood and adolescence for children with specific language impairments: meta-analyses of controlled prospective studies. J Child Psychol Psychiatry, 2013. 54(5): p. 516-24.

5. Conti-Ramsden, G., et al., Specific language impairment and school outcomes. I: identifying and explaining variability at the end of compulsory education. Int J Lang Commun Disord, 2009. 44(1): p. 15-35.

6. Durkin, K., et al., Specific language impairment and school outcomes. II: Educational context, student satisfaction, and post-compulsory progress. Int J Lang Commun Disord, 2009. 44(1): p. 36-55.

7. Mok, P.L.H., et al., Longitudinal trajectories of peer relations in children with specific language impairment. Journal of Child Psychology and Psychiatry, 2014. 55(5): p. 516-527.

8. Toseeb, U., et al., Development of Prosocial Behaviour from Childhood to Early Adulthood: A Longitudinal Cohort Study of Young People with a History of Language Impairment. Research in Developmental Disabilities, submitted.

9. Reilly, S., et al., Predicting language at 2 years of age: a prospective community study. Pediatrics, 2007. 120(6): p. e1441-9.

10. Hoff-Ginsberg, E., Mother-child conversation in different social classes and communicative settings. Child Dev, 1991. 62(4): p. 782-96.

11. Nelson, H.D., et al., Screening for speech and language delay in preschool children: systematic evidence review for the US Preventive Services Task Force. Pediatrics, 2006. 117(2): p. e298-319.

12. McKean, C., et al., Levers for Language Growth: Characteristics and Predictors of Language Trajectories between 4 and 7 Years. PLoS One, 2015. 10(8): p. e0134251.


Specific requirements of the project

Applicants should have:

The project start date is expected to be September 2017

Student eligibility

The Scholarship is open to UK and EU students.


Informal enquiries can be made to:

Cate Lawton,

The supervisory team for this project will be Dr Umar Toseeb, Prof Peter Clough, and Dr Julie Marshall. Specific queries regarding the research project will be forwarded to the supervisory team for response

How to apply

Please quote the reference: VC-HPSC-UT-2017-4.

Applications should be completed using the Postgraduate Research Degree Application Form.

Application Form should be emailed to:


Closing date

Research Study