"Disconnected From Everyone and Everything Around Them": A Mixed Method Study to Explore the Perspectives of Children With Language Difficulties and Their Caregivers On Mental Health Concerns and Mental Health Support.

backgroundGlobally, as many as 1 in 8 children experience severe and persistent language difficulties. These children are at heightened risk for mental health difficulties, however, both the ways in which mental health concerns manifest in the context of language difficulties, and the experiences of children with language difficulties and their caregivers in accessing and engaging with formal mental health supports remain under researched.

aimThe aim of the current study was to explore lived experience perspectives (child and caregiver) on mental health concerns and, mental health support, for children (≤ 18 years) with language difficulties.

methodA 2-phased sequential explanatory design was employed, which combined findings from an online international survey of caregivers (n = 120) of children with language difficulties with data from semi-structured interviews with both children (n = 4) and caregivers (n = 12).

resultsCombined data from the survey and interviews highlighted a high level of caregiver concern about the mental health of children with language difficulties but low levels of access to formal mental health support. Interviews highlighted several reasons for not accessing formal mental health supports including limited availability of mental health care providers; funding and time constraints (i.e., not wanting to over-schedule their child); mental health providers lacking knowledge about DLD, and perceived or actual barriers of traditional methods of therapy (e.g., one-on-one talk therapy) for children with language difficulties. CONCLUSIONS AND IMPLICATIONS: The findings of our study support the view that children with language difficulties are at risk of mental health concerns and yet are also under-served by mental health services. These findings highlight the need for targeted interprofessional training and integrated models of collaborative care between mental health and language specialists to more adequately meet these children's needs. Future research to engage a wider range of child perspectives and the perspectives of clinicians on the facilitators and barriers to engaging children with language difficulties in formal mental health support is needed. KEY POINTS: Children and adolescents with language difficulties experience high rates of anxiety, low self-esteem, and social difficulties, often in response to academic and peer-related challenges. Despite significant mental health concerns, most families report limited access to formal mental health support, citing barriers such as service unavailability, lack of professional understanding of language difficulties, and the unsuitability of traditional talk-based therapies. There is a critical need for interprofessional collaboration between speech-language pathologists and mental health professionals, alongside targeted training and inclusive therapeutic approaches, to ensure accessible and effective support for this population. WHAT THIS PAPER ADDS: What is already known on this subject Globally, as many as 1 in 8 children experience severe and persistent language difficulties. These children are at heightened risk for mental health difficulties. What this study adds to existing knowledge Our study provides lived experience perspectives on mental health concerns and mental health support in the context of language difficulties. The findings highlight caregiver concerns about self-esteem, anxiety, peer difficulties and the inaccessibility of formal mental health support. What are the potential or actual clinical implication of this study? Children with language difficulties are at risk of mental health concerns and yet are also under-served by mental health services. Findings highlight the need for targeted interprofessional training and integrated models of collaborative care between mental health and language specialists to more adequately meet these children's needs.