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Twenty-Year Follow-Up of Children with and without Speech-Language Impairments: Family, Educational, Occupational, and Quality of Life Outcomes

Joseph H. Beitchman
University of Toronto
Centre for Addiction and Mental Health, Toronto, Ontario, Canada

E. B. Brownlie
Centre for Addiction and Mental Health, Toronto, Ontario, Canada

Correspondence concerning this article should be addressed to Carla J. Johnson, Ph.D., University of Toronto, Department of Speech-Language Pathology, Rehabilitation Sciences Building, 160-500 University Avenue, Toronto, Ontario, Canada M5G 1V7. Electronic mail should be sent to carla.johnson{at}utoronto.ca.

Purpose: Parents, professionals, and policy-makers need information on the long-term prognosis for children with communication disorders. Our primary purpose in this report was to help fill this gap by profiling the family, educational, occupational, and quality of life outcomes at age 25 of young adults (N = 244) from the Ottawa Language Study, a 20-year, prospective, longitudinal study of a community sample of individuals with (n = 112) and without (n = 132) a history of early speech and/or language impairments. A secondary purpose of this report was to use data from earlier phases of the study to predict important, real-life outcomes at age 25.

Method: Participants were initially identified at age 5 and subsequently followed at ages 12, 19, and 25. Direct assessments were conducted at all four time periods in multiple domains (demographic, communicative, cognitive, academic, behavioral, and psychosocial).

Results: At age 25, young adults with a history of language impairments showed poorer outcomes in multiple objective domains (communication, cognitive/academic, educational attainment, and occupational status) than their peers without early communication impairments and those with early speech-only impairments. However, those with language impairments did not differ in subjective perceptions of their quality of life from those in the other two groups. Objective outcomes at age 25 were predicted differentially by various combinations of multiple, inter-related risk factors, including poor language and reading skills, low family SES, low performance IQ, and child behavior problems. Subjective well-being, however, was primarily associated with strong social networks of family, friends, and others.

Conclusion: This information on the natural history of communication disorders may be useful in answering parents' questions, anticipating challenges that children with language disorders might encounter, and in planning services to address those issues.

Key Words: speech impairment, language impairment, educational outcomes, occupational outcomes, family, quality of life, longitudinal

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