title: Bilingual children referred for psychiatric services: associations of language disorders, language skills, and psychopathology.
abstract: OBJECTIVE
  To investigate (1) the prevalence of language deficits and disorders and (2) the relationship of bilingual language skills and psychopathology, in Spanish-English bilingual children referred for child and adolescent psychiatry services.
  
  
  METHODS
  Bilingual language skills, emotional/behavioral problems, sociodemographics, immigration variables, and nonverbal IQ were studied in 50 consecutively referred children.
  
  
  RESULTS
  Estimated prevalence was high for language deficits (48%) and disorders (41%), with most cases (>79%) being of the mixed receptive-expressive type. In children with clinically significant emotional/behavioral problems, bilingual language skills were strongly and inversely correlated with problem scores, particularly global problems (r = -0.67, p < .001); social, thought, and attention problems (r > or = -0.54; p < .004); delinquency (r = -0.66, p < .001); and aggression (r = -0.52, p < .01). These correlations remained significant after IQ adjustment.
  
  
  CONCLUSIONS
  Prior findings from monolingual children were confirmed in this bilingual sample, namely (1) the high prevalence of mixed receptive-expressive and other language disorders and delays and (2) the close tie between poor language skills and emotional/behavioral problems. The data strongly suggest the clinical importance and feasibility of language assessment and the significance of receptive problems in bilingual children referred for psychiatric services. A safe approach is to fully assess language skills, rather than misattributing these children's language delays to normal bilingual acquisition processes.
authors.affiliation: Judge Baker Children's Center and Harvard Medical School Department of Psychiatry, Boston, MA 02115, USA. topi@hms.harvard.edu
authors.forename: Claudio O
authors.initials: CO
authors.lastname: Toppelberg
authors.forename: Laura
authors.initials: L
authors.lastname: Medrano
authors.forename: Liana
authors.initials: L
authors.lastname: Peña Morgens
authors.forename: Alfonso
authors.initials: A
authors.lastname: Nieto-Castañon
mesh_terms: D000293:Adolescent; D000342:Affective Symptoms / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D002675:Child, Preschool; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D004641:Emigration and Immigration; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D015994:Incidence; D007805:Language Development Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D007807:Language Tests; D008297:Male; D019303:Multilingualism; D012017:Referral and Consultation