Twice-exceptionality unmasked: A systematic narrative review of the literature on identifying dyslexia in the gifted child.

In this systematic narrative review, we synthesised the small existing body of research on children who are gifted and dyslexic (G-D) in order to investigate the claim that G-D students have a unique profile, characterised by well-masked word-level reading and spelling difficulties. Our focus was on both the cognitive and academic profiles of this subgroup of twice-exceptional (2e) children and the assessment protocols used to identify them. Findings suggest that despite having processing deficits associated with dyslexia, G-D students' gifted strengths, especially those relating to oral language, may enable them to compensate for their reading difficulties, at least to an extent that they fail to meet standard diagnostic criteria. However, G-D students also perform poorly on word-level reading, reading fluency and spelling tasks when compared with both control groups and their gifted, non-dyslexic peers, providing clear evidence of impaired achievement. Findings from this review highlight the need for (a) a more nuanced approach to the assessment of students presenting with highly discrepant profiles and (b) future research into both the cognitive and academic profiles and the instructional needs of this highly able yet poorly understood group of students, whose potential may be masked and thus underestimated in the school setting.

Cognitive and affective perspective taking amongst adolescent offenders with variants of callous-unemotional traits.

Evidence suggests that associations between antisocial behaviour, callous-unemotional (CU) traits and cognitive empathy (e.g. perspective taking) vary depending on more fine-grained dimensions of these constructs. This study examined associations between adolescent antisocial behaviour and individual differences in cognitive and affective perspective taking ability. Based on current theory regarding distinct variants of CU traits, we further tested whether the correlates of CU traits differed amongst youth with high versus low levels of anxiety. Participants were 130 male adolescents (81 youth offenders; 49 non-offenders) aged 13-20 years, of predominantly Caucasian and Aboriginal Australian ethnicity. Perspective taking skills were indexed using performance-based testing, and self-report data was collected on CU traits and anxiety in a cross-sectional design. Offender status was associated with poorer cognitive and affective perspective taking. In addition, associations between CU traits and perspective taking skills were moderated by anxiety. Specifically, CU traits were associated with poorer skills for second-order cognitive perspective taking amongst high-anxiety youth, whereas CU traits were associated with better cognitive and affective perspective taking skills amongst low-anxiety youth. More fine-grained assessment of such factors stands to enhance understanding of, and effective intervention for, antisocial youth.

Oral language skills, callous and unemotional traits and high-risk patterns of youth offending.

Extensive research has associated adolescent delinquent behavior with verbal deficits, yet for some subgroups of youth offenders better verbal ability has been associated with increased risk. This study examined associations between specific oral language skills and established markers of high-risk youth offending comprising callous and unemotional (CU) traits, early age of the first offence, and violent offending. Measures of language, CU traits, anxiety, as well as official youth justice data, were collected for adolescent male offenders and non-offenders (n = 130; aged 13-19 years; 62% youth offenders). Pragmatic language was found to be differentially associated with distinct variants of CU traits based on high/low levels of anxiety. Furthermore, among youth offenders with primary variant (low anxiety) CU traits, more violent offending was associated with better structural language skills, while earlier age of first offence was associated with better pragmatic language skills.

The oral language and emergent literacy skills of preschoolers: Early childhood teachers' self-reported role, knowledge and confidence.

BACKGROUND: Early childhood teachers (ECTs) play a significant role in equipping children with oral language and emergent literacy skills ahead of school entry. They are well positioned to play a vital role in ensuring preschool children receive a high-quality preschool curriculum to prepare them for later literacy learning. AIMS: The purpose of this study was to explore early career ECTs' views and confidence regarding their role in providing preschoolers with oral language and emergent literacy support and to examine their perceptions of their preservice preparation. METHODS & PROCEDURES: Nine Australian early career ECTs were recruited via purposive sampling for an in-depth, semi-structured interview. Data were analysed using an inductive thematic analysis approach. OUTCOMES & RESULTS: Participants attached strong significance to their role in facilitating children's oral language growth and emergent literacy skills and reported a range of practices to support children's learning. However, they rarely referred to using established language facilitation strategies or using dialogic book reading prompts. Further, emergent literacy concepts such as phonological awareness and print awareness were not routinely described as features of participants' classroom activities. Participants did not consistently make a clear conceptual distinction between the constructs of oral language and emergent literacy and often used these terms interchangeably. Notably, participants indicated that they did not feel confident in their ability to identify preschool children who were not meeting developmental language milestones and reported that they felt poorly equipped to do so by their preservice training. CONCLUSIONS & IMPLICATIONS: ECTs' strong willingness to support preschool children's oral language and emergent literacy skills may be hindered by gaps in their knowledge; these may contribute to important and missed opportunities for identifying and supporting preschoolers' oral language and emergent literacy growth. WHAT THIS PAPER ADDS: What is already known on this subject? High-quality learning experiences in preschool are important for maximising preschoolers' oral language and emergent literacy growth. Early childhood teachers can play an important role in facilitating this development and preparing children for later literacy learning. What this paper adds to existing knowledge? The study findings provide insight into ECTs' perceptions of their role and support in developing children's oral language and emergent literacy skills. The results indicated ECTs did not feel confident with their knowledge of children's language milestones or identifying children with language difficulties. Participants reported that their preservice training left them underprepared in the area of oral language. What are the potential or actual clinical implications of this work? ECTs demonstrated a strong willingness to support preschoolers' oral language and emergent literacy skills. However, their self-reported knowledge gaps and low confidence may have implications for the early detection of children who are not reaching language developmental milestones in a timely way.

Speech and language therapy for adolescents in youth justice: A series of empirical single-case studies.

BACKGROUND: Adolescents in contact with youth justice are a vulnerable and marginalized group at high risk of developmental language disorder (DLD) and other communication difficulties. Though preliminary studies have demonstrated the benefits of speech and language therapy (SLT) services in youth justice, limited research has empirically tested the efficacy of intervention in these settings. AIMS: To evaluate the extent to which intensive, one-to-one language intervention improved the communication skills of incarcerated adolescents with below-average (> 1 SD below the mean) language and/or literacy skills. METHODS & PROCEDURES: A series of four empirical single case studies was conducted, using multiple baseline intervention design. Individualized intervention programmes were administered, and progress on outcome measures (probes) was evaluated throughout the baseline, intervention and maintenance phases using Tau-U, a non-parametric distribution-free statistic. Additional measures were used as secondary outcomes of the intervention, including standardized language subtests, subjective rating tools by participants and their teachers collected pre- and post-intervention, and a brief structured participant interview, independently administered by youth justice staff. OUTCOMES & RESULTS: Medium-to-large effect sizes, the majority of which were statistically significant, were detected on the primary outcome measure across the four cases, indicating improvements in the targeted communication skills. Positive results were also evident in comparisons of pre- and post-measures on standardized language subtests, subjective self- and teacher ratings of communication, and the participants' impressions of the interventions. For those participants who could be followed up, gains in language skills were generally maintained at 1 month post-intervention. CONCLUSIONS & IMPLICATIONS: This study provides further evidence of the efficacy of one-to-one SLT intervention for adolescents in youth justice in order to address language and literacy difficulties. These findings inform future SLT service provision for adolescents in these settings, with clear policy and practice implications. Future research should investigate the wider benefits to individuals' engagement in youth justice intervention and recidivism, as well as assessing maintenance of gains over a longer period. What this paper adds What is already known on this subject The high rates of DLD in youth justice is well known, with difficulties spanning multiple areas of language and literacy. SLTs are increasingly working in community and custodial youth justice settings, and a few preliminary studies have demonstrated the effectiveness of such work. What this paper adds to existing knowledge This study extends the evidence base of the efficacy of SLT for language and literacy difficulties in youth justice, using a series of four empirical single case studies. It is also argued that SLT should be more actively considered in planning multidisciplinary interventions for young people in custody. What are the potential or actual clinical implications of this work? The results of this research support current moves to include SLT services in youth justice systems, and illustrate for clinicians currently working in this sector a way of structuring and measuring the impact of intervention services.

Improving communication outcomes for young offenders: a proposed response to intervention framework.

BACKGROUND: Speech, language and communication needs (SLCN) are strongly overrepresented in young offender populations, and there is growing commitment internationally to ensuring access to speech-language therapy services for such young people. However there is currently no framework in which such interventions might be conceptualized, delivered and evaluated. This is significant given the role of language competence in the development of prosocial skills and also in the transition to literacy. AIMS: To present Response to Intervention (RTI) as a framework in which SLCN of young offenders might be systematically addressed and evaluated within youth justice settings, led by speech-language therapists, in conjunction with other education and welfare team members. METHODS & PROCEDURES: Literature regarding prevalence rates of SLCN in young offenders is reviewed, together with the limited extant evidence on interventions for this group. The importance of applying evidence-based interventions is argued, and a framework for adapting RTI for SLCN in custodial settings is outlined. MAIN CONTRIBUTION: A framework for adapting RTI to design, deliver and evaluate speech-language therapy interventions in youth custodial settings is presented. CONCLUSIONS: Speech-language therapy interventions for young offenders will be better addressed at policy, practice and research levels if a framework such as an RTI adaptation is employed. It is expected, however, that this model will evolve over time, as intervention evidence pertaining to the youth offender population emerges.

Child speech, language and communication need re-examined in a public health context: a new direction for the speech and language therapy profession.

BACKGROUND: Historically speech and language therapy services for children have been framed within a rehabilitative framework with explicit assumptions made about providing therapy to individuals. While this is clearly important in many cases, we argue that this model needs revisiting for a number of reasons. First, our understanding of the nature of disability, and therefore communication disabilities, has changed over the past century. Second, there is an increasing understanding of the impact that the social gradient has on early communication difficulties. Finally, understanding how these factors interact with one other and have an impact across the life course remains poorly understood. AIMS: To describe the public health paradigm and explore its implications for speech and language therapy with children. METHODS & PROCEDURES: We test the application of public health methodologies to speech and language therapy services by looking at four dimensions of service delivery: (1) the uptake of services and whether those children who need services receive them; (2) the development of universal prevention services in relation to social disadvantage; (3) the risk of over-interpreting co-morbidity from clinical samples; and (4) the overlap between communicative competence and mental health. OUTCOMES & CONCLUSIONS: It is concluded that there is a strong case for speech and language therapy services to be reconceptualized to respond to the needs of the whole population and according to socially determined needs, focusing on primary prevention. This is not to disregard individual need, but to highlight the needs of the population as a whole. Although the socio-political context is different between countries, we maintain that this is relevant wherever speech and language therapists have a responsibility for covering whole populations. Finally, we recommend that speech and language therapy services be conceptualized within the framework laid down in The Ottawa Charter for Health Promotion.

Australian speech-language pathologists' self-rated confidence, knowledge, and skill on constructs essential to practising in literacy with children and adolescents.

PURPOSE: To investigate Australian speech-language pathologists' (SLPs') knowledge of language and literacy constructs, skills in linguistic manipulation, and self-rated ability and confidence. METHOD: Two hundred and thirty-one SLPs from across Australia completed an online knowledge and skill assessment survey. RESULT: There was substantial individual variability regarding performance on items measuring the knowledge and skills of essential literacy constructs. SLPs were most likely to rate their confidence in providing intervention for phonological and phonemic awareness as "very good" or "expert". They reported lower confidence providing intervention for all other aspects of literacy. The majority of SLPs reported what they described as inadequate preservice training to practise in literacy. There was variability between respondents in their self-reported alignment with approaches and beliefs that are unsupported by current research evidence on reading instruction and support. CONCLUSION: The level and consistency of SLPs' literacy knowledge and skills requires improvement. The perception of inadequate preparation to practise in literacy may mean that SLPs are reluctant to engage in this area of practice. Minimum accreditation requirements specifically for literacy are recommended, together with assurance of ongoing professional learning opportunities spanning all components of literacy.

Teachers' perspectives on the role and scope of practice of speech-language pathologists working to support literacy in the early years of school.

Purpose: The purpose of this study was to explore the views of teachers in early year levels about the role and scope for speech-language pathologists (SLPs) to work on literacy support in schools.Method: Sixty-one teachers from mainstream government schools across Victoria, Australia, completed an anonymous, online survey.Result: Although many respondents reported knowing that SLPs support the literacy learning of some students in their school, they had limited awareness of the scope of speech-language pathology practice in literacy instruction and intervention.Conclusion: Limited awareness of SLPs' expertise and scope of practice may be leading to missed opportunities for collaborative practices. In order to capitalise on SLPs' skill set for the benefit of students, the speech-language pathology profession should better promote and raise awareness of the various ways in which SLPs can collaborate within interprofessional literacy teams in schools.

Do clinical pathways enhance access to evidence-based acute myocardial infarction treatment in rural emergency departments?

OBJECTIVE: The objective of this study is to measure the impact of a five-step implementation process for an acute myocardial infarction (AMI) clinical pathway (CPW) on thrombolytic administration in rural emergency departments. DESIGN: Cluster randomised controlled trial. SETTING: Six rural Victorian emergency departments participated. INTERVENTION: The five-step CPW implementation process comprised (i) engaging clinicians; (ii) CPW development; (iii) reminders; (iv) education; and (v) audit and feedback. MAIN OUTCOME MEASURES: The impact of the intervention was assessed by measuring the proportion of eligible AMI patients receiving a thrombolytic and time to thrombolysis and electrocardiogram. RESULTS: Nine hundred and fifteen medical records were audited, producing a final sample of 108 patients eligible for thrombolysis. There was no significant difference between intervention and control groups for median door-to-needle time (29 mins versus 29 mins; P = 0.632), proportion of those eligible receiving a thrombolytic (78% versus 84%; P = 0.739), median time to electrocardiogram (7 mins versus 6 mins; P = 0.669) and other outcome measures. Results showed superior outcome measures than other published studies. CONCLUSIONS: The lack of impact of the implementation process for a chest pain CPW on thrombolytic delivery or time to electrocardiogram in these rural hospitals can be explained by a ceiling effect in outcome measures but was also compromised by the small sample. Results suggest that quality of AMI treatment in rural emergency departments (EDs) is high and does not contribute to the worse mortality rate reported for AMIs in rural areas.

Restorative Justice conferencing and the youth offender: exploring the role of oral language competence.

BACKGROUND: Restorative Justice is an approach to responding to youth offending that aims to be collaborative and conciliatory rather than adversarial. In this respect, it is a welcome innovation in justice, welfare, and educational settings, and is gaining favour around the world. To date, however, the Restorative Justice literature has not considered the possible implications of unidentified language impairment in the young offenders who are asked to participate in face-to-face conferences with their victim(s). AIMS: The aims of this paper are (1) to bring two paradigms together: Restorative Justice on the one hand, and the literature on language and social cognition impairments in vulnerable and socially marginalized young people on the other; (2) to stimulate awareness and interest in this aspect of public policy and practice by speech-language pathologists; and (3) to suggest some research questions that need to be tackled from an oral language competence perspective. METHODS & PROCEDURES: A narrative review of the relevant literature pertaining to both Restorative Justice and oral language competence in vulnerable young people was conducted, with particular emphasis on the implications of the undetected language impairments as a source of possible unintended harm to both victims and offenders in Restorative Justice conferences. MAIN CONTRIBUTION: This is the first paper that specifically addresses the oral language skills of vulnerable and socially marginalized young people with respect to their capacity to participate in Restorative Justice conferences. CONCLUSIONS: It is important that speech-language pathologists contribute their specialized knowledge and clinical skills to public policy-making and debate, and practice that pertains to marginalized young people who may have undetected oral language impairments. Speech-language pathology as a profession is well positioned to plan and execute important programmes of research on this growing approach to dealing with youth offending and reducing recidivism.

Parents's plans to supply their adolescents with alcohol.

The aim was to determine the extent to which parent and adolescent characteristics and patterns of alcohol use influence parents' plans to supply their adolescent aged 14-16 years with full serves of alcohol (i.e. not necessarily initiation) in the next 6 months. A cross-sectional sample of parents from Victoria, Australia, completed an online survey. Parents' plans to supply alcohol in the next 6 months was significantly associated with their reports of supplying alcohol in the previous 3 months (ß=0.51, P<0.01), perceptions that their adolescent drinks (ß=0.34, P<0.01), reports of not practising religion (ß=0.13, P<0.01), and Alcohol Use Disorders Identification Test scores (ß=0.09, P=0.04). The total variance explained by the model was 57.4% F (9, 242)=36.2, P<0.01. Parents' plans to supply their adolescent with alcohol might be a reflection of the normalisation of alcohol use in Australia. There is a need to support Australian parents to review their own alcohol use, clarify their views on alcohol use by their adolescent and confidently restrict their child's access to alcohol, irrespective of their own drinking patterns.

Investigating Adolescent Discourse in Critical Thinking: Monologic Responses to Stories Containing a Moral Dilemma.

Purpose The adolescent developmental task of establishing autonomy from parents is supported through various aspects of executive functioning, including critical thinking. Our aim was to investigate younger and older adolescent language performance in form, content, and use in response to a moral dilemma task. Method Forty-four typically developing adolescents completed a language sampling task, responding to stories that contained a moral dilemma for one of the characters. Two age groups participated: younger adolescents (n = 24, 12;2-13;11 [years;months]) and older adolescents (n = 20, 16;1-17;11). Participants produced a monologue in response to an open-ended question prompt. Responses were transcribed and analyzed for discourse production on measures of form (verbal productivity and syntactic complexity) and content (semantic diversity and word percentages in three semantic domains: affective, social, and cognitive). Language use was evaluated using a coding system based on Bloom's revised taxonomy of thinking. Results There were no significant group differences in performance on measures of syntactic complexity and semantic diversity. Significant differences were found in adolescents' language using Bloom's revised taxonomy. The younger adolescents demonstrated a significantly higher proportion of utterances at Level 1 (remembering and understanding) compared to older adolescents, while the older age group produced a higher proportion at Level 3 (evaluating and creating). Conclusions The moral dilemma task was effective in demonstrating the growth of adolescent language skills in use of language for critical thinking. The results highlight the clinical utility of the moral dilemma task in engaging adolescents in discourse involving critical thinking, whereas the associated coding scheme, based on Bloom's revised taxonomy of thinking, may differentiate levels of critical thinking and provide direction for intervention.

The oral language and reading comprehension skills of adolescents in flexible learning programmes.

Purpose: Access to flexible learning programmes (FLPs) for students who have been excluded or diverted from mainstream school settings is increasing internationally. While still technically "engaged with education" such students face long-term vulnerability with respect to acquiring marketable employment skills post-school. Language and literacy skills are central to such training; hence, this study describes the oral language and reading comprehension profiles of a sample of flexible learning programmes (FLP) students.Method: Fifty young people (mean age 16 years) enrolled in three FLPs in Victoria, Australia were assessed by a speech-language pathologist in order to profile their oral language and reading comprehension skills.Result: Seventy-two percent of participants had oral language skills that placed them in an at-risk range on standardised measures, and 47.5% had reading comprehension ages of ≤12 years. A moderate significant association existed between oral language and reading comprehension skills.Conclusion: Language and reading comprehension difficulties are prevalent in this population and may be missed in the context of the mental health and adjustment difficulties experienced by this group, but are likely to be key to academic engagement and success. Speech-language pathology scope of practice needs to include FLP settings.

Narrative language skills of maltreated children living in out-of-home care.

Purpose: Children's narrative accounts of their experiences are central to the prosecution of perpetrators of alleged maltreatment. We describe the narrative language skills of children who were placed in out-of-home care (OOHC) following substantiated maltreatment. It was hypothesised that (i) children with such histories would display narrative language skills that fall significantly below published age-expected norms, (ii) narrative language skills and core language skills would be positively correlated and (iii) narrative language skills would be associated with measures of socio-economic disadvantage.Method: Eighty-three children (40 males and 43 females) aged 5;3 to 12;10 (M = 7.9, SD = 2.3) from English-speaking home backgrounds were assessed using the Test of Narrative Language and the Clinical Evaluation of Language Fundamentals (CELF-4) Core Language Score. The Raven's Coloured Progressive Matrices, a measure of nonverbal intelligence, was employed as a covariate.Result: Forty-two percent of children scored in the below-average range on the Narrative Language Index Ability Index. The same proportion scored at/above age-expected levels on the Narrative Comprehension subtest, and 19% scored at/above age-expected levels on Oral Narration. There was a significant correlation between CELF-4 Core Language Scores and the Narrative Language Index Ability Index. Female carers' education was significantly positively associated with overall narrative language scores; however, household income and index of socio-economic disadvantage were not significantly associated with narrative language scores.Conclusion: Children who are victims of substantiated maltreatment should be considered at-risk for compromised ability to provide a narrative account of their experiences. The heterogeneity and often scant oral narrative language skills of these children highlights the importance of police/human services training on best-practice forensic interviewing. Policy and practice implications for speech-language pathology early intervention to support the needs of at-risk children are also discussed.

A cluster randomised trial to assess the impact of clinical pathways on AMI management in rural Australian emergency departments.

BACKGROUND: People living in rural Australia are more likely to die in hospital following an acute myocardial infarction than those living in major cities. While several factors, including time taken to access hospital care, contribute to this risk, it is also partially attributable to the lower uptake of evidence-based guidelines for the administration of thrombolytic drugs in rural emergency departments where up to one-third of eligible patients do not receive this life-saving intervention. Clinical pathways have the potential to link evidence to practice by integrating guidelines into local systems, but their impact has been hampered by variable implementation strategies and sub-optimal research designs. The purpose of this study is to determine the impact of a five-step clinical pathways implementation process on the timely and efficient administration of thrombolytic drugs for acute myocardial infarctions managed in rural Australian emergency departments. METHODS/DESIGN: The design is a two-arm, cluster-randomised trial with rural hospital emergency departments that treat and do not routinely transfer acute myocardial infarction patients. Six rural hospitals in the state of Victoria will participate, with three in the intervention group and three in the control group. Intervention hospitals will participate in a five-step clinical pathway implementation process: engagement of clinicians, pathway development according to local resources and systems, reminders, education, and audit and feedback. Hospitals in the control group will each receive a hard copy of Australian national guidelines for chest pain and acute myocardial infarction management. Each group will include 90 cases to give a power of 80% at 5% significance level for the two primary outcome measures: proportion of those eligible for thrombolysis receiving the drug and time to delivery of thrombolytic drug. DISCUSSION: Improved compliance with thrombolytic guidelines via clinical pathways will increase acute myocardial infarction survival rates in rural hospitals and thereby help to reduce rural-urban mortality inequalities. Such knowledge translation has the potential to be adapted for a range of clinical problems in a wide array of settings. TRIAL REGISTRATION: Australia New Zealand Clinical Trials Registry code ACTRN12608000209392.

Speech-Language Pathology and the Youth Offender: Epidemiological Overview and Roadmap for Future Speech-Language Pathology Research and Scope of Practice.

Purpose This article is concerned with the growing body of international evidence indicating that adolescents in contact with the youth justice system are likely to have severely compromised oral language skills, receptively and expressively. A smaller, but persuasive, literature also points to poor literacy skills in this population. Language and literacy skills underpin academic, social, and vocational success ( C. Snow, 1983 ; P. C. Snow, 2016 ; Snowling & Hulme, 2012 ) and are central to the professional expertise of speech-language pathology as a profession ( P. C. Snow, 2016 ). Method In this article, I review the epidemiology of youth offending together with research evidence concerning the language and literacy skills of this population. I outline the major practice and research implications of these findings for speech-language pathology as a profession, considering the "school-to-prison pipeline" via key domains of early years' reading instruction, young people's passage through the justice system, restorative justice processes, and design and delivery of language and literacy interventions for young people on youth justice orders. Results Implications for speech-language pathology scope of practice and future research are outlined. Conclusions Speech-language pathology as a profession has a significant role to play in advocating for vulnerable young people at each point in the school-to-prison pipeline. This includes strengthening the evidence base concerning speech-language pathology language and literacy interventions and lobbying governments to fund speech-language pathology services to address the complex communication needs of this population, both on community-based and custodial orders.

Speech-language pathology intervention in a youth justice setting: Benefits perceived by staff extend beyond communication.

PURPOSE: Young people in youth justice (YJ) settings face high-risk for unidentified language disorder, however, speech-language pathology (SLP) services are not routinely offered in such settings. The aim of this study was to explore and describe the perceptions and experiences of YJ staff in a custodial centre of the utility of having a speech-language pathologist working with young offenders. METHOD: Following a SLP intervention trial, two staff focus groups were conducted by an independent SLP. Interview probes were developed through review of the literature and consultation with the practitioner who conducted the clinical intervention. Focus groups were digitally recorded for thematic analysis, which was carried out by the three authors independently. RESULT: YJ staff expressed consistently positive views about the SLP intervention trial in their centre. Staff indicated that they learnt a great deal about the complexity of communication difficulties in this population, and that this information informed and guided their own practices. They expressed surprise at the engagement of young people in the SLP service, and supported its embedding in the YJ setting. CONCLUSION: YJ staff endorsed the value of a SLP service in a custodial setting. Further research should focus on refining measurement of this service and its impact.

The influence of maltreatment history and out-of-home-care on children's language and social skills.

This study examined the extent to which maltreatment history and the characteristics of out-of-home care correlated with the language and social skills of maltreated children. Participants in this study were 82 maltreated children aged between 5 and 12 years of age. All children were residing with state-designated carers in out-of-home-care. The children were presented with standardised tests assessing language and social skills. Results showed that the sample performed significantly below the normative mean on both tests. Correlation analyses showed social skills, but not language skills were correlated with aspects of maltreatment history. The education level of the state-designated carer/s was correlated with the children's language skills; higher education level was associated with higher language skills. The study provides evidence that at the group level, language and social skills are poor in maltreated children. However, gains in language skills might be made via the out-of-home-care environment. Improvements in the social skills of maltreated children may require additional support.