Abstract
Children with specific learning disorder (SLD) have poor academic skills, but they also experience difficulties with their peers, including an inability to recognize interpersonal conflict, infer emotion, and resolve social conflict. In addition, children with SLD are known to have problems with language. The importance of language to social cognition is well-established in research with children with typical and atypical development. Thus, we review literature that investigates language and social cognition in children with SLD compared with their peers. We also explore the link between language and social cognition in children with typical and atypical language development. Review of this literature suggests that the language deficits associated with SLD put children with SLD at a risk for deficits in social cognitive skill. The literature also points toward a critical need for early identification of SLD and research investigating social perspective taking in individuals with SLD across the lifespan. Last, we propose that clinicians should assess language before diagnosing and implementing intervention for the academic and social difficulties that children and adolescents with SLD experience.
Overview
According to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013), a specific learning disorder (SLD) is a neurodevelopmental disorder characterized by persistent impairment in academic skills well below the individual’s chronological age that have a negative impact on the individual’s performance at school, in the workplace, or in other daily activities. Children with SLD not only have poor academic skills, but also have poor social experiences (Wiener & Schneider, 2002); they are 10 times more likely to have social competence deficits compared with children with typical academic achievement (Dahle et al., 2011). They are less likely to be sought out in the classroom as a work or play partner and have fewer friendships (Pijl & Frostad, 2010). They also demonstrate difficulty recognizing interpersonal conflict (Shondrick et al., 1992), inferring emotion, and coming up with effective strategies to resolve social problems (Bauminger & Kimhi-Kind, 2008). Some researchers argue that these social cognitive deficits are due to the experience of having an SLD (Walker & Nabuzoka, 2007) as children with SLD are treated differently by their teachers and peers, which affects their sense of self and interpersonal interactions. Yet, there is evidence that these children exhibit social cognitive deficits long before they are identified with an SLD (Vaughn et al., 1990). Moreover, we know that deficits in language that are associated with SLD are also critical for social functioning. It is more likely that the social cognitive problems of children with SLD are actually a characteristic of their disorder (Galway & Metsala, 2011). We know that SLD is associated with poor language skills (McArthur et al., 2013; Oliveira et al., 2021; Spanoudis et al., 2019; Van der Leij et al., 2013) and the importance of language to social cognition in children with both typical (Astington & Jenkins, 1999; Bailey & Im-Bolter, 2020; Milligan et al., 2007) and atypical development (Bailey & Im-Bolter, 2019; Cohen et al., 1998; Im-Bolter et al., 2013) is well-established. Thus, it is possible that language serves as the underlying mechanism for the social cognitive deficits in children with SLD. We propose that language deficits put children with SLD at risk for impaired social cognitive skill. In support of this argument, we review and discuss the literature pertaining to (a) language in children with SLD, (b) social cognitive development and how it differs in children with SLD compared with their typically developing peers, and (c) the link between language and social cognition in children with typical and atypical language development.
Language and SLD
Early Language as a Predictor of SLD
Language is predictive of SLD, but more importantly, this predictive power is shown very early in development (Fuchs et al., 2012; Maassen et al., 2022) and some aspects of language (syntax) may be more important than others (phonological awareness; Flax et al., 2009). Children with SLD demonstrate weak language skill prior to receiving formal education (Maassen et al., 2022; Richardson et al., 2009; Snowling et al., 2003) and comorbidity rates between SLD and language impairments range from 50% (McArthur et al., 2000) to 75% (Newbury et al., 2011). In addition, there is evidence that all aspects of structural language (phonological awareness, semantic, syntactic) are early neurodevelopmental markers of SLD (Flax et al., 2009; Van der Leij et al., 2013). For example, compared with children not at risk for SLD, children at risk take longer to categorize speech sounds at 6 months, have difficulty imitating speech sounds to produce new words at 17 and 29 months (Maassen et al., 2022; Richardson et al., 2009, demonstrate weaker phonological awareness (the ability to identify and manipulate phonemes) between 3 and 4 years, and show poor semantic (understanding of the meaning and properties of words) and syntactic language (understanding of the rules of grammatically correct sentence structure) between 3 and 4 years (Snowling et al., 2003).
Phonological Awareness and SLD
Research investigating early predictors of achievement in typically developing children provides evidence of the relation between early phonological awareness and later academic achievement (Krajewski & Schneider, 2009; Savage et al., 2007; Snowling et al., 2003). In their meta-analysis and review of literature examining children with familial risk of SLD (dyslexia) and language development, Snowling et al. (2003) reported that children with family risk of SLD are behind their peers in the development of phonological awareness which predicts reading difficulties, whereas children who do not go on to develop reading problems show phonological awareness that is consistent with controls. Difficulties with phonological awareness may persist into middle childhood for children with SLD; children between the ages of 7 and 10 with SLD have phonological awareness scores that are lower than typically developing peers, but comparable with children with specific language impairment (Oliveira et al., 2021).
Although it is not surprising that phonological awareness is critical for mapping speech sounds onto letters for reading and writing, it is also essential for solving math computations, whereby children rely on storage of phonological information for Arabic-to-verbal translations when solving simple and complex math problems (Amland et al., 2021). Phonological difficulties at age 5 predicts poor performance on standardized math tasks (e.g., number facts, calculations, and concepts) at age 7 for children with and without SLD (Jordan et al., 2010). Moreover, phonological awareness assessed at age 5 and 11 is also predictive of all areas of learning on national standardized tests of achievement (reading, writing, math, and science) in 11-year-old children after accounting for gender, special education needs, baseline cognitive skills (e.g., parental ratings of spoken language), social development, and socioeconomic status. Krajewski and Schneider (2009) reported an association between phonological awareness assessed at the beginning of kindergarten to knowledge of number words (e.g., knowledge of number sequence, recognition of Arabic numbers) and numeracy (i.e., linking number words with quantity, determining numerical differences between sets of objects and number relations) later in the academic year, as well as overall applied math ability in Grade 3. They also found that early phonological awareness was indirectly associated (via number knowledge) with the developmental shift of knowledge of number words to number relations (e.g., quantity comparison, magnitude) and Grade 3 math ability (math calculations, applied math, and geometry). They concluded that phonological awareness was a predictor of math achievement and that deficits in phonological awareness may result in delayed math development.
Semantics, Syntax, and SLD
Although the literature suggests that phonological awareness may be an early indicator of SLD, other research suggests that early indications of SLD in the language domain are not limited to phonology (Snowling et al., 2003). In fact, other early oral language skills (e.g., syntax) may be a better predictor of SLD than phonological awareness (Flax et al., 2009; Scarborough, 2005). Semantic language (the meaning of words and sentences) allows us to attribute meaning to words, shapes, and numbers, whereas syntactic language (recognition and formation of sentence structure) allows us to understand written phrases and create an infinite number of messages. Longitudinal research suggests that children who are diagnosed with specific reading disorder between the ages of 8 and 9 have smaller vocabularies in early childhood compared with their peers (Maassen et al., 2022; Snowling et al., 2003). Snowling and colleagues (2003) showed that early semantic and syntactic language ability during preschool (age 3) was predictive of phonological awareness at age 6, which in turn was predictive of reading decoding at age 8. Language skills at age 3 were also predictive of general language ability at age 6, which in turn predicted reading comprehension at age 8. Their work establishes the importance of early language as a predictor of SLD.
Findings from the Dutch Dyslexia Programme, a longitudinal study that followed the reading skills and early intervention for children with familial risk for SLD, show that early difficulties with semantic and syntactic language predict later SLD (Maassen et al., 2022; Van der Leij et al., 2013). Van der Leij et al. (2013) reported that 53-month-old children who used shorter and less complete sentences (i.e., less developed syntactic skills) and had vocabulary deficits (e.g., used fewer categories of words) demonstrated reading problems in Grades 2 and 3. This is consistent with other studies that show early syntactic language (between 30 and 48 months) is predictive of SLD in elementary school (Richardson et al., 2009; Scarborough, 1990). Van der Leij et al. reported that the at-risk children who were later identified with SLD in the fifth grade showed worse semantic language (e.g., labeling letters, objects, and colors) at the age of 5 compared with average academic achievers. However, three out of four children who demonstrate syntactic language delays at 2.5 years demonstrate reading skills in Grade 2 that met diagnostic criteria for SLD, as well as delayed math achievement (Scarborough & Dobrich, 1990).
As previously mentioned, although the relation between language skill and reading may be clear, language is critical for math as well; math skill requires understanding the different semantic properties of words (e.g., the word factor has different meanings in different contexts), the meaning of math symbols and vocabulary, and grammatical rules to fully understand math statements. Praet and colleagues (2013) looked at kindergarten language skills (semantic and syntactic) as a predictor of later academic achievement, including math (e.g., counting, estimation) in Grade 1. They found that all language measures assessed during kindergarten were significantly correlated with concurrent (kindergarten) and later (Grade 1) math scores. Praet et al. also reported that overall language ability accounted for 22% of the variance in math skill during kindergarten after controlling for early math ability (i.e., number identification and counting knowledge). In sum, Praet et al. show the importance of language for math skill in kindergarteners and that language is crucial for advancing math skill in grade school.
Clearly, the research described above establishes the importance of early language skill for later academic achievement; however, language continues to be important for academic achievement in school-age children with SLD (Jordan et al., 2010; Snowling et al., 2003; Swanson et al., 2008).
Language in School-Age Children With SLD
All aspects of language have been shown to be predictive of later achievement in children with SLD during the elementary school years (Adlof et al., 2010; Celinska, 2004; Fuchs et al., 2012; Hecht et al., 2001; Maassen et al., 2022; Snowling et al., 2003). For instance, second grade phonological awareness predicts math skill in the fifth grade (Hecht et al., 2001) and children with SLD have poor phonological awareness compared with average achieving children throughout the elementary and high school years (Flax et al., 2009; Willcutt et al., 2013). Elementary school–age children (Grades 1–8) who meet criteria for SLD show worse semantic (Bishop & Adams, 1990; Celinska, 2004) and syntactic language skill (Adlof et al., 2010; Celinska, 2004; Snowling et al., 2003) compared with children without SLD. More specifically, children with SLD demonstrate language comprehension, oral expression, and semantic language that are within the impaired range (i.e., at least 1 standard deviation below the normative mean; Alloway & Gathercole, 2005). They also have more difficulty understanding and forming complex grammatical statements (Bishop & Adams, 1990).
Additional evidence for the importance of language to academic achievement can be found in research investigating the efficacy of academic intervention programs that include a language component (Gillon & Dodd, 1995; Hay et al., 2007). Hay and colleagues (2007) examined two reading interventions that did or did not include an oral language component in first grade children at risk for learning problems. This component included activities to promote oral language (e.g., knowledge of nouns and verbs, classification and organization of objects) and social communication skills. As expected, at the end of the school year, the group receiving reading plus oral language activities not only showed improvement in their language skills, but also performed better on tasks of reading than the group that did not receive the additional language intervention. Similarly, Gillon and Dodd (1995) also reported that when given interventions that included training in phonology, semantics, and syntax, children between the ages of 10 and 12 show improved reading ability. Taken together, these works provide evidence that an approach to learning remediation that involves targeting broader language skill may be more effective for children with SLD.
Given the language difficulties found in children with SLD, it is natural to compare them with another group of children who have compromised language skill, children with developmental language disorder (DLD; characterized by difficulties in language acquisition that are well below age expectations; Gallagher et al., 2023). Moreover, this group of children is interesting to consider given their social communicative deficits, which children with SLD also demonstrate (Brinton et al., 1998). McArthur et al. (2000) reviewed four SLD and three DLD studies and found that 55% of children with SLD could also be identified with DLD and that 51% of children with DLD could be identified with SLD. They noted that the children in these studies were recruited because they were diagnosed and receiving services for either SLD or DLD, yet more than half could be diagnosed with the other disorder. This highlights not only the high degree of co-occurrence of SLD and DLD, but potential difficulties with differential diagnosis. This is problematic given that language is not only the medium through which learning occurs, but also social interaction. Thus, it comes as no surprise that children with SLD also have impaired social cognitive skills.
Social Cognitive Development
To understand how social cognitive skills are impaired in children with SLD, it is necessary to first explain the complexity of social cognition. Social cognition is an umbrella term used to describe a set of interrelated skills involved in the interpretation and navigation of social information, including emotion cognition, perspective taking, and social problem-solving (Dodge et al., 1986). Theories that guide research investigating the development of social problem-solving incorporate aspects of emotion cognition and social perspective taking (Dodge et al., 1986; Schultz et al., 1989), which are essential to effectively resolve interpersonal conflict in a manner that satisfies both parties. Schultz et al. (1989) proposed a model of social problem-solving with four distinct aspects: (a) problem identification (recognition that a problem exists and the emotions associated with the problem), (b) strategy generation (the generation of potential solutions that could be used to resolve the conflict), (c) strategy evaluation (consideration of potential strategies and the potential obstacles that could arise in their implementation), and (d) solution evaluation (evaluation of the outcome).
The ability to process social information is necessary for social problem-solving success. Children with good social information processing will encode pragmatic language cues that are relevant to the situation (e.g., facial expression, vocal prosody), whereas children with poor social information processing may encode irrelevant physical cues (e.g., hair color; Dodge et al., 1986). Encoding relevant cues serves to inform a child’s mental representation of the potentially differing perspectives of the self and other. Successful social conflict resolution requires that the individuals involved have a mental representation of the different perspectives (social perspective taking) that are the root of the social conflict (Schultz et al., 1989). Schultz et al.’s (1989) model is particularly important to consider when evaluating developmental differences in social cognition, as recent research suggests that social perspective taking for the four aspects of social problem-solving may develop asynchronously (Bailey & Im-Bolter, 2020).
Social Perspective Taking and Social Problem-Solving
Studies that are guided by Schultz et al.’s (1989) model of social problem-solving aim to understanding the process of social perspective taking during social conflicts based on Selman’s (1980) theory of social perspective taking. According to Selman (1980), social perspective taking involves processing social information, as well as ascribing meaning and reflecting on the inter- and intrapersonal relations of thoughts, feelings, and actions. Selman postulates that social perspective taking is a developmental process that occurs via a hierarchical series of stages that differ qualitatively. The first stage of perspective taking (egocentric: unable to differentiate between acts and feelings) is evident in children between the ages of 3 and 6 years. This shifts sometime between the ages of 5 and 9 when children begin to demonstrate differentiated and subjective perspective taking (unilateral: distinguishing between acts and feelings). At about 7 to 12 years of age, children begin to demonstrate self-reflective and reciprocal perspective taking (reciprocal: viewing the self from a second-person perspective and understanding that others can do the same). Between the ages of 10 and 15, children begin to demonstrate third person and mutual perspective taking (collaborative: viewing the conflict from a bystander point of view and simultaneously coordinating the perspectives of self and other; Selman, 1980).
There are a handful of studies that have investigated cognitive processes associated with social perspective taking informed by Selman’s (1980) model (e.g., Bailey & Im-Bolter, 2019; Hanten et al., 2008; Im-Bolter et al., 2013; Yeates et al., 2004). The primary focus of these studies is atypical development (e.g., epilepsy, brain injury, psychiatric disorder), but findings with respect to their control samples are informative. Yeates et al. (2004) found that language was a significant predictor of social perspective taking after accounting for age, ethnicity, and group designation (i.e., brain injury vs. no brain injury). Similarly, Im-Bolter et al. (2013) showed that language is a significant predictor of social perspective taking during social problem-solving in both the clinic and non-clinic groups. Clearly, language is a key cognitive resource for social perspective taking and it is reasonable to propose that difficulties in this domain may hinder development of social perspective taking. This may be why children with SLD have social perspective taking deficits in a social problem-solving context (Agaliotis & Kalyva, 2008; Carlson, 1987; Kravetz et al., 1999).
Social Perspective Taking and Social Problem-Solving in SLD
Research shows that children with SLD are able to identify when a social problem exists (Bauminger & Kimhi-Kind, 2008; Tur-Kaspa, 2004) but have difficulty recalling core details of a social problem when asked about it later (Bauminger et al., 2005). As we might expect, there should be age differences in social problem-solving with younger children performing more poorly than older children. Tur-Kaspa (2004) found that kindergarten children with and without SLD performed similarly with respect to encoding social-pragmatic cues, interpreting the problem, and generating competent strategies but kindergarteners with SLD were more likely to select incompetent solutions to social conflicts when given a selection of strategies than their peers without SLD. However, compared with their same-age peers without SLD, children with SLD in Grade 4 demonstrated deficits in understanding and encoding social-pragmatic cues, interpreting the problem, and forming competent strategies during a social conflict (Bauminger et al., 2005; Bauminger & Kimhi-Kind, 2008), although they were able to choose competent solutions when given a choice (Bauminger et al., 2005).
These age differences reflect developmental differences in social perspective taking and language skills needed for successful social problem-solving. Thus, in younger children, who have less developed social perspective taking and language than older children, there may be no difference in performance regardless of SLD status due to a floor effect. Research that provides evidence of less mature social perspective taking in older children with SLD provides support for this idea. For instance, Kravetz et al. (1999) found that children in Grades 4 and 5 with SLD showed less mature, unilateral social perspective taking compared with children without SLD who demonstrated more mature, reciprocal social perspective taking. Similarily, Kalyva and Agaliotis (2009) found that children between the ages of 10 and 12 with SLD were more likely to select hostile and avoidant strategies that reflected a unilateral social perspective compared with their same-age peers without SLD (Kalyva and Agaliotis, 2009).
These difficulties in social perspective taking during social problem-solving appear to be mitigated with intervention. Kalyva and Agaliotis (2009) found that after receiving social story intervention, 10- to 12-year-old children with SLD were more likely to choose strategies reflecting compromise and accommodation (i.e., reciprocal social perspectives), whereas the group who did not receive intervention selected strategies reflecting a unilateral social perspective. The social stories they used were rich in mental state language and the relationship between individuals, perhaps building the semantic knowledge needed to consider different social perspectives. Moreover, scaffolding children with SLD during social conflict by providing them with prosocial goals could serve as a form of intervention.Children, regardless of age or learning status, are more likely to select prosocial strategies when given options to choose from rather than being asked for independent open-ended responses (Oliva & La Greca, 1988). Boys with SLD form less sophisticated goals when asked open-ended questions, but provide responses similar in quality to that of their peers when provided with a more restricted choice of goals (Oliva & La Greca, 1988). A question such as, “How could you get the child to share?” which includes language that highlights reciprocal thought (i.e., sharing) may promote reciprocal perspective taking.
Findings from the above studies indicate that children with SLD demonstrate delays in the development of social perspective taking in comparison with their peers without SLD and that intervention, which includes verbal communication and enrichment of social semantic knowledge, appears effective for promoting social perspective taking. This makes sense when we consider the critical role that language plays in optimizing social interactions and social communication. Language has been shown to be important for the understanding that others may have thoughts that differ from our own (Astington & Jenkins, 1999; Bailey & Im-Bolter, 2020; Im-Bolter et al., 2016; Milligan et al., 2007), something that is necessary to move from an egocentric to unilateral to reciprocal perspective. As such, language may facilitate a child’s progression to a more sophisticated level of social perspective taking. That means that children with poor language skill (e.g., children with SLD) are likely to have a less sophisticated level of social cognitive skills such as social perspective taking.
Social Perspective Taking and Language
Language is the mechanism used to attribute meaning to a social situation and to initiate, interact, and respond to others (Bruner, 1998). Many studies establish a relation between language and social perspective taking in children during the preschool years (e.g., Astington & Jenkins, 1999; Milligan et al., 2007). This literature focuses on the relation between language and false belief understanding, also referred to as first-order theory of mind (ToM; the ability to mentally represent thoughts, feelings, and intention to predict future behavior; e.g., Astington & Jenkins, 1999; Milligan et al., 2007). However, other research, which is consistent with Selman’s (1980) theory of social perspective taking, examines the relation between language and the coordination of social perspectives (e.g., Bailey & Im-Bolter, 2020; Im-Bolter et al., 2013). Coordination of social perspective taking differs from first-order ToM because it entails simultaneous consideration of the inter- and intrapersonal relations of thoughts, feelings, and actions (Selman, 1980), and how our interpretation of the perspectives of others informs our own perspective. First-order ToM does not reflect this complex integration of perspectives that facilitates successful conflict resolution.
Tasks that measure more advanced ToM can be viewed as more analogous to measures of the coordination of social perspective taking, but there remains a subtle distinction that may appear difficult to show empirically. Advanced ToM is often measured using tasks that assess mental state reasoning (e.g., understanding that an individual’s actions are motivated by their intentions; Happé, 1994) using vignettes that depict a situation where a character says something that they do not mean (Happé, 1994) or unintentionally commits a faux pas (Baron-Cohen et al., 1999). Mental state reasoning is demonstrated if the intention of the character is understood (e.g., we sometimes tell white lies to avoid hurting others’ feelings). In contrast, tasks that reflect Selman’s (1980) model of social perspective taking would assess the developmental level of perspective taking during different aspects of the problem-solving process (e.g., what is the best way to solve the problem?). A lower level (egocentric) of social perspective taking would be reflected in solutions that emphasize the self (e.g., If I get what I want). At a higher, collaborative level of social perspective taking, the solution would reflect coordination of both perspectives (self and other), be acceptable to both individuals involved in the conflict, and preserve their relationship (Schultz et al., 1989). Although ToM is sometimes referred to as social perspective taking, ToM does not include the coordination of social perspective taking as discussed in the review below. We acknowledge, however, that ToM research may be relevant to our discussion given that ToM involves perspective taking.
The literature investigating the relation between ToM and language is extensive; however, there is much less research focused on the coordination of social perspectives during social conflict. The handful of studies that exist suggest a relation between language and the coordination of social perspective taking in preschool (Capage & Watson, 2001), school-age children (Bailey & Im-Bolter, 2020), and adolescents (Im-Bolter et al., 2013), as well as in school-age children and adolescents referred to mental health clinics (Cohen et al., 1998; Im-Bolter et al., 2013; Zadeh et al., 2007).
Evidence From the Typically Developing Population
The studies that investigate social cognition in children with typical and atypical development support the importance of language to social perspective taking (Bailey & Im-Bolter, 2019; Cohen et al., 1998; Farmer, 2000; Marton et al., 2005) but there are none that we are aware of that investigate language and social perspective taking in children with SLD. Evidence of the importance of language for social perspective taking can be observed in studies that consider language and strategies for conflict resolution, where strategies can reflect different levels of social perspective taking. Capage and Watson (2001) examined the relation between language and the relevance of strategies suggested for social conflicts. Preschool children were presented with a vignette where the main character (protagonist) wanted to play with a toy that another child had been playing with for quite some time and asked what the protagonist could say or do to have a chance to play with the toy. All strategies were coded for relevance in terms of solving the problem. Capage and Watson found that better overall (semantic and syntactic) language skill was associated with a greater proportion of relevant strategies. More importantly, poor language was associated with a greater proportion of aggressive strategies (recall that aggressive strategies reflect egocentric social perspective taking; Selman, 1980). The ToM literature also suggests that semantic and syntactic language may be important for social perspective taking in typically developing children (Astington & Jenkins, 1999; Im-Bolter et al., 2016; Milligan et al., 2007), although there appears to be no consensus as to which is a better predictor.
Some research suggests that semantic language is more highly correlated with ToM (Ruffman et al., 2003), whereas other research suggests that syntax is more important (Astington & Jenkins, 1999). A meta-analysis by Milligan et al. (2007) suggests that a particular aspect of syntax, sentential complements (phrases that consist of a main clause with a subordinate clause embedded within it), is more important to ToM and other aspects of language (although not significantly so). If sophisticated syntactic skill like understanding sentential complements is essential for understanding the intentions of others, then it also must be necessary to facilitate the more complex process of coordinating different social perspectives. It is plausible to propose that children with SLD, who have impaired language ability (Praet et al., 2013; Van der Leij et al., 2013), have difficulty forming the mental representations needed for the coordination of social perspectives. Literature investigating social perspective taking ability in children known to have impaired language skill (e.g., children with language impairment) supports this idea.
Evidence From Atypical Populations
Research that focuses on social perspective taking in children with DLD supports the idea that language may underlie the social cognitive deficits in children with SLD for two reasons: (a) it provides strong evidence for the importance of language for social perspective taking and (b) children with SLD have compromised language skill (Snowling et al., 2003) that seems to reflect an undiagnosed DLD (McArthur et al., 2000). The literature suggests that children with DLD have more difficulty with mental state understanding compared with their same-age peers without DLD, but do not differ from language age-matched controls. Thus, it appears that the level of language development predicts developmental level of mental state understanding (one aspect of social cognitive development). However, research that investigates social cognitive development in children with DLD suggests that the association between language and social cognition goes beyond mental state understanding, whereby children with DLD are shown to have poor social cognitive skills.
Similar to children with SLD, children with DLD have fewer friends than children without DLD and the friendships that that they do have are poor quality (Fujiki et al., 1996). Children with DLD are more likely to play alone or watch other children play from the sidelines (Fujiki et al., 1999). When playing or working with their peers, children with DLD speak and are spoken to less than their partners, and are less likely to have their wants and needs be satisfied during the decision-making process when working with other children (Brinton et al., 1997; Fujiki et al., 1997). If a conflict occurs during unstructured play, that conflict is less likely to be resolved if it involves a child with DLD (Horowitz et al., 2005). In instances when a conflict is resolved, it is more likely to be due to a unilateral exchange (e.g., one child wishes are followed) as opposed to a reciprocal exchange (Horowitz et al., 2005).
In middle childhood, children with DLD are more likely to use strategies to resolve social conflict that are not consistent with developmental expectations (Brinton et al., 1998; Marton et al., 2005). Children with DLD between the ages 7 and 10 produce social problem-solving strategies that are aggressive in nature or include passive/withdrawn behavior (Marton et al., 2005). These types of strategies are consistent with Selman’s description of egocentric social perspective taking and characterize social perspective taking in 3- to 6-year-olds. Brinton et al. (1998) reported that children with DLD between the ages of 8 and 12 were more likely to propose strategies for problem-solving that reflect unilateral (characteristic of 5- to 9-year-olds) rather than reciprocal social perspective taking when working with same-age peers.
Using Selman’s (1980) model of social perspective taking, Stevens and Bliss (1995) found that although children with DLD were able to come up with as many strategies as their same-age peers with typical development, the strategies were at a lower developmental level (i.e., less reciprocal social perspective taking). Children without DLD were more likely to produce strategies reflecting reciprocal thinking, whereas children with DLD were more likely to come up with strategies reflecting egocentric or unilateral social perspective taking. Their findings highlight the importance of language for more mature social perspective taking. This is consistent with other research that investigates social perspective taking (Stevens and Bliss, 1995) and strategy use (Horowitz et al., 2005; Marton et al., 2009) in children with DLD.
Research by Cohen et al. (1998) with a mental health clinic sample also demonstrated the importance of language for social perspective taking. Cohen et al. found that compared with children without DLD, children with DLD demonstrated less mature social perspective taking in three of the four aspects of social problem-solving: identifying a problem within a social context, identifying and overcoming any obstacles associated with a chosen strategy, and identifying whether a problem was successfully resolved. To ensure findings were not due to differences in children’s ability to express themselves, the authors controlled for expressive semantic and syntactic language ability and the findings did not change. It could be argued that children who attend mental health clinics are likely to have less mature social perspective taking that is influenced by psychological disorder. Research does suggest that externalizing disorders are predictive of social perspective taking even after accounting for intelligence and language (Marton et al., 2009). However, it is important to highlight that Cohen et al. showed that among a clinical sample of children, it was DLD status rather than psychological disorder that placed the children at a greater disadvantage with respect to social perspective taking skills.
Further support for the notion that language is important for social perspective taking comes from other investigations in typical and atypical populations. These studies also provide insight as to which aspects of language may be more implicated compared with others. There are moderate to large correlations between language ability and social perspective taking in children and adolescents with and without psychopathology, whereby better language is associated with a higher developmental level of overall social perspective taking (Im-Bolter et al., 2013; Zadeh et al., 2007). Studies that include only measures of syntactic language ability (e.g., Zadeh et al., 2007) report higher correlations between language and social perspective taking than studies that include measures of both semantic and syntactic language (e.g., Im-Bolter et al., 2013; Marton et al., 2009). In addition, better syntactic language ability is strongly associated with social perspective taking during social problem-solving in clinically referred children and adolescents (Zadeh et al., 2007). Language scores that include both semantic and syntactic measures are also shown to be associated with social perspective taking during social problem-solving, accounting for 18% of the variance in social perspective taking ability in children with and without attention deficit hyperactivity disorder (Marton et al., 2009).
Clearly, the literature reviewed above provides strong support for the proposal that language may be the underlying mechanism for the social cognitive deficits found in children with SLD. The relation between language and mental state understanding in children with typical (Astington & Jenkins, 1999; Filippova & Astington, 2010; Milligan et al., 2007) and atypical language development (Farmer, 2000) is well-established. Language is also shown to be associated with the coordination of social perspectives or social perspective taking particularly with respect to the selection of strategies for conflict resolution, which demonstrate unilateral rather than reciprocal social perspective taking (Horowitz et al., 2005; Stevens & Bliss, 1995).
Discussion
It has been theorized that the cognitive problems associated with learning difficulties are also the root of social cognitive struggles that children with SLD experience (Wiener, 2004). If children with SLD have issues with processing and learning information that is explicitly taught in the classroom, then they should have similar issues processing and learning social information, which is rarely explicitly taught. This might explain why children with SLD have difficulty understanding other perspectives to recognize and resolve conflict in a manner that their peers find acceptable. Another important aspect of cognition impacted in children with SLD is language. Language is critical to social perspective taking because social communication between individuals is dependent on language. In fact, Holtgraves and Kashima (2008) point out that a social situation that does not involve language would be rare. Language is the tool used to create and exchange meaning, and provides the means to interpret social information, attribute meaning to form a mental representation of events, and communicate intentions to others. In fact, the language we use shapes the overall meaning of what is being said. For instance, the statement “Why won’t you listen to me?” infers accusation and is likely to encourage conflict, whereas “I feel unheard, can we talk?” removes blame and is more likely to elicit empathy and discussion in individuals. Moreover, we use language to hypothesize how others form mental representations of these same events, and how those interpretations relate to our own.
During social conflict, a child will react in a manner that is consistent with how they ascribe meaning to the event and their interpretation of what the other may be thinking or feeling. If a child has deficits in the skill needed to ascribe meaning (i.e., semantic language), then it is unlikely that the child is going to form an accurate representation of this event. As previously explained, children with SLD lack the skill (language) needed to attribute meaning to the perspective of another person, consider that perspective in relation to their own, and communicate their own perspective to others. As a result, children act in a manner that reflects their (often erroneous) interpretation of events because of their language deficits. Thus, their behavior during conflict reflects immature social problem-solving as they are unable to coordinate social perspectives at a developmentally appropriate level. Understandably, this has a negative impact on their interpersonal relationships so that other children are less likely to befriend them or include them in play.
Future Directions for Research
More research is needed to better understand social perspective taking in individuals with SLD to determine the severity of the delay. Based on our review, during early adolescence children with SLD continue to demonstrate egocentric or unilateral coordination of social perspectives when they should be at a reciprocal level. There appears to be no research investigating social perspective taking in older children with SLD. Is development of this skill delayed or arrested? Are individuals with SLD able to eventually demonstrate the highest level of social perspective taking? To answer these questions, researchers need to consider individual differences in social perspective taking in individuals with SLD across the lifespan.
In addition, it is clear from the review above that more research is needed with respect to the role of language in the social cognitive functioning of children with SLD. While some children with SLD meet criteria for language impairment, many do not. Thus, research should consider the relation between language and social perspective taking during social problem-solving in children with SLD who do and do not have delayed language. Other research indicates that language and perspective taking are correlated in atypical populations (Bailey & Im-Bolter, 2020; Im-Bolter et al., 2013). Hence, we might expect that children with SLD who do not have language impairment may have better social perspective taking skill. Furthermore, when considering measures of language, attention should be given to not only overall language ability, but also specific areas of structural language. Given the findings in the literature specific to clinically referred populations (i.e., children referred to mental health clinics for assessment and treatment), it is possible that syntactic language may be more strongly associated with social perspective taking in children with SLD than semantic language.
Research is also needed in the area of early identification of SLD. Given the long-term ramifications of SLD (e.g., poor mental health, poor interpersonal relationships), early identification and intervention is essential; early intervention should include a focus on oral language skill. More research should be conducted to confirm how soon we can assess language development and other cognitive functions that can be used as markers for assessment in children to implement interventions sooner. Certainly, the review here provides evidence that early language ability, phonology in particular, is predictive of learning problems (Fuchs et al., 2012; Richardson et al., 2009). Earlier assessment is needed because valuable time is lost that could be used for intervention for those at risk to improve quality of life. Ideally, screening should take place as early as infancy. Based on the review here, we know that children with SLD also exhibit social cognitive deficits and these deficits are apparent in the preschool period. It may be possible that there are early social cognitive markers that are indicative of SLD, such as eye gaze or joint attention during infancy, that have not yet been considered as early predictors of SLD. This follows with arguments set forth by other researchers that propose that early screening should include (1) markers that are observable in all children, (2) markers that occur within a narrow time frame, (3) assessment of markers should be inexpensive and reliable, and (4) markers should be predictive of SLD (strive for 100% sensitivity and specificity; Shapiro et al., 1984).
Implications for Practice
In addition to the aforementioned research applications, this article provides rationale for recommendations for the learning environment of children with SLD. It is clear that assessment of children with SLD should not be limited to academic skills given the overlap in etiology between SLD and DLD. It would be important to consider SLD when assessing DLD and vice versa. In fact, many cases of SLD may be DLD that manifest as learning problems. Moreover, language assessment is necessary before implementing interventions for learning difficulties, as the intervention is likely to be language based.
In addition to pedagogical applications, this article provides insight for social cognitive applications. Interpersonal relationships with peers can provide a protective factor for low self-worth (Bullock et al., 2020; Shany et al., 2013) and internalizing (Bullock et al., 2020; Chen et al., 2024) and externalizing disorders (Cao et al., 2020). However, children with SLD have poor interpersonal relationships with their peers (Nowicki et al., 2014), so their peer relationships fail to circumvent the psychosocial consequences associated with SLD, and thus targeted intervention is needed. Remediation of the social difficulties that children with SLD face should include a focus on social perspective taking that includes an oral language component. Although interventions involving social stories are shown to be effective for decreasing inappropriate social behavior, they do not appear to increase prosocial behavior in children with SLD (Kalyva & Agaliotis, 2009). These types of interventions may benefit from including explicit strategies to help children consider other perspectives during a social conflict. This makes sense, given that prior research suggests that considering strategies that reflect more developed perspective taking is the easiest aspect of social problem-solving for school-age children (Bailey & Im-Bolter, 2020). Moreover, children with SLD seem better able to consider other perspectives when resolving interpersonal problems if they are given explicit prosocial cues to assist them (Carlson, 1987). Thus, intervention may be more effective if the level of perspective taking that a child is able to demonstrate consistently is considered so that scaffolding techniques are included to assist the child in reaching the next stage of social perspective taking.
Last, given the number of social cognitive difficulties that are associated with SLD, diagnosis should include assessment of social cognition. At the very least, parents and teachers should be aware that poor social cognition may be an indicator of SLD so that assessment can be sought out early in a child’s academic career, if not before.
Conclusion
Children with SLD have impaired language skills that can have a negative impact beyond the academic environment to social experiences via compromised social perspective taking. Impairments in language characterize SLD and as such should be considered during diagnosis, especially when accompanied by deficits in social skills. It is critical that interventions for SLD and social skills take language into consideration. Unfortunately, diagnosis of SLD cannot be determined until after school enrolment (i.e., requires assessment of academic achievement). As a result, early intervention is compromised and treatment is typically implemented after significant delays have already occurred. However, given the importance of language, a diagnostic assessment that includes language skill may serve to increase recognition and intervention of SLD in a manner that circumvents the negative social consequences (e.g., social perspective taking) associated with this disorder.
Footnotes
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
This research was supported by a Social Sciences and Humanities Research Council of Canada research grant awarded to Katharine Bailey (767-2013-1797)
