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Predictors of wellbeing in young adults with aphasia and young adults with developmental language disorder

Kladouchou, V. (2021). Predictors of wellbeing in young adults with aphasia and young adults with developmental language disorder. (Unpublished Doctoral thesis, City, University of London)

Abstract

In health research, there is an increasing interest in the impact of disorders on people’s wellbeing, while understanding its main predictors is crucial before effective interventions and services can be developed. Accumulating evidence shows that both aphasia and developmental language disorder (DLD) have profound social and emotional effects on people’s lives, with most of research focusing on older adults with aphasia and children/adolescents with DLD. Although young adulthood is a challenging life-stage, stroke incidence increases in young adults (YA), and DLD has been acknowledged as a lifelong disorder persisting beyond adolescence to young adulthood, there is a gap in the literature concerning the wellbeing of YA with these disorders. The main aim of this research is to investigate predictors of wellbeing in YA with aphasia and YA with DLD and make a direct comparison between the two for first time. This will help stakeholders understand the similar and different pathways to wellbeing between two language disorders of different etiologies that have described to share some common symptoms.

A cross-sectional between-group study was designed. YA (18-40 years old) recruited adopting a broad recruitment strategy which included the involvement of schools, organisations, and use of social media. Fourteen different questionnaires and psychometric measures were administered to all participants to capture wellbeing (dependent variable) and potential drivers of it, including demographics, language, cognition, health, social functioning, emotional health, and personal resources (independent variables). The feasibility of testing procedure and acceptability of testing materials were informed by a pilot study. One-way ANOVAs and Kruskal-Wallis tests were used as appropriate to compare language, cognition, and wellbeing across the three groups. Consistent and differentiating predictors and correlates of wellbeing across groups were investigated with the use of standard multiple regression and statistical comparison of correlations of independent samples, respectively.

Nineteen individuals with aphasia (mean age of 34.8 years), 20 with DLD (mean age of 28.2 years), and 39 people with no history of language disorders (mean age of 29.5 years) were recruited, resulting in a total of 78 participants. A) YA from clinical groups shared similar language and cognitive profiles, scoring significantly lower in language and cognitive domains compared to controls. B) Positively, wellbeing of young people with language disorders was similar to that of neurotypical controls. C1) General health, social support, emotional and behavioural difficulties, and self-esteem were significant consistent predictors of wellbeing for the overall sample, accounting for 57% of the variance in the wellbeing scores. C2) There was a statistically significant difference in how social connectedness and self-esteem were associated with wellbeing between TD and aphasia groups; the relationship was stronger for the TD group. The relationship of overall language with wellbeing was significantly different between the TD and DLD groups, as was the relationship between oral expression and wellbeing for the aphasia and DLD groups. The links between language and wellbeing were strong for the DLD group, but small/unimportant for the other two groups.

Despite common clinical characteristics, similar levels of wellbeing, and some sharing predictors of wellbeing between the two clinical groups, their pathways to wellbeing differed, perhaps reflecting the different origin and etiology of the two language disorders (developmental vs acquired). For YA with DLD wellbeing was primary affected by their inherent clinical characteristics, while having grown up with intact language skills YA with aphasia and their wellbeing were mostly influenced by the emotional and health consequences secondary to aphasia. Finally, in TD YA, internal resources and social aspects of life seemed to drive wellbeing the most. This work can stimulate new research that considers the multifaceted nature of wellbeing, inform the development of support services tailored to the specific needs of young adults, and encourage clinicians to consider holistic therapeutic approaches with continual psychosocial support in order to help YA with aphasia and those with DLD reach their full potential.

Publication Type: Thesis (Doctoral)
Subjects: P Language and Literature > P Philology. Linguistics
Departments: Doctoral Theses
Doctoral Theses > School of Health Sciences Doctoral Theses
School of Health Sciences > Language & Communication Science
Date Deposited: 11 May 2021 11:09
URI: https://openaccess.city.ac.uk/id/eprint/26123
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