Troubles du langage oral et écrit chez des jeunes pris en charge par l'aide sociale à l'enfance et bénéficiant de soins hospitaliers

Background: Children and adolescents involved with foster care are a population at high risk of developing psychiatric disorders and poor language skills. Here, we aimed to assess in children and adolescents admitted in a university department of child and adolescent psychiatry whether being involved with foster care would change oral and written language impairments they face. Method: We conducted a case-control study in a sample of 104 inpatients aged six to 18 years (50 supported by foster care; 54 not supported). Assessment included family and medical histories, axis 1 diagnoses and a systematic screening of written abilities using the French version of the 1-minute reading test, a spelling task and two tasks of sentence comprehension. For subjects showing at least one score below two standard deviations at one screening task, a full language assessment was performed including tasks for oral language, phonological skills, word identification, naming speed, syntax and comprehension. Results: We found more language impairments in inpatients involved with foster care than controls. They had lower scores in complex language comprehension tasks, more impaired phonological skills, and more fragile word identification strategies (both the grapho-phonologic conversion and the assembling strategy). We found a significant association between language and gender (male), intellectual disability and pervasive developmental disorder. Although externalized disorders were significantly associated with written language impairment, this association was mediated by gender. Finally, children and adolescents involved with foster care were at higher risk not to be treated for a language impairment (odd ratio = 3.5 [95%CI: 1.03-12.05], P=0.038). Conclusion: The severity and prevalence of language impairments among youths involved with foster care and requiring psychiatric inpatient stay show the impact of learning disabilities in this population. In terms of prevention, assessment of language skills should be promoted in this population as they appear to be at risk of not receiving proper speech or reading remediation.