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Top Lang Disorders Vol. 27, No. 2, pp. 146–166 Copyright c 2007 Wolters Kluwer Health | Lippincott Williams & Wilkins Relational , Victimization, and Language Development Implications for Practice

Jamie M. Ostrov, PhD; Stephanie A. Godleski, BA

This review explores the development of relational aggression and relational victimization among peers, with specific emphasis on clinical implications for speech–language pathologists. Develop- mental manifestations of relational aggression and victimization are reviewed from early childhood through emerging adulthood. The concurrent and prospective associations between relational ag- gression and language development are examined specifically. Best practices in the assessment and evaluation of relational aggression and victimization are introduced and the current empirically based interventions for relational aggression and victimization are highlighted. Finally, a develop- mental psychopathology framework is introduced to guide future clinical practice and scholarship in the study of children and adolescents with comorbid language and peer relationship problems. Key words: developmental psychopathology, language development, peer relationships, rela- tional aggression, relational victimization

EER RELATIONSHIPS serve as a salient early and middle childhood period (Parker, Pcontext for social–emotional, cognitive, Rubin, Erath, Wojslawowicz, & Buskirk, and behavioral development (Hartup, 1996), 2006). The developmental psychology lit- beginning in early childhood and continuing erature indicates that skills acquired within throughout the lifespan (Rubin, Bukowski, & peer relationships during early childhood Parker, 2006). Meaningful and sustained peer (e.g., conflict resolution, emotion regulation, relationships become prominent around 30 perspective taking, friendship formation months of age and continue to exert a pow- capacity, and prosocial skills) are carried erful influence on children throughout the forward into peer interactions in middle childhood and (see Ostrov & Weinberg, 2004; Sroufe, Egeland, & Carlson, From the Department of Psychology, University at 1999). Buffalo, The State University of New York. Peer relationship problems may manifest We thank members of the Social Development Labora- in a number of ways, including aggression, tory for their assistance with the preparation of this victimization, social withdrawal, and peer manuscript. Special thanks to Adam Mullins and Emily rejection (Bierman, 2004; Parker et al., Ries for their contributions. We acknowledge the past work and ideas of Drs David H. Arnold, Nicki R. Crick, 2006). They also can be exacerbated by co- Teri L. Estrem, Craig H. Hart, Patricia H. Hawley, Jong- occurring language problems (Conti-Ramsden Hyo Park, and their colleagues for serving as the impe- & Botting, 2004; Gallagher, 1991; Redmond tus for the current review. We thank Dr Geralyn R. Tim- ler for her helpful guidance and support in the prepa- & Timler, in press). The present review ration of this manuscript. We also thank Dr Julie W. addresses the development of relational ag- Bowker for insightful suggestions on an earlier version gression and relational victimization, as well of this manuscript. as techniques for school-based assessment Corresponding author: Jamie M. Ostrov, PhD, Depart- and intervention for relational aggression ment of Psychology, University at Buffalo, The State Uni- versity of New York, 214 Park Hall, Buffalo, NY 14260 among peers. This article also introduces a (e-mail: [email protected]). developmental psychopathology framework 146 LWW/TLD LWWJ328-04 April 19, 2007 11:6 Char Count= 0

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for research and practice that may facilitate years, researchers and clinicians have been interdisciplinary collaboration among psy- directing more to the develop- chologists, providers, and ment of physical and relational victimization speech–language pathologists (SLPs). (Juvonen & Graham, 2001). Within the scope of the present review, we focus only on rela- RELATIONAL AGGRESSION AND tional aggression and the chronic or frequent VICTIMIZATION: DEFINITIONS AND receiving of relational aggression, which DEVELOPMENTAL MANIFESTATIONS has been defined as relational victimization (Crick & Grotpeter, 1996) and not other Aggression is defined as the intent to conceptually related constructs (Bjorkqvist, hurt, harm, or injure another person (Dodge, 1994; Cairns, Cairns, Neckerman, Ferguson, Coie, & Lynam, 2006). Traditionally, physical & Gariepy, 1989; Galen & Underwood, 1997). aggression (e.g., hitting, kicking, punching, Developmental researchers have focused pushing) has been defined as the intent to on exploring the developmental manifes- harm another person via physical force or the tations of relational aggression and victim- threat of physical harm (Dodge et al., 2006). ization (Crick et al., 2001; Crick, Ostrov, & An additional subtype of aggressive behavior, Kawabata, 2007). During early childhood, relational aggression, is apparent during early relational aggression is often direct, and the childhood and continues throughout develop- identity of the perpetrator is known (Crick, ment. It is defined as using the removal or Ostrov, Appleyard, Jansen, & Casas, 2004). the threat of the removal of relationships as Even in contexts that involve malicious secret the means of harm (e.g., directly excluding spreading, the behaviors have been observed a child from play by saying “you can’t play to be overt (i.e., within earshot and view of with me,” or “you can’t be my friend”; Crick the victim) (Ostrov, Woods, Jansen, Casas, & & Grotpeter, 1995). Relational aggression may Crick, 2004). Finally, during early childhood, be displayed in both verbal (e.g., “You can’t the behaviors are often in response to a spe- come to my birthday party”) and nonverbal cific situation or event that occurred in the ways (e.g., placing hands on a chair so a child present moment and not in response to past may not sit at the snack table) and may be de- events (Crick, Werner, et al., 1999). In later de- livered in these direct ways or more covertly velopmental periods, the behaviors become (e.g., spreading malicious rumors about oth- more covert, involving more sophisticated ers) during later developmental periods. means of harm (Crick, Werner, et al., 1999). Whereas relational aggression focuses on The role of gender in the development of the child acting as the aggressor, relational relational aggression has often been explored victimization focuses on the child who is the in past research. In general, during early child- recipient of this aggression. Peer victimiza- hood and within peer contexts, girls are more tion has been characterized as frequent or relationally aggressive than boys, and they chronic receipt of aggressive behaviors from direct more relational aggression to female one or more peers over time (Olweus, 1995; peers than they do to male peers (Bonica, Schwartz, Dodge, Pettit, & Bates, 1997). Yeshova, Arnold, Fisher, & Zeljo, 2003; Crick, Recently, this definition has been expanded Casas, & Mosher, 1997; Crick, Ostrov, Burr, to include exposure to direct confronta- et al., 2006; Hawley, 2003; Nelson, Robinson, tion (e.g., physical, verbal, or nonverbal & Hart, 2005; Ostrov, 2006; Ostrov et al., aggression) or being threatened with the 2004; Ostrov & Keating, 2004; Russell, Hart, removal of the relationships as the means Robinson, & Olsen, 2003; Sebanc, 2003) of harm (e.g., relational aggression; Crick & although not all authors find these effects Grotpeter, 1995; Juvonen & Graham, 2001). (Estrem, 2005; Hart, Nelson, Robinson, Olsen, Less research has focused on the study of & McNeilly-Choque, 1998; Johnson & Foster, subtypes of , but in recent 2005). One study conducted during the early LWW/TLD LWWJ328-04 April 19, 2007 11:6 Char Count= 0

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school years indicated that 7- and 8-year-olds relational aggression has been associated inferred relationally aggressive story charac- with more severe forms of psychopathology ters as being female and physically aggressive including ADHD (Blachman & Hinshaw, 2002; characters as being male (Giles & Heyman, Zalecki & Hinshaw, 2004), borderline person- 2005). The findings are more mixed at subse- ality disorder features (Crick, Murray-Close, quent developmental periods and seem to be & Woods, 2005), internalizing (e.g., loneli- a function of the type of methods used and ness, social isolation, withdrawal, depressive the culture studied. However, the evidence symptoms), and externalizing problems (e.g., seems to indicate that girls continue to be delinquency; Crick & Grotpeter, 1995; Crick, more relationally aggressive than boys during Ostrov, & Werner, 2006; Murray-Close et al., middle childhood (Crick, 1996; Crick & 2007). In adolescence, relational aggression Grotpeter, 1995; Crick, Ostrov, & Werner, is predictive of eating disorders and per- 2006; French, Jansen, & Pidada, 2002; Murray- sonality disorders (Werner & Crick, 1999), Close, Ostrov, & Crick, 2007; Rys & Bear, alcohol use (Storch, Werner, & Storch, 2003), 1997) but not all authors find this effect symptoms of disruptive behavior disorders (David & Kistner, 2000; Tomada & Schneider, (Prinstein, Boergers, & Vernberg, 2001), as 1997). well as jealousy and poor relationship quality Across development, sanctions for physical within romantic relationships (Linder, Crick, aggression become increasingly costly; thus, & Collins, 2002). it may not be surprising that males are re- For victims, similar developmental asso- ported as being high in relational aggression ciations have been identified. For example, during adolescence and emerging adulthood during early childhood, relational victimiza- (Crick et al., 2007), perhaps as they learn to tion has been associated with peer rejection, avoid penalties for physical aggression. Even loneliness, internalizing problems, and a in developmental periods when clear gen- lack of prosocial behavior (Bonica et al., der differences are no longer present, how- 2003; Crick, Casas, & Ku, 1999; Ostrov et ever, relational aggression predicts social– al., 2004). In middle childhood, relational psychological adjustment problems more for victimization is associated with problems girls and women than for boys and men such as peer rejection, social anxiety, social (Werner & Crick, 1999). avoidance, loneliness, externalizing and internalizing symptoms (Crick & Grotpeter, OUTCOMES ASSOCIATED WITH 1996; Crick & Nelson, 2002; Cullerton-Sen RELATIONAL AGGRESSION AND & Crick, 2005) as well as alcohol, tobacco, VICTIMIZATION and marijuana use (Sullivan, Farrell, & Kliewer, 2006). For adolescents, relational Across development, both relational aggres- victimization is predictive of social phobia sion and relational victimization have been as- (Storch, Masia-Warner, Crisp, & Klein, 2005), sociated with poor social–psychological ad- social anxiety (La Greca & Harrison, 2005), justment. Aggressors and victims both face se- loneliness (Storch & Masia-Warner, 2004), rious developmental risks. and internalizing problems (Prinstein et al., For aggressors, relational aggression has 2001). In sum, both relational aggression and been associated with concurrent and prospec- victimization are associated with maladaptive tive peer rejection, loneliness, student– outcomes. teacher conflict, , impulsivity– hyperactivity, and a lack of prosocial behavior LANGUAGE AND RELATIONAL in early childhood (Crick et al., 1997; Crick, AGGRESSION AND VICTIMIZATION Ostrov, Burr, et al., 2006; Ostrov, 2006; Ostrov et al., 2004; Ostrov & Crick, 2007; Ostrov Researchers have demonstrated that some & Godleski, 2006). In middle childhood, children with language impairment (LI) are LWW/TLD LWWJ328-04 April 19, 2007 11:6 Char Count= 0

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at higher risk for impairments in social to be a regular target of peer physical and ver- competence (e.g., , frustration, bal victimization (measured by the My Life in tolerance) and internalizing problems. For School Questionnaire). Deficient expressive example, some children with LI display so- language skills (measured with the Expressive cial withdrawal (i.e., reticence, spend more Vocabulary Test [EVT]) at age 7 seemed to time in solitary-passive or solitary-active play be most associated with peer physical victim- than in interactive collaborative play) and less ization 4 years later (e.g., “During this week, prosocial behavior (Fujiki, Brinton, Morgan, another child in school tried to kick me”; & Hart, 1999; Hart, Fujiki, Brinton, & Hart, Conti-Ramsden & Botting, 2004; Knox & 2004). Furthermore, subgroups of young Conti-Ramsden, 2003). Researchers also have children with LI and behavior problems de- found that children with SLI had difficulty velop future conduct and antisocial behav- making friends and were not accepted by ioral problems including externalizing disor- their peers (Conti-Ramsden & Botting, 2004; ders (Brownlie et al., 2004; Conti-Ramsden & Fujiki et al., 1999). Botting, 2004; Stoneham, 2001; Van Cleave & Although LI and development of relational Davis, 2006). aggression have not been closely examined, Studies have shown that children with researchers have studied associations of LI often have social withdrawal problems, receptive and expressive language in ag- which appear as reticence, solitary-passive, gression for typically developing children and solitary-active withdrawal (Fujiki et al., with a range of language abilities. The first 1999; Hart et al., 2004). Such children may study of this type reported that receptive be at risk for additional peer problems, as vocabulary scores were positively associated are children whose social withdrawal stems with concurrent relational aggression (Crick, from being fearful, anxious, depressed, or vic- Werner, et al., 1999). Bonica et al. (2003) timized (Asher, Parker, & Walker, 1996; Katz also documented a positive association & Buchholz, 1999). Socially withdrawn chil- between expressive language and teacher- dren often are less accepted by their peers, reported relational aggression. A third study less assertive, less socially skilled, and display partially replicated this finding, as Hawley more negative affect than typically develop- (2003) found that teacher-reported relational ing peers (Dumas & LaFreniere, 1993; Hart aggression was positively associated with et al., 2000; Rubin, Chen, & Hymel, 1993). concurrent receptive language for pre– Such difficulties interfere with their forma- school-aged girls but not for boys. However, a tion of meaningful peer relationships. Docto- fourth study diverged from those findings and roff, Greer, and Arnold (2006) also found that indicated that as teacher-reported relational emergent literacy problems were associated and physical aggression increased, expressive with a higher frequency of observed solitary and receptive language scores decreased play in a large diverse sample of boys and girls (Estrem, 2005). Finally, Park et al. (2005) during early childhood. found that children’s receptive language abil- To date, researchers have not closely ex- ities during early childhood were negatively amined the development of relational aggres- predictive of both future relational aggression sion or victimization in children with LI. Lon- and physical aggression during middle child- gitudinal research has revealed associations hood. Park et al. also found that expressive between specific language impairment (SLI) language skills in early childhood were pos- and peer victimization. Specifically, Conti- itively associated with relational aggression Ramsden and Botting (2004) followed a group in middle childhood. Unfortunately, these of children (n = 242) with specific LI in Eng- authors were not able to test and control for land from middle childhood (i.e., 7-year-olds) initial levels of relational aggression. In sum, and found that at age 11, they were signifi- across the five studies the findings are mixed. cantly more likely than a comparison group We echo the call for further prospective LWW/TLD LWWJ328-04 April 19, 2007 11:6 Char Count= 0

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longitudinal research to carefully address with as few as five sessions (i.e., 50 min total these questions in samples of children with per child). Observers always conduct obser- typical and atypical development (Heim & vations close enough to the focal child to hear Benasich, 2006). and see the full peer interaction. Assessments of reliability are conducted throughout the study to avoid observer drift, PSYCHOLOGICAL ASSESSMENT which occurs when an observer deviates TECHNIQUES from the way in which behaviors were operationalized during training to a personal The changing developmental manifesta- view of the behavior. Intra-Class Correlations tions of relational aggression require differ- (a standard means of assessing interobserver ent assessments (i.e., observations, teacher agreement) must be assessed on 15% to and parent report, peer sociometrics, and 30% of the observations and found to be self-report) at each developmental period. consistently above .70 to provide evidence Most assessment techniques for relational ag- for favorable interrater reliability (Crick, gression are designed for use in school set- Ostrov, Burr, et al., 2006; Ostrov, 2006; tings, but in some cases they may be used Ostrov & Keating, 2004). This observational in other settings (e.g., laboratory, clinic) as method has been found to have acceptable well. The measures described here were de- convergent validity (see Table 1), with mod- veloped for psychologists to use with typically erate correlations between teachers and functioning children. SLPs and communica- observers for relational and physical aggres- tion scholars may help move the developmen- sion (Crick, Ostrov, Burr, et al., 2006; Ostrov, tal field forward by investigating adaptations 2006; Ostrov & Keating, 2004). These levels of of these measures for clinical use among sam- correspondence are consistent with validity ples of children with LI (see Gallagher, 1991; coefficients for other observations of physical Redmond, 2002). aggression and are deemed acceptable by current convention (Leff & Latkin, 2005). In Naturalistic observations their review of the Early Childhood Observa- During early childhood, when aggressive tion System, Leff and Latkin (2005) concluded behaviors are most direct and immediate, nat- that “...strengths... include that it can be uralistic observations are an efficient means to used across multiple school settings, the document these behaviors. Under the proper codes are well-defined, training procedures conditions, however, observations may be are well-articulated in the manual, and initial used throughout development. Naturalistic reliability and validity data are promising” observation schemes exist to assess chil- (p. 484). Other classroom-wide observation dren’s relational aggression conducted during schemes for studying relational aggres- free play using an adaptation of procedures sion have been proposed by McEvoy, Estrem, (Crick, Ostrov, Burr, et al., 2006) developed by Rodriguez, and Olson (2003) and by McNeilly- Ostrov and Keating (2004) and reviewed by Choque, Hart, Robinson, Nelson, and Olsen Leff and Latkin (2005). In the Early Childhood (1996). Observation System (Ostrov & Keating, 2004), a focal child approach can be used, with each child being observed for 10 min per session Analogue observations by a trained observer (for specific codes, see Semistructured observations, involving ana- Table 1). Typically this method involves the logue situations designed to mimic typical focal child being observed eight times (a to- classroom activities, may also be used to ob- tal of 80 min per child at each assessment), serve relational aggression in young children. although Ostrov and Keating found that reli- Ostrov and Keating (2004) created a brief ana- able and valid observations may be conducted logue situation to test various aggressive and LWW/TLD LWWJ328-04 April 19, 2007 11:6 Char Count= 0

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Table 1. Naturalistic observation coding scheme (early childhood observation system)

Convergent validity Exemplars of (Teacher report and behavior Interrater reliability observation correlations)

Physical aggression Hit, slap, push, kick, ICCs from .75 to .96 r = from .40 to .45 taking objects, and threats of physical aggression: “I’ll pinch you if you don’t give me that...” Relational aggression Exclusion (verbal: ICCs from .81 to .82 r = from .40 to .55 “You can’t play with me/us,” nonverbal: Holding hands out so child can’t enter play area), Friendship Withdrawal: “I will not be your friend anymore unless...” Verbal aggression Mean names and ICCs from .64 to .81 r = .40 verbal . Other and not involving the relationship or physical force Prosocial behavior Sharing, helping, and ICCs from .73 to .90 Not published inclusion in a game or activity

Note. Reliability and validity coefficients as reported in Crick, Ostrov, Burr, et al. (2006), Ostrov (2006), Ostrov et al., (2004), Ostrov, Gentile, and Crick (2006), and Ostrov and Keating (2004). Additional codes for received behavior (e.g., received prosocial behavior; physical and relational victimization) are part of the observation system. The full coding manual and observation forms for research purposes are available upon request from the first author. The observation measure was originally published in Ostrov and Keating (2004). ICC = Intra-Class Correlation Coefficient.

prosocial behaviors (i.e., within dyads or tri- tool (e.g., red crayon for Elmo picture) and ads) in early childhood. The situation involved two are functionally useless white crayons. a coloring task involving limited availability The children are instructed on how to use a of the preferred colorful crayon. Either mixed 3-min hourglass to indicate how much time or same-gender dyads or triads can be invited remains for each picture. At the end of the 3- to participate in the assessment. Each assess- min trial, the experimenter collects the 3 pic- ment includes three trials of 3 min each (total tures and crayons and distributes the new pic- time = 9 min). For each trial, the children are ture and new crayons. At the end of the assess- given the same developmentally appropriate ment, the children are each given access to a picture to color (e.g., Elmo). For triads, three box of crayons to diminish any distress that crayons are placed on the table equidistant was experienced during the session. With this from all children. One crayon is the functional technique, the children may be videotaped LWW/TLD LWWJ328-04 April 19, 2007 11:6 Char Count= 0

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Table 2. Semistructured observation system (coloring task) procedures

Procedure Ostrov et al. (2004) Ostrov and Keating (2004)

Sample characteristics Sample size = 60 Sample size = 48 Age: M = 54 months, SD = 6.06 Age: M = 64 months, SD = 6.77 Group Triad Dyad Sessions 3 developmentally appropriate pictures 3 developmentally appropriate pictures Time 3 min per session (9 total) 3 min per session (9 total) Materials 9 total pictures (pictures were digitally 6 total pictures scanned, and most dark images were removed to make white crayon functionally useless) 9 total crayons (2 white crayons per 6 total crayons (1 white crayon session) per session) 3-min hourglass Three 1-min hourglasses Small digital video camera (positioned Large video camera (positioned in corner of the room) in front of children) Specific procedures Male and female experimenters Male experimenter Experimenter partially hidden Same and mixed gender groups Same gender groups Children given sticker for Children given full box of crayons to participation color with at the end of the session Coding Coders unaware of hypotheses Coders unaware of hypotheses Reliability assessed for 30% Reliability assessed for 58% Behaviors are summed within category Behaviors are summed within (Ostrov & Keating, 2004) category

and aggressive and prosocial behaviors can cedure, if implemented in a systematic and later be reliably coded using the same natural- ethical manner, is helpful to evaluate chil- istic observational codes from the Early Child- dren’s social competence skills (e.g., nego- hood Observation System. This brief analogue tiation, prosocial behavior, assertiveness) as system has been found to predict children’s well as suggesting some points of intervention behavior according to concurrent naturalistic regarding externalizing behavior (e.g., phys- observations (with r’s ranging from .45 to .48 ical and relational aggression). Although not for relational, verbal, and physical aggression tested and not developed for this purpose, the for girls and a significant correlation of .64 for coloring task or similar procedures could also boys and physical aggression) and to predict be useful within the context of in vivo peer- future (12 months later) relational aggression based intervention to facilitate appropriate in- in naturalistic interactions (r = .53) and peer- teractions between peers in their natural envi- reported relational aggression (r = .68; Ostrov ronment and to improve frustration tolerance et al., 2004; Ostrov & Keating, 2004). and pragmatic communication skills among To date the coloring task has been used only children. Despite the required time to code in developmental research in early childhood the videotapes, we argue that the rich quali- and has not been used as part of a clinical as- tative and quantitative data that are revealed sessment. SLPs and other school-based profes- with this direct observation procedure is sionals may find that this brief analogue pro- unlike the nature of reported data obtained LWW/TLD LWWJ328-04 April 19, 2007 11:6 Char Count= 0

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from teacher, parent, or peer informants. Fu- nication, but the responses may reveal help- ture research is needed to determine the ap- ful information nevertheless. In such cases, propriate norms for both typical and atypical SLPs should use observational assessments samples. that also consider nonverbal manifestations of behavior, although nonverbal communication Teacher and parent report could also be impaired. Assessment strategies, with paper and pen- cil instruments for instance, may be similar Self-report for both teachers and parents, but each set Self-report of aggressive behavior may be of informants is privy to different informa- more valid for older children because rela- tion. Despite the benefits of assessing multi- tional aggression becomes more covert, sub- ple contexts, few studies have included par- tle, and complex over time (Crick, Casas, ent reports of relational aggression (Crick & Nelson, 2002). An example of a measure et al., 2004). Yet it may be particularly impor- of self-reported relational aggression can be tant to include parent report, as it appears that found in Linder et al. (2002). Items may be the early parent–child relationship has a role adapted to include varying conceptualizations in the etiology of relationally aggressive be- of relational aggression such as “My friends havior (Casas et al., 2006). know that I will think less of them if they A time efficient measure of relational ag- do not do what I want them to do,” which gression is the Children’s Social Behavior are assessed on a Likert scale from 1 (not Scale–Teacher Report (CSBS-TR; Crick, 1996; at all true)to7(very true). This measure Crick, Bigbee, & Howes, 1996), which has has demonstrated internal consistency in col- been used as both a parent and a teacher re- lege students (Linder et al., 2002). Again, port of relational aggression in children (rang- SLPs should consider whether the linguistic ing in age from 8 to 12 years). This measure complexity of items on self-report methods contains six items, such as “telling friends that may influence the ability of children with LI s/he will not like them if they don’t do what to understand the items. Appropriate mod- s/he says.”Respondents are asked to rate these ifications might include adapting self-report items regarding the focal child’s behavior with methods to an interview format with a con- a 5-point response scale (Crick, 1996). Crick crete response scale anchored by pictures to and colleagues demonstrated appropriate in- which the child may point to indicate her ternal consistency for the relational aggres- response. sion items (Casas et al., 2006; Crick et al., 1996, 1997). This measure has also demon- Hypothetical tasks strated appropriate factor structure (Crick & Since some children with LI may have Grotpeter, 1995). Furthermore, test–retest re- particular problems with social–cognitive or liability for relational aggression, as measured pragmatic language skills (see review by Red- by the CSBS-TR, has been high over 6 months mond & Timler, in press), it is increasingly im- (Collett, Ohan, & Myers, 2003; Crick, 1996). portant to explore the social–cognitive prob- In addition, this measure has demonstrated lems that both typically and atypically devel- moderate correlation with peer report of re- oping children display (Crick & Dodge, 1994). lational aggression in both boys and girls Relationally aggressive children may have spe- (Crick, 1996). In the preschool teacher report cific patterns of social–cognitive functioning version of this measure (i.e., PSBS-TF; Crick that may be apparent to SLPs and provide fur- et al., 1997), scores also correlate with ob- ther indication for the need for intervention. served aggression (Ostrov & Keating, 2004). Specifically, relationally aggressive children Some of the traditional items on this measure often have a hostile attribution bias (HAB) may not be appropriate for children with LI, for ambiguous provocation situations (Crick, as many of the items require verbal commu- 1995). That is, when placed in an ambiguous LWW/TLD LWWJ328-04 April 19, 2007 11:6 Char Count= 0

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hypothetical situation (e.g., a child overhears video format with a concrete response scale others discussing a party and wonders why anchored by pictures to which the child may she has not been invited), relationally aggres- point to indicate her response. sive children will often interpret the intent as hostile rather than benign and, in turn, Peer report they respond with reactive aggressive behav- Sociometric evaluations in the form of peer ior (Crick, 1995; Crick, Grotpeter, & Bigbee, nominations and ratings may offer important 2002). Intervening for HAB may be effective information about peer relationships across for decreasing school-based relational aggres- development. Such techniques have been sion (Leff, Goldstein, Angelucci, Cardaciotto, used with children ranging from early child- & Grossman, in press) and also may be an im- hood through early adolescence. These tech- portant component of language treatment for niques may be particularly important for SLPs children identified with pragmatic communi- in their work with children with SLI, who cation disorders. have been found to be less well accepted than Aspects of social cognition, such as HAB, typically developing peers (Fujiki, Brinton, can be assessed by asking children to self- Hart, & Fitzgerald, 1999). With preschool chil- report on relational intent attributions and dren or others who are not able to read, sort- feelings of distress in response to socially ing pictures of classmates into limited nom- ambiguous situations. One measure, involv- inations (usually the top three children) of ing hypothetical-situation vignettes of socially those liked most (“like to play with a lot”)and ambiguous relational provocation situations, least (“don’t like to play with”) may be use- developed by Crick (1995), has been used ful (Harrist & Bradley, 2003; McNeilly-Choque with third to sixth graders. Hypothetical sto- et al., 1996). Sociometric ratings in which chil- ries depict relational provocation by focus- dren sort every classmate have been found ing on potential rejection (e.g., discovering to be valid and reliable during early child- that a friend is playing with someone else). hood (ages 3 to 8 years; Burr, Ostrov, Jansen, For each story, the child indicates a reason Cullerton-Sen, & Crick, 2005). Prior to age for the provocation with two options indicat- 3, children may have difficulty understanding ing hostile intent, such as “Your friend was the task (Hymel, 1983). From either ratings or mad at you,” and two indicating benign in- nominations, one can categorize children as tent, such as “Your friend didn’t see you on rejected or accepted (Harrist & Bradley, 2003) the playground.”The next question asked the and get a sense of their peers’ perceptions of child whether the provocative behavior was their general behavior. intended to be mean or not. In studies with children ranging from third In three independent samples, Crick, to ninth grades, ratings and nominations can Grotpeter, et al. (2002), Crick (1995), and also involve selecting individuals, who fit item Leff et al. (2006) demonstrated acceptable descriptions, such as a “peer who tries to internal consistency for measures of HAB for make another classmate not like others by relational provocations for children without spreading rumors about them” (Crick 1997; LI. More research is needed to explore the Rose, Swenson, & Waller, 2004). Peer ratings usefulness of hypothetical tasks and situation of aggression correspond with observations vignette methods with children with LI and (Crick, Ostrov, Burr, et al., 2006;) and teach- comorbid learning disability, for whom appro- ers’ evaluations in early childhood (Wu, Hart, priate accommodations may be required. For Draper, & Olsen, 2001). Because formal socio- example, these children may have diminished metric assessments may be time-consuming, abstract reasoning and cognitive processing anonymous surveys could be used in mid- skills and standard paper-and-pencil versions dle childhood and adolescence to assess per- of the hypothetical tasks may need to be ceptions of school climate and peer relation- adapted to a cartoon (see Leff et al., 2006) or ships (Yoon, Barton, & Taiariol, 2004). Peer LWW/TLD LWWJ328-04 April 19, 2007 11:6 Char Count= 0

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relationship researchers should partner with fer insight into domains to target during in- SLPs to modify peer sociometric assessments tervention. As a reminder, however, norms so that children with LI may also participate for social development measures often are in these procedures. A challenge for the use not created using samples including children of peer sociometrics is that typically 70% of with LI (Redmond, 2002). Furthermore, ex- children in a classroom must participate for ternalizing or internalizing symptomatology valid assessments (Crick & Ladd, 1989) and assessments that contain language-oriented ethically, SLPs should obtain permission from items may put children with LI at a disad- parents for all the children in the room to par- vantage when receptive and expressive lan- ticipate in the procedure. As an alternative, guage problems are possibly misconstrued as teachers in early childhood classrooms have psychopathology (Redmond, 2002). Interpre- demonstrated themselves to be competent tation of results by interdisciplinary teams informants on similar information (McEvoy is suggested as a means for avoiding such et al., 2003; Wu et al. 2001). problems.

Implications for collaboration in EVIDENCE-BASED INTERVENTIONS FOR assessment (between SLPs and RELATIONAL AGGRESSION AND psychologists) RELATIONAL VICTIMIZATION Assessment of and social com- petence can be conducted by interdisci- As developmentally salient as relational ag- plinary teams, including psychologists, SLPs, gression appears to be, interventions tar- and social workers. Casas et al. (2006) and geting relational aggression have been slow McEvoy et al. (2003) suggested that multiple in coming. Peer interventions exist to as- informants across contexts may be important sist children who are excluded by changing for relational aggression and may be partic- their behavior through social skills training ularly important for children with LI (Red- aimed at increasing appropriate interaction mond, 2002). In addition, as children develop, (Fraser, Day, Galinksy, Hodges, & Smokowski, modifying assessment measures is important 2004; Nangle, Erdley, Carpenter, & New- to measure relational aggression accurately at man, 2002), social–cognitive training aimed different ages. at changing underlying maladaptive cogni- Those assessments that would be most tions (Strayer, 1984), and the peer–mediator helpful to school-based SLPs would be ones approach aimed at increasing appropriate that can be carried out with ease within communicative interaction and social integra- the usual context of speech and language as- tion with peers (Goldstein, & Schneider, & sessment; thus, parent and teacher reports Thiemann, 2007). may be particularly relevant. Varied mem- Although these interventions may help chil- bers of the team might collect the inter- dren become more accepted, most to view data, which could then be interpreted deal with generalization of skills, exclusion for through interdisciplinary discussion. With nonbehavioral reasons such as disabilities or older clients, self-report may also be a vi- physical appearance, or the global social envi- able option. With the client’s consent, struc- ronment and peer group (Harrist & Bradley, tured interviews could be recorded by a psy- 2003). In addition, interventions rarely of- chologist and analyzed for multiple language fer global classroom approaches for reduc- features by an SLP. Observations, although ing relationally aggressive behaviors that in- more time-consuming, could provide infor- corporate work with relationally aggressive mation for the SLP regarding both aggressive individuals as well as their victims. It has behavior and language/communication skills been suggested that the best interventions in vivo. Placing the peer and language be- for relational aggression would take into ac- havior in context via observations might of- count peer group dynamics (Rose et al., 2004; LWW/TLD LWWJ328-04 April 19, 2007 11:6 Char Count= 0

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Young, Boye, & Nelson, 2006), address both the classrooms receiving the intervention re- victims and aggressors (Yoon et al., 2004), and ported liking to play with each other more. target positive change for the entire school cli- However, teacher and observational report mate (Yoon et al., 2004; Young et al., 2006). did not indicate changes in classroom inter- One of the first preventive interventions for actions. Furthermore, the children’s reported relational aggression, called Second Step, a Vi- feelings of social dissatisfaction significantly olence Prevention Program, was created by increased in the intervention group (Harrist & the Committee for Children (Grossman et al., Bradley, 2003). Thus, this intervention could 1997). This school-based program attempts to be considered only moderately successful. To teach social and emotional skills in order to add to the evidence base, we recommend increase empathy, impulse-control, problem- that future interdisciplinary studies target a solving, and -management skills (Com- more extensive array of relationally aggres- mittee for Children, 2006). These skills sive behaviors and focus on increasing social are taught through scripted lessons supple- competence and friendship formation skills mented with pictures or videos followed to replace the relationally aggressive behav- by discussions, role plays, or other concep- ior. SLPs could be of great benefit in such tual activities such as homework (Grossman studies by helping modify existing modules et al., 1997; Taub, 2001). The length of to focus on facilitating social communication, lessons and choice of stimuli (e.g., puppets for social competence, and social interaction younger children) were created to be devel- skills. opmentally appropriate (Committee for Chil- In addition to existing interventions, some dren, 2006). Van Schoiack-Edstrom, Frey, and promising interventions regarding relational Beland (2002) used the Second Step approach aggression are being empirically derived and with a group of early adolescents and found piloted by Leff et al. (in press). These in- positive results, such as reduced tolerance terventions help reduce relational aggression for physical and relational aggression and in- and increase prosocial behavior and may also creased perceptions of ease in using social lend themselves to being incorporated with skills (Van Schoiack-Edstrom et al., 2002). Al- other programs designed to increase func- though this study had no control group, such tional communication. Furthermore, it seems preliminary findings appear to justify future that increases in communication skills can interdisciplinary work with the Second Step lead to decreases in inappropriate behavior program. (Wickstrom-Kane & Goldstein, 1999). Harrist and Bradley (2003) developed an To date, the evidence-based literature on intervention on the basis of the book You peer interventions for relational victimization Can’t Say You Can’t Play by Vivian Paley is limited. An example of a new promising in- (1992). This intervention is classroom-wide tervention, however, is the Walk away, Ignore, in kindergarten aimed at reducing social ex- Talk, Seek help (WITS) program created by clusion. First, the children listened to Paley’s Leadbeater, Hoglund, and Woods (2003). This (1992) fairy tale addressing program attempts to reduce school and class- and inclusion, discussed feeling excluded, and room levels of victimization through a book- participated in role plays regarding group- based curriculum that allows teachers to im- entry issues. The rule “you can’t say you can’t plement the program through literature and play”was then introduced into classroom pol- activities within the preexisting curriculum. icy in the classrooms receiving the interven- It also includes pamphlets for siblings, as well tion by teachers and research assistants. The as activity books and other reminder items rule implementation was reinforced with ref- such as pens and pencils. Implementation of erences to the fairy tales, discussions, and the program appears to moderately decrease role plays as well as with banners, color- victimization and increase social competence ing pages, and bookmarks. The children in (Leadbeater et al., 2003). LWW/TLD LWWJ328-04 April 19, 2007 11:6 Char Count= 0

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This suggests empirical questions for SLPs psychological adjustment problems. Develop- to investigate. Does intervention for rela- mental psychopathologists are working with tional aggression have an impact on com- an eye toward application (Ciccheitti, 2006). munication skills? Does functional communi- An interdisciplinary approach to an under- cation training reduce relational aggression? standing of how risk and protective factors Finally, might interventions reduce victimiza- work together may influence the efficacy of tion among children with speech disorders particular types of interventions for children and LI who perceive themselves as being vic- with peer relationship issues and LI. timized (Savage, 2005), given the evidence that they actually may be victimized at higher Multiple domains of functioning rates than typical peers (Conti-Ramsden & Although peer relationship researchers Botting, 2004; Van Cleave & Davis, 2006)? have attended to the importance of cogni- SLPs could partner with school psycholo- tive functioning (e.g., memory, perspective gists in conducting this intervention research. taking, and attention), they typically have Many psychologists have small group therapy neglected the importance of language de- components (e.g., Leff et al., in press) in their velopment (for an exception, see Asher & studies, in which SLPs could serve as cofacili- Gazelle, 1999). Future research and clinical tators. In addition, SLPs could work with psy- work should involve collaborative work be- chologists to adapt the programs and accom- tween psychologists and SLPs to ameliorate modate children with LI who may have recep- this critical gap in understanding. Just as tive language problems. The use of cartoons, peer relationship and social development re- videos, and other alternative formats for as- searchers must assess language and cognitive sessment (Leff et al., 2006) and service deliv- skills, SLPs and language scholars should con- ery may also be particularly effective for chil- tinue to work to place children with LI in dren with LI. their appropriate social and developmental contexts. IMPLICATIONS FOR PRACTICE Such research might result in new clini- cal tools for use in assessing multiple do- How may developmental, school, and mains of functioning efficiently. For exam- clinical-child psychologists collaborate with ple, Bierman (2004) developed a model for SLPs in the diagnosis and treatment of chil- assessing problematic peer relationships in dren with LI and aggressive behavioral or which the researcher or clinician would eval- peer victimization problems? The treatment uate the child’s self-system (e.g., social cogni- of language problems and co-occurring so- tions or HABs and emotion regulation), child’s cial difficulties should be framed in a collab- social behaviors (e.g., aggressive, prosocial, orative, interdisciplinary process (Gallagher, anxious), peer context (e.g., reputation, so- 1991). It is argued that a developmental psy- cial networks), and peer relations (e.g., peer chopathology framework (Cicchetti, 2006; rejection, friendship status, and association Sroufe, 1997), which recognizes the interac- with delinquent peers). A comprehensive as- tion between multiple domains of function- sessment of the child’s social context, in- ing (i.e., social, cognitive, and biological), cluding these four domains of peer relations, the role of developmental contexts, multi- would permit the SLPs to address these de- ple levels of analysis, processes of resilience, velopmental issues within the context of and the importance of studying both typi- therapy. cal and atypical development will be infor- mative for the collaboration we are calling Role of context and multiple levels for between SLPs and other school-based pro- of analysis fessionals addressing peer relationship dif- In a practical sense, children are affected ficulties, co-occurring with LI and social– by a variety of ecological contexts (e.g., LWW/TLD LWWJ328-04 April 19, 2007 11:6 Char Count= 0

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from home or microsystem influences to of the same school-based service delivery cultural or macrosystem factors). Interactions team to inform treatment. All members of the between these levels of systemic impact service provider team should strive to fur- are crucial for understanding children’s func- ther improve the connections between home tioning (Bronfenbrenner, 1979). All school- and school, and interdisciplinary interven- based practitioners should work collabora- tions may incorporate parents as part of the tively with other professionals (e.g., SLPs, so- team in trying to address systemic factors that cial workers, pediatricians, school nurses, and may have triggered or may be maintaining psychologists) to assess the role of the close such problems. familial relationships, home and neighbor- hood contexts, and to understand each child Resilience within his or her appropriate developmen- The developmental psychopathology prin- tal and sociocultural niche. When address- ciple of resilience underscores the princi- ing relational aggression or victimization and ple that plasticity and change are possible in comorbid LI, psychologists and SLPs should most circumstances, but are more difficult work together to gather information concern- the longer individuals remain on a maladap- ing a child’s home environment (e.g., level tive developmental pathway (Sroufe, 1997). of stress, parent–child relationship, socioe- As defined by Luthar and Cicchetti (2000), conomic status, and parental education) as resilience is not a trait or characteristic of well as the degree of parental involvement in a child, rather a balance between risk and school as an index of contextual factors that protective factors in the presence of adver- may influence the prognosis of a child with sity. They defined it as a “dynamic process LI. An appropriate understanding of the mul- wherein individuals display positive adapta- tiple levels of context and the various levels of tion despite experiences of significant adver- analysis (e.g., individual, dyad or friendship, sity or trauma”(p. 858). peer group, school, and community) is cru- A comprehensive assessment of risk and cial for creating both individual and school- protective factors includes an evaluation of wide intervention and prevention efforts that positive and negative peer functioning (e.g., are effective and that will generalize into other aggressive behavior, friendship status, and salient relationship contexts. prosocial behaviors) as well as cognitive pro- Two well-established predictors of future cesses. Such an assessment will be helpful relational aggression are the parent–child rela- in understanding the various points of inter- tionship and specifically the presence of psy- vention for a school-based service provider chological control (e.g., love withdrawal) be- team. Moreover, a comprehensive assessment tween a caregiver and a child (e.g., Nelson, at multiple time points is needed to both quan- Hart, Yang, Olsen, & Jin, 2006) and having tify initial indicators of adversity and docu- an older relationally aggressive sibling (Stauf- ment resilient outcomes. Thus, the principle facher & Dehart, 2006a, 2006b). Thus, despite of resilience suggests that chronically relation- the financial and ethical challenges, clinicians ally victimized or aggressive individuals who should work with other service providers to have been on a maladaptive pathway across attempt to assess all potential risk factors development will most likely show improve- for relational aggression even if they are out- ment in the face of this adversity when inter- side the school. This information could be vention is conducted early and when interven- obtained as part of a comprehensive team tion builds on and enhances existing protec- assessment as educators, psychologists, and tive factors rather than simply focusing on di- school social workers are often privy to in- minishing risk factors. formation concerning children’s home, neigh- borhood, and cultural background. Given the Typical and atypical development appropriate clinical arrangements, such in- Finally, a developmental psychopathology formation may be shared among members framework underscores the importance of LWW/TLD LWWJ328-04 April 19, 2007 11:6 Char Count= 0

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studying both typical and atypical processes questioning the need for referral to a men- to inform the etiology and treatment of psy- tal health provider is listed in Table 3. With chopathology. SLPs are well trained to identify specific reference to relational aggression, al- typical and atypical developmental patterns. though current literature is limited in this Certainly, knowledge of developmentally ap- area, there are some potential warning signs. propriate social interactions is necessary for For example, children who are high relative an informed evaluation of children’s peer rela- to their peer group on relational aggression, tionships. Developmental milestones regard- relational victimization, or both (i.e., provoca- ing peer relationships are well established and tive victims) may demonstrate concurrent and follow a typical sequence (Parker et al., 2006). future social–psychological problems (e.g., For example, as the capacity for language and disruptive–behavioral disorders, internalizing symbolic reasoning becomes refined around problems, somatic complains; Crick, Ostrov, 31–36 months of age, children’s play shifts & Werner, 2006; Cullerton-Sen & Crick, 2005; from an almost exclusive emphasis on soli- Zalecki & Hinshaw, 2004) and consultation tary activity to more collaborative and socio- and/or referral may be warranted. dramatic play (Parker et al., 2006) in which As hypothesized throughout this article, it children work together to create joint play is conceivable that children with LI and co- themes and assume social roles (e.g., teacher, morbid peer victimization problems may ex- caregiver) in their play. SLPs should be aware perience language improvements if they are that an additional key developmental task dur- able to have stable meaningful relationships ing early childhood is that most children have with peers. SLPs who target social skills for at least one reciprocal friend and these rela- improvement may find positive changes in tionships tend to be stable across time (Parker expressive language. Alternatively, interven- et al., 2006). Thus, with knowledge of these tions for LI may result in improved peer re- and other typical developmental manifesta- lationships and a decrease in relational vic- tions, SLPs may be effective at document- timization, serving as an important marker for ing problems within the peer domain and improvement in overall functioning. Impor- for relational aggression or victimization more tantly, it is not best practice simply to teach specifically. children to “use their words”to better express their feelings during conflict. This often re- CONCLUSIONS sults in the use of “negative” or relationally aggressive words. Instead, SLPs could work This article has addressed a wide range of with children to teach appropriate expressive issues in the area of social development and skills, as well as friendship formation, peer peer functioning, with a primary focus on re- group entry, conflict resolution, and inclusion lational aggression and victimization. With re- social skills (Brinton & Fujiki, 1999). gard to broader concerns, a number of au- Bierman (2004) has identified several do- thors have commented on the assessment mains of social competence (e.g., social par- and evaluation of children and adolescents ticipation, prosocial behavior, self-control, who may have social–psychological adjust- communication skills) that we believe SLPs ment and peer functioning problems (e.g., are well equipped to address in clinical prac- Asher & Gazelle, 1999; Bierman, 2004; Camp- tice. Clearly SLPs are experts in how children bell, 2002; Gallagher, 1991). should appropriately express themselves and Interdisciplinary approaches to assessment have extensive training in how to work with and intervention have been suggested, but children developing typically and atypically what should SLPs do when they encounter with skills such as turn taking, listening skills, problems of social development that seem to and verbally inviting a child to play (Bierman, fall outside their scope of practice? A brief 2004). review of some general social development Child development researchers in psychol- indicators that should be considered when ogy should be encouraged to work with SLPs LWW/TLD LWWJ328-04 April 19, 2007 11:6 Char Count= 0

160 TOPICS IN LANGUAGE DISORDERS/APRIL–JUNE 2007 Bowker, and McKinnon (1995) Research Network (2004) Nagin, and Tremblay (2006) Wagner, and Chapman (1992) (2006) Bierman (2004) Ladd and Troop-Gordon (2003) Parker et al. (2006) Bierman (2004) Rubin, Chen, McDougall, NICHD Early Child Care Cote, Vaillancourt, LeBlanc, Waschbusch (2002) Bierman (2004) Crick (1996) Zahn-Waxler, Radke-Yarrow, Crick, Ostrov, and Werner Murray-Close et al. (2007) Zalecki and Hinshaw (2004) Hipwell et al. (2002) Cullerton-Sen and Crick (2005) Crick and Grotpeter (1996) Prinstein et al. (2001) Troop-Gordon and Ladd (2005) developmental periods. Peer rejection mayfriendship be status. buffered by avoids peer contact and onlylevels engages of in social solitary withdrawal play. and High problematic social in anxiety middle are childhood increasingly and adolescence. elevated relative to peers beyondonset age and 5 persistent it aggressive is behavior ofwith may concern. serious be Early conduct associated problems later in development. Those with comorbid attention-deficit/hyperactivity disorder, disruptive behavioral disorders, or learningparticularly disorders vulnerable may to be maladaptive outcomes. prosocial behavior around 18 monthsmonths) and complex increasingly comforting (18–24 behaviors. Thoseon that aggression are and high low onrisk prosocial of behavior problems are in at early greater and middle childhood. to peers. More problematic ifand elevated adolescence. in More middle of childhood concerncomorbid if attention-deficit/hyperactivity also disorder, present borderline with personality features (impulsive, stormy relationships, self-harm), depressive symptoms, delinquency, conduct problems, and/or somatic complaints. loneliness, negative peer reputations, victimssubtypes, of and/or multiple co-occurring aggression subtypesmost may in be need of intervention.harmful Social effects. support may buffer the Friendlessness and peer rejection are concerns during all May be a concern during early childhood (from age 3 to 5) if Normative during first 3 years of childhood and steadily drops. If Children should be capable of displaying active but simple During early childhood may be normative in low levels relative If associated with internalizing and externalizing problems, friendships or nominated as disliked solitary play, avoids peers, appears upset, and cries easily pushing, bites, takes others’ property, disruptive, and deception cooperative, self-control, and concern for others’ feelings threats, social exclusion, malicious rumor spreading, and of relational and/or physical aggression Children without any mutual Withdrawn, quiet, shy, Hitting, kicking, punching, Sharing, helping, including, Chronic and frequent receipt General social development indicators for referral to a mental health professional rejection avoidant and shy disruptive skills victimization Behavior displayed and receivedFriendship status and peer Description Developmental considerations Sources Socially withdrawn anxious Physical aggression and Prosocial behavior and social Relational aggression Friendship withdrawal Relational and physical Table 3. LWW/TLD LWWJ328-04 April 19, 2007 11:6 Char Count= 0

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during development, conceptualization, and tify and communicate possible solutions to implementation of intervention projects that negotiate peer conflict. Finally, developmen- address core social skills (Bierman, 2004). In tal psychopathologists and SLPs should be en- particular, researchers should work with SLPs couraged to work together as integral mem- to modify intervention and assessment meth- bers of the clinical and research team to ods so that they are valid and effective for design, implement, and test the efficacy of children with LI. In addition, mental health preventive interventions for relational aggres- professionals and SLPs should work collabora- sion/victimization. tively as members of service provider teams. In summary, the study of peer relation- Areas that are less clearly delineated along ships broadly defined and relational aggres- disciplinary boundaries are also likely points sion/victimization more specifically are devel- of successful interdisciplinary collaboration. opmental topics of inquiry that would greatly For example, emotional understanding is a benefit from the expertise of language schol- key domain of social functioning in children, ars. Ultimately, working collaboratively with and SLPs could help psychologists develop other school-based service providers is neces- more effective procedures for helping chil- sary to target the multiple domains of func- dren express their own feelings appropri- tioning and to design and implement appro- ately and identifying others’ feelings accu- priate intervention programs for individual rately (Bierman, 2004, p. 195). Moreover, fa- children and larger peer groups. If the rel- cilitating social problem-solving skills is an- atively disparate research and practice areas other area of social competence in which SLPs of developmental psychopathology and com- have training and experience. They can help municative disorders can become more inte- developmental psychopathologists and oth- grated, then children experiencing comorbid ers understand under what conditions chil- psychological and language problems may be dren with and without LI are able to iden- more likely to have resilient outcomes.

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