Factors associated with language difficulties and special educational needs among children with language difficulties: a retrospective cohort study
- 1Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
- 2Division of Developmental Pediatrics, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
Abstract
Background: Language difficulties are a prevalent developmental concern, but prognostic heterogeneity makes early identification of high-risk children challenging. This study aimed to investigate factors associated with language difficulties and to identify early predictors of special educational needs (SEN) in Turkish-speaking children.
Methods: A retrospective cohort study was conducted at a tertiary paediatric hospital in Türkiye. The analytical cohort for the analysis of factors associated with language difficulties consisted of 255 children with language difficulties and 51 children who were judged to have typical development after evaluation, all initially referred for speech delay between May 2014 and May 2021. Multivariable logistic regression was used to identify independent associations.
Results: In the multivariable model, later age at presentation (adjusted OR 1.08 per month, 95% CI 1.01 to 1.16) and vitamin D deficiency (adjusted OR 4.22, 95% CI 1.00 to 17.75) were significantly associated with language difficulties. Within the language difficulties cohort (n=255), children with SEN (n=88) presented at a later age (mean difference 8.6 months, 95% CI 5.5 to 11.6) and had higher odds of screen exposure >2 hours/day (OR 2.1, 95% CI 1.1 to 4.2) compared with those without SEN (n=154).
Conclusions: Later age at presentation and vitamin D deficiency were associated with language difficulties, while later age at presentation and increased screen exposure were associated with SEN among children with language difficulties. These findings highlight the importance of early screening and suggest that modifiable factors like screen time may be valuable intervention targets. The role of vitamin D in language disorders requires further prospective investigation.
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BibTeX
@article{sancak2026factors,
title = {{Factors associated with language difficulties and special educational needs among children with language difficulties: a retrospective cohort study}},
author = {Ertugrul Sancak and Ayse Mete Yesil and Emel Omercioglu and Buse Şencan Karakuş and Gökçenur Özdemir and Elif Nursel Özmert},
journal = {BMJ Paediatrics Open},
year = {2026},
month = oct,
doi = {10.1136/bmjpo-2025-004098},
url = {https://doi.org/10.1136/bmjpo-2025-004098},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Factors associated with language difficulties and special educational needs among children with language difficulties: a retrospective cohort study
AU - Ertugrul Sancak
AU - Ayse Mete Yesil
AU - Emel Omercioglu
AU - Buse Şencan Karakuş
AU - Gökçenur Özdemir
AU - Elif Nursel Özmert
PY - 2026
DA - 2026/10/26
JO - BMJ Paediatrics Open
DO - 10.1136/bmjpo-2025-004098
UR - https://doi.org/10.1136/bmjpo-2025-004098
AB - Background: Language difficulties are a prevalent developmental concern, but prognostic heterogeneity makes early identification of high-risk children challenging. This study aimed to investigate factors associated with language difficulties and to identify early predictors of special educational needs (SEN) in Turkish-speaking children. Methods: A retrospective cohort study was conducted at a tertiary paediatric hospital in Türkiye. The analytical cohort for the analysis of factors associated with language difficulties consisted of 255 children with language difficulties and 51 children who were judged to have typical development after evaluation, all initially referred for speech delay between May 2014 and May 2021. Multivariable logistic regression was used to identify independent associations. Results: In the multivariable model, later age at presentation (adjusted OR 1.08 per month, 95% CI 1.01 to 1.16) and vitamin D deficiency (adjusted OR 4.22, 95% CI 1.00 to 17.75) were significantly associated with language difficulties. Within the language difficulties cohort (n=255), children with SEN (n=88) presented at a later age (mean difference 8.6 months, 95% CI 5.5 to 11.6) and had higher odds of screen exposure >2 hours/day (OR 2.1, 95% CI 1.1 to 4.2) compared with those without SEN (n=154). Conclusions: Later age at presentation and vitamin D deficiency were associated with language difficulties, while later age at presentation and increased screen exposure were associated with SEN among children with language difficulties. These findings highlight the importance of early screening and suggest that modifiable factors like screen time may be valuable intervention targets. The role of vitamin D in language disorders requires further prospective investigation.
SN - 2399-9772
ER -