Archive for category assessment
The answers are yes, no, maybe, it depends. Last time we talked about “yes.” This time let’s talk about:
Yes, no, maybe, it depends. Read the rest of this entry »
I belong to a Facebook group SLPs for Evidence Based Practice. There is frequent discussion of what works and what doesn’t in intervention and in assessment. My work has often focused on assessment and assessment practices. And, I have to say that it is frustrating to find that something does (or doesn’t) work but that clinical practices take so long to change. So, I wonder what is our obligation in the field to be aware of the evidence? And what is our obligation to make changes in our practices? Read the rest of this entry »
A question that often comes up about our research is how to apply it clinically. Much of our work is motivated by clinical questions and ultimately we aim to have some clinical solutions. It’s hard sometimes to move directly from research to application. Sometimes the clinical questions we pose have no or very little research available to move to the next step. So, we have to step back and do the more basic descriptive work to understand the nature of bilingualism and of bilingual impairment before we can then more forward again to answer questions about assessment and treatment. Now that we’ve done more work that has implications for assessment and have the BESA available for clinicians we can start to think about more direct application.
I wrote a year ago that we can get the most accurate indicator of language impairment on the BESA when we combine the best language across domains. So, we might combine Spanish morphosyntax with English semantics for a language composite. But, how do you write up results to incorporate into a report?
In a fairly recent paper, we provide some illustrations of how to use test information to make clinical decisions using the BESA. We go through the parent and teacher interview we use to determine possible concern about speech and language ability in each language and how we determine language use and exposure. Finally, we demonstrate how we combine and compare Spanish and English performance across each domain to determine language impairment. I hope these help in writing up your clinical reports.
I’m at the airport in Washington DC after participating in a workshop at tha NIH on dual language learners. We talked about the state of the art. What’s cool is that there has been so much progress. We know that bilingualism isn’t bad for you and that in fact it could be good for you. We have better ideas about how to diagnose bilinguals with language impairment. At least in some languages. We know about what works for Spanish and English. We have emerging data for Mandarin-English and Vietnamese-English as well as other language pairs. We have an emerging picture about bilingual development in two languages.
But, there’s still a lot we don’t know. We don’t fully understand how changes in the linguistic environment affect child performance on language measures. We still don’t have a God handle in intervention for bilinguals with langquge impairment. Do we treat in one language or both? Do we use translanguaging approaches?
I don’t think we fully understand how bilingualism affects the brain. Nor do we know how the environment shapes the brains of children with language impairment.
We heard about reading disorder and mechanisms associated with dyslexia. Children can and do learn to read in two languages but we don’t really understand how those languages interact and how languages that have different writing systems interact in the bilingual brain.
Even though we’ve made progress in identification of impairment we don’t do such a great job across languages and at all ages.
So we know a lot we have a ways to go
This popped up on the habla.lab facebook page today and I shared it there, but I thought I’d share it here too.
GRRRR is of course my first reaction. We’ve talked about this so many times in the past but these myths persist. The one that is currently in vogue is that bilinguals are delayed in both languages (which is basically what this is) but that is not, in fact the case. It depends on the domain and the language being tested (and how it is being tested).
What we find for bilinguals is that often they show what we term “mixed dominance” that is for one domain (e.g., semantics) an individual child will show dominance in one language (e.g., English)– and that is well within normal limits, but in another domain (grammar) they may show dominance in the other language (e.g., Spanish). If you look at only one language they may look delayed, but if you look at the stronger language in each domain they do not (we developed the Bilingual English Spanish Assessment to derive a language composite based on the strongest performance by domain).
I think that this happens also when you test groups of bilinguals, average scores are lower than average in each language (AS A GROUP), but if you look at the HIGHER language, individual children are performing well. Actually, they may be performing better because they know MORE (they know the vocabulary and grammar and discourse style of at least TWO languages)== that’s more not less.
A few years ago I was talking with an assistant principal of a bilingual school. He cited research about the cognitive benefits of bilingualism as a primary rationale for his school’s bilingual approach. Yet, he also lamented the fact that many of the Latinx students at his school were “lost in translation” in that they didn’t have full competency in Spanish or English. I was left wondering how it was possible for bilingualism to be positioned as leading to cognitive benefits while actual bilingual children were positioned as linguistically deficient.
This deficit perspective of the bilingualism of Latinx students is certainly not new, though its framing has changed over time. Prior to the 1960s researchers argued that bilingualism led to cognitive deficiencies. These alleged cognitive deficiencies were used to explain the low IQ scores of Latinx students. The basic argument was that bilingualism confused Latinx students and inhibited their cognitive development.
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I haven’t posted for a while, things have been pretty busy finishing up a project and starting another, applying for grant money so that we can pay for proposed projects and so on. But, today I got a message from a bilingual SLP who works in early intervention. She had some concerns about some decisions and procedures being made by the local school district. She was working to do an assessment of a 3-year old child who had approximately 10 words in his or her vocabulary. Now most of us would see this as strong evidence of a language delay or impairment. But, what if the child’s first language is not English?
We have been working on the question of how to best identify language impairment in bilinguals for a long time. One guideline that has been around for a long time is to test in both languages. In workshops and in presentations I often will repeat TEST IN BOTH LANGUAGES, test in both languages… But, how should results from two languages be combined? Read the rest of this entry »
A long time ago (about 25 to 30 years ago) I learned that bilingual children should be tested in their dominant or home language. The prevailing view then was that if you tested in the weaker language you wouldn’t be letting the child demonstrate what they knew. I think that this part is true. The other part of this perspective is that there wouldn’t be anything in the weaker language that wouldn’t be represented in the stronger language. I don’t believe that this part is true. It’s the 21st century… we know better. Read the rest of this entry »
In 2009, there was an article published in the Archives of Childhood Disease that was subsequently picked up by Science Daily wherein the authors stated, “…if a child uses a language other than English in the home, deferring the time when they learn English reduces the chance of starting to stutter and aids the chances of recovery later in childhood.” This notion of bilingualism posing an increased risk for the development and persistence of stuttering has resulted in many parents questioning whether or not they should delay exposure to a second language until after the pre-school years – arguably the most optimal time period for second language acquisition. I have personally fielded multiple phone calls from parents as well as SLPs of bilingual children and my response to all has been the same – bilingualism is not a risk factor for the development or persistence of stuttering, however, it does appear to be a risk factor for the mis-identification of stuttering in bilingual speakers who are typically fluent.
Why is this the case? There are at least a few critical reasons to consider.
First, we need to recognize that the relatively few studies that have been completed thus far with bilingual persons who stutter are compromised by the lack of specificity with regard to bilingualism. As we detail in Coalson, Pena, and Byrd (2012) across the limited bilingual stuttering studies that presently exist, a large majority fail to adequately describe the participant’s bilingualism – most simply refer to the participant as “bilingual,” with no further details regarding language history, function, use, etc. provided.
Second, we have assumed for quite some time that SLPs do not have to speak the language of the person who stutters in order to be able to accurately identify the presence of stuttering. From this assumption we have further assumed that we can easily identify stuttering in bilingual speakers whether we do or do not speak each of the languages the person speaks. A significant limitation to this line of thinking is the investigation of identification accuracy of stuttering in Spanish-English bilinguals (Lee, Robb, Olmond, & Blomgren, 2014) did not include foils (i.e., speakers who do not stutter) – rather the only requirement was analysis of speakers with confirmed stuttering.
With that in mind, what do we really know about the identification accuracy of stuttering when the SLP also has to listen for the presence of stuttering in a bilingual Spanish-English speaker who does not stutter?
We recently published a study (Byrd, Watson, Bedore, & Mullis, in press) that demonstrates that, as expected, most SLPs are able to accurately identify stuttering in bilingual children with confirmed stuttering. What was unexpected given the assumption that identification of stuttering should be easy even if you do not speak the language, is that most SLPs mis-identified the presence of stuttering in the bilingual Spanish-English speaking children who are typically fluent. When these SLPs were asked why they thought the typically fluent bilingual speaker was a stutterer, almost all referred to the high frequency of speech disfluencies the child produced. A crucial consideration that none of the SLPs acknowledged is that their measure of what they considered to be high is based on guidelines derived from monolingual English speaking children who stutter. This raises the question – can these monolingual guidelines be applied to bilingual speakers?
In another newly published study (Byrd, Bedore, & Ramos, 2015) we demonstrate that the application of these monolingual guidelines to the bilingual speaker would result in the mis-identification of stuttering. In fact, the typically fluent Spanish-English bilingual children whose speech output we analyzed produced stuttering-like disfluencies at rates well above the 3% guideline, with some producing frequencies as high as 38%. These bilingual children who again were not stutterers also produced a mean number of iterations (repetition of the disfluent moment) that was markedly higher than what has been reported in monolingual English-speaking children who stutter. Why are these speakers so disfluent? Consider that the bilingual speaker is navigating many more motor and linguistic decisions than the monolingual speaker – the more potential decisions to make, the higher the likelihood for revisions or what we hear as speech disfluency.
Upon consideration of these findings, how can we differentiate a bilingual child who stutters from a bilingual child who does not?
Additional research is needed but our preliminary data suggest that clinicians should consider the quality not the quantity with regard to the speech disfluencies produced. For example, the production of monosyllabic word repetitions drove the frequency of stuttering-like disfluencies well above the 3% guideline. These bilingual children also produced high rates of sound repetitions and syllable repetitions – all of which are classically considered to be stuttering-like behaviors when produced above 3%. However, none of the typically fluent bilingual children we examined produced atypical prolonging of sounds – this finding suggests that the tension of the disfluent moment may be another differentiating factor. The typically fluent bilingual children we examined produced easy, effortless repetitions – no atypical tension characteristic of stuttering was observed. We also suggest that clinicians consider the rhythm as opposed to the number of iterations – is each repetition rhythmic in nature or is it highly arrhythmic? The latter would be indicative of stuttering. Our data also indicate that parent concern may be a differentiating factor. From a cultural perspective parent concern may be better evaluated as degree of concern rather than presence or absence but regardless among our cohort of bilingual children who do not stutter there was no present or past parent concern of stuttering to any degree.
Together, our data suggest clinicians should take caution when identifying stuttering in bilingual speakers. Even with monolingual speakers, the presence of stuttering should never be confirmed based solely on frequency, but with the frequency rates being so high in bilingual speakers, clinicians need to be extra careful not to be erroneously swayed by numbers that in monolingual speakers would be considered highly atypical as what is atypical for monolinguals may in fact be typical for bilinguals.