Archive for category child language impairment

Working with children who have language impairment: Don’t forget the “glue”

While acquiring language, children show a tendency to use function words with a very high frequency compared to content words. These high frequency words are referred to as core vocabulary words, a term frequently used in AAC. These include pronouns, prepositions, conjunctions, articles, auxiliary verbs, modals, indefinites, as well as content words including adverbs, but few nouns or verbs. Function words provide speakers a bridge to combine words to increase their utterance length. You can think of these as the glue that binds together grammar and vocabulary. This “glue” is important and are used across different kinds of contexts including conversations and story-telling. They are used across many contents including work, school and home.

We were interested in understanding how children with language impairment (LI) use these core vocabulary words. We wanted to know which core words they used; if patterns were different in each language; and if children with language impairment used these same core words as often as those with typical development.

So, in a recent longitudinal study we looked at use of core vocabulary words in Spanish-English bilingual children with and without LI. We analyzed 30 core vocabulary words in Spanish and English narrative samples of children in kindergarten and again in first grade. Children with LI produced fewer core vocabulary words and used them less frequently compared to their typically developing (TD) peers. This difference was more pronounced in first grade.

Graphical abstract_revised
One lesson we can draw from this is that children with LI have much more sparse vocabulary as compared to their typical peers consistent with previous findings. What was unexpected was that they also use core words much less often than their TD peers. While this does not mean that intervention should focus on, for example, the articles “the” “la” or “el” in therapy. Or at least not exclusively. But, it is important to think about how these core vocabulary words supports learning of the content words (such as nouns). It may be important to teach content words in phrases rather than in isolation so that the core words are reinforced. These can also serve as “frames” to teach other content words. As children progress we can continue to help them to link together learned phrases into sentences and conversation. So, as you work with children with language impairment, don’t forget about the glue that holds it all together.

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Doing the right thing

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 »

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Can I give the BESA with an Assistant if I don’t Speak Spanish?

I’ve been asked this question a couple of times now, the most recent was a few days ago, so I thought I’d write about it here. The bottom line is YES, WITH TRAINING. But, let me explain. Read the rest of this entry »

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Reporting Bilingual Results

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.

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Bilingualism for Children with Disabilities

I have a new paper out that is part of a special issue in the Journal of Communication Disorders. I encourage you to read the whole issue. It is based on an international collaboration where researchers used different methods including interviews, observations, record and policy review to understand current perspectives on bilingualism in children with developmental disabilities. The set of papers is excellent and shows that indeed we as a field have increased and evolved in what we know about bilingualism. Teachers, special educators, parents, and policy makers understand that it is important for children who speak different language at home and at school to be bilingual. There is a growing awareness that bilingualism can be an advantage. This is very good news. For me, I was heartened to know that the message is getting through, that there is a broader awareness, and that there is more attention and effort to putting these ideas into practice.

At the same time, it’s hard to do. We still need to figure out the practicalities of supporting the home and school languages. We need to learn more about what can transfer between languages and how parents and teachers can support and reinforce language learning to best benefit the child. There are many people trying to do what’s best for these kiddos but we need more practical, applicable methods. I talk a little about this and how the knowledge base has increased in my paper. Read it– it’s available through the journal for free till the middle of December, 2016.

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Bilingual AND Special Education: YES!

When I was a practicing SLP I remember sitting in IEP meetings and arguing for BOTH speech-language therapy services AND ESL for bilingual or ELL children who had speech and/or language impairment. Often, I would be told that, no, their district POLICY said that we would have to pick that it would be EITHER ESL or SLP services but NOT BOTH! Read the rest of this entry »

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Bilingual Research Needs

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 

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Flashback!

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?

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You Tube Channel

John Consalvi from LinguaHealth interviewed me last summer about the BESA’s development and use. Here is the You Tube channel. In time for Valentine’s Day!

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Combining Tests Results across 2 Languages

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 »

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