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.

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?

Measuring vocabulary development in bilingual children

Took me a while to come across this, but I ran across this post today looking for a copy of Core, et al’s paper and here’s a nice summary. The post spoke to me (and not only because it was posted on my birthday) but also because the work demonstrates the importance of looking at both languages when testing bilingual children–

so to Speak

The topic of my first Research Tuesday Blog is (drumroll please): “Total and Conceptual Vocabulary in Spanish–English Bilinguals From 22 to 30 Months: Implications for Assessment.”

This is all there is to see, folks

To understand the purpose and findings of this article it is beneficial to know the difference between total and conceptual vocabulary.

Total vocabulary is the sum of the words a child knows across two languages.

Conceptual vocabulary gives the child credit for knowing concepts rather than words, and concepts that are represented in both languages are counted only once.

So basically, when looking at a bilingual child’s total vocabulary you would count both the word perro and the word dog. If you were looking at conceptual vocabulary you would only give the child credit for knowing one concept: the furry, four-legged creature in my house which barks and eats kibble is a dog/perro.

The bottom…

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BESA Research

I’ve been meaning to post some information about the Bilingual English Spanish Assessment and we have. Here, we respond to some FAQs. And here, I provided an overview of what it does, how it works, and its specificity/sensitivity data. In addition to this information and what is in the manual, we have written a number of papers over the years that led directly to what we included (and excluded) from the BESA. So, below I will provide some of the links to abstracts of papers we’ve written about earlier versions of the BESA. These are the studies that we conduced to refine the items and the test so that the final published version has a high degree of classification accuracy.

Really? Can kids with Language Impairment or _____ Learn TWO Languages?

Is the earth round, really? It seems flat to me. I’ve been in many places in the world and I haven’t heard about anyone falling off it and so from my own logic and experience it appears the earth is flat. This is how evidence goes it seems and I find myself getting frustrated but I do try to understand the logic of disbelief– even in light of evidence. Yes, the earth is round (a sphere actually) and children with language impairment and those with other disabilities that affect language learning CAN (and do) become bilingual. No, they do not become MORE delayed.

Bilingual intervention: why not?

Bilingualism is finally being understood as what it is: a typical, positive and enriching form of living and of communicating in the United States. That is, an asset rather than a deficit. In many cities, dual language programs are flourishing and parents from multiple backgrounds are showing a commitment to bilingual language and literacy development. This is great news; however, there are still some concerns about bilingual education and bilingual children with language disorders. Are these children able to learn in a dual language classroom? Will they feel overwhelmed and confused? Will they manage to learn English? What should we recommend their parents?

We can now make some recommendations based on recent research conducted with Latino Spanish-speaking preschoolers with language impairment (Gutierrez-Clellen et al., 2012; Restrepo et al., 2013; Simon-Cereijido et al., 2013). And the recommendation is definitely bilingual! We found that the Spanish-speaking children with language disorders learned new English words and increased the length of their English phrases at a faster rate from interventions in Spanish and English, rather than in English only. Moreover, they also showed gains in Spanish.

In a separate study, we collaborated with Head Start teachers who taught our lessons in small groups to bilingual children with and without language impairment (Simon-Cereijido & Gutierrez-Clellen, 2014). All of the children, regardless of ability, made more progress than the bilingual children who did not receive the lessons and who were instructed in English only. Thus, a bilingual approach proved to be more beneficial than an English only approach for the children with language impairment.

This intense vocabulary and oral language intervention was developed following quality preschool evidence-based practices combined with a bilingual approach. Units of four 30-minute lessons were designed around bilingual picture books and every unit introduced the storybook, the new words, and the games in Spanish, the strong language of these children. The children, then, were ready to listen to the same information in English the following day. Days 3 and 4 alternated the languages. We explicitly designed several hands-on activities to repeatedly teach new, less frequent vocabulary (a weakness found in a great number of typical and atypical Latino children). We also designed “Talk and Play” games to facilitate the production of longer utterances. The “Talk and Play” activities used themes from the storybooks, familiar words, and a few toys that would allow the children to take “speaking” risks in a playful environment.

There is still much more to figure out about interventions and programs for bilingual children with language disorders. However, we do know more than before, and we should feel more and more confident to support bilingualism at home and at school.

Gutierrez-Clellen et al., 2012
http://ajslp.pubs.asha.org/article.aspx?articleid=1757528
Restrepo et al., 2013
http://jslhr.pubs.asha.org/article.aspx?articleid=1795805
Simon-Cereijido et al., 2013
http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=9042269&fulltextType=RA&fileId=S0142716412000215
Simon-Cereijido & Gutierrez-Clellen, 2014
http://www.tandfonline.com/doi/full/10.1080/13670050.2013.866630#.U0Btoqg7s6Y

Assessment of Bilingual Children

Accurate assessment of bilingual children is a challenge for educators including speech-language pathologists all over the world. When children have exposure to more than one language it might be difficult to know if low language and reading scores are due to lack of enough experience in the language tested or if these are indicative of a language impairment or language based reading delay. A number of research groups all over the world have been working on this problem for a number of years. Three years ago I participated in a workshop on bilingualism in Wales. A two-volume book, in part, is the current product of that workshop. For those who buy the pair, currently there is a discount offered.

Does Bilingualism Increase Stuttering?

Maybe, but I don’t think so. What we do know is that we don’t really know enough about how bilingualism interacts with stuttering. We know that bilingualism doesn’t make autism worse; we know that bilingualism doesn’t increase the risk of language impairment, so consistent with these findings; I think that bilingualism shouldn’t make stuttering worse. There is one study that reports that children who start learning their second language later in childhood bilinguals are less likely to stutter than bilinguals who start using both their languages from an early age. As pointed out however, it seems that the prevalence of stuttering in bilinguals is no higher (or maybe less) than that of monolinguals. I think however we need to get a handle on what stuttering looks like in bilinguals to make accurate diagnosis. We know for example that bilinguals demonstrate more tip of the tongue phenomena and that mazes (pauses, hesitations, reformulations) are different in different languages.

Dynamic assessment can contrbute to diagnostic decisions about bilinguals

Last June, I gave a keynote on dynamic assessment at SRCLD and presented recently analyzed data using DA with bilingual kindergarteners. We are currently in the process of writing the paper on this and hope to submit it soon for publication. If all goes well with the review and revision process maybe in a year it’ll be accepted and then a few months after that before it is available. Meanwhile however, we’re not the only ones to take on this question. So, here’s a summary of what I’ve found recently.

Receptive and Expressive Semantics: Does Bilingual Experience Matter?

The short answer is yes. But, the longer answer is more interesting I think. It’s well-known that we can understand more words than we can express. Generally though, there are strong associations between receptive and expressive language, the more words you understand the more words you can express. We see normal receptive-expressive gaps in early language development, later development, as well as in mature learners. As adults, there are words that we can recognize by context in reading for example, but don’t use them expressively or don’t consistently recall them. On standardized tests however, these inherent differences between the two kinds of tasks are controlled. We can compare performance on expressive and receptive tasks through use of standardized scores often using a mean of 100 and a standard deviation of 15. Large receptive-expressive discrepancies where receptive knowledge is much stronger than expressive knowledge can be an indicator of language impairment. How does this work in bilinguals?