Where to start?

Do you ever wonder how to decide if a bilingual child has a developmental language disorder (DLD)? We have a new paper here where we outline one approach we developed to identify DLD in bilinguals when there isn’t a gold standard.

Usually, when you develop a new test or approach you compare how well it works against a gold standard. Sensitivity and specificity percentages are how well the new test classifies compared to the gold standard. If the new test is at least 80% accurate in its classification (both sensitivity and specificity), then we say it’s a good test. But, what do we do when there is no gold standard as is often the case when we are testing bilingual kids? Can we use this approach for different language pairs? WHERE DO WE START?

1. We started with expert clinicians. Clinicians who were Spanish-English bilinguals, who had several years of clinical experience, who had worked a lot with Spanish-English bilingual kids.
2. We looked at the literature. How does English DLD present? How does Spanish DLD present? Where would we see this?
3. Our expert clinicians reviewed test, interview and language sample data for 167 kids and made judgements about each of their languages in three domains: narratives, grammar, & semantics.

We made a form, where we asked clinicians to review each case, and to make notes. The included the three domains across the top, and the sources of information (here language samples) along the side.

Clinicians made their notes as they went through the files. We asked them to look at patterns of performance rather than at test scores (see example):

Then, we asked them to provide a rating for each language x domain, and an overall rating, based on their observations of children’s patterns of performance and their knowledge of ESL.

Every 10 cases, the three clinicians discussed the case together and their reasons for their ratings. They re-rated those cases after the discussion. Our findings are that there was high agreement overall in the domain ratings and in the decisions about who had impairment. When there were disagreements, they were usually a 1-point difference. What’s interesting is that even when they paid attention to different things, they were able to make judgements that were consistent with each other.

We then went back to look at the test scores of the kids that were judged to have and not have DLD. And we found large, significant differences on almost all measures of interest. We propose that this might be a good way to structure the data we collect when conducting bilingual assessment. We can then systematically rate each domain to then compare across languages and come up with a rating. We hope to expand this work, and we hope to see what kinds of measures and observations are informative for clinical decision making.

New Book on ELL Children

The Guilford Press is releasing a new book edited by Marilyn Shatz and  Louise C. Wilkinson called: The Education of English Language Learners: Research to Practice. Lisa Bedore, Karin Boerger, and I have a chapter in it focusing on semantic development in bilinguals. Here’s a list of the chapter titles and authors (we think we’re in good company and we’re looking forward to seeing the book in print):

Why do people react so negatively to the idea of dual-language programs?

In Austin, the school district is looking to start a dual-language program. If you read the comments in reaction to this you see a lot of mixed reactions. It seems that many people don’t (or don’t want to) understand the purpose of dual-language education. Or is it that they’re afraid of people who speak other languages?

What I find so surprising is that people would be threatened by the idea of using state and federal money to educate children in two languages (English and another language). The negative comments seem to indicate that some people believe that teaching in two languages will cause children to not learn English. But, that is simply not true. People all over the world speak two languages. English is a very common language all over the world. I don’t think there is any way that the language is threatened.

Dual-language programs do work. Children can and will become bilingual given input and opportunity to use the two languages. Knowing two languages can be a benefit educationally. Culturally, knowing more than one language can help you connect with people from other backgrounds and cultures. I think that knowing two languages can help children understand that there can be other ways of constructing words and sentences. Even one’s vocabulary can be enhanced by learning vocabulary in another language and translating to your own.

It’s the Wrong Question (Initially): Part 2

In a recent post, I discussed the therapy goal driving the language of intervention and not vice versa.  In Part 2, I provide an example focusing on speech sound disorders and some more explanation.

Suppose you determine that a Spanish-English bilingual child has a speech sound disorder in which the trill-sound in Spanish (in a word such as “perro”–dog) and the r-sound (as in “read”) are misarticulated.  The goal drives the language of intervention.  If you want to remediate the r-sound, you are obligated to do so in English.  Only English has that sound-not Spanish.  The same is true, of course, for the trill sound in Spanish.  You must work on it in Spanish.  Clearly, these are somewhat easy cases and easy decisions.

What happens with a sound such as the s-sound, if it is misarticulated in both languages?  By the way, if a bilingual child has a disorder, it will occur in both languages, not just in one language (a topic for another post).  So, back to the misarticulation of the s-sound in both languages.  The goal (and my bias) is to increase the accuracy of that sound in both languages ultimately, but how should this be done?  At this point, language of intervention is relevant. 

Surprisingly, there are very few studies of treating speech sound disorders in bilingual children (we actually have very few treatment studies in speech-language pathology, but that’s a subject for the future).  Such studies include:

Holm, A., & Dodd, B. (2001). Comparison of cross-language generalisation following speech therapy. Folia Phoniatrica et Logopaedica, 53, 166-172.

Holm, A., Ozanne, A., & Dodd, B. (1997). Efficacy of intervention for a bilingual child making articulation and phonological errors. International Journal of Bilingualism, 1, 55-69.

Ray, J. (2002). Treating phonological disorders in a multilingual child: A case study. American Journal of Speech-Language Pathology, 11, 305-315.

Although these studies provide some direction for us, they are all case studies, and thus, we can’t generalize them.  That being said, we do need to find some direction.  The numerous factors that the students raised (and that were also included in the previous post) come into play: home language, parental choice, use, proficiency, dominance, school language, language of the speech-language pathologist, and availability of interpreters/translators. 

You might choose the initial language of intervention based on those, or perhaps other, factors.  You might also deliver treatment in one of the following ways:

• English first (or Spanish) to some criterion and then in Spanish (or English) to some criterion
• 1 week in English and 1 in Spanish
• English (or Spanish) for a set number of sessions and then Spanish (or English) for a set number of sessions

 At this point, we don’t have research evidence that privileges one approach over the other.  However, regardless of which language you start in, it is critical to monitor how that skill is generalized to the other language.  If it generalizes, then theoretically you would not have to work on it in the other language.  If it does not generalize, however, it would be appropriate to target it in the other language as well.  Again, the goal drives the language of intervention with the ultimate outcome of raising a bilingual child who is a competent speaker of both languages.

It’s the Wrong Question (Initially): Part 1

In a recent class on assessment and treatment of diverse populations, we were discussing treating communication disorders in bilingual children by speech-language pathologists.  In preparation for this discussion, the students had read papers such as:

Kohnert, K., Yim, D., Nett, K., Kan P.F., Duran, L. (2005). Intervention with linguistically diverse preschool children: A focus on developing home language(s). Language, Speech and Hearing Services in Schools, 36, 251-263.

Gutiérrez-Clellen, V. (1999). Language choice in intervention with bilingual children. American Journal of Speech-Language Pathology, 8, 291-302.

Goldstein, B. (2006).  Clinical implications of research on language development and disorders in bilingual children.  Topics in Language Disorders, 26, 318-334.

I opened the discussion with an open-ended question, “what is the first question you need to ask yourself in planning treatment for bilingual children with communication disorders?”  Each and every student said something like, “What language should I treat in?”  We then discussed how to make that decision.  They raised a number of factors that would be important to know in making that decision such as: home language, parental choice, use, proficiency, dominance, school language, language of the speech-language pathologist, and availability of interpreters/translators.  In discussing this topic for almost an hour, we could not agree on exactly how to answer this question.  I then told them the truth.  There was a reason they couldn’t truly answer the question. 

It’s the wrong question (initially).  Said another way, it’s the right question but at the wrong time. 

I then asked them if the child were monolingual, what would be their first question.  They all said, “What’s the goal?”  Then why, I asked, is that not the same question for bilinguals?  Silence.

Language of intervention is, of course, an important and critical question to answer in working with bilingual children, but I don’t think it’s the first one.  Determining the goal drives the language.  Language of intervention does not signal the goal.

In a future post, I will provide more detail on this notion and give you an example.

How proficient is proficient enough?

The Des Moines Register had an article yesterday about a high school senior who refused to take the English language fluency test required for students who learned English as a second language. Her argument was that she was fluent in English and that this was evidenced by the fact that she has nearly a straight A average in courses that are taught exclusively in English. Her parents are immigrants from Laos but she was born in the U.S. While she learned Lao at home, she has likely been exposed to English her entire school career.

So, how long do you need, and when can yearly proficiency testing stop?

How to measure proficiency: More questions than answers here

In research as well as in educational and other settings the question of linguistic proficiency is critical. This question is something that I continually struggle with in working with children. How proficient is proficient enough? What does it mean? What should we measure? I’ve been influenced by my own clinical background and the work of other researchers in this area.