Does bilingualism hurt children with DLD?

You know I’m gonna say no. But, it’s important to establish what does happen and to do so with data. After several studies we have enough data to look at this question more carefully with a set of children with developmental language disorder (aka: language impairment; specific language impairment; or primary language impairment) who had varying levels of exposure to Spanish and English.

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.

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?

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?

Bilingual Assessment and Language Dominance: We need to MOVE ON

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. 

Can Semantics Testing be used to Determine Language Impairment in Bilinguals?

As you know, there is a lack of appropriate standardized instruments to appropriately determine language impairment in bilingual children. We have made strides though in assessment Spanish-English bilinguals, which is the biggest bilingual group of kids here in the US especially in the area of morphosyntax. Work by Bedore, Restrepo, Gutierrez-Clellen, demonstrates the kinds of errors that Spanish speaker and bilingual Spanish-English speakers with language impairment make. But, there isn’t quite as much in the area of semantics.

Independent Research using the BESA

My collaborators and I did a number of studies of morphosyntax, semantics, phonology and pragmatics that informed development of the final version of the BESA. We’ve since done other studies using the BESA as an indicator of language impairment or phonological impairment. In addition, it is important to have independent studies of the BESA that evaluate its effectiveness. There are a few studies so far that use the BESA, and I hope soon there will be more. Here is what I think is only a partial list: 

Receptive-Expressive Gaps in Bilinguals with LI

In a new paper in the area of semantics, we did an analysis of a group of bilingual 7 to 9;11 year old children with and without language impairment. We were interested in seeing if children with LI showed similar patterns on receptive and expressive semantics tasks compared to bilingual children with typical development. In a previous study, we examined younger (preschool age) bilingual children on expressive and receptive semantics items on the BESOS. In that study, described here, we found that in English, children showed higher standard scores receptivity compared to the scores they were able to achieve expressively when they had very little English exposure. We proposed that it was important to understand this potential for a receptive-expressive gap in children with LI.

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.

BESA Q & A

Q: What is the age range of the BESA?

A: 4;0 to 6;11.

Q: How many children in the norming sample?

A: There are 874 children with typical development are included in the norms. A total of 420 children completed testing in both languages; 739 completed testing in Spanish and 632 children completed testing in English.

Q: Do you have to test in both languages on the BESA?

A: You can test in Spanish, English or both. Use the BIOS (bilingual input/output survey included) to determine whether to test one or both languages.

Q: How do I use the Bilingual Input Output Survey (BIOS)?

A: Use it to determine Spanish and English use at home and at school

Q: What’s the ITALK?

A: ITALK stands for Inventory to Assess Language Knowledge. There are parent and teacher versions of this questionnaire to identify areas of possible concern.

Q: Is the BESA normed only on Mexican-American children?

A: No, for Spanish about 16 different dialects of Spanish are represented; for English there are about 7 regional dialects represented. What’s more important is that we compared at the item level to ensure minimal bias on the basis of dialect.

Q: Is the pragmatics subtest normed?

A: No, this is done as an activity to gauge how the child interacts. You can use it as a warm-up and as an observation, and to supplement the standardized assessment.

Q: How long does it take to administer the BESA?

A: It depends on what you give. The morphosyntax and semantics subtests take 15-20 minutes each (per language); phonology takes 5-10 minutes (each language); and pragmatics takes about 5 minutes (you give it in one or both mixed depending on the child). So all together it takes about 1.5 hours to administer the WHOLE thing in BOTH languages.

Q: Are the subtests the same in each language?

A: No. We designed the test using a “dual-focus” approach where we used a test blueprint and generated items for each language based on the markers, structure, and culture of that language.

Q: Do you allow for codeswitching on the BESA?

A: Yes, on pragmatics and semantics children can respond in either language.

Q: What kind of scores do you get from the BESA?

A: Raw scores are converted to standard scores for each subtest and to age-equivalents. For the morphosyntax the cloze and sentence repetition subsections yield scaled scores which are summed before looking up the standard score that corresponds to the sum. For semantics, there are receptive and expressive subscores that are converted to scaled scores. These are summed and converted to a standard score. The best (Spanish or English) morphosyntax and best (Spanish or English) semantics standard scores are combined for a language index.