Professional practices and opinions about services available to bilingual children with developmental disabilities: An international study

Early intervention speech-language pathologists' beliefs and practices related to assessing dual language learners

INTRODUCTION

Early intervention (EI) speech-language pathologists (SLPs) are required to provide culturally and linguistically responsive assessments for dual language learners (DLLs). However, SLPs consistently report feeling underprepared to assess DLLs and research demonstrates gaps in implementation of best practices in pediatric outpatient and school-based settings. This study was designed to understand EI SLPs' beliefs and practices related to assessing DLLs referred to early intervention programs.

METHODS

A total of 132 EI SLPs completed a survey in which they were asked to describe their assessment procedures for a DLL case scenario and were further asked to identify the degree to which they agreed with a variety of assessment practices for assessing DLLs.

RESULTS

Results revealed that EI SLPs' beliefs aligned with best practices for assessing DLLs. However, substantial gaps exist between EI SLPs' beliefs and their self-reported practices for assessing DLLs.

CONCLUSIONS

These results suggest DLLs may not be receiving evidence-based EI assessments, leading to the potential perpetuation of both over- and under-diagnosis of speech and language delays within this population. Implications include the need to increase the quality of EI SLPs assessment practices through additional training, the removal of systems-level barriers, and the continued need for increased training within preprofessional training programs.

It's our job to bridge the gap: Perspectives of bilingual autism providers on heritage language care

LAY ABSTRACT

In the United States, many people have heritage languages they speak in their homes other than English, such as Chinese or Spanish. Autistic children whose families speak different languages could benefit from support and teaching in their heritage languages. Still, caregivers have reported that it is challenging to do so. Many autism professionals make suggestions that are not based on research. To date, researchers have not examined the perspectives of the small group of bilingual professionals in the United States who provide bilingual support for autistic children. Therefore, this study explored how bilingual autism providers in the United States talked about their work, bilingualism, and the impacts their bilingual work has on autistic children and families. The bilingual providers in this study reported many positive outcomes for autistic children when they can learn and use their heritage languages and some negative outcomes when providers cannot communicate in the same language. Recommendations from this study highlight the need to recruit more bilingual providers in the field of autism.

Parent-led Communication Therapy for Young Bilingual Autistic Children: A Scoping Review

A scoping review of the literature was undertaken using JBI guidelines to map the evidence of parent-led therapy (PLT) for young autistic children (≤ 6 years) raised in bilingual environments. Reviewers used Covidence to screen located sources. Sixteen papers met inclusion criteria. A strong acceleration of reports of PLT for young autistic children measured in bilingual environments was observed, with 93.8% of papers (n = 15) published since 2015. Reporting of participants' language environments (home language(s)/L1s and societal language(s)/L2s) was inconsistent. A large majority of these studies, 87.5% (n = 14) were conducted in North America or in collaboration with a North American institution. Diverse PLT programs and methodologies were identified. There is variation in demographic information collected and outcomes reported. Evidence gaps in the literature are identified and the value of undertaking systematic review on this topic is considered. This scoping review points to the necessity of further empirical research and practice that centres parents in early and specific support for autistic children raised in bilingual environments. Suggestions for improving reporting standards of language profiles are provided.

Speech-language pathologists' perceptions of childhood bilingualism

The value of learning multiple languages has increased in the past 20 years. Despite this, some professionals continue to provide misinformation about bilingualism to many families around the United States, resulting in recommendations of implementing a monolingual approach for children. This study investigated the perceptions held by speech-language pathologists (SLPs) regarding childhood bilingualism. A total of 320 SLPs completed a survey stating their perceptions on childhood bilingualism for typically developing children and children with disabilities. Based on the number of responses, 292 participants were analysed quantitatively utilising a binary logistic regression to identify whether SLPs thought childhood bilingualism was advantageous or neutral, while incorporating the predictors of bilingual status and bilingualism education received. Additionally, a qualitative content analysis was conducted on 173 participants' responses to an open-ended question about their perceptions on childhood bilingualism. Results revealed that SLPs' bilingual status did not predict the probability of an advantageous perception for typically developing children, but it did for children with disabilities; however, SLPs who had received bilingualism education had a higher probability of having advantageous perceptions in both populations. Qualitative results revealed the use of appraisals related to multiple themes. This study served to understand the thoughts of SLPs in relation to the education they are providing to parents and the services they are providing to different populations - whether it be typically developing children or children with disabilities. There are implications for bilingual and cultural-linguistic education to be implemented across graduate programmes to ensure that optimal services are provided to the diverse groups in our case loads.

Autism and bilingualism: A thematic analysis of practitioner perspectives in the United Kingdom

BACKGROUND

At least 25% of autistic children worldwide have the potential to grow up in a bilingual environment. However, many autistic children are being denied opportunities to access additional languages and the cultural, familial and community connections that come with this. There is little evidence identifying the barriers to language learning and access, and no research addressing the perspectives of speech and language therapists (SLTs), who are crucial in supporting parents to make informed choices about bilingualism with their child.

AIMS

The aim of this research was to understand the experiences of SLTs working with autistic bilingual children, to understand the main considerations when working with families, and the opportunities and barriers for training, including the sources of information that current practice is based on.

METHODS AND PROCEDURES

Twelve SLTs from across the United Kingdom were recruited for this study. All participants were experienced in working with autistic bilingual children and their families (M = 7 years, range 4-23 years). Semi-structured interviews were conducted and focused on the experiences of SLTs regarding familial bilingual experiences, the effect of sociocultural factors of practice, and the extent to which practice is based on current research.

OUTCOMES AND RESULTS

Data were analysed using reflexive thematic analysis. Three central themes were identified from the interviews: (1) participants discussed parental uncertainties as to whether they were doing the right thing for their child, (2) while participants were in support of bilingualism, they were not always confident that they were providing the right advice and found it difficult to in keep up to date with relevant, evidence-based research, and (3) participants highlighted a need to shift towards a more inclusive and culturally diverse practice.

CONCLUSIONS AND IMPLICATIONS

This is the first qualitative study to understand the perspectives of SLTs working with autistic bilingual children. We identify several key difficulties in supporting access to language learning, and these findings have immediate and longer-term implications for supporting SLTs, and in turn, the children and families they support.

WHAT THIS PAPER ADDS

What is already known on the subject Research suggests that autistic children currently have fewer opportunities to maintain bilingualism compared to neurotypical peers. Despite the lack of evidence, many families remain concerned that bilingualism will have a negative impact on their child's development. To date, little is known about the perspectives of speech and language therapists (SLTs) who play a significant role in supporting the development of autistic bilingual children. This is the first study to provide an in-depth qualitative analysis of the experiences of SLTs working with autistic bilingual children and their families in the United Kingdom. What this study adds The results highlight a number of reoccurring barriers in providing optimal support: first, frequently cited concerns about bilingualism from parents that link to a lack of understanding about autism and the role of SLTs more generally. Second, SLTs do not have confidence in the assessments and tools available and described a lack of emphasis on cultural factors in practice. Many SLTs were concerned about the limited options for resources and interventions available in other languages, which could be challenging for parents who were less proficient or confident communicating in English. Third, SLTs reported having limited opportunities to keep up to date with relevant research to support their decision-making processes. What are the clinical implications of this work? These results have several important implications for practice-they highlight the need for more inclusive practices where possible, a need for more diversity within the profession and further opportunities to be provided with evidence-based advice around good practice. The results also suggest a benefit of providing accessible, evidence-based resources for parents about autism and bilingualism, to ensure that research key findings are reaching families.

Assessing the speech production of multilingual children: A survey of speech-language therapists in French-speaking Belgium

BACKGROUND

Assessing the speech production of multilingual children is challenging for speech-language therapists (SLTs) around the world. Scientific recommendations to improve clinical practice are available, but their implementation has mostly been described in studies from English-speaking countries.

AIMS

This survey aimed to describe the perspectives and practices of SLTs in assessing the speech production of multilingual children in French-speaking Belgium.

METHODS & PROCEDURES

An online survey was completed by 134 SLTs in French-speaking Belgium.

OUTCOMES & RESULTS

SLTs predominantly used norm-referenced assessment approaches, which are not recommended for use with multilingual children, and lacked necessary training and resources to implement recommended practices in the assessment of speech production of multilingual children. The shift towards more appropriate practices with multilingual children seems to be in its infancy among SLTs in French-speaking Belgium. Some challenges identified by the SLTs were common to those in other countries and languages, such as the difficulty to distinguish between speech differences and speech disorders. Other challenges were specific to the French language and/or the Belgian context, such as the lack of appropriate tools in French.

CONCLUSIONS & IMPLICATIONS

Action is required to improve clinical practice in assessing the speech production of multilingual children in French-speaking contexts: better training for SLTs regarding linguistic diversity, more implementation research in the field of SLT, and advocacy for linguistic diversity with decision makers.

WHAT THIS PAPER ADDS

What is already known on this subject Existing research indicates that assessing the speech production of multilingual children is challenging for speech-language therapists (SLTs). Scientific recommendations for best practices have been published, and the shift to more appropriate assessment practices may be progressing differently across countries. SLTs' practices have been described in surveys, mostly conducted in English-speaking countries. Although French is the fifth most spoken language in the world, data about SLTs' perspectives and practices in French-speaking regions are scarce. What this study adds The implementation of recommended practices in assessing multilingual children's speech production was limited among SLTs in French-speaking Belgium. The norm-referenced approach to assessment was predominant and few SLTs used recommended practices (e.g., criterion-referenced measures, dynamic assessment, assessment of the child's speech production in the home language). Some challenges were identified that related specifically to practices in French-speaking contexts (e.g., lack of French tools) and Belgian context (e.g., health policies unfavourable to multilingualism). These findings confirm that specific understanding of a situation is needed to develop context- and/or language-specific solutions-and ultimately improve clinical practice. What are the clinical implications of this work? SLTs in French-speaking Belgium require specific training and support to provide appropriate assessment of speech production in multilingual children. Efforts to improve practices in French-speaking contexts should focus on increasing understanding and consideration of cultural and linguistic diversity at all levels of the child's environment. Evidence-based knowledge, assessment tools and multilingual resources are available to SLTs on websites in French and in English.

Perspectives of Indian speech language pathologists towards assessing adolescents with language impairments

PURPOSE

Perspective-based studies have been carried out on health professionals to create clinical implications that will positively impact the healthcare system. There are no such studies exploring the perspectives of Indian speech language pathologists (SLPs) towards handling adolescents with language impairments. Therefore, the current study aims to explore the perspectives of Indian SLPs on the assessment of adolescent language.

METHODS

The study followed a cross-sectional study design following a non-random convenient sampling procedure. A total number of 102 SLPs participated in the study. Phase 1 comprised developing a questionnaire to identify the perspectives of SLPs towards the assessment of adolescents with language impairments. A total of 9 questions were formulated for the same. Phase 2 included the data collection which was conducted through an online survey. Phase 3 focused on the data analysis. Descriptive statistics were to determine the mean and SD for continuous variables, and frequency and percentage for discrete variables.

RESULTS

The current study results indicated significant disparities in the perspectives of SLPs towards adolescent language assessment. An overall level of poor awareness and a superficial understanding of the core area (about adolescence, and the areas and tools for assessment) was evident.

CONCLUSION

Understanding the perspectives of SLPs towards adolescent language assessment is critical in paving the way for future clinical development and research.

Augmentative and Alternative Communication Services for Emergent Bilinguals: Perspectives, Practices, and Confidence of Speech-Language Pathologists

PURPOSE

The purpose of this project was to examine the perspectives, practices, and confidence of speech-language pathologists (SLPs) regarding service provision for emergent bilinguals who use augmentative and alternative communication (AAC) through a nationwide survey.

METHOD

Licensed SLPs (N = 179) completed an online survey, which included Likert-type and multiple-choice questions.

RESULTS

Findings from the survey revealed a discrepancy between SLPs' perceptions and practices regarding service provision for emergent bilinguals who use AAC. Furthermore, most SLPs surveyed reported varying levels of confidence in serving this population and indicated that they frequently lacked training and resources to serve bilingual clients who use AAC.

CONCLUSION

This research highlighted the need for increased resources, research, and education to support service provision for emergent bilinguals who use AAC.

Identity-Focused Practice in Augmentative and Alternative Communication Services: A Framework to Support the Intersecting Identities of Individuals With Severe Disabilities

PURPOSE

The purpose of this clinical focus article is to consider a framework of identity in provision of services to individuals with severe disabilities who use augmentative and alternative communication (AAC).

METHOD

Components of the framework for identity include personal, social, and cultural areas. These aspects are identified in extant literature on AAC services and discussed through the lens of the Communication Bill of Rights (National Joint Committee for the Communication Needs of Persons with Severe Disabilities in 1992). Identity-focused practice is discussed as being relevant to self-determination and quality of life among individuals with severe disabilities.

RESULTS

A case study illustrates identity-focused practice in delivery of services to an adolescent who uses AAC, considering personal, social, and cultural identities.

CONCLUSIONS

This clinical focus article proposes a theoretical framework and provides a practice example for addressing the intersecting identities of individuals with severe disabilities. Furthermore, this clinical focus article argues that identity is a basic human right and area in which additional efforts are needed in the application of AAC solutions.

Barriers to access and utilization of healthcare services for minority-language speakers with neurodevelopmental disorders: A scoping review

Introduction

Minority-language speakers in the general population face barriers to accessing healthcare services. This scoping review aims to examine the barriers to healthcare access for minority-language speakers who have a neurodevelopmental disorder. Our goal is to inform healthcare practitioners and policy makers thus improving healthcare services for this population.

Inclusion criteria

Information was collected from studies whose participants include individuals with a neurodevelopmental disorder (NDD) who are minority-language speakers, their family members, and healthcare professionals who work with them. We examined access to healthcare services across both medical and para-medical services.

Method

Searches were completed using several databases. We included all types of experimental, quasi-experimental, observational and descriptive studies, as well as studies using qualitative methodologies. Evidence selection and data extraction was completed by two independent reviewers and compared. Data extraction focused on the barriers to accessing and to utilizing healthcare for minority-language speakers with NDDs. The search process and ensuing results were fully reported using a diagram from the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping review.

Results

Following the database search, a total of 28 articles met our final selection criteria and two articles were hand-picked based on our knowledge of the literature, for a total of 30 articles. These studies revealed that minority-language speakers with NDDs and their families experience several barriers to accessing and utilizing healthcare services. These barriers, identified at the Systems, Provider and Family Experience levels, have important consequences on children's outcomes and families' well-being.

Discussion

While our review outlined several barriers to access and utilization of healthcare services for minority-language speakers with NDDs and their families, our findings give rise to concrete solutions. These solutions have the potential to mitigate the identified barriers, including development and implementation of policies and guidelines that support minority-language speakers, practitioner training, availability of referral pathways to appropriate services, access to tools and other resources such as interpretation services, and partnership with caregivers. Further research needs to shift from describing barriers to examining the efficacy of the proposed solutions in mitigating and eliminating identified barriers, and ensuring equity in healthcare for minority-language speakers with NDDs.

Effects of early foreign language instruction and L1 transfer on vocabulary skills of EFL learners with DLD

Research on second language learning by children with DLD has mainly focused on naturalistic L2 acquisition with plenty of exposure. Very little is known about how children with DLD learn foreign languages in classroom settings with limited input. This study addresses this gap and targets English as a foreign language (EFL) learning by Russian-speaking children with DLD. We ask whether learners with DLD benefit from a later onset of EFL instruction because older children are more cognitively mature and have more developed L1 skills. The second aim of this study is to determine whether EFL learners with DLD benefit from positive L1 transfer in vocabulary learning. We administered a receptive vocabulary test to younger (Grade 6, n = 18) and older (Grade 10, n = 15) children with DLD matched on the amount of prior EFL instruction. The younger group started EFL instruction in Grade 2 and the older group in Grade 6. The performance of the two groups was compared after four and a half years of English lessons. Half of the words in the test were English-Russian cognates and half were noncognates. Contra to our hypothesis, the results showed no difference between younger and older children. Both groups equally benefitted from cognate vocabulary suggesting that positive cross-language transfer is available to children with DLD, irrespective of their age and onset of EFL instruction.

Language Control and Code-Switching in Bilingual Children With Developmental Language Disorder

PURPOSE

The current study examined language control and code-switching in bilingual children with developmental language disorder (DLD) compared to bilingual peers with typical language development (TLD). In addition, proficiency in each language and cognitive control skills were examined as predictors of children's tendency to engage in cross-speaker and intrasentential code-switching.

METHOD

The participants were 62 Spanish/English bilingual children, ages 4;0-6;11 (years;months), including 15 children with DLD and 47 children with TLD. In a scripted confederate dialogue task to measure language control, children took turns describing picture scenes with video partners who were monolingual speakers of English or Spanish. The Dimensional Change Card Sort indexed cognitive control, the Bilingual English Spanish Assessment assisted in identifying DLD, and parent ratings from the Inventory to Assess Language Knowledge indexed proficiency in Spanish and English.

RESULTS

Children with DLD were more likely to engage in cross-speaker code-switching from Spanish to English (i.e., responding in English when addressed in Spanish) than children with TLD, even when controlling for proficiency in each language. Intrasentential code-switching (i.e., integrating both languages within an utterance) did not differ between groups. Cognitive control was more associated with cross-speaker than with intrasentential code-switching.

CONCLUSIONS

These findings highlight the need to consider cross-speaker and intrasentential code-switching separately when seeking distinguishing features of code-switching in bilingual children with DLD. The use of increased cross-speaker code-switching by children with DLD especially with Spanish speakers highlights the need for increased support of home language use.

Assessment of minority language skills in English-Irish-speaking bilingual children: A survey of SLT perspectives and current practices

BACKGROUND

An increasing number of children in the UK and Ireland are growing up speaking more than one language. The many advantages of bilingualism are acknowledged; however, this increased linguistic diversity presents particular challenges for speech and language therapists (SLTs). The case is often more complex with speakers of minority languages such as Welsh and Irish, which are acquired almost exclusively in bilingual contexts. Lack of appropriate standardized assessments for bilinguals is a key issue for SLTs internationally; however, little is known about the practices, personal perspectives or wider challenges faced by SLTs in assessing minority language skills. We focus on SLTs working with English-Irish bilinguals across Northern Ireland (NI) and the Republic of Ireland (ROI) where status, use and exposure to Irish differ significantly.

AIMS

To investigate the perceptions and practices of SLTs in NI and the ROI in the assessment of bilingual English-Irish-speaking children.

METHODS & PROCEDURES

A 33-item online survey was distributed to SLTs working with children in community settings in NI and the ROI.

OUTCOMES & RESULTS

A total of 181 SLTs completed the survey. The majority of respondents had bilingual English-Irish-speaking children on their caseloads; however, less than one-quarter had assessed Irish language skills. Responses indicate confusion as to whether best-practice guidelines applied in this particular context where the majority of speakers have English as their first language and limited domains of exposure to Irish outside of the education system. Resources available to assess Irish language skills were found to be limited. Informal analysis of language samples emerged as the most popular assessment tool. SLTs in the ROI had a significantly higher level of competence in the Irish language than SLTs in NI. This reduced the challenge of assessment. Many SLTs reported scoring assessments standardized on monolingual populations when assessing English language skills in bilingual English-Irish-speaking children.

CONCLUSIONS & IMPLICATIONS

Our findings highlight the challenges faced by SLTs in meeting best-practice guidelines in the assessment of speakers of minority languages such as Irish. Further work is needed to ensure clinicians and other professionals have access to information and enhanced training on bilingual language acquisition in minority language contexts and implications for assessment and diagnosis. This study underlines the need for further research on the acquisition of minority languages as well as the development of alternative assessment tools to assist SLTs in meeting the needs of this population.

WHAT THIS PAPER ADDS

What is already known on the subject Existing research indicates that SLTs face challenges in assessing bilingual clients. Lack of assessment resources is a global issue, particularly with respect to minority languages. Emerging research indicates that SLTs and other professionals are dissatisfied with current resources for assessing Irish-speaking bilinguals and are struggling to meet best-practice guidelines. What this paper adds to existing knowledge The status of the Irish language differs significantly between NI and the ROI, while English is the dominant language in both areas. This study provides the first exploration of current assessment practices for bilingual English-Irish-speaking children as reported by SLTs across both regions. The challenges of assessing bilingual clients in many other countries are mirrored by SLTs in NI and the ROI. The majority of children acquiring Irish are doing so in a specific context: the immersion education setting. This raises uncertainty for SLTs about whether the definition of bilingualism actually applies. Despite clinicians and clients sharing the same majority language, the complexity of minority language assessment remains. What are the potential or actual clinical implications of this work? SLTs require specific support and resources to help them meet the assessment needs of bilingual English-Irish-speaking children. Ongoing education and training are required for clinicians and other professionals to facilitate understanding of the complexities surrounding bilingual speakers of minority languages and the application of best-practice guidelines. A greater understanding of the context in which children are acquiring Irish and the impact this may have on their acquisition of English would further support clinicians in identifying speech, language and communication needs in this population.

Deaf Children's ASL Vocabulary and ASL Syntax Knowledge Supports English Knowledge

The current study contributes empirical data to our understanding of how knowledge of American Sign Language (ASL) syntax aids reading print English for deaf children who are bilingual and bimodal in ASL and English print. The first analysis, a conceptual replication of Hoffmeister ( 2000), showed that performance on the American Sign Language Assessment Instrument correlated with the Sanford Achievement Test-Reading Comprehension (SAT-RC) and the Rhode Island Test of Language Structures (RITLS, Engen & Engen, 1983). The second analysis was a quantile regression using ASL assessments to predict English print abilities. Different ASL skills were important for English reading comprehension (SAT-RC) versus understanding English syntax (RITLS); the relationship between ASL skills and English print performance also varied for students at different English print ability levels. Strikingly, knowledge of ASL syntax was robustly correlated with knowledge of English syntax at all ability levels. Our findings provide novel and strong evidence for the impact of ASL on the development of English literacy.

A qualitative inquiry of professionals' perceptions of bilingualism for children with language delay

Purpose: This study aimed to understand the knowledge, attitudes and beliefs of early childhood health and education professionals on bilingualism and heritage language maintenance for children with language delay, and how their interactions with caregivers may influence the decision-making process to maintain or not maintain speaking heritage languages with children.Method: A qualitative methodology was used to explore the research aims. Seven early childhood health and education professionals with experience working with bilingual families participated in in-depth interviews. Data were analysed using a grounded theory approach and a symbolic interactionism theoretical framework.Result: Understandings of bilingualism and language development were strongly influenced by socially and culturally contextualised factors, such as the linguistic context in Australia. Barriers and facilitators to supporting bilingualism and helping caregivers make informed choices included: unique child and family characteristics, the level of trust in professional advice, and the level of professional agency to support knowledge and practice.Conclusion: Findings highlighted the need to focus on the processes involved in supporting caregivers to make informed decisions about bilingualism and heritage language maintenance for children with language delay. The need for professional development on bilingualism and language development for early childhood health and education professionals was also highlighted.

Language profiles of Welsh-English bilingual children with Down syndrome

PURPOSE

Given that children with Down syndrome (DS) have language learning difficulties, concerns have been raised about the capacity of these children to acquire two (or more) languages. This research examines the language profiles of bilingual children with DS and typically developing (TD) children in comparison to monolinguals, with a view towards identifying the factors associated with language abilities within these populations.

METHOD

Four groups of children were recruited: Welsh-English bilinguals with DS (n=10), English monolinguals with DS (n=10), TD Welsh-English bilinguals (n=10) and TD English monolinguals (n=10). Children were individually matched on nonverbal cognitive ability (NVCA) to each child in the bilingual DS group and the four groups were matched on socioeconomic status and gender. Bilinguals were matched on current and lifetime exposure to Welsh and age of first exposure to their L2. Within DS and TD groups, chronological age was statistically controlled for. Language abilities were assessed via standardised assessments and specially designed tasks. Bilinguals were assessed in both of their languages.

RESULTS

Results show no effect of language status on measures of expressive and receptive language abilities or phonological awareness. Language impairments were evident for both DS groups, particularly for expressive morphosyntax. Welsh receptive vocabulary scores of the bilinguals with DS were comparable to the TD bilinguals. Working memory, phonological awareness and chronological age were the strongest predictors of receptive language outcomes in both DS groups, explaining 90% of the variability.

CONCLUSIONS

In conclusion, we report no adverse outcomes on language development for bilinguals with DS. To our knowledge, this is the first group study of bilingualism in children with DS within the UK. Findings align with and add to the growing body of literature that reports that bilingualism does not negatively impact the language development of children with developmental disabilities. Clinical and educational implications are discussed.

Bilingualism in children with a dual diagnosis of Down syndrome and Autism Spectrum Disorder

Research shows that a substantial proportion of children with Down syndrome (DS) also meet the clinical criteria for Autism Spectrum Disorder (ASD). Children with this dual diagnosis display a linguistic profile that includes significant language delays and language impairments which often differ from the impairments observed in each developmental disability (DD) separately. Given the challenges observed with language acquisition for children with DS-ASD, concerns might be raised regarding the outcomes and suitability of a bilingual environment for children with this dual diagnosis specifically. The aim of this research was to explore the language profiles of four children with DS-ASD. A multiple case-study approach was employed. Four children with a confirmed DS-ASD diagnosis who had received exposure to two languages (English and Welsh) were assessed on a range of cognitive and linguistic measures. Performance was compared to three control groups; bilinguals with DS, English monolinguals with DS and mental age-matched typically developing bilinguals. Assessments comprised of expressive and receptive language, phonological awareness, working memory and non-verbal cognitive abilities. Considerable variability was found in the cognitive and linguistic profiles of the case-study participants. Children with DS-ASD displayed similar language profiles to that of the bilingual and monolingual children with DS in the areas tested, although performance was generally lower than that of the TD bilingual children. Although substantial variability was found, participants were developing bilingual abilities in a similar trajectory to children with DS in line with the degree of exposure to each language. This research highlights the need to assess bilingual children with complex dual diagnoses with an individualistic approach and carefully consider how to appropriately assess and treat bilingual children within speech and language therapy provisions.

Can children with DLD acquire a second language in a foreign-language classroom? Effects of age and cross-language relationships

There is a growing pressure to teach foreign languages as early as possible, and children with Developmental Language Disorder (DLD) are not immune from these pressures. However, current scholarship lacks crucial insights into how children with DLD respond to L2 learning with minimal (classroom) exposure. In this paper, we report the results of a longitudinal study tracing the development of L1 Russian and English as a Foreign Language (EFL) skills in a group of learners with DLD (age of EFL onset: 7;9-12;1). The performance of the DLD group was compared to that of typically-developing controls, matched for classroom EFL exposure. Proficiency in English and Russian was measured three times (after one, one-and-a-half and two years of EFL instruction). At Time 1, there were no significant differences between groups on the EFL measures, but the performance of the typically-developing children significantly improved with time, and that of the DLD group did not. In the DLD group, age of EFL onset was positively related to English receptive vocabulary size. The relation between L1 and L2 proficiency in the DLD group was weaker than in the comparison group. This pattern is probably due to the floor performance of the DLD group in the grammatical domain, but may also indicate that the disorder affects cross-language transfer in the vulnerable domains.

Multilingualism and augmentative and alternative communication: examining language ideology and resulting practices

Although the literature suggests that multilingual augmentative and alternative communication (AAC) interventions hold benefits for children from multilingual backgrounds, there is little guidance on how such interventions can be implemented. While various barriers to this process have been noted, language ideology has not received much attention in the AAC literature. This paper aims to highlight multilingualism as both a linguistic and a sociopolitical phenomenon. An awareness of the influence of language ideology on AAC practice may lead to more considered and reflective approaches when supporting multilingual clients and their families. A description of the multilingual experience is followed by a discussion of language ideologies and views of multilingualism and how these may translate into AAC practices. Through a series of questions, AAC practitioners are encouraged to reflect on the influence of language ideology on their practices. The influence of language ideology on the legal and policy context, service models, and family language practices and choices is then explored. By situating AAC interventions for children from multilingual backgrounds within a macrosystemic and ideological framework, researchers and practitioners may be able to identify not just constraints on but also opportunities for providing person- and family-centered intervention.

Autism and dual immersion: sorting through the questions

Purpose

The dual immersion (DI) model of bilingual education, which focuses on educating language-minority and majority students side by side using the two languages in roughly equal proportions, is gaining popularity. And yet, students with disabilities – even those who are already multilingual – are routinely steered away from such programs in favor of English-only special education options. The paper aims to discuss these issues.

Design/methodology/approach

This paper explores the potential benefits and challenges associated with including multilingual students with autism in DI classrooms, beginning with an exploration of literature related to students with autism who are also multilingual learners (MLLs) (irrespective of educational placement), followed by a small body of literature on the inclusion of students with disabilities in general in DI programs, and finally an analysis of the characteristics of DI classrooms to extrapolate about the ways in which this environment might be both supportive of and challenging for students with autism.

Findings

The analysis reveals that DI programs are simultaneously well positioned (theoretically) and ill equipped (practically) to effectively support MLLs who are also on the autism spectrum.

Originality/value

In spite of mounting evidence that being multilingual may advantage children with autism, very little scholarship has even raised the question of whether students with autism might benefit from participation in bilingual programs where academic instruction is delivered in two languages (Beauchamp and MacLeod, 2017; Durán et al., 2016; Marinova-Todd et al., 2016; Seung et al., 2006). This paper identifies practical implications related to including students with autism in DI programs and suggests directions for future research.

AAC services for multilingual populations: South African service provider perspectives

BACKGROUND

In South Africa, many persons in need of augmentative and alternative communication (AAC) come from multilingual backgrounds. There is as yet a limited evidence base (locally and internationally) for the provision of AAC services to multilingual populations. The perspectives of service providers can assist in gaining an understanding of current practices and the factors that influence these.

AIMS

The study aimed to obtain the perspectives of AAC service providers about practices in providing AAC systems and AAC intervention to clients from multilingual backgrounds.

METHODS & PROCEDURES

Fifteen AAC service providers were purposefully chosen to participate in one of three focus groups - two face-to-face and one online focus group. Data from the face-to-face focus groups was transcribed verbatim. Thematic analysis was used to identify themes and subthemes in the data.

OUTCOMES & RESULTS

Four overarching themes were identified, namely (a) current practices, (b) factors influencing current practices, (c) service provides' orientation towards different language options in AAC intervention, and (d) needs and desired developments regarding AAC technology. This paper reports on the first three themes. Service providers reported their practices to range from a focus on L1 exclusively, L2 exclusively, to a multilingual (sequential or simultaneous) approach. The South African language context, family language preferences and choices, service provider skill and knowledge, as well as AAC technology were identified as factors influencing their practices. Although many viewed access to multiple languages through AAC as positive, they also expressed concerns and reservations about providing multilingual AAC services.

CONCLUSIONS & IMPLICATIONS

Although service providers in general saw the need to give clients from multilingual backgrounds access to multiple languages using AAC, this did not always translate into multilingual AAC practices. Both extrinsic factors (e.g. the lack of appropriate AAC devices, software and apps giving access to non-English languages) and intrinsic factors (service providers' language competency and their beliefs about the cognitive demands of multilingual AAC systems) influenced their practices and choices. Appropriate AAC service delivery to multilingual populations in South Africa would require not only appropriate AAC technology developments, but also research evidence to establish the efficacy of multilingual AAC interventions for clients with a variety of characteristics.

Pulling it all together: The road to lasting bilingualism for children with developmental disabilities

Children with DD must and do become bilingual, but the research reported in this special issue raises questions about equitable access to bilingual opportunities and provision of appropriate supports to ensure optimal bilingual growth in these children. The purpose of the present article was to apply the findings from our international collaboration to inform policy and practice on bilingualism in children with developmental disabilities (DD). To do this, we first overview the research presented in detail in other articles of this special issue: a narrative literature review, a review of site policies and practices related to special education and language education, a qualitative analysis of key informant interviews, and a quantitative analysis of surveys of practitioners. From these overviews emerge a complex set of contextual factors that impact bilingual development in children with DD. We then use the Bioecological Systems model of Bronfenbrenner and Morris (2007) and conceptual maps (C-maps) to examine the particular circumstances of three hypothetical children with DD who are in very different bilingual contexts. In so doing, areas of both positive and negative influence on lasting bilingualism are identified for each child. We end with recommendations for increasing access to and support for bilingualism in children with DD.