Bilingualism in children with developmental disorders: A narrative review

The Impact of Clear and Loud Speech Cues on Acoustic and Perceptual Features of Speech Production in Adolescents With Down Syndrome

PURPOSE

There are few evidence-based speech interventions designed to alter speech production in a way that ultimately results in increased speech intelligibility in adolescents with Down syndrome (DS). The primary purpose of this study was to examine the impact of clear and loud speech cues on acoustic and perceptual features of speech production in adolescents with DS.

METHOD

Eight adolescents diagnosed with DS repeated sentences of varying lengths in three conditions: habitual, big mouth (i.e., clear speech), and strong voice (i.e., loud speech). Four hundred eighty adult listeners (20 listeners per adolescent per condition) provided orthographic transcriptions of adolescent's speech, which were used to calculate intelligibility scores. Acoustic measures of speech rate, articulation rate, proportion of time spent pausing, vocal intensity, and fundamental frequency were calculated for each sentence.

RESULTS

The big mouth condition resulted in significantly increased intelligibility, slowed speech and articulation rates, increased pauses, increased vocal intensity, and increased fundamental frequency. The strong voice condition resulted in significantly increased vocal intensity and fundamental frequency, but no other changes. Speech rate was the only variable that explained any of the variance in intelligibility.

CONCLUSIONS

Adolescents with DS respond differently to clear and loud speech cues. In particular, clear speech cues resulted in significant increases in intelligibility, but loud speech cues did not. Clear speech cues hold promise as an intervention strategy for adolescents with DS.

The impact of educational and medical systems on autistic children from multilingual American homes: A systematic review

LAY ABSTRACT

Research has found that autistic children can navigate multilingual schools and communities without harming their language skills or school success. However, they may encounter specific challenges within the United States, where educational and healthcare systems are insufficiently equipped to meet their needs. This review examined 46 US-based studies on the topic and findings reveal persistent deficit-based ideas about multilingualism and autism (e.g., professionals recommending that autistic students only speak and learn in English) accompanied by patterns of unequal identification of autism among multilingual children. These findings highlight issues of disproportionality and inadequate access to educational and healthcare resources. However, recent studies indicate that incorporating a child's native language in education not only enhances learning and behavioral outcomes but also boosts cognitive functions like problem-solving and planning. Taken as a whole, current research suggests that intentionally addressing linguistic diversity will allow educational and medical systems to better serve autistic children.

`It's not just linguistically, there's much more going on': The experiences and practices of bilingual paediatric speech and language therapists in the UK

BACKGROUND

Despite the high prevalence of bilingualism in the United Kingdom, few speech and language therapists (SLTs) are bilingual themselves. Most SLT research on bilingualism has generated knowledge to inform service delivery for bilingual clients, but few studies have investigated how being a bilingual SLT influences one's professional experiences and practices. Better understanding the unique positionality of bilingual SLTs can yield critical insights to meaningfully address issues of diversity, inclusion and equity in the profession.

AIMS

To investigate the experiences and practices of bilingual paediatric SLTs in the United Kingdom through the lens of Cultural-Historical Activity Theory-International Classification of Functioning, Disability and Health (CHAT-ICF), a new theoretical framework developed to conceptualise the activities of professionals working in the field of disability.

METHODS

In this qualitative study, 19 bilingual paediatric SLTs practising in the United Kingdom were interviewed individually. Participants were recruited through a snowball sampling strategy, and semi-structured interviews conducted online. The data were analysed using reflexive thematic analysis and following a hybrid inductive-deductive approach to map the results onto the CHAT-ICF framework.

RESULTS

Six overarching components of the CHAT-ICF framework hosted the 12 sub-themes identified to capture the experiences and practices of bilingual SLTs: (1) Subject (intersectionality); (2) Tools (language skills, education, clinical resources); (3) Rules (systemic barriers, sense of responsibility); (4) Community (sense of inclusion); (5) Division of labour (parents, colleagues); and (6) Practice (empathy with children, holistic mindset, flexible approaches). The use of the CHAT-ICF theoretical lens revealed two fundamental structural phenomena: (1) the distribution of sub-themes across many components of CHAT-ICF demonstrated that being a bilingual SLT is a multifactorial experience; and (2) the chain reactions between sub-themes illustrated the dynamic nature of bilingual SLTs' experiences which can be harnessed to challenge marginalisation and promote equity in the profession.

CONCLUSION & IMPLICATIONS

This is the first qualitative study to date to provide in-depth insights into the experiences and practices of bilingual SLTs in the United Kingdom. These insights can be mobilised to inform the meaningful inclusion of bilingual SLTs in workforce planning efforts and service development. Recommendations include using intersectional lenses, providing cultural and anti-racism awareness training to SLTs, developing more diverse clinical resources and flexible approaches for bilingual families, valuing bilingualism in recruitment processes and increasing accountability at the leadership level. Research giving voice to bilingual SLTs, and other underrepresented demographics in the SLT workforce, can catalyse action to promote a more diverse and inclusive profession in line with the Royal College of Speech and Language Therapists' strategic vision 2022-2027.

WHAT THIS PAPER ADDS

What is already known on the subject Most research on bilingualism in speech and language therapy is focused on issues related to service provision and delivery for bilingual clients with little consideration for bilingual speech and language therapists' (SLTs) unique positionality. A few survey studies have shown that bilingual SLTs report significantly higher competency and greater confidence when working with clients who speak multiple languages, but there are significant gaps in understanding how bilingualism impacts other aspects of their professional experiences. What this paper adds to existing knowledge This is the first study to provide in-depth insights into the experiences and practices of bilingual SLTs in the United Kingdom. We show that being bilingual profoundly impacts many aspects of their professional experiences, including their clinical identity, skillset, sense of inclusion in the workplace, work relationships and clinical approaches. Bilingual SLTs expressed developing trust relationships with bilingual families and adopting flexible approaches to account for their clients' environmental factors, all of which can contribute to more equitable SLT services. This study also makes a novel contribution by proposing and using the Cultural-Historical Activity Theory-International Classification of Functioning, Disability and Health (CHAT-ICF) framework to conceptualise and investigate SLTs' experiences and practices. What are the potential or actual clinical implications of this work? This study provides evidence-based recommendations to inform progress towards the Royal College of Speech and Language Therapists' strategic vision 2022-2027 and the diversification of the profession. Actions to support bilingual SLTs and diversify the profession include shifting a rigid mindset of linguistic and cultural `competence' to self-growth and awareness, developing more diverse clinical resources and flexible approaches for bilingual families, valuing bilingualism in SLT recruitment processes and career progression and increasing accountability and leadership around issues of diversity in the workplace. The novel CHAT-ICF framework has the potential to be used to support therapists' reflexivity in their practice or structure audits of rehabilitation services. Intersectionality theories and transformative processes can catalyse positive change in clinical services and research around bilingualism.

A survey of speech and language therapists' opinions of bilingualism and the advice they give to bilingual families of children with speech, language and communication needs - a comparative study between the UK and Singapore

There is emerging evidence that bilingualism is advantageous to children with speech, language and communication needs (SLCN), reflected in recommendations to promote maintenance of the home language. However, little is known about Speech and Language Therapists (SLTs)' opinions on bilingualism and practices with bilingual families. To survey the opinions and practices of SLTs on this topic, a questionnaire was developed and delivered as an anonymous web-based survey. We recruited SLTs from Singapore, where bilingualism is the norm amongst the general population and enshrined in government policies, and the UK, where bilingualism is less prevalent and not embedded in government policy. Questions probed SLTs' opinions, advice given to parents/carers, personal and professional experience of bilingualism, and knowledge of and opinions on official guidelines from the Royal College of Speech and Language Therapy (RCSLT). The survey revealed variability in opinions and practices of SLTs working with bilingual families. Amongst the UK-based respondents, the RCSLT bilingualism guidance was generally perceived positively, however, many were unfamiliar with its content, or found barriers to its implementation. Most SLTs reported recommending bilingualism to families of children with SLCN and suggesting that parents/carers speak in all languages they are proficient in, but a minority reported views and practice based on outdated assumptions: practitioners who believed bilingualism can cause or contribute to SLCN were less likely to recommend that parents/carers speak languages they are proficient in. These findings can help identify areas to target within training and continuing professional development to increase evidence-based advice given to bilingual families.

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.

Morphological and Inhibitory Skills in Monolingual and Bilingual Children With and Without Developmental Language Disorder

PURPOSE

This study examined the language and nonverbal inhibitory control skills of Italian monolingual and bilingual typically developing (TD) preschoolers with Italian as their second language and of age-matched monolingual and bilingual peers with developmental language disorder (DLD).

METHOD

Four groups of preschoolers were enrolled: 30 TD Italian monolinguals, 24 TD bilinguals, 19 Italian monolinguals with DLD, and 19 bilinguals with DLD. All children were assessed in Italian on vocabulary, receptive morphosyntax, and morphological markers for DLD in the Italian language (i.e., third-person verb inflections, definite articles, third-person direct-object clitic pronouns, simple prepositions) and nonverbal inhibitory control skills. Group performance was compared using a series of one-way analyses of variance.

RESULTS

Monolingual and bilingual children with DLD achieved significantly lower performance in all language measures compared to both TD monolingual and bilingual children. However, TD bilinguals, although comprehensively showing better language skills than monolinguals with DLD, achieved a performance closer to that of monolinguals with DLD but significantly higher than that of bilinguals with DLD. Both TD monolinguals and bilinguals showed better results than both DLD groups in inhibitory control tasks, particularly in the interference suppression task.

CONCLUSIONS

This study provides a picture of language and inhibitory control characteristics of children with various language profiles and adds to the literature on potential markers of DLD among bilingual children. These results suggest that the assessment of nonlinguistic markers, which are associated with language impairment, could be a useful approach to better specify the diagnosis of DLD and reduce cases of misdiagnosis in the context of bilingualism.

Ototoxic and nephrotoxic drugs in neonatal intensive care units: results of a Spanish and Italian survey

Neonates face heightened susceptibility to drug toxicity, often exposed to off-label medications with dosages extrapolated from adult or pediatric studies. Premature infants in Neonatal Intensive Care Units (NICUs) are particularly at risk due to underdeveloped pharmacokinetics and exposure to multiple drugs. The study aimed to survey commonly used medications with a higher risk of ototoxicity and nephrotoxicity in Spanish and Italian neonatal units. A prospective cross-sectional study was conducted in Italian and Spanish neonatal units using a web-based survey with 43 questions. A modified Delphi method involved experts refining the survey through online consensus. Ethical approval was obtained, and responses were collected from January to July 2023. The survey covered various aspects, including drug-related ototoxic and nephrotoxic management, hearing screening, and therapeutic drug monitoring. Responses from 131 participants (35.9% from Spain and 64.1% from Italy) revealed awareness of drug toxicity risks. Varied practices were observed in hearing screening protocols, and a high prevalence of ototoxic and nephrotoxic drug use, including aminoglycosides (100%), vancomycin (70.2%), loop diuretics (63.4%), and ibuprofen (62.6%). Discrepancies existed in guideline availability and adherence, with differences between Italy and Spain in therapeutic drug monitoring practices.

CONCLUSIONS

The study underscores the need for clinical guidelines and uniform practices in managing ototoxic and nephrotoxic drugs in neonatal units. Awareness is high, but inconsistencies in practices indicate a necessity for standardization, including the implementation of therapeutic drug monitoring and the involvement of clinical pharmacologists. Addressing these issues is crucial for optimizing neonatal care in Southern Europe.

WHAT IS KNOWN

• Neonates in intensive care face a high risk of nephrotoxicity and ototoxicity from drugs like aminoglycosides, vancomycin, loop diuretics, and ibuprofen. • Therapeutic drug monitoring is key for managing these risks, optimizing dosing for efficacy and minimizing side effects.

WHAT IS NEW

• NICUs in Spain and Italy show high drug toxicity awareness but differ in ototoxic/nephrotoxic drug management. • Urgent need for standard guidelines and practices to address nephrotoxic risks from aminoglycosides, vancomycin, loop diuretics, and ibuprofen.

Assessing the Impact of Bilingualism on the Linguistic Skills of Children with Autism Spectrum Disorder (ASD) in Greece: A Scoping Review

(1) Background and Objectives: This review aims to identify the latest literature on the possible effect of bilingualism on the linguistic skills of children with autism spectrum disorder (ASD) residing in Greece. (2) Materials and Methods: The literature was searched in the databases of Scopus and PubMed by selecting articles and by reviewing four studies published in peer-reviewed journals. This Scoping Review is based on the standards of PRISMA recommendations for scoping reviews, while the PCC framework was used as a guide to construct clear and meaningful objectives and eligibility criteria. (3) Results: The publications included in the review addressed a variety of language-related skills, including morphology, the syntax-pragmatics interface, narrative ability, as well as both receptive and expressive language skills. (4) Conclusions: Three out of four studies provide evidence that bilingual ASD children are not disadvantaged compared to monolingual peers but rather enjoy some benefits, to a certain extent, due to bilingualism. However, the number of the reviewed studies as well as the limitations of the studies themselves render this conclusion tentative. Additionally, the findings set guidelines that speech therapists, educators, psychologists, and doctors in the Greek context need to follow when treating or educating bilingual children with ASD.

The use of tele-audiology in ototoxicity monitoring: A scoping review

INTRODUCTION

Due to the growing burden of disease in South Africa, encompassing conditions such as tuberculosis, human immunodeficiency virus, and cancer, the holistic management of affected patients incorporating ototoxicity monitoring is a necessity. However, ototoxicity monitoring in developing countries may be limited due to a lack of resources and inadequate healthcare facilities. Subsequently, the use of tele-audiology may be a revolutionary technique with the potential to provide audiology services to under-served populations with limited access.

METHODS

The study aimed to describe the use of tele-audiology services in ototoxicity monitoring through a scoping review of English peer-reviewed articles from June 2009 to June 2020. Seventeen articles were purposively selected from the following databases: PubMed, Science Direct, Taylor and Francis Online, WorldCat, and Google Scholar. Data was extracted as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses diagram and results were analyzed using deductive thematic analysis.

RESULTS AND DISCUSSION

While a minority of the studies indicated that the cost of implementation and network connectivity within a South African context pose as barriers, most researchers reported that tele-audiology provides a reliable, time-efficient, cost-effective, and easily accessible alternative for ototoxicity monitoring. Hardware including the WAHTS, KUDUwave, and OtoID, along with software such as the TabSINT, Otocalc, uHear, and the hearTest, have proven to be useful for ototoxicity monitoring. A need for further investigations regarding the feasibility of tele-audiology implementation in South Africa is evident. Despite this, it provides audiologists with an opportunity to offer contact-less services during COVID-19, thus, confirming its versatility as an augmentative method for ototoxicity monitoring.

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.

Parental Survey on Spanish‑English Bilingualism in Neurotypical Development and Neurodevelopmental Disabilities in the United States

Objectives

The cognitive and social benefits of bilingualism for children, including those with neurodevelopmental disabilities (NDDs), have been documented. The present study was designed to characterize and compare English and Spanish use in Hispanic families with and without NDDs residing in the U.S. as well as to understand parental perceptions of their child's bilingualism and of community and professional support.

Methods

We conducted an online survey of 84 Spanish-speaking parents of 4- to 24-year-olds with (n = 44) and without NDDs (n = 40) who were born in and living in the U.S.

Results

We found that bilingualism was a desired goal for 95% of our families. We also found, however, that 17.1% of parents of children with NDDs have raised them as monolinguals English-speakers, as they thought there were reasons for that, while all families from the NT group raised their children in both languages. In addition, nearly 40% of the NDD children only speak English, compared to a 5% in the NT group. Finally, parents of children with NDDs cite a lack of support for bilingualism in the community (47.6% do not feel supported, compared to a 7.9% in the NT group) and recommendation from professionals as major factors for not raising their children as bilingual.

Conclusions

The results suggest a need to educate professionals from many disciplines about the benefits of bilingualism for children with NDDs and for implementation of inclusion policies that provide access to dual-language programs.

Developing the Mansoura Early Feeding Skills Assessment Scale for Preterm Infants

Purpose

This study aimed to develop a new bedside scoring system scale that assesses preterm infants' oral feeding skills (OFS) in the neonatal intensive care unit (NICU).

Methods

A literature review and critical appraisal of available oral feeding assessment tools/scores were performed. Subsequently, we developed the "Mansoura Early Feeding Skills Assessment" (MEFSA) scale, an 85-item observational measure of oral feeding skills with three main sections. Forty-one preterm infants who did not receive oral feeding but were clinically stable enough to initiate oral feeding were included in the study. Next, we applied and interpreted the MEFSA to describe and score their feeding skills.

Results

Applying the MEFSA resulted in a smooth feeding transition, early start of oral feeding, full oral feeding, and discharge with a shorter period of tube feeding in preterm infants.

Conclusion

The MEFSA is a successful bedside scoring system that assesses the OFS of preterm infants in the NICU.

Sentence Length Effects on Intelligibility in Two Groups of Older Children With Neurodevelopmental Disorders

PURPOSE

The purpose of this study was to examine the impact of sentence length on intelligibility in two groups of older children with neurodevelopmental disabilities.

METHOD

Nine children diagnosed with cerebral palsy (CP) and eight children diagnosed with Down syndrome (DS), between the ages of 8 and 17 years, repeated sentences varying in length from two to seven words. Three hundred forty adult listeners (20 listeners per child) provided orthographic transcriptions of children's speech, which were used to calculate intelligibility scores.

RESULTS

There was a significant main effect of sentence length on intelligibility for children with CP. Intelligibility significantly increased from two- and three-word sentences to four-, five-, and six-word sentences, then significantly decreased from four-, five-, and six-word sentences to seven-word sentences. There was a main effect of sentence length on intelligibility for children with DS. Intelligibility significantly increased from two-word sentences to four-, five-, and six-word sentences.

CONCLUSIONS

The primary findings of this study include the following: (a) Unlike in typically developing children, sentence length continues to influence intelligibility well into adolescence for children with neurodevelopmental disorders, and (b) sentence length may influence intelligibility differently in children with CP than in children with DS; however, other factors besides the type of neurodevelopmental disorder (e.g., severity of speech motor involvement and/or cognitive-linguistic impairment) could play a role in the relationship between sentence length and intelligibility and must be investigated in future studies.

Differential Impacts of Sentence Length on Speech Rate in Two Groups of Children With Neurodevelopmental Disorders

PURPOSE

The primary purpose of this study was to examine the effect of sentence length on speech rate and its characteristics, articulation rate, and pauses in children with neurodevelopmental disorders.

METHOD

Nine children diagnosed with cerebral palsy (CP) and seven children diagnosed with Down syndrome (DS) repeated sentences varying in length from two to seven words. Children were between the ages of 8 and 17 years. Dependent variables included speech rate, articulation rate, and proportion of time spent pausing.

RESULTS

For children with CP, there was a significant effect of sentence length for speech rate and articulation rate but not for the proportion of time spent pausing. In general, the longest sentences were produced with a faster speech and articulation rate than the shortest sentences. For children with DS, there was a significant effect of sentence length for the proportion of time spent pausing but not for speech rate or articulation rate. In general, children with DS spent significantly more time pausing in the longest sentences, particularly seven-word sentences, than in any other sentence length.

CONCLUSIONS

Primary findings include the following: (a) Articulation rate and pause time are differentially impacted by sentence length, and (b) children with CP and children with DS respond differently to increases in cognitive-linguistic load.

Learning graphic symbols in two languages: Effects of monolingual teaching

PURPOSE

Limited research exists to guide augmentative and alternative communication (AAC) intervention for children from multilingual backgrounds. When a graphic symbol-based AAC system is provided to children, they need to learn the meaning of the graphic symbols. This study determined the effect of teaching the association between a graphic symbol and a spoken word in one language on the ability of bilingual children without disabilities to transfer this learning to their second language.

METHOD

A one-group pre-test-post-test design was used. The ability of 30 English-Afrikaans bilingual children aged 4-5 years to provide the spoken words associated with nine graphic symbols in English and Afrikaans was evaluated before and after teaching them the symbol-word associations in English.

RESULT

Correct symbol-word associations in English increased from a median of 0-9 post-teaching, while correct symbol-word associations in Afrikaans increased from a median of 0-6. A moderate positive relationship was identified between children's performance on symbol-word associations in Afrikaans during the post-test and their use of Afrikaans in the home.

CONCLUSION

Results suggest the presence of positive transference of graphic symbol-word associations learnt in one language to another known language. The implications of this finding on the provision of multilingual AAC intervention are discussed.

Referential expressions in monolingual and bilingual children with and without Autism Spectrum Disorder (ASD): A study of informativeness and definiteness

The current study evaluated the separate and combined effects of bilingualism and Autism Spectrum Disorder (ASD) on informativeness and definiteness marking of referential expressions. Hebrew-speaking monolingual children (21 with ASD and 28 with typical language development) and Russian-Hebrew-speaking bilingual children (13 with ASD and 30 with typical language development) aged 4-9 years participated. Informativeness, indexed by referential contrasts, was affected by ASD, but not by bilingualism. Definiteness use was non-target-like in children with ASD and in bilingual children, and it was mainly predicted by children's morpho-syntactic abilities in Hebrew. Language-universal and language-specific properties of referential use are discussed.

Language intervention in bilingual children with developmental language disorder: A systematic review

BACKGROUND

Although there is a growing body of literature on cognitive and language processing in bilingual children with developmental language disorder (DLD), there is a major gap in the evidence for language intervention. Critically, speech-language therapists are often required to make clinical decisions for language intervention on specific domains, such as phonology, vocabulary, morphosyntax and literacy.

AIMS

To examine evidence for language intervention and cross-language transfer effects in bilingual children with DLD. Specifically, the study aimed to review intervention evidence targeting non-linguistic cognitive skills and six areas of language: phonology, vocabulary, morphosyntax, pragmatics, narrative skills and literacy.

METHODS & PROCEDURES

We carried out searches in five electronic databases: CINAHL, Scopus, Psychinfo, Proquest and Sciencedirect. Data from selected papers were extracted and organized into the three following categories: study information, participant information and intervention information. Critical appraisal for selected papers was conducted using a quality assessment tool (QAT).

OUTCOMES & RESULTS

We included 14 papers in the review. The majority indicated evidence for vocabulary intervention. There was limited evidence for intervention targeting phonology or morphosyntax. Cross-language generalization effects were evident for vocabulary, but in some instances also reported for morphosyntax and literacy.

CONCLUSIONS & IMPLICATIONS

The present review indicates that there is a significant gap in the literature regarding language intervention for several key language areas such as morphosyntax, narrative skills and literacy. There are only limited data for the effects of cross-language generalization indicating that more research is needed in this area specifically for skills beyond vocabulary.

WHAT THIS PAPER ADDS

What is already known on the subject Previous studies have examined the effects of bi- and monolingual intervention in bilingual children with DLD. Although the results indicated superior effects for bilingual compared with monolingual intervention, language intervention evidence in specific language domains (e.g., vocabulary, literacy) has not been investigated. What this paper adds to existing knowledge This study will add intervention evidence specific to language domains such as phonology, vocabulary, morphosyntax, pragmatics, narrative skills and literacy. Additionally, we have synthesized intervention evidence on non-linguistic cognition given that these skills are often impaired in bilingual children with DLD. The review has also demonstrated evidence for the effects of cross-language transfer beyond vocabulary skills, especially when the intervention was provided in the home language. What are the potential or actual clinical implications of this work? Although there was a lack of intervention evidence in language domains such as pragmatics, the results indicated some evidence for intervention targeting vocabulary. However, positive effects of cross-language generalization were not constrained to vocabulary but were also reported for intervention targeting mean length of utterance and literacy in the home language. This result indicates an interactive nature of the two languages, as well as provides further evidence for supporting home language(s) in intervention. Finally, intervention targeting non-linguistic cognition may yield additional cross-domain generalization to language skills specifically for bilingual children with DLD.

The effects of bilingualism on cognition and behaviour in individuals with attention deficits: A scoping review

Background

Weaknesses in executive function have persistently been found to be associated with Attention Deficit Hyperactivity Disorder (ADHD), while bilinguals have been argued to show advantages in executive functions. While there has been some research into how bilingualism affects cognitive skills and behaviour in individuals with attention deficits, the question is still very much open. The aim of this systematic review is to gather, synthesise and evaluate existing evidence on how bilingual language experience and attention deficits affect executive function performance and ADHD-related symptoms in children and adults.

Methods

Following PRISMA guidelines, a comprehensive literature search in relevant databases (PsycInfo, PubMed, Scopus, ERIC, Web of Science, EMBASE, MEDLINE, LLBA) was performed using search strings related to attention difficulties/ADHD and bilingualism. All quantitative studies were included that presented original empirical data on the combined effects of bilingualism and attention levels, regardless of age group and methodology. The screening procedure revealed nine relevant studies.

Results

Across the nine identified studies, a total of 2071 participants were tested. Of these, seven studies involved children and two adults. The studies varied considerably with respect to their design and methodology, the targeted executive function skills or behavioural symptoms, as well as their measure of bilingualism and attention levels. Most studies assessed aspects of executive function performance such as interference control, response inhibition, working memory or cognitive flexibility. Three studies looked at the effects of bilingualism on ADHD-related symptoms or ADHD diagnosis. Across the studies, no systematic advantage or disadvantage of bilingualism on cognitive performance or behaviour in people with attention deficits was observed.

Conclusion

The limited number of identified studies provide no consistent evidence that bilingualism alleviates or intensifies attention difficulties in adults or children with ADHD. Based on the current state of research, individuals with ADHD and their families should not be concerned that learning additional languages has a negative impact on functioning or cognitive performance.

Systematic review registration

https://doi.org/10.17605/OSF.IO/PK768.

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.

Audiologists’ Perceptions of Hearing Healthcare Resources and Services in South Africa’s Public Healthcare System

Background:

Hearing loss poses a significant burden globally. Its prevalence is exceptionally high in countries across the African region, where healthcare resources and services remain inaccessible. This study aimed to describe audiologists’ perceptions regarding hearing healthcare resources and services within South Africa’s public healthcare system.

Methods:

A national self-developed telephonic survey was conducted with audiologists in public healthcare system hospitals across South Africa, with the final sample comprising 100 audiologists.

Results:

Most (82%) audiologists indicated that their hospitals did not have adequate hearing healthcare resources to render efficient audiology services to patients. Binaural amplification devices (invasive and non-invasive) for adults with bilateral hearing loss who adhered to the criteria for these devices were perceived to be unavailable in most hospitals. Audiologists also perceived that universal newborn hearing screening services, adult aural rehabilitation services, and follow-up care for all hearing devices post-warranty expiration were limited.

Conclusion:

Efforts should be made to upsurge hearing healthcare resources, including increasing the financial budgets allocated to audiology resources so that increased diagnostic and screening audiology equipment and hearing devices can be procured where required, and additional audiologists can be employed within the South African public sector hospitals where needed.

Hearing Impairment in South Africa and the Lessons Learned for Planetary Health Genomics: A Systematic Review

Hearing impairment (HI) is a silent planetary health crisis that requires attention worldwide. The prevalence of HI in South Africa is estimated as 5.5 in 100 live births, which is about 5 times higher than the prevalence in high-income countries. This also offers opportunity to drive progressive science, technology and innovation policy, and health systems. We present here a systematic analysis and review on the prevalence, etiologies, clinical patterns, and genetics/genomics of HI in South Africa. We searched PubMed, Scopus, African Journals Online, AFROLIB, and African Index Medicus to identify the pertinent studies on HI in South Africa, published from inception to April 30, 2021, and the data were summarized narratively. We screened 944 records, of which 27 studies were included in the review. The age at diagnosis is ∼3 years of age and the most common factor associated with acquired HI was middle ear infections. There were numerous reports on medication toxicity, with kanamycin-induced ototoxicity requiring specific attention when considering the high burden of tuberculosis in South Africa. The Waardenburg Syndrome is the most common reported syndromic HI. The Usher Syndrome is the only syndrome with genetic investigations, whereby a founder mutation was identified among black South Africans (MYO7A-c.6377delC). GJB2 and GJB6 genes are not major contributors to nonsyndromic HI among Black South Africans. Furthermore, emerging data using targeted panel sequencing have shown a low resolution rate in Black South Africans in known HI genes. Importantly, mutations in known nonsyndromic HI genes are infrequent in South Africa. Therefore, whole-exome sequencing appears as the most effective way forward to identify variants associated with HI in South Africa. Taken together, this article contributes to the emerging field of planetary health genomics with a focus on HI and offers new insights and lessons learned for future roadmaps on genomics/multiomics and clinical studies of HI around the world.

Assessing Language Skills in Bilingual Children: Current Trends in Research and Practice

A continuously challenging issue in the field of speech–language pathology is accurately identifying and diagnosing a language disorder in school-aged (pre-kindergarten through 5th grade) bilingual children, as bilingual children are disproportionately under- and overidentified with a language disorder. The current review focuses on the assessment of bilingual children in pre-kindergarten through fifth grade, aimed to inform teachers, pediatricians, parents, and other relevant professionals of issues surrounding assessment of these dual-language learners. We examine the barriers to assessing bilingual children for language disorders, such as the lack of availability of bilingual tests, underinformative current best practice guidelines, lack of speech–language pathologist (SLP) training/knowledge of bilingualism, and use of interpreters. We discuss the necessary considerations when SLPs use norm-referenced tests with bilingual children, such as norming samples, accurate identification of a language disorder, reliability and validity, test administration, and potential solutions to using otherwise poorly suited norm-referenced tests. We also consider research on several alternative measures to norm-referenced assessments, including dynamic assessment, nonword repetition, language sampling, nonlinguistic cognition, and parent report. We conclude by synthesizing the information in this review to offer six principles of best practices for bilingual assessment.

Early years autism and bilingualism: An interpretative phenomenological analysis of parent perceptions during lockdown

AIM

This study explores how bilingual parents of autistic children made language decisions for their families, how the event of the SARS-CoV-2 pandemic and subsequent lockdown impacted the communication environment of their households, and whether these experiences affected their language habits.

METHOD

Semi-structured interviews were conducted with five bilingual parents of autistic children who lived through lockdown in France. Data were analysed using interpretative phenomenological analysis. Demographic and background information was collected using an adapted version of the Questionnaire for Parents of Bilingual Children.

RESULTS

Participants reported conflicting advice given by a range of practitioners. Parents expressed differing beliefs about the impact of language choices on their children. Parents described active engagement with their children's home-learning as generally positive. Parents identified an increase in children's exposure to their first language during the lockdown. Parents reported an increase in children's overall communication abilities.

CONCLUSION

Parents believed that their children's positive communication development during lockdown was related to increased exposure to their first language(s), and direct involvement in their children's learning programs.

Perspectives and Experiences of Autistic Multilingual Adults: A Qualitative Analysis

Background

The combined experience of autism and bilingualism is poorly understood, leading to poor support for autistic people in multilingual environments or those interested in languages. While most available studies focus on the language and cognitive profiles of autistic bilinguals, or on the experiences of parents, little is known about the lived experiences of autistic multilinguals.

Methods

To address this question, this study examined the impact of autism and multilingualism on the lives of 54 autistic multilingual adults who completed an online survey assessing the profiles of autistic bi- and multilinguals. We conducted a thematic analysis of responses to the survey's open-ended questions to explore motivations for learning languages and the perceived benefits of being both autistic and multilingual.

Results

There was a wide range of language profiles in the sample, with various levels of proficiency, ages of acquisition, and learning environments. Respondents felt that being autistic can both positively and negatively influence language learning. They reported various motivating factors for the acquisition of multiple languages, including social aspects and a predisposition for language learning. Respondents reported many benefits of multilingualism, such as educational, employment, or leisure opportunities; social skills and understanding of other people; self-confidence in their own abilities; and relationships with family, friends, and the worldwide autistic community.

Conclusions

Unlike previous work with autistic multilinguals involving case studies, the larger sample involved here offers valuable insight into the profiles and experiences of this overlooked population. Importantly, autistic people can experience numerous benefits from multilingualism. These findings will have implications for language education practices as well as for multilingual families and the practitioners who support them.

Lay summary

Why was this study done?: We wanted to understand what it feels like to be both autistic and multilingual, in a world where it is often assumed that both cannot go together. The combined experience of autism and bilingualism is poorly understood. This leads to poor support for autistic people in bilingual environments or for those interested in languages. Most studies available focus on the language and mental abilities of autistic bilinguals, or on the experiences of parents. However, very few studies focus on the lived experiences of autistic multilinguals themselves.What was the purpose of this study?: The purpose of this study was to understand the experiences of autistic multilingual adults. We focused on their learning motivations and the perceived benefits of being autistic and multilingual.What did the researchers do?: Fifty-four autistic multilingual adults completed an online questionnaire designed for autistic bi- and multilinguals. The questionnaire included questions about the respondents' language history and language profiles. There were also open-ended questions about the respondents' motivations for learning languages, and their general experience of being both autistic and multilingual. We analyzed and summarized the responses to these open-ended questions to understand the experience of autistic multilingual adults.What were the results of the study?: Our sample had a diverse range of language profiles and experiences. Respondents thought that autism could be both an advantage and a disadvantage for language learning. They reported a range of motivations for language learning, including a predisposition for language learning. They considered relationships as both a motivation to learn languages and a benefit of multilingualism. Respondents thought that being multilingual had brought them many opportunities for leisure, travels, education, and employment. They considered that being multilingual had improved their self-confidence. They also thought that being multilingual had increased their awareness and understanding of autism, allowing them to connect with the wider autistic population.What do these findings add to what was already known?: Previous research with autistic multilinguals involved only one or two participants. The larger group of autistic multilinguals involved in this study offers valuable insight into the lived experiences of this overlooked population.What are potential weaknesses in the study?: The online questionnaire was not originally designed to collect in-depth data on lived experiences. This means that the questions included very few prompts: respondents were able to discuss the aspects of their experience that were the most important to them. The absence of specific topics in the results does not mean that they are not experienced, but simply that the participants did not spontaneously mention them. Future research should build upon our findings and focus on specific topics, such as learning environments or opportunities.How will these findings help autistic adults now or in the future?: These findings will help autistic adults by highlighting the diversity and richness of their language profiles, abilities, and experiences. This will prompt families, educators, and practitioners to better support and include autistic people in multilingual environments or those interested in languages.

Dual Language Learning Predicts Improved Executive Functioning in Youth with Autism

Previous findings show executive functioning advantages associated with dual language learning (DLL) among neurotypical individuals, yet few studies have investigated these effects in youth with autism spectrum disorder (ASD). The present study investigated effects of DLL and socioeconomic status (SES) on parent-reported executive functioning, verbal ability, and social-emotional functioning using a sample of DLL (n = 53) and monolingual (n = 106) youth with ASD without intellectual disability, matched on gender and full-scale IQ scores. After controlling for the effects of SES, results showed that monolingual youth had better outcomes on verbal ability, while DLL youth had fewer parent-reported problems with executive functioning and unusual behaviors. These findings indicate that bilingualism may mitigate executive functioning deficits in youth with ASD.

"It's Like Stealing What Should be Theirs." An Exploration of the Experiences and Perspectives of Parents and Educational Practitioners on Hebrew-English Bilingualism for Jewish Autistic Children

Parents of autistic children are routinely advised to raise them monolingually, despite potential negative effects of monolingualism and no evidence of harm from bilingualism. There is, however, limited research on this topic. This study explored experiences and perspectives of educational practitioners (‘practitioners’) and parents of Hebrew–English bilingual autistic children on bilingualism and monolingualism. Using interpretative phenomenological analysis, we explored the experiences of 22 parents and 31 practitioners using both oral and written interviews. The analysis revealed that religious continuity is a crucial factor in bilingual decision-making. Unexpectedly, both practitioners and parents felt that having to adopt a monolingual approach was unjust, in line with conceptions of forced monolingualism. This article recommends awareness training on community languages and research in other communities.

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.

Autistic People's Access to Bilingualism and Additional Language Learning: Identifying the Barriers and Facilitators for Equal Opportunities

Bilingualism is a valuable tool that enriches and facilitates cultural, social and lived experiences for autistic and non-autistic people alike. Research consistently finds no negative effects of bilingualism and highlights the potential for positive effects across cognitive and socio-cultural domains for autistic and non-autistic children. Yet parents of autistic children remain concerned that bilingualism will cause delays in both cognitive and language development and are still frequently advised by practitioners to raise their child monolingually. Evidently, findings from research are not reflected in practice or subsequent advice, and it is essential to identify ways to ensure equal access to additional language learning. We briefly summarise the existing literature on bilingualism and autism, considering perspectives from the bilingual autistic community, and experimental research. We identify the most pertinent barriers to participation for autistic bilingual children in terms of familial, clinical and educational perspectives. We propose novel solutions to promote additional language learning and suggest changes to practice that will contribute to an evidence base for families and practitioners. This commentary makes innovative recommendations at both the individual and societal level to ensure that autistic bilingual people have equal rights and opportunities to language learning and are optimally supported in accessing them.

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 and Rapid Automatized Naming: effects of language switching on lexical access and reading speed

PURPOSE

To assess whether bilingualism, on a language switching experiment, is associated with higher or lower accuracy and speed of the rapid automatized naming of objects and investigate the influence of language switching on reading speed.

METHODS

The performance of 50 Brazilian bilingual children in the Rapid Automatized Naming Task, whose L1 was Brazilian Portuguese and who were exposed to English daily at school, was assessed. Forty-seven monolingual (Brazilian Portuguese) children were grouped according to age.

RESULTS

Language switching interfered with the performance of the bilingual children in the Rapid Automatized Naming Task in terms of speed and accuracy. No correlations were found between the performance in the RAN task and Reading Speed.

CONCLUSION

Brazilian bilingual students showed poor performance in the rapid naming task on the switch trial when compared to monolingual students, showing higher rates of mistakes, especially hesitations. Only the performance of bilingual students in the rapid naming task in L2 correlated with L1 reading speed.

Exploratory Qualitative Analysis of Early Literacy Engagement in Latinx Parents of a Child With a Cleft

ABSTRACT

Literacy interventions are needed for children born with orofacial clefts, particularly for Latinx children who may experience multiple risk factors. To collect formative data for intervention design, focus groups and interviews were completed with 18 Latinx parents of children ages 13 to 49 months with orofacial clefts. Interviews focused on literacy experiences and practices. Six themes were identified through inductive qualitative analysis: child reading skills were highly valued; parents were motivated to improve on their childhood reading experiences; bilingualism was a goal for all parents; parents noted challenges in building child reading skills; reading engagement was broadly defined; and impact of cleft diagnosis was wide-reaching. Implications for intervention include a bilingual strength-based approach incorporating cleft-specific speech concerns, play, parallel online programming, behavioral strategies, and social support options. Use of telephone and online intervention with mailed materials can also help address family resource and time limitations.

Parental Perceptions and Decisions Regarding Maintaining Bilingualism in Autism

A growing body of evidence suggests that bilingual exposure does not negatively impact children on the autism spectrum. This study sought to illuminate parents’ perceptions and choices regarding maintaining bilingualism in autism. Semi-structured interviews were conducted with 16 family members in England and Wales. Data were analysed using interpretative phenomenological analysis (IPA). Although parents expressed positive attitudes towards bilingualism, these views were not always congruent with their language practices. Instead, several factors influenced decisions about language maintenance in autism, including the severity of the child’s autism, advice received, and the importance of English as the dominant societal language. This article calls for greater support for families in making language decisions that are suitable for the individual child and their family.

Patient perceptions of oral health care following stroke: a qualitative study

BACKGROUND

Stroke is a serious cerebrovascular disease and is one of the world's leading causes of disability. Maintaining good oral health is a challenge among those hospitalised after stroke. A multidisciplinary approach to oral care involving non-dental professionals can be beneficial in improving oral health outcomes for patients. The aim of this study was to understand the perceptions of stroke survivors regarding oral healthcare across acute and rehabilitation settings.

METHODS

A descriptive qualitative approach was used. Face-to-face semi-structured interviews were conducted. A framework analysis was employed to analyse the data. Patients who had recently experienced a stroke were purposively recruited across both acute and rehabilitation settings, at two metropolitan hospitals in Sydney, Australia. In total, 11 patients were interviewed.

RESULTS

Although participants recognised the importance of oral health, few understood the link between oral and general health. Regular oral hygiene practices varied since having stroke, with a few receiving oral care assistance from nurses. Time, cost and lack of information were some barriers to accessing dental services, while supportive measures such as coordination of oral care, financial subsidy and nurse assistance were strategies proposed to support oral care practices amongst stroke survivors.

CONCLUSIONS

There is scope to improve current models of oral care in stroke. While stroke survivors understand the importance of oral care, an integrated oral health model with a multidisciplinary approach could improve health outcomes.

Longitudinal Social and Communication Outcomes in Children with Autism Raised in Bi/Multilingual Environments

Globally, there are more bilingual speakers than monolingual speakers; however, scant research evidence exists regarding social communication development and outcomes for bilingual children with autism spectrum disorder (ASD). A stronger evidence base will facilitate health professionals and educators providing accurate recommendations regarding language use. This study employed a longitudinal cohort design to compare social and communication skills, at baseline and over 12 months, for 60 monolingual and 60 bilingual children with ASD receiving community based early intervention. We found few differences at intake, and no difference in the magnitude of change over 12 months for this cohort. Findings support the notion that there is no basis on which to discourage home language use with bilingual children with ASD.

The Promise of Comprehensive Early Reading Instruction for Children With Autism and Recommendations for Future Directions

Purpose

Children with autism have an increased likelihood of reading difficulties. The reasons for this are numerous and varied, but many children with autism can learn to read when they are provided with evidence-based early reading instruction.

Method

Here, we provide an overview of some of the factors that impact early reading development for children with autism and a rationale for the provision of comprehensive early reading instruction consistent with the recommendations of the National Reading Panel (NRP). We discuss research on NRP instruction for children with autism, including some of our own empirical studies. We also discuss some areas of research that were not emphasized by the NRP but that we view as important. We offer recommendations that extend beyond NRP guidelines in order to advance knowledge and improve practice.

Conclusions

Comprehensive early reading instruction holds great promise for children with autism, but there are gaps in our understanding that need to be addressed. These include the most effective method(s) for tailoring reading instruction to the needs of the individual while optimizing delivery to small groups of children, supporting skills and making other accommodations not outlined by the NRP, and consideration of bilingualism and of reading instruction in languages other than English, among other issues. While our focus in this review article is early reading instruction for children with autism who use oral language, we acknowledge that there is a major gap in the literature concerning reading instruction for those who do not use oral language. We hope that this review article will be helpful to clinicians, educators, and researchers alike, as well as children with autism and their families, friends, and support networks.

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.

Capitalizing on cross-language similarities in intervention with bilingual children

PURPOSE

This study examined the effects of a vocabulary intervention for bilingual children that was conducted in children's first language, Spanish, and included explicit instruction on cognates. We measured effects in terms of change from pre- to post-intervention in Spanish as well as associations with the non-target language, English.

METHOD

Participants were 12 Spanish-English bilingual children, aged 6-8 years, with and without Developmental Language Disorder. Children completed the intervention in pairs (one child with DLD and a typically developing peer) for 70-minute sessions, 3 days a week, for four weeks. Intervention targeted 32 words (16 cognates, 16 non-cognates) using four storybooks (8 words/book) and interactive activities that highlighted similarities across languages. Pre- and post-intervention measures in Spanish and English included tasks of word definition and cognate facilitation.

RESULTS

As a group, children showed improvement in definition quality and cognate naming in Spanish. There was a positive correlation between definition quality and cognate naming for the typically developing children, but not for the children with DLD. All children showed positive cross-language correlations on post-intervention measures.

CONCLUSIONS

Bilingual children, with and without DLD, have the capacity to improve in their awareness and use of cognates. Explicit teaching of cognates can be an effective tool for building vocabulary skills. Children with DLD may need additional time and support to apply their knowledge of cognates to vocabulary learning.

Bilingualism in autism: Language learning profiles and social experiences

LAY ABSTRACT

Bilingualism changes the way people relate to others. This is particularly interesting in the case of autism, where social interaction presents many challenges. A better understanding of the overlap between the social variations of bilingualism and autism could unveil new ways to support the social experiences of autistic people. This research aims to understand the language learning and social experiences of autistic people who speak one, two or more languages. A total of 297 autistic adults (aged between 16 and 80 years) completed an online questionnaire that included general demographic questions, social life quality self-rating questions, language history questions, and open questions about the respondents' bilingualism experience. Respondents had a wide range of language experiences: there were 89 monolingual English speakers, 98 bilinguals, 110 respondents knew three languages or more, all with a wide range of abilities in their languages. In the full group, younger respondents were more satisfied with their social life, and respondents with many languages were more satisfied with their social life than respondents with few languages. In the multilingual group, younger respondents were more satisfied with their social life, and the more skilled in their third language the more satisfied with their social life. This is the first study describing the language history and social experiences of a large group of bilingual and multilingual autistic adults. It highlights how autistic people can encounter a new language, learn it and use it in their daily life, and how their bilingualism experiences shape their social life.

Post-stroke Complications and Mortality in Burkinabè Hospitals: Relationships with Deglutition Disorders and Nutritional Status

Stroke frequently causes deglutition disorders, leading to a decline in nutritional status and complications, and increasing mortality. Sub-Saharan data are scarce. The objectives of this study were to assess complications and mortality among hospitalized patients in Burkina Faso during the first two weeks after stroke, and to investigate associated factors. Patients with stroke were followed prospectively in Ouagadougou and Bobo-Dioulasso hospitals. Deglutition disorders and nutritional parameters were assessed at baseline (D0) and on Days 8 (D8) and 14 (D14). Complications and mortality were recorded up to D14. Factors associated with complications and mortality were investigated using multivariate analysis. Of the 222 patients included, 81.5% developed at least one complication, and mortality was 17.1%. At D0, D8, and D14, the rate of deglutition disorders was 37.4%, 28.4%, and 15.8%, respectively, and that of undernourishment 25.2%, 29.4%, and 31.0%, respectively. In multivariate analysis, only the presence of deglutition disorders was a risk factor for developing at least one complication (OR = 5.47, 95% CI 1.81-16.51). Factors predicting death were the presence of deglutition disorders at D0 (OR = 7.19, 95% CI 3.10-16.66), and at least one seizure during follow-up (OR = 3.69, 95% CI 1.63-8.36). After stroke, the rates of complications, death, and undernourishment were high compared to Western countries. Prevention and management of deglutition disorders, and specific follow-up of patients with seizures could reduce post-stroke mortality.

Multilingualism and augmentative and alternative communication in South Africa - Exploring the views of persons with complex communication needs

Background

Augmentative and alternative communication (AAC) can assist persons with complex communication needs to communicate competently with a variety of communication partners in a variety of contexts. However, AAC systems and intervention often do not take multilingual aspects into consideration.

Objective

This small-scale exploratory study had three aims, namely: (1) to describe the self-reported language skills of multilingual South African adults using AAC, (2) to describe the languages and communication modalities they used in interaction and (3) to obtain their views regarding access to various languages.

Methods

Twenty-seven adults using AAC were recruited via an empowerment programme, as well as an email list for persons interested in AAC, and provided responses to a questionnaire. To compensate for access and written language challenges, the questionnaire was administered with help and/or as a face-to-face interview where needed. Responses were analysed using mostly descriptive statistics.

Results

Participants generally could not express themselves in all the languages they understood and were regularly exposed to. Speech-generating devices specifically gave access almost exclusively to English. Participants expressed a desire to increase their expressive language repertoire, and mentioned both limitations of communication technology as well as their own literacy skills as barriers to overcome in this regard.

Conclusion

In order for multilingual South African adults using AAC to express themselves in multiple languages, appropriate AAC systems and interventions as well as literacy learning opportunities need to be developed and provided.

Keywords

adult, augmentative and alternative communication; multilingualism; complex communication needs, language and communication skills; self-report, views.

The school experiences of bilingual children on the autism spectrum: An interpretative phenomenological analysis

BACKGROUND

With growing numbers of bilingual children on the autism spectrum in UK classrooms, the interaction between autism and bilingualism is becoming a pressing issue for practitioners, researchers and families. In this study, we report the school experiences of bilingual, autistic children in the UK through their own voice with focus on five aspects of their school life.

METHOD

Using interpretative phenomenological analysis (IPA) as a methodological framework, semi-structured, computer-assisted interviews were conducted with 11 children aged 7 to 14 from across England and Wales. Interviews were carried out in English and took place in mainstream schools or the children's home, depending on their preference.

RESULTS

Results indicate that, while children's school experiences vary widely, there were commonalities in this population's identity formation, including being bilingual, and their classroom experiences. Most notably, children educated in more multilingual environments (i.e. in schools with larger multilingual populations) expressed more positive views about multilingualism than those in more monolingual settings. In line with previous studies, limited social circles and classroom anxiety were present in participants' school experiences.

IMPLICATIONS

The findings of this paper suggest that giving autistic children from bilingual backgrounds opportunities to explore their linguistic identities in the classroom may enhance their experiences of school. Further research should focus on parents' and practitioners' attitudes and perspectives towards the support available for this population.

Linguistic Skills in Bilingual Children With Developmental Language Disorders: A Pilot Study

The current pilot study compared the linguistic characteristics of a cohort of simultaneous bilingual children (Italian, L1; German L2) with developmental language disorders (DLDs) and those of bilingual peers with typical language development (TLD). Importantly, the two groups were balanced for a number of environmental variables (e.g., age of first exposure to the L2, acquisition contexts, degree of exposure to both languages) known to affect linguistic development in both TLD and DLDs. The analyses included the assessment of the participants' phonological short-term memory. Their lexical, grammatical and narrative abilities were analyzed in both languages by administering the Italian and German equivalent forms of the Battery for the assessment of language in children aged 4 to 12 - BVL_4-12 (Marini et al., 2015). The children with DLDs had reduced phonological short-term memory and lexical skills that, in turn, contributed to the reduced levels of local coherence and informativeness of their narratives. Such difficulties were found at similar levels in their two languages. These results suggest that reduced phonological short-term memory and lexical selection skills may reflect a core symptom in both mono- and bilingual children with developmental language disorders.

Narrative abilities of bilingual children with and without Developmental Language Disorder (SLI): Differentiation and the role of age and input factors

PURPOSE

The narrative abilities of bilinguals with TD and with DLD/SLI in their English L2 were examined in order to 1) identify the narrative components that differentiate these two groups and 2) determine the role of age and input factors in predicting L2 narrative abilities in each group.

METHOD

Participants were 24 English L2 children with DLD and 63 English L2 children with TD, matched on age (mean = 5; 8) and length of exposure to the L2 (mean = 24 months). Narrative samples were elicited using a story generation task and a parent questionnaire provided age and input variables.

RESULTS

Bilinguals with DLD had significantly lower scores for story grammar than their TD peers, but showed similar scores for narrative microstructure components. Length of L2 exposure in school and richness of the L2 environment predicted better narrative abilities for the group with TD but not with DLD. Older age predicted better narrative abilities for the group with DLD but not with TD. Quantity of L2 input/output at home did not predict story grammar or microstructure abilities in either group.

CONCLUSION

Story grammar might differentiate between children with TD and DLD better than microstructure among bilinguals with less exposure to the L2 and when a story generation task is used. Bilinguals with TD make more efficient use of L2 input than bilinguals with DLD.