The language abilities of bilingual children with Down syndrome

[Formula: see text] Predicting language outcomes in bilingual children with Down syndrome

Continuous approaches to measuring bilingualism have recently emerged as a means of understanding individual variation in language abilities. To date, limited information is available to assist in understanding the language abilities of bilingual children with Down syndrome (DS), who are specifically known to have a large variation in linguistic outcomes. Group studies in this population report that children exposed to two languages do not differ from their monolingual counterparts after considering age and non-verbal cognitive abilities, although no study to date has examined the relationship between the amount of exposure to one language and the linguistic abilities in the other language within this population. This study sought to identify whether exposure to an additional language, specifically Welsh, predicted linguistic abilities in the majority language, in this case, English. Sixty-five children between the ages of 5;5-16;9 who had varied linguistic experiences completed a range of cognitive and linguistic assessments. Results from hierarchical regression analyses show that the amount of exposure to Welsh had no impact on language abilities in English, after controlling for non-verbal cognitive abilities, short-term memory and socioeconomic status. This demonstrates that exposure to an additional language does not have a negative impact on language development, a finding that has important clinical and educational implications.

The Effects of Language Background and Parental Education on Measures of Cognitive Ability: An Analysis of the WPPSI-IV Cognitive Profiles of Monolingual, Simultaneous Bilingual, and Sequential Bilingual German Children Aged 4 to 7 Years

BACKGROUND

The present study investigated the possible effects of language background (monolinguals, simultaneous bilinguals, and sequential bilinguals) and parental education (no/low, medium, high, and highest parental education) on measures of cognitive ability provided by the Wechsler Primary and Preschool Scale-Fourth Edition (WPPSI-IV).

METHODS

Statistical analyses were based on a sample of 290 children (130 females, 160 males). Three multivariate variance analyses were conducted to identify possible effects. In cases of statistically significant main effects, post hoc analyses were additionally performed to identify group differences.

RESULTS

The results indicated that simultaneous bilinguals performed more similarly to monolinguals than sequential bilinguals. On average, sequential bilinguals achieved significantly lower scores on the Verbal Comprehension Index (VCI), the Vocabulary Acquisition Index (VAI), and the associated subtests than monolinguals and simultaneous bilinguals. Significantly lower average scores on VAI and the associated subtests were found for simultaneous bilinguals compared to monolinguals. Children with parents having no, a lower, or a medium educational level achieved significantly lower scores on VCI, VAI, and the FSIQ than children with parents having a high or highest educational level on average.

CONCLUSIONS

The present findings suggest that the WPPSI-IV represents a suitable and reliable test battery for the assessment of cognitive skills in children with different language backgrounds and parental educational levels.

SLPs' perceptions of language learning myths about children who are DHH

This article reports on speech-language pathologists' (SLPs') knowledge related to myths about spoken language learning of children who are deaf and hard of hearing (DHH). The broader study was designed as a step toward narrowing the research-practice gap and providing effective, evidence-based language services to children. In the broader study, SLPs (n = 106) reported their agreement/disagreement with myth statements and true statements (n = 52) about 7 clinical topics related to speech and language development. For the current report, participant responses to 7 statements within the DHH topic were analyzed. Participants exhibited a relative strength in bilingualism knowledge for spoken languages and a relative weakness in audiovisual integration knowledge. Much individual variation was observed. Participants' responses were more likely to align with current evidence about bilingualism if the participants had less experience as an SLP. The findings provide guidance on prioritizing topics for speech-language pathology preservice and professional development.

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.

Speech-Language Pathologists' Endorsement of Speech, Language, and Literacy Myths Reveals Persistent Research-Practice Gap

PURPOSE

We explore the extent to which speech-language pathologists (SLPs) are operating under assumptions about speech, language, and literacy that are not supported by evidence or are contradicted by evidence.

METHOD

SLPs (N = 106) marked the degree to which they endorsed or rejected four true and 11 myth (i.e., false) statements on a visual analog scale via an online survey. We analyzed the degree to which participants agreed or disagreed with these statements related to speech, language, and literacy development and impairment.

RESULTS

Based on results of one-sample t tests, participants as a group correctly rejected seven myth statements and correctly endorsed three true statements. Participants as a group provided equivocal responses to the remaining four myth statements and one true statement. Scores for each statement spanned all or nearly all of the possible range. Even when participants overall showed relatively strong disagreement with a particular myth statement, at least a few participants endorsed the myth statement.

CONCLUSIONS

The findings indicate areas of relative strength for SLPs' knowledge of current evidence for augmentative and alternative communication, bilingualism, and language input that supports language development. Identified areas of relative weakness include knowledge of the expected grammatical and speech production skills of children with typical development and the influence of ear infections in childhood on language impairment. Additional research is needed to evaluate efforts to enhance SLPs' knowledge and use of evidence-based practices.

Caregiver Experiences With Oral Bilingualism in Children Who Are Deaf and Hard of Hearing in the United States: Impact on Child Language Proficiency

PURPOSE

Best practices recommend promoting the use of the home language and allowing caregivers to choose the language(s) that they want to use with their child who is deaf or hard of hearing (DHH). We examined whether Spanish-speaking caregivers of children who are DHH receive professional recommendations on oral bilingualism that follow best practices. We also assessed whether professional recommendations, caregiver beliefs, and language practices had an impact on child language(s) proficiency.

METHOD

Sixty caregivers completed a questionnaire on demographic questions, language(s) use and recommendations, beliefs on bilingualism, and child language proficiency measures in English, Spanish, and American Sign Language (ASL). Professional recommendations on oral bilingualism were reported descriptively, and linear regression was used to identify the predictors of child language(s) proficiency.

RESULTS

We found that only 23.3% of the caregivers were actively encouraged to raise their child orally bilingual. Language practices predicted child proficiency in each language (English, Spanish, and ASL), but professional recommendations and caregiver beliefs did not.

CONCLUSIONS

Our results revealed that most caregivers received recommendations that do not follow current best practices. Professional training is still needed to promote bilingualism and increase cultural competence when providing services to caregivers who speak languages different from English.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.21644846.

Bilingual Language Development in Infancy: What Can We Do to Support Bilingual Families?

Many infants and children around the world grow up exposed to two or more languages. Their success in learning each of their languages is a direct consequence of the quantity and quality of their everyday language experience, including at home, in daycare and preschools, and in the broader community context. Here, we discuss how research on early language learning can inform policies that promote successful bilingual development across the varied contexts in which infants and children live and learn. Throughout our discussions, we highlight that each individual child's experience is unique. In fact, it seems that there are as many ways to grow up bilingual as there are bilingual children. To promote successful bilingual development, we need policies that acknowledge this variability and support frequent exposure to high-quality experience in each of a child's languages.

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.

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.

Language Preference of a Multilingual Individual With Disabilities Using a Speech Generating Device

Individuals with disabilities who are English learners (ELs) and communicate using speech generating devices (SGDs) may demonstrate a preference for instructional language and language output of their SGDs. The influence of interventionist language on the preference of SGD language output and frequency of mands was examined using an alternating-treatments design with an embedded concurrent-chain arrangement with a 10-year-old with Down syndrome whose heritage language was Spanish. Language preference assessment for ELs is recommended because heritage language may be preferred for children with disabilities who use SGDs.

Speech Production Accuracy and Variability in Monolingual and Bilingual Children With Cochlear Implants: A Comparison to Their Peers With Normal Hearing

Purpose This study investigates consonant and vowel accuracy and whole-word variability (also called token-to-token variability or token-to-token inconsistency) in bilingual Spanish-English and monolingual English-speaking children with cochlear implants (CIs) compared to their bilingual and monolingual peers with normal hearing (NH). Method Participants were 40 children between 4;6 and 7;11 (years;months; M _age = 6;2), n = 10 each in 4 participant groups: bilingual Spanish-English with CIs, monolingual English with CIs, bilingual Spanish-English with NH, and monolingual English with NH. Spanish and English word lists consisting of 20 words of varying length were generated, and 3 productions of each word were analyzed for percent consonants correct, percent vowels correct, and the presence of any consonant and/or vowel variability. Results Children with CIs demonstrated lower accuracy and more whole-word variability than their peers with NH. There were no differences in rates of accuracy or whole-word variability between bilingual and monolingual children matched on hearing status, and bilingual children had lower accuracy and greater whole-word variability in English than in Spanish. Conclusions High rates of whole-word variability are prevalent in the speech of children with CIs even after many years of CI experience, and bilingual language exposure does not appear to negatively impact phonological development in children with CIs. Contributions to our understanding of underlying sources of speech production variability and clinical implications are discussed.

How Young Children Learn Language and Speech

Pediatric clinicians are on the front line for prevention of language and speech disorders. This review uses prevailing theories and recent data to justify strategies for prevention, screening and detection, diagnosis, and treatment of language and speech disorders. Primary prevention rests on theories that language learning is an interaction between the child's learning capacities and the language environment. Language learning occurs in a social context with active child engagement. Theories support parent education and public programs that increase children's exposure to child-directed speech. Early detection of delays requires knowledge of language milestones and recognition of high-risk indicators for disorders. Male sex, bilingual environments, birth order, and chronic otitis media are not adequate explanations for significant delays in language or speech. Current guidelines recommend both general and autism-specific screening. Environmental and genetic factors contribute to primary language and speech disorders. Secondary and tertiary prevention requires early identification of children with language and speech disorders. Disorders may be found in association with chromosomal, genetic, neurologic, and other health conditions. Systematic reviews find that speech-language therapy, alone or in conjunction with other developmental services, is effective for many disorders. Speech-language interventions alter the environment and stimulate children's targeted responding to improve their skills.

How do maternal interaction style and joint attention relate to language development in infants with Down syndrome and typically developing infants?

Down syndrome (DS) is more detrimental to language acquisition compared to other forms of learning disability. It has been shown that early social communication skills are important for language acquisition in the typical population; however few studies have examined the relationship between early social communication and language in DS. The aim of the current study is to compare the relationship between joint attention and concurrent language skills, and maternal interactive style and concurrent language skills in infants with DS and in typically developing (TD) infants matched for mental age. We also investigated if these relationships differ between children with DS and TD children. Twenty-five infants with DS (17-23 months) and 30 TD infants (9-11 months) were assessed on measures of joint attention, maternal interactive style and language. The results indicated a significant positive relationship between responding to joint attention (RJA) and concurrent language for the DS group, and a significant positive relationship between maternal positive expressed emotion (PEEM) and concurrent language for the TD group. We hypothesise that different social-communication factors are associated with language skills in DS, at least between 17 and 23 months of age compared to TD infants of similar non-verbal and general language abilities.

Should Heritage Languages be Incorporated into Interventions for Bilingual Individuals with Neurodevelopmental Disorders? A Systematic Review

Special education policies recognize the need for developing and preserving the heritage languages of individuals with disabilities. Yet there seems to be a disconnect between policy and practice. Should the heritage languages of bilingual individuals with neurodevelopmental disorders be incorporated into interventions? This review evaluated 18 studies that examined the effects of heritage language instruction on treatment outcomes for individuals with neurodevelopmental disorders. Overall, results suggest a small effect favoring interventions delivered in the heritage language versus interventions delivered solely in the majority language. In general, studies were also found to be of high-quality according to What Works Clearinghouse Standards. Findings are discussed in terms of recommendations for future research and practice.

Raising Children with Autism Spectrum Disorders in Monolingual vs Bilingual Homes: A Scoping Review

BACKGROUND

Approximately 20% of children in Canada and the United States are raised in bilingual family homes. Current recommendations for typically developing children are to encourage and support bilingual exposure in the home; however, there are no specific guidelines for families of children with autism spectrum disorders (ASDs), a disorder in which communication deficits are considered a hallmark feature.

OBJECTIVE

The aim of this study is to present a scoping review of studies that compare cognitive, linguistic, and behavioral outcomes for children with ASDs raised in monolingual vs bilingual homes.

METHODS

A systematic search of 6 databases for peer-reviewed literature and gray literature search through dissertation databases, conference archives, and reference lists of pertinent studies was conducted.

RESULTS

Nine studies were included. No consistent differences were observed in the categories of core ASDs behaviors, cognitive function, or language. The studies suggest a potential bilingual advantage on nonverbal intelligence quotient scores, adaptive functioning, and expressive vocabulary.

CONCLUSION

There is no evidence of a detrimental effect of raising children with ASDs in a bilingual home.

Practitioner Review: Multilingualism and neurodevelopmental disorders - an overview of recent research and discussion of clinical implications

BACKGROUND

Language and communication skills are essential aspects of child development, which are often disrupted in children with neurodevelopmental disorders. Cutting edge research in psycholinguistics suggests that multilingualism has potential to influence social, linguistic and cognitive development. Thus, multilingualism has implications for clinical assessment, diagnostic formulation, intervention and support offered to families. We present a systematic review and synthesis of the effects of multilingualism for children with neurodevelopmental disorders and discuss clinical implications.

METHODS

We conducted systematic searches for studies on multilingualism in neurodevelopmental disorders. Keywords for neurodevelopmental disorders were based on Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition categories as follows; Intellectual Disabilities, Communication Disorders, Autism Spectrum Disorder (ASD), Attention-Deficit/Hyperactivity Disorder, Specific Learning Disorder, Motor Disorders, Other Neurodevelopmental Disorders. We included only studies based on empirical research and published in peer-reviewed journals.

RESULTS

Fifty studies met inclusion criteria. Thirty-eight studies explored multilingualism in Communication Disorders, 10 in ASD and two in Intellectual Disability. No studies on multilingualism in Specific Learning Disorder or Motor Disorders were identified. Studies which found a disadvantage for multilingual children with neurodevelopmental disorders were rare, and there appears little reason to assume that multilingualism has negative effects on various aspects of functioning across a range of conditions. In fact, when considering only those studies which have compared a multilingual group with developmental disorders to a monolingual group with similar disorders, the findings consistently show no adverse effects on language development or other aspects of functioning. In the case of ASD, a positive effect on communication and social functioning has been observed.

CONCLUSIONS

There is little evidence to support the widely held view that multilingual exposure is detrimental to the linguistic or social development of individuals with neurodevelopmental disorders. However, we also note that the available pool of studies is small and the number of methodologically high quality studies is relatively low. We discuss implications of multilingualism for clinical management of neurodevelopmental disorders, and discuss possible directions for future research.

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

This study aimed to gather information from school- and clinic-based professionals about their practices and opinions pertaining to the provision of bilingual supports to students with developmental disabilities. Using an online survey, data were collected in six socio-culturally and linguistically diverse locations across four countries: the United States, Canada, the United Kingdom, and the Netherlands. In total, 361 surveys were included in the analysis from respondents who were primarily teachers and speech-language pathologists working in schools, daycares/preschools, or community-based clinics. The overall picture that emerged from the data reflected a disconnection between practice and opinion. In general, respondents believed that children with both mild and severe disabilities are capable of learning a second language, although their opinions were more neutral for the latter group. However, children with both mild and severe disabilities who spoke only a minority language at home had less access to services for second language learners than did their typically developing peers, although respondents agreed that such services should be more available. Regardless of clinical group, children who lived in homes where a minority language was spoken were often exposed to, assessed in, and treated in the majority language only; again, respondents generally disagreed with these practices. Finally, second language classes were less available to children in the two disability groups compared to typically developing bilingual children, with general agreement that the opportunity to acquire a second language should be more available, especially to those with mild disabilities. Although the results indicate that there is a considerable gap between current practices and professional opinions, professionals appear to be more supportive of bilingual educational opportunities for these populations than was suggested by previous research.

Bilingualism in children with developmental disorders: A narrative review

Children with developmental disabilities (DD) often need and sometimes opt to become bilingual. The context for bilingual acquisition varies considerably and can impact outcomes. In this first article of the special issue, we review research on the timing and amount of bilingual exposure and outcomes of either direct language intervention or educational placements in three groups of children with DD: Specific Language Impairment (SLI), Autism Spectrum Disorders (ASD), and Down syndrome (DS). Children with SLI have been studied more than the other two groups. Findings showed that, on the one hand, the communication skills of simultaneous bilinguals and matched monolinguals with DD were similar for all groups when the stronger language or both languages of the bilingual children were considered. On the other hand, similar to typically developing children, sequential bilinguals and matched monolinguals with SLI (other groups not studied) differed on some but not all second language (L2) measures; even after an extended period of exposure, differences in L2 outcomes were not completely resolved. There is emerging evidence that the typological similarity of the languages being learned influences L2 development in sequential bilinguals, at least in children with SLI. Increasing the frequency of exposure seems to be more related to development of the weaker language in bilinguals with DD than their stronger language. Language intervention studies show the efficacy of interventions but provide little evidence for transfer across languages. In addition, only one (unpublished) study has compared the language and academic outcomes of children with DD in different language education programs. Research on bilingual children with DD in different educational settings/programs is limited, probably as a result of restricted inclusion of these children in some educational settings. We argue for the implementation of full inclusion policies that provide increased access to dual language programs for children with DD and access to a complete range of support services.

The Development of English as a Second Language With and Without Specific Language Impairment: Clinical Implications

PURPOSE

The purpose of this research forum article is to provide an overview of typical and atypical development of English as a second language (L2) and to present strategies for clinical assessment with English language learners (ELLs).

METHOD

A review of studies examining the lexical, morphological, narrative, and verbal memory abilities of ELLs is organized around 3 topics: timeframe and characteristics of typical English L2 development, comparison of the English L2 development of children with and without specific language impairment (SLI), and strategies for more effective assessment with ELLs.

RESULTS

ELLs take longer than 3 years to converge on monolingual norms and approach monolingual norms asynchronously across linguistic subdomains. Individual variation is predicted by age, first language, language learning aptitude, length of exposure to English in school, maternal education, and richness of the English environment outside school. ELLs with SLI acquire English more slowly than ELLs with typical development; their morphological and nonword repetition abilities differentiate them the most. Use of strategies such as parent questionnaires on first language development and ELL norm referencing can result in accurate discrimination of ELLs with SLI.

CONCLUSIONS

Variability in the language abilities of ELLs presents challenges for clinical practice. Increased knowledge of English language learning development with and without SLI together with evidence-based alternative assessment strategies can assist in overcoming these challenges.

Causal effects on child language development: A review of studies in communication sciences and disorders

We reviewed recent studies published across key journals within the field of communication sciences and disorders (CSD) to survey what causal influences on child language development were being considered. Specifically, we reviewed a total of 2921 abstracts published within the following journals between 2003 and 2013: Language, Speech, and Hearing Services in Schools (LSHSS); American Journal of Speech-Language Pathology (AJSLP); Journal of Speech, Language, and Hearing Research (JSLHR); Journal of Communication Disorders (JCD); and the International Journal of Language and Communication Disorders (IJLCD). Of the 346 eligible articles that addressed causal factors on child language development across the five journals, 11% were categorized as Genetic (37/346), 83% (287/346) were categorized as Environmental, and 6% (22/346) were categorized as Mixed. The bulk of studies addressing environmental influences focused on therapist intervention (154/296=52%), family/caregiver linguistic input (65/296=22%), or family/caregiver qualities (39/296=13%). A more in-depth review of all eligible studies published in 2013 (n=34) revealed that family/caregiver qualities served as the most commonly controlled environmental factor (e.g., SES) and only 3 studies explicitly noted the possibility of gene-environment interplay. This review highlighted the need to expand the research base for the field of CSD to include a broader range of environmental influences on child language development (e.g., diet, toxin exposure, stress) and to consider more directly the complex and dynamic interplay between genetic and environmental effects.

LEARNING OUTCOMES

Readers will be able to highlight causal factors on child language development that have been studied over the past decade in CSD and recognize additional influences worthy of consideration. In addition, readers will become familiar with basic tenets of developmental systems theory, including the complex interplay between genetic and environmental factors that shapes child development.

Raising children bilingually

The purpose of this article is to describe the process of becoming bilingual by sharing my own experience being raised in a four-language environment and how it influenced the upbringing of my daughter in two, and subsequently three languages. The other purpose is to dispel the myth that children with language, developmental and/or intellectual impairments or those diagnosed as being on the autism spectrum cannot or should not be exposed to two languages because it is confusing, or because they simply cannot handle two languages due to their disability. As a bilingual speech and language pathologist (SLP) who has practiced in the United States for four decades, I have unfortunately witnessed that many teachers as well as other well-meaning professionals including psychologists, therapists and even physicians discourage these children’s parents from using their first language because it might be confusing or too difficult for the child to handle. A review of recent research on children with special needs who have a variety of language, learning and communication challenges contradicts this view. The information presented should be helpful not only to parents but also to various professionals including therapists and physicians who come into contact with children with special needs who are growing up in a bilingual environment.

Communicative Development in Bilingually Exposed Chinese Children With Autism Spectrum Disorders

PURPOSE

We examined the association of bilingual exposure with structural and pragmatic language development in Chinese children with autism spectrum disorders (ASDs).

METHOD

The parents of 54 children with ASD exposed to 1 (n = 31) or 2 (n = 23) Chinese languages completed (a) a questionnaire to evaluate their child's competence in structural language and pragmatic ability in their dominant language (Children's Communication Checklist-Second Edition; Bishop, 2006), and (b) a questionnaire to assess their child's social functioning (Social Responsiveness Scale; Constantino & Gruber, 2005; Wang, Lee, Chen, & Hsu, 2012). In addition, parents completed thorough interviews regarding the linguistic environment of their children (Language Environment Interview; Hambly & Fombonne, 2011).

RESULTS

Multivariate analyses of variance revealed that bilingually exposed children with ASD did not demonstrate significantly different performance on any standard measure relative to their monolingual peers.

CONCLUSIONS

The findings suggest that bilingual language exposure is not associated with additional challenges for the development of the dominant language in children with ASD. The lack of negative associations in our sample is not likely to be due to the comparatively early diagnosis and/or intervention that are available in other countries. We discuss implications for decisions regarding the linguistic environment of children with ASD.

Syntactic bootstrapping in children with Down syndrome: the impact of bilingualism

PURPOSE

The purpose of the study was to add to our knowledge of bilingual learning in children with Down syndrome (DS) using a syntactic bootstrapping task.

METHOD

Four groups of children and youth matched on non-verbal mental age participated. There were 14 bilingual participants with DS (DS-B, mean age 12;5), 12 monolingual participants with DS (DS-M, mean age 10;10), 9 bilingual typically developing children (TD-B; mean age 4;1) and 11 monolingual typically developing children (TD-M; mean age 4;1). The participants completed a computerized syntactic bootstrapping task involving unfamiliar nouns and verbs. The syntactic cues employed were a for the nouns and ing for the verbs.

RESULTS

Performance was better on nouns than verbs. There was also a main effect for group. Follow-up t-tests revealed that there were no significant differences between the TD-M and TD-B or between the DS-M and DS-B groups. However, the DS-M group performed more poorly than the TD-M group with a large effect size. Analyses at the individual level revealed a similar pattern of results.

CONCLUSION

There was evidence that Down syndrome impacted performance; there was no evidence that bilingualism negatively affected the syntactic bootstrapping skills of individuals with DS. These results from a dynamic language task are consistent with those of previous studies that used static or product measures. Thus, the results are consistent with the position that parents should be supported in their decision to provide bilingual input to their children with DS.

LEARNING OUTCOMES

Readers of this article will identify (1) research evidence regarding bilingual development in children with Down syndrome and (2) syntactic bootstrapping skills in monolingual and bilingual children who are typically developing or who have Down syndrome.

Survey of Spanish Parents of Children Who Are Deaf or Hard of Hearing: Decision-Making Factors Associated With Communication Modality and Bilingualism

Purpose

The purpose of the present study was (a) to describe factors and trends associated with Spanish parents' choice of communication modality and spoken-language bilingualism for children who are deaf or hard of hearing (DHH) and (b) to identify if bilingual variables predict children's bilingual status in a country where bilingualism is common.

Method

Seventy-one Spanish parents of children who are DHH completed an online survey that included questions about demographics, family and professional involvement and support, accessibility to information and services, and bilingual background and beliefs. Analyses were completed to describe groups and to examine how variables were associated with parents' decisions.

Results

Thirty-eight percent of parents chose to raise their children to be spoken-language bilingual. Most parents indicated that they believed being bilingual was beneficial for their children and that children who are DHH are capable of becoming bilingual in spoken languages. Parent's bilingual score, beliefs about raising children who are DHH bilingually, and encouragement to do so, were significantly associated with children's bilingual status.

Conclusion

In communities where bilingualism is common, bilingual parents will often choose to raise children who are DHH bilingual in spoken languages. Implications for practice and future studies in the United States are provided.

The efficacy of a vocabulary intervention for dual-language learners with language impairment

PURPOSE

In this study, the authors evaluated the efficacy of a Spanish-English versus English-only vocabulary intervention for dual-language learners (DLLs) with language impairment compared to mathematics intervention groups and typically developing controls with no intervention. Further, in this study the authors also examined whether the language of instruction affected English, Spanish, and conceptual vocabulary differentially.

METHOD

The authors randomly assigned 202 preschool DLLs with language impairment to 1 of 4 conditions: bilingual vocabulary, English-only vocabulary, bilingual mathematics, or English-only mathematics. Fifty-four DLLs with typical development received no intervention. The vocabulary intervention consisted of a 12-week small-group dialogic reading and hands-on vocabulary instruction of 45 words. Postintervention group differences and linear growth rates were examined in conceptual, English, and Spanish receptive and expressive vocabulary for the 45 treatment words.

RESULTS

Results indicate that the bilingual vocabulary intervention facilitated receptive and expressive Spanish and conceptual vocabulary gains in DLLs with language impairment compared with the English vocabulary intervention, mathematics intervention, and no-intervention groups. The English-only vocabulary intervention differed significantly from the mathematics condition and no-intervention groups on all measures but did not differ from the bilingual vocabulary intervention. Vocabulary growth rates postintervention slowed considerably. Results support the idea that bilingual interventions support native- and second-language vocabulary development.

CONCLUSION

English-only intervention supports only English. Use of repeated dialogic reading and hands-on activities facilitates vocabulary acquisition.

Language Disorders in Multilingual and Multicultural Populations

We review the characteristics of developmental language disorders (primary language impairment, reading disorders, autism, Down syndrome) and acquired language disorders (aphasia, dementia, traumatic brain injury) among multilingual and multicultural individuals. We highlight the unique assessment and treatment considerations pertinent to this population, including, for example, concerns of language choice and availability of measures and of normative data in multiple languages. A summary of relevant, recent research studies is provided for each of the language disorders selected.

Issues in bilingualism and heritage language maintenance: perspectives of minority-language mothers of children with autism spectrum disorders

PURPOSE

The author investigated the language practices of 10 bilingual, Chinese/English-speaking, immigrant mothers with their children with autism spectrum disorders. The aim was to understand (a) the nature of the language practices, (b) their constraints, and (c) their impact.

METHOD

The author employed in-depth phenomenological interviews with thematic and narrative analyses to yield themes.

RESULTS

Interviewees reported that they adopted language practices perceived to be advantageous to intervention access and wellness. They valued Chinese language but did not pursue its use if it was believed to hinder the children's overall development of English acquisition. All of the mothers believed that bilingualism made learning more challenging. Many believed that it caused confusion or exacerbated disabilities. These deficit views of bilingualism were commonly reinforced by professionals. All of the mothers were motivated to help their children learn English but had no assistance to do so. Practices were sustainable only when they were aligned with families' preferred communication patterns.

CONCLUSIONS

There is an urgent need for practitioners to be better informed about issues related to intergenerational language practices in minority-language families. Language use between parents and children is a complex matter that is unique to each family. Parents need to be supported to make language use decisions that are self-enhancing and congruent with their families' needs.

Influence of additional language learning on first language learning in children with language disorders

BACKGROUND

Multilingualism can bring about various positive outcomes to typically developing children. Its effect on children with language difficulties is not yet clear.

AIM

The aim of this study was to examine the effects of multilingual learning as a medium of instruction (MOI) on first language (L1) acquisition of children with language disorders (LD).

METHODS & PROCEDURES

Nineteen Cantonese-speaking students aged 5;8-6;8 who were diagnosed with LD were recruited from a school that used Putonghua (an alternative Chinese dialect) as the MOI when learning Chinese language and were compared with 18 age-and-gender-matched Cantonese-speaking students with LD from a school that used Cantonese as the MOI when learning Chinese language. All the students also learned English (L2) as a subject at school. Proficiency in Cantonese was tested at the beginning and the end of the semester in Grade One in terms of: (1) grammar, (2) expressive vocabulary, (3) auditory textual comprehension, (4) word definition and (5) narration.

OUTCOMES & RESULTS

Mixed-model ANOVAs revealed an effect of time on language proficiency indicating positive gains in both groups. Interaction effects between time and group were not significant. There was a trend that children learning Putonghua showed slightly more improvement in auditory textual comprehension.

CONCLUSIONS & IMPLICATIONS

Proficiency gains were similar across groups. The study found no evidence that a multilingual learning environment hinders the language proficiency in L1 in students who have LD.

Survey of bilingualism in autism spectrum disorders

This survey study investigates issues related to bilingualism and autism. Bilingualism is common around the world but there is little published information to guide professionals and parents in making decisions about bilingualism for children with autism. Participants were 49 parents or guardians of children with autism who were members of a bilingual family; 75% were raising their child with autism spectrum disorders (ASD) to be bilingual or multilingual. Professionals did not always support this choice. Parents reported that living in a bilingual community and the need to communicate with various people in a variety of venues supported a bilingual choice along with the enrichment and job opportunities that bilingualism afforded. Parents also reported concerns around choosing bilingualism for their children with ASD, such as lack of services and supports and concerns about whether their children would be able to learn two languages. Children with ASD exposed to two languages were often reported to be acquiring their languages of exposure, albeit to varying degrees. Given the small sample size and the exploratory nature of the study, the need for more research is emphasized.

Neuropsychological effects of second language exposure in Down syndrome

BACKGROUND

While it has been common practice to discourage second language learning in neurodevelopmental disorders involving language impairment, little is known about the effects of second language exposure (SLE) on broader cognitive function in these children. Past studies have not found differences on language tasks in children with Down syndrome (DS) and SLE. We expand on this work to determine the effects on the broader cognitive profile, including tests tapping deficits on neuropsychological measures of prefrontal and hippocampal function.

METHOD

This study examined the specific cognitive effects of SLE in children with DS (aged 7-18 years). Children with SLE (n = 13: SLE predominantly Spanish) and children from monolingual homes (n = 28) were assessed on a standardised battery of neuropsychological tests developed for DS, the Arizona Cognitive Test Battery. The current exposure level to a language other than English in the SLE group was greater than 4 h per day on average.

RESULTS

No group differences were observed for any outcome, and level of exposure was also not linearly related to neuropsychological outcomes, several of which have been shown to be impaired in past work.

CONCLUSION

There were no measurable effects of SLE on neuropsychological function in this sample of children with DS. Potential clinical implications of these findings are discussed.

Towards evidence-based practice in language intervention for bilingual children

Evidence-based practice requires that clinical decisions be based on evidence from rigorously controlled research studies. At this time, very few studies have directly examined the efficacy of clinical intervention methods for bilingual children. Clinical decisions for this population cannot, therefore, be based on the strongest forms of research evidence, but must be inferred from other sources. This article reviews the available intervention research on bilingual children, the current clinical recommendations for this population, and the strength of the empirical and theoretical support on which these recommendations are based. Finally, future directions are suggested for documenting current methods of intervention and developing optimal methods for different groups of bilingual children. Although the current research base is limited, the few studies available to date uniformly suggest that interventions that include a focus on both languages are superior to those that focus on only one language. The available research offers little guidance, however, as to the particular treatment methods that may be most appropriate. Further research is required to examine efficacy with larger numbers of children and children of various bilingual backgrounds. It is suggested that efforts to develop and test intervention methods for bilingual children must carefully consider the linguistic heterogeneity of bilingual children and the cultural variation in communication styles, child rearing practices, and child rearing beliefs. This will lead to the development of methods that may involve treatment methods that are more suitable for other languages and cultures.

LEARNING OUTCOMES

Readers will become familiar with current recommendations for the treatment of bilingual children with language impairment, including which language or languages to use, the requirement for cultural sensitivity, and specific procedures that may be beneficial for bilingual populations. The heterogeneity of the bilingual population of children is highlighted. Readers will gain an understanding of the strength of research evidence backing up recommended practices, as well as of gaps in our current knowledge base and directions for further development and research.

Bilingualism and Children With Down Syndrome

This article discusses bilingualism and the factors that influence rate of bilingual development and fluency. Subsequently, the author highlights questions often asked regarding bilingualism and children with Down syndrome, and provides case study examples of children and bilingual language development.

Parental Report of Infant Language Skills: A Review of the Development and Application of the Communicative Development Inventories

The Communicative Development Inventories (CDIs) are parent report measures of vocabulary and other aspects of language development in very young children. They have evolved over the past 20 years to be one of the most well recognised assessments of infant language. Of particular significance is the fact that the CDIs are the first measures of their kind to be widely translated and adapted for use in many different languages. The inventories have served a variety of functions including measuring early language acquisition, deriving normative data on language acquisition, and both identifying and describing children whose early language is significantly delayed. This review describes the development of the CDIs, summarises the volume of research that has been generated in a range of applications of the measures, and evaluates their current standing both as a research tool and as a clinical measure. Issues around the sensitivity and predictive value of the CDIs are also considered.