Understanding Disorder Within Variation: Production of English Grammatical Forms by English Language Learners

A cross-sectional investigation of disfluencies in typically developing Spanish-English bilingual children

PURPOSE

This study examined the language skills and the type and frequency of disfluencies in the spoken narrative production of typically developing Spanish-English bilingual children.

METHOD

A cross-sectional sample of 106 bilingual children (50 boys; 56 girls) enrolled in kindergarten through Grade 4, produced a total of 212 narrative retell language samples in English and Spanish. A specialized fluency coding system was implemented to index the percentage of total (%TD) and stuttering-like disfluencies (%SLD) in each language. Large-scale reference databases were used to classify children's dual language proficiency profiles (balanced, English dominant, Spanish dominant) based on language sample analysis measures of morphosyntax and lexical diversity.

RESULTS

The bilingual Spanish-English children in this study did not demonstrate significant cross-linguistic differences for mean %TD or %SLD. However, the mean %TD and %SLD in both languages exceeded the risk threshold based on monolingual English-speaking norms. English dominant bilingual children demonstrated significantly lower %TD in English than Spanish. Spanish dominant children demonstrated significantly lower %SLD in Spanish than English.

CONCLUSIONS

This study included the largest sample size of bilingual Spanish-English children investigated to date from a fluency perspective. The frequency of disfluencies was found to be variable across participants and change dynamically as a function of grade and dual language proficiency profiles, indicating the need for studies that employ larger sample sizes and longitudinal designs.

Recast Therapy for Treating Syntax in Bilingual Children With Developmental Language Disorder: A Feasibility and Early Efficacy Study Examining the Role of Language of Intervention on Outcomes

PURPOSE

The purpose of this study is to examine the feasibility of the delivery of complex syntax recast therapy via telepractice to Spanish-English bilingual children and provide preliminary evidence of the efficacy of this approach.

METHOD

Fifteen bilingual children with developmental language disorders were stratified based on language proficiency and randomized to one of three treatment conditions: Spanish only (n = 5), English only (n = 6), or Spanish + English (n = 4). Using a within-subject design, we hypothesized that we could document treatment efficacy based on change in the treated structure in the absence of change in an untreated comparison structure. All 15 children completed ~16 hr of treatment via telepractice and participated in pre- and posttesting of their production of conditional adverbs (treated structure) and subject relative clauses (untreated structure) carried out by a masked assessor.

RESULTS

Analyses included all participants. Treatment fidelity was high, and participant attendance was remarkable, indicating feasibility. Regarding efficacy, recast therapy led to group-level gains on treated syntactic structures that exceeded those observed for the untreated comparison structure. For the 11 children who received therapy in only one language, approximately equal gains were observed in both the treated and untreated languages for conditional adverbials.

CONCLUSIONS

Preliminary evidence suggests that for highly overlapping structures like conditional adverbials, recast therapy is effective and leads to change in both of the child's languages. Larger studies are required to understand how language of administration and proficiency may affect outcomes.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.23739996.

Semantic Difficulty for Bilingual Children: Effects of Age, Language Exposure, and Language Ability

PURPOSE

Semantic tasks evaluate dimensions of children's lexical-semantic knowledge. However, the relative ease of semantic task completion depends on individual differences in developmental and language experience factors. The purpose of this study was to evaluate how language experience and language ability impact semantic task difficulty in English for school-age Spanish-English bilingual children with and without developmental language disorder (DLD).

METHOD

Participants included 232 Spanish-English bilingual children in second through fifth grade with (n = 35) and without (n = 197) DLD. Data included children's performance on the English Semantics subtest of the Bilingual English-Spanish Assessment-Middle Extension Field Test Version (BESA-ME), age of English acquisition, and percent English language exposure. Task difficulty, a measurement of the relative ease of task completion, was calculated for six semantic task types included on the BESA-ME. Multilevel regression modeling was conducted to estimate longitudinal growth trajectories for each semantic task type.

RESULTS

Results showed that language ability and grade level drive semantic task difficulty for all task types, and children with DLD experienced greater difficulty on all task types compared to their typically developing peers. Longitudinally, semantic task difficulty decreased for all children, regardless of language ability, indicating that semantic task types became easier over time. While children made gains on all semantic tasks, the growth rate of task difficulty was not equal across task types, where some task types showed slower growth compared with others. English language exposure emerged as a significant predictor of semantic task difficulty while age of acquisition was not a significant factor.

CONCLUSIONS

This study clarifies developmental profiles of lexical-semantic performance in bilingual children with and without DLD and supports clinical decision-making regarding children's English language learning.

Bilingual Primary Progressive Aphasia: A Scoping Review of Assessment and Treatment Practices

BACKGROUND

Primary progressive aphasia (PPA) is a neurodegenerative syndrome characterized by speech and/or language impairment with relatively spared cognition. Research investigating behavioral speech-language intervention and methods for cognitive-linguistic assessment in PPA has predominantly centered around monolingual speakers. This gap hinders the widespread adoption of evidence-based approaches and exacerbates the inequities faced by culturally and linguistically diverse populations living with PPA.

OBJECTIVE

This scoping review synthesizes the current evidence for assessment and treatment practices in bilingual PPA as well as the operationalization of bilingualism in PPA.

METHODS

Arksey & O'Malley's scoping review methodology was utilized. Information was extracted from each study and entered into a data-charting template designed to capture information regarding operationalization of bilingualism in PPA and assessment and treatment practices.

RESULTS

Of the 16 identified studies, 14 reported the results of assessments conducted in both languages. Three studies reported positive naming treatment outcomes. Thirteen studies included English-speaking participants, revealing linguistic bias. Most studies reported age of acquisition, proficiency, and patterns of language use rather than providing an operational definition for bilingualism.

CONCLUSIONS

Neither formal assessment measures nor clear guidelines for assessment of bilingual PPA currently exist; however, language-specific measures are emerging. Speech-language intervention in bilingual PPA has been relatively unexplored, representing a significant gap in the literature. In order to improve diagnostic and treatment options for bilingual PPA, targeted efforts to increase representation of bilinguals from various sociocultural contexts, as well as those who speak a variety of language pairs, is necessary.

Sharpening Our Tools: A Systematic Review to Identify Diagnostically Accurate Language Sample Measures

PURPOSE

This systematic review provides a comprehensive summary of the diagnostic accuracy of English language sample analysis (LSA) measures for the identification of developmental language disorder.

METHOD

An electronic database search was conducted to identify English publications reporting empirical data on the diagnostic accuracy of English LSA measures for children aged 3 years or older.

RESULTS

Twenty-eight studies were reviewed. Studies included between 18 and 676 participants ranging in age from 3;0 to 13;6 (years;months). Analyzed measures targeted multiple linguistic domains, and diagnostic accuracy ranged from less than 25% to greater than 90%. Morphosyntax measures achieved the highest accuracy, especially in combination with length measures, and at least one acceptable measure was identified for each 1-year age band up to 10 years old.

CONCLUSION

Several LSA measures or combinations of measures are clinically useful for the identification of developmental language disorder, although more research is needed to replicate findings using rigorous methods and to explore measures that are informative for adolescents and across diverse varieties of English.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.21183247.

Identifying Language Disorder in Bilingual Children Using Automatic Speech Recognition

PURPOSE

The differential diagnosis of developmental language disorder (DLD) in bilingual children represents a unique challenge due to their distributed language exposure and knowledge. The current evidence indicates that dual-language testing yields the most accurate classification of DLD among bilinguals, but there are limited personnel and resources to support this practice. The purpose of this study was therefore to determine the feasibility of dual-language automatic speech recognition (ASR) for identifying DLD in bilingual children.

METHOD

Eighty-four Spanish-English bilingual second graders with (n = 25) and without (n = 59) confirmed diagnoses of DLD completed the Bilingual English-Spanish Assessment-Middle Extension Morphosyntax in both languages. Their responses on a subset of items were scored manually by human examiners and programmatically by a researcher-developed ASR application employing a commercial speech-to-text algorithm.

RESULTS

Results demonstrated moderate overall item-by-item scoring agreement (k = .54) and similar classification accuracy values (human = 92%, ASR = 88%) between the two methods using the best-language score. Classification accuracy of the ASR method increased to 94% of cases correctly classified when test items with poorer discrimination in the ASR condition were eliminated.

CONCLUSION

This study provides preliminary support for the technical feasibility of ASR as a bilingual expressive language assessment tool.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.20249994.

Measuring English Narrative Microstructure in Preschool Dual Language Learners

PURPOSE

The purpose of the study was to examine the change in specific English microstructure features according to language ability in preschool Spanish-English dual language learners.

METHOD

We collected English narratives from 22 Spanish-English dual language learners with typical language development (TD) and 22 Spanish-English dual language learners with developmental language disorder (DLD) at the beginning and end of their first year in Head Start. Children came from Spanish-speaking homes and were exposed to English and Spanish in their preschool classrooms. We analyzed children's use of English microstructure across time using the Narrative Assessment Protocol.

RESULTS

Both groups showed improvement in overall English microstructure use, although children with TD made greater gains than children with DLD. Phrase structure (noun phrases, coordinating conjunctions, and prepositional phrases) increased in both groups, but more so in children with TD than with DLD. Sentence structure (compound, complex, negative, and interrogative sentences) increased in both groups. Verb use, noun use (Tier 2 nouns and nouns marked with plural and possessive endings), and modifiers (adverbs and adjectives) neither changed across time nor differed between groups.

CONCLUSIONS

Spanish-English dual language learners who attend Head Start and come from Spanish-speaking homes, regardless of language ability, may not readily acquire verbs, nouns, and modifiers during their first year of formal English exposure, suggesting that they would benefit from explicit instruction in these areas. Preschool Spanish-English dual language learners with DLD may make less progress than their peers with TD in phrase structure use, indicating that explicit instruction in this microstructure feature may be beneficial for children with DLD.

English BESA Morphosyntax Performance Among Spanish-English Bilinguals Who Use African American English

Purpose This study examined the use of African American English (AAE) among a group of young Latinx bilingual children and the accuracy of the English Morphosyntax subtest of the Bilingual English-Spanish Assessment (BESA) in classifying these children with and without developmental language disorder (DLD). Method Children (N = 81) between the ages of 4;0 and 7;1 (years;months) completed a narrative task and the BESA Morphosyntax subtest. We identified DLD based on four reference measures. We compared specific dialectal features used by children with DLD and their typically developing peers. We also conducted an overall analysis of the BESA subtest and subsequent item-level analyses to determine if particular items were more likely to contribute to the correct classification of the participants. Results Children with DLD used three AAE forms in their narrative samples (subject-verb agreement, zero copula/auxiliary, or zero past tense) more frequently than their typically developing peers. Area-under-the-curve estimates for the cloze, sentence repetition, and composite scores of the BESA indicated that the assessment identified children with DLD in the sample with good sensitivity. Item analysis indicated that the majority of items (84%) significantly differentiated typically developing children and children with DLD. Conclusions The BESA English Morphosyntax subtest appears to be a valid tool for the identification of DLD in children exposed to AAE and Spanish. We provide practical implications and suggestions for future research addressing the identification of DLD among children from culturally and linguistically diverse backgrounds.

Contribution of Nonverbal Cognitive Skills on Bilingual Children’s Grammatical Performance: Influence of Exposure, Task Type, and Language of Assessment

This study explores the contribution of nonverbal working memory and processing speed on bilingual children’s morphosyntactic knowledge, after controlling for language exposure. Participants include 307 Spanish–English bilinguals in Kindergarten, second, and fourth grade (mean age = 7;8, SD = 18 months). Morphosyntactic knowledge in English and Spanish was measured using two separate language tasks: a cloze task and a narrative language task. In a series of four hierarchical linear regressions predicting cloze and narrative performance in English and Spanish, we evaluate the proportion of variance explained after adding (a) English exposure, (b) processing speed and working memory, and (c) interaction terms to the model. The results reveal the differential contribution of nonverbal cognitive skills across English and Spanish. Cognition was not significantly related to performance on either grammatical cloze or narrative tasks in Spanish. Narrative tasks in English were significantly predicted by processing speed, after controlling for age and exposure. Grammatical cloze tasks in English posed an additional cognitive demand on working memory. The findings suggest that cognitive demands vary for bilinguals based on the language of assessment and the task.

Grammatical Characteristics of Vietnamese and English in Developing Bilingual Children

Purpose Defining parameters for typical development in bilingual children's first and second languages can serve as the basis for accurate language assessment. This is the first study to characterize Vietnamese and English grammatical development in a sample of bilingual children. Method Participants were 89 Vietnamese-English bilingual children, aged 3-8 years. Children completed story retell tasks in Vietnamese and English. Stories were transcribed and analyzed for grammaticality, error patterns, subordination index, and types of subordinating clauses. Of key interest were associations with age and identifying developmental patterns that were shared across languages or unique to a given language. Results Age correlated with more measures in English than in Vietnamese, suggesting that older children had higher grammaticality and greater syntactic complexity in English than younger children. Children also produced greater syntactic complexity with age in Vietnamese, but not higher grammaticality. There were a set of error patterns shared across languages (e.g., object omission) and patterns specific to each language (e.g., classifier errors in Vietnamese, tense errors in English). While children produced nominal, adverbial, and relative clauses in Vietnamese and English, the proportion of each clause type differed by language. Conclusions Results from this typically developing sample provide a reference point to improve clinical practice. Characterizing developmental patterns in sentence structure in Vietnamese and English lays the groundwork for investigations of language disorders in this bilingual population.

Beyond Scores: Using Converging Evidence to Determine Speech and Language Services Eligibility for Dual Language Learners

Purpose Speech-language pathologists have both a professional and ethical responsibility to provide culturally competent services to dual language learners (DLLs). In this tutorial, we recommend that clinicians use a comprehensive assessment of converging evidence to make diagnostic decisions in DLLs in accordance with the American Speech-Language-Hearing Association's Code of Ethics. The content of this tutorial is most appropriate for Spanish-English DLLs between the ages of 4 and 8 years. Method We propose a converging evidence approach, in which one single method is not the deciding factor in making diagnostic decisions regarding the dual language and speech production skills of DLLs. Converging evidence refers to the idea that multiple pieces of assessment data must come together and trend in the same direction to make a diagnostic decision. We recommend gathering assessment data using a combination of language experience questionnaires, bilingual language sample analysis using large-scale reference databases, evaluation of learning potential, and standardized testing. These four assessment methods allow clinicians to examine the child in different contexts to determine their strengths and weakness in communication abilities. Conclusion We illustrate the converging evidence framework using two case studies to guide the clinician through the diagnostic decision-making process.

Insights Into Category Sorting Flexibility in Bilingual Children: Results of a Cognitive Lab Study

Purpose The purpose of this study was to explore how bilingual children shift sets to gain flexibility when forming categories. Using a cognitive lab approach focused on understanding how learners approach problems, we asked children to sort 10 sets of pictures representing common objects in two different ways and to explain their rationale for the sort. We explored the relationship between age and language use on their performance. Method Forty-six typically developing Spanish-English bilingual children (25 girls, 21 boys) participated in the study. They ranged in age from 4;0 to 10;11 (years;months). Receptive and expressive responses to a novel category sorting task were collected. Results Forty-four of the 46 children tested were able to perform the category sorting task. Within language, receptive and expressive category sorting scores were positively and significantly correlated while only expressive scores were significantly associated across languages. There were significant correlations between the sorting scores and age and language output and input. Children's ability to provide expressive responses explaining their sort strategy was moderately correlated with their language experience, especially English output. Conclusions The category sorting task proved useful in eliciting sorting behaviors and naming from the children tested. The age effect suggests that sorting may reflect their general developmental experience rather than their language-specific experience. The cognitive lab approach allowed us to understand how children shift sets and verbalize their understanding of the categorization process. Knowing how children approach this task can inform future work to develop ways to strategically select language intervention goals and document progress.

The Utility of an English Semantics Measure for Identifying Developmental Language Disorder in Spanish-English Bilinguals

Purpose We examined the English semantic performance of three hundred twenty-seven 7- to 10-year-old Spanish-English bilinguals with (n = 66) and without (n = 261) developmental language disorder (DLD) with varying levels of English experience to classify groups. Method English semantic performance on the Bilingual English-Spanish Assessment-Middle Extension Experimental Test Version (Peña et al., 2008) was evaluated by language experience, language ability, and task type. Items that best identified DLD for children with balanced and high English experience were selected. Separately, items that best identified children with high Spanish experience were selected. Results Typically developing bilingual children performed significantly higher than their peers with DLD across semantic tasks, with differences associated with task type. Classification accuracy was fair when item selection corresponded to balanced or high level of experience in English, but poor for children with high Spanish experience. Selecting items specifically for children with high Spanish experience improved classification accuracy. Conclusions Tailoring semantic items based on children's experience is a promising direction toward organizing items on a continuum of exposure. Here, classification effectively ruled in impairment. Future work to refine semantic items that more accurately represent the continuum of exposure may help rule out language impairment.

"Did I Say Cherry?" Error Patterns on a Blocked Cyclic Naming Task for Bilingual Children With and Without Developmental Language Disorder

Purpose Using a blocked cyclic picture-naming task, we compared accuracy and error patterns across languages for Spanish-English bilingual children with and without developmental language disorder (DLD). Method Pictured stimuli were manipulated for semantic similarity across two (Same and Mixed) category contexts. Children's productions were scored off-line for accuracy, error frequency, and error type. Results Typically developing children were more accurate and produced fewer errors than their peers with DLD; however, this was moderated by task language and semantic context. Children were generally more accurate when naming pictures in English compared to Spanish and in the Mixed-category context compared to the Same-category context. Analyses of error types further showed that children with less English language exposure specifically produced more nonresponses in English than in Spanish. Children with DLD produced more of each error type than their typically developing peers, particularly in Spanish. Conclusions Regardless of language ability, bilingual children demonstrated greater difficulty with lexical retrieval for pictured items in the semantically related context than in the unrelated context. However, bilingual children with DLD produced more errors of all types than is typical for children developing more than one language. Their greater error rates are not secondary to limited second language exposure but instead reflect deficits inherent to the nature of language impairment. Results from this study are discussed using a framework of semantic constraint, where we propose that because bilingual children with DLD have impoverished semantic networks, and this knowledge insufficiently constrains activation for lexical selection, thereby increasing error production.

Including Nonlinguistic Processing Tasks in the Identification of Developmental Language Disorder

Purpose Accurate identification of developmental language disorder (DLD) remains challenging, particularly for children who speak different dialects, languages, or more than 1 language. Children with DLD, on average, have shown subtle deficits on nonlinguistic cognitive processing tasks, and performance on such tasks may be minimally influenced by language experience. This study explores whether nonlinguistic cognitive processing tasks can contribute to the identification of DLD in children from diverse linguistic backgrounds. Method Study 1 combined data from 4 U.S.-based investigations to yield a sample of 395 children, ages 6-10 years, who spoke only English or both Spanish and English. Study 2 consisted of an international sample of 55 kindergarten children living in Vietnam. Each study included children with DLD and children with typical development. Participants completed nonlinguistic cognitive tasks of processing speed, auditory working memory, and attentional control. Data analysis compared typically developing to DLD groups by age and language background. Then, we empirically derived cut-points to report diagnostic accuracy (sensitivity, specificity, and positive and negative likelihood ratios). Results For all 3 tasks, adequate sensitivity or specificity (but not both in most cases) was achieved in nearly all age groups. Likelihood ratios reached moderately to very informative levels in several instances. Diagnostic results were maintained when monolingual and bilingual samples were combined into a single group. Conclusions Nonlinguistic cognitive processing tasks may contribute to accurate identification of DLD in combination with other measures. Further research is needed to refine tasks, confirm cut-points established here, and extend findings to children from additional language backgrounds.

Evaluating English Morpheme Accuracy, Diversity, and Productivity Measures in Language Samples of Developing Bilinguals

Purpose

This work explores the clinical relevance of three measures of morpheme use for preschool-age Spanish-English bilingual children with varying language skills. The 3 measures reflect accuracy, diversity (the tense marker total), and productivity (the tense and agreement productivity score [TAP score]) of the English tense and agreement system.

Method

Measures were generated from language samples collected at the beginning and end of the participants' preschool year. Participants included 74 typically developing Spanish-English bilinguals and 19 peers with low language skills. The morpheme measures were evaluated with regard to their relationships with other language sample measures, their ability to reflect group differences, and their potential for capturing morphological development at group and individual levels.

Results

Across both groups, the tense marker total and TAP scores were associated with other language measures and demonstrated both group differences and growth over time. The accuracy measure met few of these benchmarks.

Conclusion

The tense marker total and TAP score, which were designed to capture emerging morphological abilities, contribute valuable information to a comprehensive language assessment of young bilinguals developing English. Case examples are provided to illustrate the clinical significance of including these measures in assessment.

Production of Spanish Grammatical Forms in U.S. Bilingual Children

PURPOSE

The purpose of this analysis was to understand how grammatical morpheme production in Spanish for typically developing Spanish-English bilingual children relates to mean length of utterance in words (MLUw) and the extent to which different bilingual profiles influence order of grammatical morpheme acquisition.

METHOD

Participants included 228 Spanish-English bilingual children ages 4;0-7;6 (years;months). Grammatical morpheme accuracy was evaluated using an experimental version of the Bilingual English-Spanish Assessment (Peña, Gutiérrez-Clellen, Iglesias, Goldstein, & Bedore, 2014). MLUw data were calculated from children's narrative samples. Production accuracy of plural nouns, singular and plural definite articles, preterite tense, imperfect aspect, direct object clitics, prepositions, subjunctive, and conjunctions was calculated and analyzed as a function of MLUw in Spanish. Level of accuracy on these forms was compared for Spanish-dominant and English-dominant groups.

RESULTS

Accuracy was significantly associated with MLUw. The relative difficulty of Spanish grammatical morphemes is highly similar across different bilingual profiles.

CONCLUSIONS

There are common elements of Spanish that are easy (imperfect, plural nouns, singular articles, conjunctions), medium (plural articles, preterite), or hard (prepositions, direct object clitics, subjunctive), regardless of whether a child is a Spanish-dominant or English-dominant bilingual.

Prologue: Toward Accurate Identification of Developmental Language Disorder Within Linguistically Diverse Schools

Purpose

Although the 5 studies presented within this clinical forum include children who differ widely in locality, language learning profile, and age, all were motivated by a desire to improve the accuracy at which developmental language disorder is identified within linguistically diverse schools. The purpose of this prologue is to introduce the readers to a conceptual framework that unites the studies while also highlighting the approaches and methods each research team is pursuing to improve assessment outcomes within their respective linguistically diverse community.

Method

A disorder within diversity framework is presented to replace previous difference vs. disorder approaches. Then, the 5 studies within the forum are reviewed by clinical question, type of tool(s), and analytical approach.

Conclusion

Across studies of different linguistically diverse groups, research teams are seeking answers to similar questions about child language screening and diagnostic practices, using similar analytical approaches to answer their questions, and finding promising results with tools focused on morphosyntax. More studies that are modeled after or designed to extend those in this forum are needed to improve the accuracy at which developmental language disorder is identified.