We Have to Talk About Something: Why NOT Talk About the Curriculum? A Guide to Embedding Language Interventions in Curricular Content

PURPOSE

Children with developmental language disorder frequently have difficulty with both academic success and language learning and use. This clinical focus article describes core principles derived from a larger program of research (National Science Foundation 1748298) on language intervention combined with science instruction for preschoolers. It serves as an illustration of a model for integrating language intervention with curricular content delivery.

METHOD

We present a five-step model for a speech-language pathologist and other school professionals to follow to (a) understand the grade-level core curriculum objectives; (b) align intervention targets with the curriculum; (c) select a therapy approach that aligns with both goals and curricular content, and (d) methods for implementing the intervention; and (e) verify that both the intervention and the curriculum have been provided in accordance with best practices. We apply this model to the Next Generation Science Standards, a science curriculum popular in the United States, and to grammar and vocabulary interventions, two areas of difficulty for children with developmental language disorders, though it would be possible to extend the steps to other curricular areas and intervention targets.

CONCLUSIONS

We conclude by discussing the barriers and benefits to adopting this model. We recognize that both speech-language pathologists and teachers may have limited time to implement language intervention within a general education curriculum, but we suggest that the long-term benefits outweigh the barriers.

A Review of Screeners to Identify Risk of Developmental Language Disorder

PURPOSE

This review aims to comprehensively summarize, compare, and evaluate screeners used to identify risk for developmental language disorder (DLD), a common learning disability that is underidentified. Screening for DLD is a cost-effective way to identify children in need of further assessment and, in turn, provides much needed supports.

METHOD

We identified 15 commercially available English language DLD screeners in North America. We then characterized each screener on 27 aspects in three domains, including (a) accessibility information (acronym, subtest, website, cost, materials included, publish year, examiner qualification, age range, administration time, and administration format), (b) usability features (dialect compatibility, progress monitoring function, actionable follow-up instruction, group assessment capability, and online administration availability), and (c) technical standards (the availability of a technical manual, conceptual definition, the sample size used in classification accuracy calculation, sample distribution, year of sample collection, outcome measure, sample base rate, cutoff score, sensitivity, specificity, positive predictive value, and negative predictive value).

RESULTS

We obtained sufficient accessibility information from 14 out of 15 (93%) screeners. In contrast, none of the screeners (0%) included comprehensive usability features. Ten screeners (67%) included a range of classification accuracy (70%-100% sensitivity and 68%-90% specificity). We provided areas of strength and weakness for each screener as a quick reference for users and generated screener recommendations for five practical scenarios.

CONCLUSIONS

Our findings presented some DLD screeners that meet most standards and highlight numerous areas for improvement, including improving classification accuracy and clarifying follow-up instructions for children who are identified with DLD risk. Screening for DLD is critical to provide timely early identification, intervention, and classroom support, which in turn facilitates student outcomes.

Remote First-Language Assessment: Feasibility Study With Vietnamese Bilingual Children and Their Caregivers

PURPOSE

There is a shortage of bilingual speech-language pathologists (SLPs) in the United States. For Vietnamese, less than 1% of SLPs speak the language compared with a Vietnamese American population of > 2.1 million. This study examines the feasibility and social validity of remote child language assessment with the help of a caregiver to address the need for first language assessments among Vietnamese-speaking children.

METHOD

Twenty-one dyads of caregivers and typically developing children (aged 3-6 years) completed two assessment sessions in their first language, Vietnamese, using Zoom videoconferencing. Sessions were counterbalanced between two conditions in which either the clinician or the caregiver was the task administrator. Children's language samples were elicited using narrative tasks. Social validity was also assessed through caregiver and child questionnaires at the end of each session.

RESULTS

There were no significant differences between conditions on language sample measures nor the measures of social validity. Both caregivers and their children felt positively about the sessions. The caregivers' feelings were related to their perception of children's feelings about the sessions. Children's feelings were related to their Vietnamese language proficiency, caregiver-reported language ability, and whether they were born outside of the United States.

CONCLUSIONS

Findings build the evidence base for telepractice as an effective and socially valid service delivery model for bilingual children in the United States. This study supports the potential for caregivers as task administrators in a telepractice setting, making assessment in a child's first language more feasible and accessible. Future investigation is needed to extend results to bilingual populations with disorders.

Understanding (un)grammaticality in context: Evidence from young Spanish-English bilinguals over time

PURPOSE

Percent grammatical utterances (PGU) provides clinicians and researchers with meaningful information on young children's grammatical abilities (Eisenberg & Guo, 2016). However, work is still needed to place PGU within the context of conventional language sample measures and understand how PGU reflects grammatical development in bilingual populations. The current study focuses on Spanish-English bilingual preschoolers to examine: 1) change in Spanish and English PGU over one year of preschool English instruction, 2) associations between PGU and other language sample measures within each language and across time, and 3) the types and frequency of error patterns in each language.

METHOD

Play-based language samples were elicited in English and Spanish from bilingual children (n = 19) at the beginning and end of an instructional preschool year in English. PGU was derived from each sample along with other language sample measures (e.g., mean length of utterance). We examined change in PGU from Time 1 to Time 2, and correlations between Time 1 PGU and Time 2 PGU for each language. Specific grammatical errors were described in terms of their frequency in each language and stability across time.

RESULTS

Average English PGU increased from Time 1 to Time 2, and correlated with other language sample measures. Conversely, average Spanish PGU did not increase from Time 1 to Time 2, nor did PGU correlate with any other Spanish measure. Error patterns in each language reflected grammatical differences across English and Spanish.

CONCLUSIONS

Our results revealed distinct developmental patterns in bilingual children's first and second languages. Associations between time points and measures in English contrasted with disassociations in Spanish. Error patterns revealed more detailed information as to how bilingual children begin to acquire grammatical structures in each of their languages. We provide a case example to illustrate how grammaticality and error patterns can be used to characterize children's language abilities. We conclude with clinical implications of grammaticality in Spanish-English bilingual children.

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.

The Cultural and Diagnostic Appropriateness of Standardized Assessments for Dual Language Learners: A Focus on Jamaican Preschoolers

Purpose The aim of this study was to investigate the appropriateness of standardized assessments of expressive grammar and vocabulary in a sample of preschool-age dual language learners (DLLs) who use Jamaican Creole (JC) and English. Adult models from the same linguistic community as these children were used to inform culturally and linguistically appropriate interpretation of children's responses to a standardized assessment. Method JC-English-speaking preschoolers (n = 176) and adults (n = 33) completed the Word Structure and Expressive Vocabulary subtests of the Clinical Evaluation of Language Fundamentals Preschool-Second Edition. Adults' responses were used to develop an adapted scoring procedure that considered the influence of JC linguistic features on responses. DLLs' responses scored using the standard English and adapted JC procedures were compared. Results JC-English DLLs and adults used similar linguistic structures in response to subtest questions. DLLs' scores differed significantly from the standardized sample on both subtests. Preschoolers received higher raw and corresponding standard scores with adapted scoring compared to standard scoring. Adapted scoring that made use of adult models yielded high classification accuracy at a rate of 93.8% for Word Structure and 92.1% for Expressive Vocabulary. Conclusions Adapting standardized assessment scoring procedures using adult models may offer an ecologically valid approach to working with DLL preschoolers that can support a more accurate assessment of language functioning. These findings suggest that the use of standardized assessments for bilingual JC-English speakers requires a culturally responsive approach. Supplemental Material https://doi.org/10.23641/asha.14403026.

Marking of Tense and Agreement in Language Samples by Children With and Without Specific Language Impairment in African American English and Southern White English: Evaluation of Scoring Approaches and Cut Scores Across Structures

Purpose As follow-up to a previous study of probes, we evaluated the marking of tense and agreement (T/A) in language samples by children with specific language impairment (SLI) and typically developing controls in African American English (AAE) and Southern White English (SWE) while also examining the clinical utility of different scoring approaches and cut scores across structures. Method The samples came from 70 AAE- and 36 SWE-speaking kindergartners, evenly divided between the SLI and typically developing groups. The structures were past tense, verbal -s, auxiliary BE present, and auxiliary BE past. The scoring approaches were unmodified, modified, and strategic; these approaches varied in the scoring of forms classified as nonmainstream and other. The cut scores were dialect-universal and dialect-specific. Results Although low numbers of some forms limited the analyses, the results generally supported those previously found for the probes. The children produced a large and diverse inventory of mainstream and nonmainstream T/A forms within the samples; strategic scoring led to the greatest differences between the clinical groups while reducing effects of the children's dialects; and dialect-specific cut scores resulted in better clinical classification accuracies, with measures of past tense leading to the highest levels of classification accuracy. Conclusions For children with SLI, the findings contribute to studies that call for a paradigm shift in how children's T/A deficits are assessed and treated across dialects. A comparison of findings from the samples and probes indicates that probes may be the better task for identifying T/A deficits in children with SLI in AAE and SWE. Supplemental Material https://doi.org/10.23641/asha.13564709.

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.

Production of Morphosyntax Within and Across Different Dialects of American English

Purpose This study examined the production of morphosyntactic markers by school-age children with and without developmental language disorder. Comparisons were made between students who speak mainstream American English (MAE) dialects and nonmainstream American English (NMAE) dialects. Method First- and second-grade students (N = 82) completed assessments of dialect use and language ability, which are designed for students who speak NMAE dialects. Students also completed an experimental production task targeting three morphosyntactic features: past tense -ed marking, third-person singular -s marking, and plural -s marking. Past tense marking and third-person singular are produced differently across MAE and NMAE dialects, whereas plural marking is produced more similarly across dialects. Results When comparing across dialects, children with typical language skills who spoke NMAE dialects overtly marked past tense and third-person singular less often compared to MAE peers. However, when comparing to same-dialect peers with language disorders, children with typical language skills who spoke NMAE dialects overtly marked these morphosyntactic markers more often than peers with developmental language disorder. Conclusion The results underscore the importance of considering a child's dialect use when assessing language ability, in particular with measures that include features that are variable in NMAE dialects. At the same time, within-dialect comparisons suggest that a broader set of morphosyntactic features may provide useful information for evaluations of language ability. Future research should investigate the source of these differences, including the extent to which students with language disorders have acquired the social and linguistic factors that condition the use of variable features.

Towards understanding the bilingual profile in typical and atypical language development: A tutorial

Purpose: The purpose of this tutorial is to inform assessment, treatment and research approaches that are uniquely tailored to bilingual children with and without developmental language disorder (DLD), a communication disorder characterised by weaknesses in language production and comprehension.Method: A review is presented on what is known about joint language activation in adult and child bilinguals. This supports a discussion of the bilingual profile, which includes cross-language interactions and associations with broader cognitive functions. This is followed by consideration on how these bilingual phenomena may manifest in the context of relatively weak language skills, as is the case with DLD.Result: In addition to exploring the bilingual profile, guidelines are provided for incorporating cognates - a type of translation equivalent with distinct overlap in form and meaning that enhances cross-linguistic interactions - in language assessment, therapy and research.Conclusion: The field of speech-language pathology would benefit from more tools specifically designed for bilingual children. Already, there is interest in clinical applications of cognates, as they may support transfer and generalisation across languages. Future research is needed to better explore this potential in child bilinguals, particularly those with DLD. Such work would help establish a developmental bilingual language processing model with clinical relevance.

Survey of assessment and intervention practices for students who speak African American English

Speech-Language Pathologists (SLPs) working with students from culturally and linguistically diverse backgrounds are encouraged to be "familiar with nondiscriminatory testing and dynamic assessment procedures" (ASHA, 2003). Little is known, however, about the extent to which SLPs implement these methods into their clinical practice. The current study explores the assessment and intervention practices used by SLPs in two states in the US for students who speak African American English (AAE), including the types and frequency of clinical practices. 247 SLPs completed an online survey regarding clinical practices for students who speak AAE as well as a questionnaire regarding their knowledge of the linguistic features of AAE. Half of SLPs reported using modified or alternative assessment practices the majority of the time or some of the time for students who speak AAE; however, SLPs reported using modified or alternative treatment practices less often. Modified scoring of standardized assessments and selecting different intervention strategies were the most commonly reported clinical practices. Knowledge of linguistic features of AAE was a significant predictor of the frequency with which SLPs report implementing modified or alternative assessment and intervention practices and SLPs with the highest levels of knowledge of AAE utilize different clinical practices than those with lower levels of knowledge of AAE. Additional information is needed about the most effective clinical practices for students who speak AAE and the barriers SLPs face to implementing nondiscriminatory clinical practices.

Introduction to the Forum: Innovations in Clinical Practice for Dual Language Learners, Part 1

Purpose The purpose of this introduction is to provide the background for this forum of American Journal of Speech-Language Pathology and an overview of the articles published in this first of two installments of this forum.

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.

Language assessment of monolingual and multilingual children using non-word and sentence repetition tasks

The number of children speaking more than one language as well as the number of languages spoken in Ireland has increased significantly posing a problem for timely identification of children with language disorder. The current study aims to profile performance of monolingual and multilingual children on language processing tasks: non-word repetition (NWR) and sentence repetition (SR). We used: (1) Crosslinguistic (CL) and English Language-Specific (LS) NWR and (2) SR in English, Polish and Russian. Children's socioeconomic status, language emergence, the age of exposure (AoE) to English and the percentage of English spoken at home were recorded. The study included 88 children age 5-8 attending a school in a disadvantaged area.CL and LS NWR yielded similar distribution of scores for monolinguals and multilinguals. The tasks identified small number of children who performed significantly lower than the mean while there were no significant differences between the groups. In English SR, monolinguals significantly outperformed multilinguals. Comparison of SR in English and Polish/Russian indicated that some children showed balanced performance in both of their languages while others showed marked differences performing better in either Polish/Russian or English depending on their AoE to English and percentage of English spoken at home.The pilot study suggests that CL-NWR is a promising screening tool for identifying monolingual and multilingual children with language disorder while SR provides more detailed information on children's language performance relative to their language exposure. SR task is recommended to be used only if comparable tasks are available in all of children's languages.