Taking Language Samples Home: Feasibility, Reliability, and Validity of Child Language Samples Conducted Remotely With Video Chat Versus In-Person

The Use of Language Sample Analysis to Differentiate Developmental Language Disorder From Typical Language in Bilingual Children: A Systematic Review and Meta-Analysis

PURPOSE

Language sample analysis (LSA) is a commonly recommended method of assessment for bilingual children. This systematic review and meta-analysis provides a comprehensive overview of the literature on the use of LSA to differentiate between developmental language disorder (DLD) and typical language (TL) in bilingual children.

METHOD

We conducted a search of several large electronic databases along with forward and backward searches and applied abstract and full-text screening procedures to identify all relevant studies. We then estimated standardized mean differences, representing the ability of LSA to differentiate between DLD and TL, using multilevel model and subgroup and moderator analyses to identify characteristics of LSA that may be associated with differences in effect size magnitude. We conducted assessments of publication bias and risk of bias by examining quality indicators for each study.

RESULTS

The search yielded 35 articles that met the inclusion criteria. Participants ranged in age from 2;0 (years;months) to 11;9, with over 40 languages represented. Across studies, the pooled standardized mean difference indicated that children with DLD performed 0.78 SD lower on LSA measures than those with TL. Measures of morphosyntactic accuracy exhibited the largest pooled effect size. Elicitation method, language of task, and age were not associated with differences in effect size.

DISCUSSION

Results of this study provide evidence of the clinical utility of LSA in differentiating between DLD and TL in bilingual children. Further research is needed to examine classification accuracy as well as task characteristics that may improve its diagnostic utility.

Should We Stop Using Lexical Diversity Measures in Children's Language Sample Analysis?

PURPOSE

Prior work has identified weaknesses in commonly used indices of lexical diversity in spoken language samples, such as type-token ratio (TTR) due to sample size and elicitation variation, we explored whether TTR and other diversity measures, such as number of different words/100 (NDW), vocabulary diversity (VocD), and the moving average TTR would be more sensitive to child age and clinical status (typically developing [TD] or developmental language disorder [DLD]) if samples were obtained from standardized prompts.

METHOD

We utilized archival data from the norming samples of the Test of Narrative Language and the Edmonton Narrative Norms Instrument. We examined lexical diversity and other linguistic properties of the samples, from a total of 1,048 children, ages 4-11 years; 798 of these were considered TD, whereas 250 were categorized as having a language learning disorder.

RESULTS

TTR was the least sensitive to child age or diagnostic group, with good potential to misidentify children with DLD as TD and TD children as having DLD. Growth slopes of NDW were shallow and not very sensitive to diagnostic grouping. The strongest performing measure was VocD. Mean length of utterance, TNW, and verbs/utterance did show both good growth trajectories and ability to distinguish between clinical and typical samples.

CONCLUSIONS

This study, the largest and best controlled to date, re-affirms that TTR should not be used in clinical decision making with children. A second popular measure, NDW, is not measurably stronger in terms of its psychometric properties. Because the most sensitive measure of lexical diversity, VocD, is unlikely to gain popularity because of reliance on computer-assisted analysis, we suggest alternatives for the appraisal of children's expressive vocabulary skill.

Guidelines and best practices for assessing young children remotely

Given the recent rise in the use of remote assessments to collect data from young children, researchers and practitioners would benefit from guidance on best practices within the field. Based on our experiences with assessing over 600 preschoolers remotely, our research team provides a set of main principles to guide professionals to successfully create and operationalize systems for remote assessment. Guidelines include detailed information about how to choose a technology platform, select and use online assessments, and how to adapt traditional tasks for remote use. We also note the challenges inherent in using certain types of tasks, provide tips for scheduling remote sessions, and offer advice for how to promote children's engagement throughout the assessment process.

Introducing a novel clinical tool to describe child engagement in telehealth speech and language assessments

Purpose: Telehealth may be a solution to access barriers in speech-language pathology. Previous investigations of telehealth assessment have alluded to factors affecting children's engagement, though these factors have not been comprehensively described.Aim: This study aimed to develop a novel clinical tool to describe the factors affecting children's engagement in paediatric telehealth assessments.Method: The Factors Affecting Child Engagement in Telehealth Sessions (FACETS) tool was developed using a mixed methods approach. Iterative analysis was conducted through a qualitative evidence synthesis, followed by the application of the tool to seven children aged between 4;3 and 5;7 years old who participated in a speech and language assessment via telehealth. Descriptive data were obtained regarding engagement on both a child-by-child and task-by-task basis. Reliability of the FACETS was determined via percent agreement and Cohen's kappa between two independent raters.Result: Using a mixed methods design, the FACETS framework was developed and refined. Application of the tool to seven case studies revealed variability in engagement with acceptable inter-rater reliability.Conclusion: The FACETS may be a useful resource for describing the factors that influence children's engagement in telehealth during the assessment. The FACETS requires further testing with clinical populations.

Validity of remote live stream video evaluation of the North Star Ambulatory Assessment in patients with Duchenne muscular dystrophy

Conducting functional assessments remotely can help alleviate the burden of in-person assessment on patients with Duchenne muscular dystrophy and their caregivers. The objective of this study was to evaluate whether scores from remote functional assessment of patients with Duchenne muscular dystrophy correspond to in-person scores on the same functional assessments. Remote live stream versus in-person scores on the North Star Ambulatory Assessment (including time [seconds] to complete the 10-meter walk/run and time to rise from the floor [supine to stand]) were assessed using statistical analyses, including intraclass correlation coefficient, and Pearson, Spearman, and Bland-Altman analyses. The remote and in-clinic assessments had to occur within 2 weeks of one another to be considered for this analysis. This analysis included patients with Duchenne muscular dystrophy, aged 4 to 7 years. Participants in this analysis received delandistrogene moxeparvovec (as part of SRP-9001-101 [Study 101; NCT03375164] or SRP-9001-102 [Study 102; NCT03769116]) or were randomized to receive placebo (in Part 1 of Study 102). This study evaluates score reproducibility between live stream remote scoring versus in-person functional assessments as determined by intraclass correlation coefficient, and Pearson, Spearman, and Bland-Altman analyses. The results showed that scores from remote functional assessment of patients with Duchenne muscular dystrophy strongly correlated with those obtained in person. These findings demonstrate congruence between live stream remote and in-person functional assessment and suggest that remote assessment has the potential to reduce the burden on a family by supplementing in-clinic visits.

Reliability and Feasibility of Administering a Child Language Assessment via Telehealth

PURPOSE

Despite the speed with which telehealth use advanced during the COVID-19 pandemic, evidence is needed to support the remote delivery of standardized assessments. This study investigated the reliability and feasibility of administering a standardized language assessment administered in real-world telehealth scenarios compared to in-person administration.

METHOD

A total of 100 children between the ages of 3 and 12 years were administered one of three versions of the Clinical Evaluation of Language Fundamentals (CELF). Children were administered the CELF by the same licensed speech-language pathologists (SLPs) in person and using telehealth, with the order counterbalanced. Means for Core Language standard scores were compared between conditions and among devices. Descriptive statistics summarized the behavior and technology disruptions during administration as well as the results of parent and SLP telehealth perception surveys.

RESULTS

In-person and telehealth mean scores on all three versions of the CELF revealed no systematic differences of one condition under- or overestimating another. The incidence of child behavior disruptions was similar for both test administration conditions. Adaptations compensated for the rare technology disruptions. Despite no significant language score and behavior differences between testing conditions, parents reported they continued to prefer in-person assessments. SLP participants viewed telehealth overall positively but identified conditions in which they continued to prefer in-person delivery.

CONCLUSIONS

This study provides evidence of minimal or no differences in scores and behavioral or technological disruptions between remote and in-person administration of the CELF core language assessments. SLP and parent participants' attitudes toward remote delivery of standardized tests appear to be evolving in a positive direction compared to previous studies.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.25292752.

VocabStudy: A remote collection of naturalistic topic-structured parental speech and toddlers' vocabularies using a mobile phone application

The current work presents VocabStudy, a collection of natural language samples and children's vocabularies collected remotely by parents via a mobile phone application. The corpus contains 567,003 word tokens and represents 144 hours of speech over a period of six months from the language environment of 63 British toddlers aged 13 to 28 months. The corpus incorporates labeled speech samples of five typical routines: mealtime, bedtime, playtime, bathtime, and nappytime (i.e., diaper). To explore consistency and variability across these five linguistic contexts, topic modeling was employed. The topic most successfully detected as having a unique structure was mealtime, which was identified as such nearly 100% of the time; bathtime, nappytime, and bedtime were found to cluster together most of the time, suggesting that they have a similar language structure; playtime was correctly identified as such about 14% of the time. To validate the accuracy of parents marking the words that their child produced, the child's utterances found in the audio recordings were examined. About 18% of the vocabulary reported by parents appeared in the transcripts, and the reported vocabulary sizes were highly correlated with the number of unique words uttered by the children (ρ = .72, p < 001). The results suggest that most parents marked the words soon after their children start producing them (p < .001, d = 0.9). I discuss the advantages and disadvantages of using a mobile phone application as a method to collect children's data remotely, what worked to keep participants entering data, and what could have been done to avoid some issues encountered.

Adapting language development research paradigms to online testing: Data from preferential looking, word learning and vocabulary assessment in toddlers

During the recent pandemic, it became necessary to adapt lab-based studies to online experiments. To investigate the impact of online testing on the quality of data, we focus on three paradigms widely used in infant research: a word recognition task using the Intermodal Preferential Looking Paradigm, a word learning task using the Switch task, and a language assessment tool (WinG) where children identify a target word amongst a set of picture cards. Our results for synchronous and asynchronous studies provide support for the robustness of online testing. In Experiment 1, robust word recognition was found in 24-month-old toddlers. In Experiment 2, 17-month-old infants consistently learned a new word. Finally, Experiment 3 demonstrated that 19- to 26-month-old children performed well on a language assessment test administered online. Overall, effect sizes or language scores were found to be higher than in lab-based studies. These experiments point to promising possibilities for reaching out to families around the world.

Open Science Considerations for Descriptive Research in Developmental Science

Descriptive developmental research seeks to document, describe, and analyze the conditions under which infants and children live and learn. Here, we articulate how open-science practices can be incorporated into descriptive research to increase its transparency, reliability, and replicability. To date, most open-science practices have been oriented toward experimental rather than descriptive studies, and it can be confusing to figure out how to translate open-science practices (e.g., preregistration) for research that is more descriptive in nature. We discuss a number of unique considerations for descriptive developmental research, taking inspiration from existing open-science practices and providing examples from recent and ongoing studies. By embracing a scientific culture where descriptive research and open science coexist productively, developmental science will be better positioned to generate comprehensive theories of development and understand variability in development across communities and cultures.

Spanish Bilingual Morphosyntactic Development in Bilingual Children With and Without Developmental Language Disorder: Articles, Clitics, Verbs, and the Subjunctive Mood

PURPOSE

The purpose of this study was to examine the growth of previously established clinical markers of developmental language disorder (DLD) in Spanish-speaking bilingual children with and without DLD.

METHOD

Forty-three bilingual children with DLD and 57 typically developing children were tested 3 times over a 2-year period. Their average age at Time 1 was 5;10 (years;months). All children completed an elicitation task examining the production of articles, clitics, verbs, and the subjunctive mood in Spanish at each time point, in addition to other behavioral testing in Spanish and English. We used growth curve analysis to examine change patterns of the morphosyntactic structures over time.

RESULTS

At the onset of the study, children without DLD produced higher accuracy rates than children with DLD across all morphosyntactic structures. In addition, there was a positive effect of time on all structures. Furthermore, the interaction between time and DLD was statistically significant for clitic pronouns.

CONCLUSION

In agreement with previous literature on language growth in monolingual children with DLD, bilingual children with DLD showed language growth that was parallel to that of bilingual children without DLD but with significantly lower levels of attainment.

SUPPLEMENTAL MATERIAL AND PRESENTATION VIDEO

https://doi.org/10.23641/asha.23810820.

Tele-Assessment of Oral Personal Narratives in Arabic- and Hebrew-Speaking Children Using the Global TALES Protocol

INTRODUCTION

Tele-assessment (TA) has the potential to enhance access to speech therapy. This preliminary study aimed to investigate the impact of assessment mode (face-to-face [FTF] vs. TA) on the microstructure level and chosen topics of personal narratives produced by Arabic-speaking and Hebrew-speaking school-age children living in Israel. We also investigated whether performance variations, if evident, could be attributed to the children's language/culture.

METHODS

Eighty-nine 10-year-old children, 38 Arabic-speaking and 51 Hebrew-speaking, living in Israel, participated in this study. Forty participants were assigned to a TA group (via Zoom) and 49 to a FTF group. All participants were assessed using the Global TALES protocol, generating six personal narratives each. The narratives were analyzed regarding the following microstructural measures: total number of words, total number of utterances (TNU), number of different words, and mean length of utterance in words (MLU-W). Additionally, each narrative was categorized into a topic according to the Global TALES protocol.

RESULTS

The analysis revealed no significant main effect of assessment mode on any of the microstructure measures. However, a significant interaction effect between language/culture and assessment mode was found for TNU and MLU-W, with a significant main effect for TNU exclusively in the Arabic narratives, with the Arabic-speaking children producing more utterances through FTF compared to TA. Across language/culture groups, there was a significant effect of assessment mode on the chosen topic. Additionally, there were significantly higher scores in the Hebrew compared to the Arabic narratives in all microstructure measures, and language/culture also influenced the chosen topics.

CONCLUSIONS

The results support the feasibility of TA mode for assessing personal narratives in school-aged children, using the Global TALES protocol. However, the results also suggest that TA results may be affected by the language/culture of the narrator. Finally, the findings highlight the potential influence of TA on the chosen topics of personal narratives, perhaps due to a decrease in the quality of communication in TA.

Longitudinal Examination of Morphosyntactic Skills in Bilingual Children: Spanish and English Standardized Scores

PURPOSE

This study aimed to examine changes in English and Spanish morphosyntactic standardized scores over time in bilingual children.

METHOD

One hundred bilingual children participated in this longitudinal study. The average age of the children at the beginning of the study was 5;11 (years;months). A subset of the participants was identified as children with developmental language disorder (DLD, n = 43). Children completed behavioral testing in Spanish and English at three time points over a period of 2 years. Growth curve modeling was employed to analyze longitudinal data.

RESULTS

Distinct patterns of Spanish and English language growth were observed. While the average standard score in English increased, the average score in Spanish decreased over time for both groups. Children with DLD showed persistent language difficulties in both Spanish and English over time in comparison to their peers.

CONCLUSIONS

The results of this study provide evidence of a shift in language proficiency from Spanish to English for bilingual children with and without language disorders. This study also shows that bilingual children with DLD show a protracted but parallel growth in morphosyntactic skills in comparison to children without DLD.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.23671464.

A realist review of digitally delivered child development assessment and screening tools: Psychometrics and considerations for future use

BACKGROUND

Developmental screening improves the detection of developmental concerns, yet numerous children are not screened/assessed. Remote child developmental tool administration has been utilized to increase screening and assessment accessibility.

METHOD

We conducted a realist review to: (1) identify existing multi-domain child development assessment and screening tools for children 0-5 years; (2) review psychometric data on their digital (i.e., only administered remotely) administration; and (3) explore contextual factors relevant to their digital administration. We searched APA PsycInfo, MEDLINE, CINAHL, and ERIC to identify tools and papers on their psychometrics. We reference-searched included articles and searched Google for relevant grey literature.

RESULTS

Of 33 multi-domain child development tools identified in objective one, five tools (in five studies) were delivered digitally and compared to traditional (e.g., paper) delivery (i.e., objective two). Studies evaluated within-group equivalence reliability (k = 2) and between-group equivalence (k = 3). Within-group equivalence reliability was established for the Vineland Adaptive Behavior Scales, and domains (e.g., gross motor) of the Ages and Stages Questionnaires 2nd edition (ASQ-2) and Revised Prescreening Denver Questionnaire (R-PDQ). Between group equivalence was demonstrated for Developmental Neuropsychological Assessment, 2nd Edition (NEPSY-II) subtests and Bayley Scales of Infant and Toddler Development, 3rd edition (Bayley-3) items. In another between group evaluation, web-based and paper versions of the ASQ-2 were deemed generally equivalent. Digital Bayley-3 inter-observer reliability ranged from 0.82 to 1.0. Examiner support, time, tool modifications, family resources, and comfort promotion supported digital administration.

CONCLUSION

Digitally delivered ASQ-2, R-PDQ, Vineland, and Bayley-3 and NEPSY-II components show promise for equivalence with traditional administration.

Face-to-face and Telespeech Therapy Services for Children during the COVID-19 Pandemic: A Scoping Review

Objectives

There has been increased interest in using telepractice in clinical services during COVID-19. Using telepractice is little known in speech and language therapy. However, the parents and speech therapists were satisfied with this method. Therefore, this scoping review aims to compare tele speech therapy and face-to-face speech therapy during the COVID-19 pandemic and determine the efficacy of available telepractices in speech therapy.

Materials & Methods

This scoping review was according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) guideline. The authors systematically searched Web of Science, PubMed, and Scopus databases with specific eligibility criteria. The eligibility criteria were studies published from 1 January 2020 to 10 May 2023 from a peer-reviewed journal and written in English. In addition, the articles were about speech therapy in children during COVID-19.

Results

Fifteen articles were included in this scoping review. Results showed that approximately all speech therapists used tele practice during the pandemic. Parents and students are satisfied with this method but have problems with it. On the other hand, some parents and SLPs preferred tele practice accompanied by face-to-face intervention. Furthermore, few studies determined the efficacy of tele practice with clear structural methods in specific populations.

Conclusion

Although tele speech therapy is acceptable for providing speech and language therapy services to children with swallowing and communication disorder, speech-language therapists should increase their information and technology to achieve successful results. Moreover, parents must play an essential role in telepractice services to facilitate effective communication between clinicians and families.

Global citizenship and social justice among speech-language pathologists: A scoping review

INTRODUCTION

This scoping review outlines the literature findings that relate to global citizenship and the interconnection between social justice among health professionals, specifically speech-language pathologists. The review aims to provide a synthesis of the relevant literature and thorough thematic identification of common themes.

METHOD

Arksey and O'Malley's scoping review framework was used for the searching of critical databases, specifically CINAHL, Medline, the Cochrane Library and Google Scholar. Following the appraisal and synthesis process of the relevant literature, key themes were identified with particular reference to social justice among health professionals (especially speech-language pathologists).

RESULTS

Four (4) key themes were identified, namely, (i) education and ongoing developmental support, (ii) ethical and moral obligations, (ii) cultural competency, and (iv) community engagement for intergroup empathy and helping.

CONCLUSION

This review defines the parameters of a speech-language pathologists' practice as a global citizen interconnected with social justice and the accountabilities to enable impactful changes creating culturally sustaining practice.

Telepractice in the diagnosis and treatment of pediatric speech-language disorders: The opinions and experiences of speech-language pathologists

PURPOSE

This prospective cross-sectional study aimed to investigate the opinions and experiences with telepractice (TP) of Dutch-speaking speech-language pathologists (SLPs) living in the Dutch-speaking part of Belgium (Flanders). This study will help to optimize care for children with speech-language disorders as we will gain more insight into the experienced barriers and facilitators while using TP for assessing and treating these disorders.

METHOD

Twenty-nine Dutch-speaking speech-language pathologists living in Flanders (age category 20-30 years: n = 16/29, 55.2%, 31-40 years: n = 10/29, 34.2%, 41-50 years: n = 2/29, 6.9%, 51-60 years: n = 1/29, 3.4%) were recruited through the social media. An online questionnaire was developed based on the available literature and administered to the SLPs. To compare the opinions and experiences of SLPs with TP, χ2 tests or Fisher's exact tests were used.

RESULTS

The study showed a statistically significant association between years of clinical experience of SLPs and their opinion that TP does not provide more options in a clinical setting compared to face-to-face contact. SLPs who had expertise in multiple domains experienced significantly more added value of TP during the corona pandemic than SLPs who had expertise in only one specific domain. Additionally, SLPs who worked in a private practice indicated significantly more difficulties in developing a therapeutic relationship due to a lack of personal contact than SLPs who worked in other settings. 51.7% (15/29) of the SLPs experienced technical barriers using TP.

CONCLUSION

Expertise in multiple domains of pediatric speech-language therapy resulted in experiencing more added value of TP during the corona pandemic, possibly because of the experience of multiple different and simultaneous advantages of TP in several domains. Additionally, SLPs in a private practice experienced more difficulties in developing a therapeutic relationship due to a lack of personal contact with their clients. This is in contrast to hospitals where children are often seen for a shorter period. Hence, there may be less chance of a negative perception of relationships with clients. Another conclusion is that treatment drop-out was not larger using TP compared to face-to-face therapy. However, SLPs experienced that the use of TP was not promoted/encouraged by their employer possibly because of technical barriers. It is hoped that the findings of this study will help SLPs and policymakers overthrow existing barriers and make telepractice a substantial, effective, and efficient service delivery model.

Sentence Diversity in Spanish-English Bilingual Toddlers

PURPOSE

There remain few available tools to assess language development in Spanish-English dual language learner (DLL) toddlers in the United States. Of interest is the development of early sentences as children move from producing single words to producing multiword utterances. This study is the first to extend sentence diversity to the context of Spanish-English DLLs by describing development from 24 to 30 months of age in children with and without language delays (LDs).

METHOD

Spontaneous language samples were collected from Spanish-dominant DLL children and their mothers as they were observed during a free-play interaction. Existing sentence diversity protocols were adapted for the DLL context to describe children's flexibility in combining subjects and verbs to form utterances in Spanish and English.

RESULTS

Children maintained an accurate separation in their grammars for subject-verb combinations in Spanish versus English. There was an overwhelming preference for Spanish subject-verb combinations with null subjects. The emergence of sentence diversity distinguished children with and without early LD unlike the emergence of word combinations.

CONCLUSIONS

Consistent with prior research, findings showed that DLLs did not confuse grammatical structures across languages. Instead, they showed a differential pattern of results in each language, such that the strongest grammatical skills were evinced first in the dominant language. Sentence diversity shows promise for assessment and progress monitoring in Spanish-English DLLs in the United States.

Improving Auditory Perception in Pediatric Single-Sided Deafness: Use of Cochlear Implants' Direct Connection for Remote Speech Perception Rehabilitation

PURPOSE

Unilateral cochlear implants (CIs) can restore binaural hearing in single-sided deafness (SSD). Direct stimulation of the CI can be obtained via the Bluetooth connection of a device to the CI, thus excluding the typical-hearing ear. This study aims to investigate the use of CI connectivity features as a rehabilitative strategy in a small cohort of children affected by SSD.

METHOD

A newly developed training protocol was presented to children with SSD who have less than 2 years of experience with CI. We developed a user-friendly and short-term (six sessions within 20 days) training protocol for speech perception that patients themselves can manage independently at home using CI connectivity systems. Children were telematically tested before and after the training by trained speech and language therapists.

RESULTS

Four patients met the inclusion criteria. They all showed better results in the final online assessment, when compared with the initial one.

CONCLUSIONS

To our knowledge, this is the first clinical focus article presenting an auditory training protocol for SSD patients with CI using the Bluetooth connectivity systems for teletherapy. The results, although preliminary, support the efficacy of this rehabilitative strategy. Further research is needed to support our findings.

Comparison of In-Person and Online Recordings in the Clinical Teleassessment of Speech Production: A Pilot Study

In certain circumstances, speech and language therapy is proposed in telepractice as a practical alternative to in-person services. However, little is known about the minimum quality requirements of recordings in the teleassessment of motor speech disorders (MSD) utilizing validated tools. The aim here is to examine the comparability of offline analyses based on speech samples acquired from three sources: (1) in-person recordings with high quality material, serving as the baseline/gold standard; (2) in-person recordings with standard equipment; (3) online recordings from videoconferencing. Speech samples were recorded simultaneously from these three sources in fifteen neurotypical speakers performing a screening battery of MSD and analyzed by three speech and language therapists. Intersource and interrater agreements were estimated with intraclass correlation coefficients on seventeen perceptual and acoustic parameters. While the interrater agreement was excellent for most speech parameters, especially on high quality in-person recordings, it decreased in online recordings. The intersource agreement was excellent for speech rate and mean fundamental frequency measures when comparing high quality in-person recordings to the other conditions. The intersource agreement was poor for voice parameters, but also for perceptual measures of intelligibility and articulation. Clinicians who plan to teleassess MSD should adapt their recording setting to the parameters they want to reliably interpret.

Describing the Spoken Language Skills of Typically Developing Afrikaans-Speaking Children Using Language Sample Analysis: A Pilot Study

PURPOSE

Language sample analysis is widely regarded as the gold standard of language assessment. However, the uncertainty regarding the optimal length of sample and the limited availability of developmental language data for nonmainstream languages such as Afrikaans complicate reliable use of the method. The study aimed to provide guidelines on representative length of sample and concurrently provide a preliminary description of the spoken language skills of Afrikaans-speaking children.

METHOD

The study involved 30 typically developing Afrikaans-speaking children aged between 3;6 and 9;6 (years;months). A descriptive research design was used to transcribe and analyze 1-hr interactions collected in natural environments of participants who were recruited using referral sampling. Video and audio recordings of the samples were transcribed using adapted Sampling Utterances and Grammatical Analysis Revised analysis procedures.

RESULTS

Results indicated that mean length of utterance in words per minute, number of different words per minute, and total number of words per minute stabilized at 30 min and no significant differences were found between 30 min and longer time segments. Morphology results concur with existing developmental findings in Afrikaans. Lexical diversity results correlated with the findings of the lexical specificity and accuracy in the Prutting and Kirchner Pragmatic Protocol (Prutting & Kirchner, 1987). The developmental trajectories for pragmatic and phonological development were consistent with existing guidelines.

CONCLUSIONS

The study concluded that a 30-min interaction segment provides a representative language sample for Afrikaans-speaking children who are between 3;6 and 9;6. It provides promising preliminary developmental data and clinical guidelines, confirming the potential of language sample analysis (LSA) as a reliable component of language assessment in Afrikaans.

Barriers and facilitators to paediatric caregivers' participation in virtual speech, language, and hearing services: A scoping review

Purpose

Virtual care-related technologies are transforming the way in which health services are delivered. A growing number of studies support the use of virtual care in the field of audiology and speech-language pathology; however, there remains a need to identify and understand what influences caregiver participation within the care that is virtual and family-focused. This review aimed to identify, synthesize, and summarize the literature around the reported barriers and facilitators to caregiver participation in virtual speech/hearing assessment and/or intervention appointments for their child.

Methods

A scoping review was conducted following the Joanna Briggs Institute manual for evidence synthesis. A search was conducted using six databases including MEDLINE, CINAHL, SCOPUS, ERIC, Nursing and Allied Health, and Web of Science to collect peer-reviewed studies of interest. Data was extracted according to a protocol published on Figshare, outlining a predefined data extraction form and search strategy.

Results

A variety of service delivery models and technology requirements were identified across the 48 included studies. Caregiver participation was found to vary across levels of attendance and involvement according to eight categories: Attitudes, child behavioral considerations, environment, opportunities, provider-family relationship, role in care process, support, and technology.

Conclusions

This review presents a description of the key categories reported to influence caregiver participation in virtual care appointments. Future research is needed to explore how the findings can be used within family-centered care models to provide strategic support benefiting the use and outcomes of virtual care.

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.

Bilingual Mandarin-English preschoolers’ spoken narrative skills and contributing factors: A remote online story-retell study

This study examined the spoken narrative skills of a group of bilingual Mandarin–English speaking 3–6-year-olds (N = 25) in Australia, using a remote online story-retell task. Bilingual preschoolers are an understudied population, especially those who are speaking typologically distinct languages such as Mandarin and English which have fewer structural overlaps compared to language pairs that are typologically closer, reducing cross-linguistic positive transfer. We examined these preschoolers’ spoken narrative skills as measured by macrostructures (the global organization of a story) and microstructures (linguistic structures, e.g., total number of utterances, nouns, verbs, phrases, and modifiers) across and within each language, and how various factors such as age and language experiences contribute to individual variability. The results indicate that our bilingual preschoolers acquired spoken narrative skills similarly across their two languages, i.e., showing similar patterns of productivity for macrostructure and microstructure elements in both of their two languages. While chronological age was positively correlated with macrostructures in both languages (showing developmental effects), there were no significant correlations between measures of language experiences and the measures of spoken narrative skills (no effects for language input/output). The findings suggest that although these preschoolers acquire two typologically diverse languages in different learning environments, Mandarin at home with highly educated parents, and English at preschool, they displayed similar levels of oral narrative skills as far as these macro−/micro-structure measures are concerned. This study provides further evidence for the feasibility of remote online assessment of preschoolers’ narrative skills.

Comparing Measures From Computer-Administered and Examiner-Administered Narrative Retells in Spanish: A Pilot Study

PURPOSE

Narrative language sample analysis (LSA) is a recommended best practice for the assessment of monolingual and bilingual children. With business-as-usual narrative LSA, examiners are actively involved in all aspects of the elicitation. Software advancements have shown multiple benefits of computer-administered language assessments, some of which may be beneficial for narrative assessments, particularly for bilingual children. The goal of this pilot study was to test the feasibility of computer-administered narrative retells in bilingual children.

METHOD

Ten English-Spanish bilingual children, kindergarten to fourth grade, completed two narrative retells using wordless picture books (Frog Goes to Dinner and Frog on His Own) in two conditions: examiner-administered and computer-administered. Five narrative measures were generated from these 20 transcripts.

RESULTS

Significant, strong correlations were observed between the two elicitation methods for four of the five measures. We completed a series of Wilcoxon signed-ranks tests and found no significant differences in measures across the elicitation methods. Follow-up descriptive analyses revealed few large differences across elicitation methods for the individual participants.

CONCLUSION

This study provides preliminary evidence on the use of a computer-administered narrative procedure and motivates further research on the method to confirm its validity and to document its effectiveness within clinical practice.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.20346648.

A propósito de la pandemia COVID-19: hablemos con los padres con respecto a los trastornos del desarrollo del lenguaje

El trastorno del desarrollo del lenguaje es un reto diagnóstico en etapas tempranas del desarrollo por lo que su adecuado abordaje e intervención permite mejorar el pronóstico de este grupo de pacientes que muchas veces son diagnosticados tardíamente sobre todo en el último periodo en el contexto de la pandemia COVID-19. El presente artículo busca dar las herramientas que permitan comprender su importancia, así como ser un eje que permita dar estrategias a los padres a modo de promover las habilidades de lenguaje y comunicación en etapas tempranas del desarrollo de sus hijos.

Measurement of Lexical Diversity in Children's Spoken Language: Computational and Conceptual Considerations

Background

Type-Token Ratio (TTR), given its relatively simple hand computation, is one of the few LSA measures calculated by clinicians in everyday practice. However, it has significant well-documented shortcomings; these include instability as a function of sample size, and absence of clear developmental profiles over early childhood. A variety of alternative measures of lexical diversity have been proposed; some, such as Number of Different Words/100 (NDW) can also be computed by hand. However, others, such as Vocabulary Diversity (VocD) and the Moving Average Type Token Ratio (MATTR) rely on complex resampling algorithms that cannot be conducted by hand. To date, no large-scale study of all four measures has evaluated how well any capture typical developmental trends over early childhood, or whether any reliably distinguish typical from atypical profiles of expressive child language ability.

Materials and Methods

We conducted linear and non-linear regression analyses for TTR, NDW, VocD, and MATTR scores for samples taken from 946 corpora from typically developing preschool children (ages 2-6 years), engaged in adult-child toy play, from the Child Language Data Exchange System (CHILDES). These were contrasted with 504 samples from children known to have delayed expressive language skills (total n = 1,454 samples). We also conducted a separate sub-analysis which examined possible contextual effects of sampling environment on lexical diversity.

Results

Only VocD showed significantly different mean scores between the typically -developing children and delayed developing children group. Using TTR would actually misdiagnose typical children and miss children with known language impairment. However, computation of VocD as a function of toy interactions was significant and emerges as a further caution in use of lexical diversity as a valid proxy index of children's expressive vocabulary skill.

Discussion

This large scale statistical comparison of computer-implemented algorithms for expressive lexical profiles in young children with traditional, hand-calculated measures showed that only VocD met criteria for evidence-based use in LSA. However, VocD was impacted by sample elicitation context, suggesting that non-linguistic factors, such as engagement with elicitation props, contaminate estimates of spoken lexical skill in young children. Implications and suggested directions are discussed.

Can You See My Screen? Virtual Assessment in Speech and Language

PURPOSE

This introduction presents the LSHSS Forum: Can You See My Screen? Virtual Assessment in Speech and Language. The goals of the forum are to document reliability and validity of assessment results conducted virtually, identify characteristics of measures that are suitable for online assessment, and provide clinical and research guidance for interpreting diagnostic results obtained in virtual settings.

METHOD

In this introduction, we provide an overview of the research completed by nine teams, who submitted research articles and notes on a variety of topics pertinent to the theme of telehealth assessments. Of these, seven teams investigated the validity and reliability of 14 different assessment tools, while two teams described training and experience issues.

CONCLUSION

The nine studies presented in this forum will provide speech-language pathologists with insight into a range of issues regarding telehealth assessment, including the breadth of suitable assessment tools; practical strategies for assessing children with a diverse range of ages, languages, skills, and abilities; and the unexpected challenges and opportunities of conducting clinical work and research during a global pandemic.

Using Animated Action Scenes to Remotely Assess Sentence Diversity in Toddlers

Although language samples are child-friendly and well-suited for obtaining global measures of language production, structured protocols have the potential to elicit many different exemplars of language structures in a shorter amount of time. We created a structured elicitation protocol, the Sentence Diversity Priming Task (SDPT), to efficiently assess sentence diversity in toddlers via video chat platforms. Sentence diversity is operationalized as the number of different subject–verb combinations in active declarative sentences. The task is presented as an animated picture book, with parents serving as the child's primary partner during administration. In this article, we provide the rationale for assessing sentence diversity, describe the task, and present preliminary analyses of compliance and developmental associations for 32 typically developing toddlers, 30–35 months old, with average language abilities. The preliminary findings suggest that the SDPT is an engaging task that holds toddlers' attention, reveals robust individual differences in their ability to produce sentences, is positively correlated with parent-reported language measures, and has the potential for assessing children's language growth over time. Finally, recommendations and tips for developing and remotely administering the protocol are provided, with an emphasis on encouraging parent involvement and increasing toddler compliance.

From a Distance: Comparison of In-Person and Virtual Assessments With Adult-Child Dyads From Linguistically Diverse Backgrounds

PURPOSE

Our proof-of-concept study tested the feasibility of virtual testing using child assessments that were originally validated for in-person testing only.

METHOD

Ten adult-child dyads were assigned to complete both in-person and virtual tests of language, cognition, and narratives. Child participants fell between the ages of 4 and 8 years; adult participants were speech-language clinicians or researchers with experience in administering child assessments. Half of child participants were Spanish-English bilinguals, and half were monolingual English speakers.

RESULTS

Results showed similar performance across in-person and virtual modalities on all assessments. Recommendations for adapting, administering, and scoring virtual measures with linguistically diverse children are discussed.

CONCLUSIONS

Although additional research on virtual assessment is needed, our results open opportunities for appropriate remote assessment, particularly for bilingual children, who may not have in-person access to speech-language pathology services.

Online Assessment of Motor, Cognitive, and Communicative Achievements in 4-Month-Old Infants

Remote methods for data collection allow us to quickly collect large amounts of data, offering several advantages as compared to in-lab administration. We investigated the applicability of an online assessment of motor, cognitive, and communicative development in 4-month-old infants based on several items of the Bayley Scales of Infant Development, 3rd edition (BSID-III). We chose a subset of items which were representative of the typical developmental achievements at 4 months of age and that we could administer online with the help of the infant’s caregiver using materials which were easily available at home. Results showed that, in a sample of infants tested live (N = 18), the raw scores of the BSID-III were significantly correlated with the raw scores of a subset of items corresponding to those administered to a sample of infants tested online (N = 53). Moreover, for the “online” participants, the raw scores of the online assessment did not significantly differ from the corresponding scores of the “live” participants. These findings suggest that the online assessment was to some extent comparable to the live administration of the same items, thus representing a viable opportunity to remotely evaluate infant development when in-person assessment is not possible.

Zoom, Zoom, Baby! Assessing Mother-Infant Interaction During the Still Face Paradigm and Infant Language Development via a Virtual Visit Procedure

The COVID-19 pandemic has necessitated innovations in data collection protocols, including use of virtual or remote visits. Although developmental scientists used virtual visits prior to COVID-19, validation of virtual assessments of infant socioemotional and language development are lacking. We aimed to fill this gap by validating a virtual visit protocol that assesses mother and infant behavior during the Still Face Paradigm (SFP) and infant receptive and expressive communication using the Bayley-III Screening Test. Validation was accomplished through comparisons of data (i.e., proportions of missing data for a given task; observed infant and maternal behaviors) collected during in-person laboratory visits and virtual visits conducted via Zoom. Of the 119 mother-infant dyads who participated, 73 participated in lab visits only, 13 participated in virtual visits only, and 33 dyads participated in a combination of lab and virtual visits across four time points (3, 6, 9, and 12 months). Maternal perspectives of, and preferences for, virtual visits were also assessed. Proportions of missing data were higher during virtual visits, particularly for assessments of infant receptive communication. Nonetheless, comparisons of virtual and laboratory visits within a given time point (3, 6, or 9 months) indicated that mothers and infants showed similar proportions of facial expressions, vocalizations and directions of gaze during the SFP and infants showed similar and expected patterns of behavioral change across SFP episodes. Infants also demonstrated comparable expressive and receptive communicative abilities across virtual and laboratory assessments. Maternal reports of ease and preference for virtual visits varied by infant age, with mothers of 12-month-old infants reporting, on average, less ease of virtual visits and a preference for in-person visits. Results are discussed in terms of feasibility and validity of virtual visits for assessing infant socioemotional and language development, and broader advantages and disadvantages of virtual visits are also considered.

Facilitators and Barriers to the Adoption of Telemedicine During the First Year of COVID-19: Systematic Review

BACKGROUND

The virulent and unpredictable nature of COVID-19 combined with a change in reimbursement mechanisms both forced and enabled the rapid adoption of telemedicine around the world. Thus, it is important to now assess the effects of this rapid adoption and to determine whether the barriers to such adoption are the same today as they were under prepandemic conditions.

OBJECTIVE

The objective of this systematic literature review was to examine the research literature published during the COVID-19 pandemic to identify facilitators, barriers, and associated medical outcomes as a result of adopting telemedicine, and to determine if changes have occurred in the industry during this time.

METHODS

The systematic review was performed in accordance with the Kruse protocol and the results are reported in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We analyzed 46 research articles from five continents published during the first year of the COVID-19 pandemic that were retrieved from searches in four research databases: PubMed (MEDLINE), CINAHL, Science Direct, and Web of Science.

RESULTS

Reviewers identified 25 facilitator themes and observations, 12 barrier themes and observations, and 14 results (compared to a control group) themes and observations. Overall, 22% of the articles analyzed reported strong satisfaction or satisfaction (zero reported a decline in satisfaction), 27% reported an improvement in administrative or efficiency results (as compared with a control group), 14% reported no statistically significant difference from the control group, and 40% and 10% reported an improvement or no statistically significant difference in medical outcomes using the telemedicine modality over the control group, respectively.

CONCLUSIONS

The pandemic encouraged rapid adoption of telemedicine, which also encouraged practices to adopt the modality regardless of the challenges identified in previous research. Several barriers remain for health policymakers to address; however, health care administrators can feel confident in the modality as the evidence largely shows that it is safe, effective, and widely accepted.

Disruption Leads to Methodological and Analytic Innovation in Developmental Sciences: Recommendations for Remote Administration and Dealing With Messy Data

The COVID-19 pandemic has impacted data collection for longitudinal studies in developmental sciences to an immeasurable extent. Restrictions on conducting in-person standardized assessments have led to disruptive innovation, in which novel methods are applied to increase participant engagement. Here, we focus on remote administration of behavioral assessment. We argue that these innovations in remote assessment should become part of the new standard protocol in developmental sciences to facilitate data collection in populations that may be hard to reach or engage due to burdensome requirements (e.g., multiple in-person assessments). We present a series of adaptations to developmental assessments (e.g., Mullen) and a detailed discussion of data analytic approaches to be applied in the less-than-ideal circumstances encountered during the pandemic-related shutdown (i.e., missing or messy data). Ultimately, these remote approaches actually strengthen the ability to gain insight into developmental populations and foster pragmatic innovation that should result in enduring change.

Tele-assessment of cognitive functions in children: a systematic review

Cognitive Tele-Assessment approach (CTA) has been widely used in adults for clinical, research, and screening purposes. In the last decades, it has been considered a useful tool for evaluating child development in both clinical and educational settings and new instruments for CTA in children have been developed. In comparison to In Person Assessment (IPA), CTA can have several advantages, such as increasing accessibility, cutting waiting lists, reducing time and travel costs, and assisting with infection control by minimizing face-to-face contact in times of pandemic. Nevertheless, several issues related to the feasibility and reliability of using CTA to evaluate cognitive development are still open. The present systematic review has a twofold aim: 1. to describe the cognitive functions that are most frequently measured by CTA in children, the procedures used, and the characteristics of the samples investigated; 2. to investigate the agreement between CTA and IPA scores in children.In the present systematic review, 23 studies using CTA in children, with typical or atypical development, have been selected and analyzed. Results support the similarities in performance scores between IPA and CTA and good compliance by children and their families in participating in CTA. Nonetheless, most studies suggest that several methodological precautions must be taken to manage technical and procedural characteristics that may represent challenges for CTA of children. Suggestions for a correct use of CTA, factors affecting the validity of the results and directions for future research are discussed.

Conducting Virtual Assessments in Developmental Research: COVID-19 Restrictions as a Case Example

Developmental researchers face considerable challenges regarding maximizing data collection and reducing participant attrition. In this article, we use our experiences implementing our study on the effects of timing of prenatal stress on maternal and infant outcomes during the COVID-19 pandemic as a framework to discuss the difficulties and solutions for these challenges, including the development of two types of virtual assessments. Specific information regarding use of virtual platforms, confidentiality, engaging children during video conferencing, and modifying the major assessments of our research are discussed. Feasibility data are presented, and data analytic challenges regarding statistical inference are outlined. Finally, we conclude with some of the unintended positive consequences for our research that resulted from making these modifications to our original methods.

Comparing Face-to-Face and Online Data Collection Methods in Preterm and Full-Term Children: An Exploratory Study

The COVID-19 pandemic has transformed the landscape for children's daily lives and the landscape for developmental psychology research. Pandemic-related restrictions have also significantly disrupted the traditional face-to-face methods with which developmental scientists produce research. Over the past year, developmental scientists have published on the best practices for online data collection methods; however, existing studies do not provide empirical evidence comparing online methods to face-to-face methods. In this study, we tested feasibility of online methods by examining performance on a battery of standardized and experimental cognitive assessments in a combined sample of 4- to 5-year-old preterm and full-term children, some of whom completed the battery face-to-face, and some of whom completed the battery online. First, we asked how children's performance differs between face-to-face and online format on tasks related to verbal comprehension, fluid reasoning, visual spatial, working memory, attention and executive functioning, social perception, and numerical skills. Out of eight tasks, we did not find reliable differences on five of them. Second, we explored the role of parent involvement in children's performance in the online format. We did not find a significant effect of parent involvement on children's performance. Exploratory analyses showed that the role of format did not vary for children at risk, specifically children born preterm. Our findings contribute to the growing body of literature examining differences and similarities across various data collection methods, as well as literature surrounding online data collection for continuing developmental psychology research.

Crosslinguistic Influence (CLI) of Lexical Breadth and Depth in the Vocabulary of Bilingual Kindergarten Children - A Bilingual Intervention Study

Introduction: Research in recent years has explored the vocabulary size (lexical breadth) of bilingual children, but less is known about the richness of bilingual word knowledge (lexical depth), and about how knowledge of words in the two languages interact. This study explores how bilingual narrative intervention with vocabulary instruction in each language may modulate crosslinguistic influence (CLI) between the languages of bilingual kindergarten children, focusing on CLI of lexical knowledge, and which factors modulate performance. Methods: Forty-one typically developing English-Hebrew bilingual children (M = 64.63 months) participated. A bilingual adaptation of Story Champs narrative intervention program (Spencer and Petersen, 2012) was used to deliver vocabulary instruction in separate blocks of home language (HL) and school language (SL) sessions. Different intervention words were targeted in each language, but the children were tested on all target words in both languages. Lexical knowledge was assessed with a definition task four times throughout the study: prior to intervention, after each intervention block, and 4-6 weeks later. Learner characteristics (chronological age, age of onset of bilingualism and length of exposure) and proficiency in each language (standardized tests, familiarity with the vocabulary introduced in the intervention at baseline) were examined as possible modulators of performance. Results: Children showed growth in lexical breadth and depth in their HL/English after HL intervention and in lexical breadth in the SL/Hebrew following SL intervention, with CLI for semantic depth observed via a qualitative analysis, but not quantitatively. Better HL/English performance was correlated with later AoB (and shorter SL exposure) and higher HL language proficiency scores. Children with higher HL/English proficiency responded better to the SL/Hebrew intervention, gaining more than those with lower English proficiency. Children with SL/Hebrew vocabulary dominance at the outset of the study also gained more from the HL/English intervention. No correlations were found between learner characteristics and SL performance. Discussion: The current study indicates that bilingual narrative intervention with vocabulary instruction may be efficacious for improving the lexical breadth and depth of bilingual kindergarten children. It suggests that CLI may enhance bilingual children's language learning success, and points to the importance of strengthening both languages of bilingual children.

Genesis of a New Generation of Telepractitioners: The COVID-19 Pandemic and Pediatric Speech-Language Pathology Services

Purpose In March 2020, the COVID-19 pandemic caused a worldwide shift from in-person care to synchronous videoconferencing or telehealth. Many barriers to remote service delivery were eliminated, effectively creating a new generation of telepractitioners. This study chronicles changes in speech-language pathology clinicians' use and perceptions of telehealth with pediatric populations. Method The Telehealth Services: Pediatric Provider Survey was created in multiple steps and then distributed broadly through social media and professional community sites. Respondents were speech-language pathologists and speech-language pathology assistants in a variety of employment settings from across the country and abroad who were serving primarily pediatric clients (n = 269). Survey questions sought to capture changes in speech-language pathology clinicians' experiences with and perceptions of telehealth before, during, and predictions after the COVID-19 pandemic. Analyses identified factors that influenced the use of telehealth services before and after March 2020 (COVID-19). Results Survey results documented the dramatic increase in telehealth use from before March 2020 to October 2020. The reasons pediatric speech-language pathology clinicians used telehealth during the pandemic were mostly a result of employer mandates or lowering infection risk for both client and clinician; however, over time, pediatric speech-language pathology clinicians increased their telehealth proficiency and discovered the benefits of telehealth. Conclusion The adoption of telehealth and the rapid improvement in proficiency is a testament to the resiliency of providers and has long-term effects on the use of telehealth into the future. Supplemental Material https://doi.org/10.23641/asha.15183690.

The Bilingual Home Language Boost Through the Lens of the COVID-19 Pandemic

Usage-based accounts of language acquisition suggest that bilingual language proficiency is dynamic and susceptible to changes in language use. The COVID-19 pandemic led to unprecedented modifications in the language learning environment of developing bilinguals. Drawing on this unique opportunity, we analyzed existing data of two matched groups of Mandarin-English bilingual children (ages 4 to 8 years, n = 38), one tested before (pre-COVID group) and the other during (COVID group) the pandemic. The dataset comprises responses to a language environment questionnaire, and scores on a sentence comprehension task and a sentence recall task in the bilinguals' two languages. Questionnaire data revealed a richer Mandarin language environment for children in the COVID group compared to peers in the pre-COVID group. On both comprehension and production tasks, the two groups performed comparably in English but the COVID group showed better performance in Mandarin than the pre-COVID group. Within the pre-COVID group, English was stronger than Mandarin in both comprehension and production. Within the COVID group, the two languages were balanced in comprehension and Mandarin was stronger than English in production. Moreover, language use variables were correlated with production performance in both languages. These patterns illustrate the intimate relationships between language use and bilingual language proficiency through the lens of COVID-19 induced language environment modification.

Children and Adolescents with Disabilities and Exposure to Disasters, Terrorism, and the COVID-19 Pandemic: a Scoping Review

PURPOSE OF REVIEW

This paper reviews the empirical literature on exposures to disaster or terrorism and their impacts on the health and well-being of children with disabilities and their families since the last published update in 2017. We also review the literature on studies examining the mental health and functioning of children with disabilities during the COVID-19 pandemic.

RECENT FINDINGS

Few studies have examined the effects of disaster or terrorism on children with disabilities. Research shows that children with disabilities and their families have higher levels of disaster exposure, lower levels of disaster preparedness, and less recovery support due to longstanding discriminatory practices. Similarly, many reports of the COVID-19 pandemic have documented its negative and disproportionate impacts on children with disabilities and their families. In the setting of climate change, environmental disasters are expected to increase in frequency and severity. Future studies identifying mitigating factors to disasters, including COVID-19; increasing preparedness on an individual, community, and global level; and evaluating post-disaster trauma-informed treatment practices are imperative to support the health and well-being of children with disabilities and their families.