Speech and Language Therapy Services for Multilingual Children with Migration Background: A Cross-Sectional Survey in Germany

Assessment of Developmental Language Disorder in Multilingual Children: Results from an International Survey

INTRODUCTION

The Multilingual-Multicultural Affairs Committee of the International Association of Communication Disorders (IALP) conducted a survey of diagnostic criteria for developmental language disorder (DLD) in multilingual children to discover how clinicians apply terminology and diagnostic criteria to multilingual children in different parts of the world.

METHODS

An international web survey was used to survey 354 participants from 44 countries about their assessment practices, and clinical opinions about assessing multilingual children for DLD.

RESULTS

The findings show that most clinicians felt confident in assessing multilingual children, and they applied the DLD terminology and inclusionary criteria to multilingual children with difficulty learning language. Clinicians used different procedures to assess heritage and societal languages. Barriers to access to services included a lack of knowledge by parents and referral sources about services available and typical multilingual development, with additional reasons differing by geographical region.

DISCUSSION

Speech pathologists across the globe have many similarities in the way that they assess multilingual children. Differences may be attributed to clinical experience, professional education, the clinician's role, the system they work in, and the clinician's own language skills. This paper advances knowledge of current clinical practices, which can be used to evaluate frameworks in international and national contexts, with implications for policy and practice to improve access to clinical services.

Fit für die Schule? Der Sprachstand 5-jähriger Kinder in Hessen und seine soziodemografischen Korrelate

Hintergrund

Der Sprachstand 5‑jähriger Kinder wird in Hessen nicht systematisch erfasst. Daher liegen keine Angaben zum Anteil sprachauffälliger Kinder in dieser wichtigen Altersgruppe kurz vor der Einschulung vor.

Fragestellung

Die Studie hatte zum Ziel, den Sprachstand 5‑jähriger Kinder zu beschreiben und soziodemografische Faktoren zu untersuchen, die mit sprachpädagogischem Förder- bzw. klinischem Abklärungsbedarf zusammenhängen.

Matherial und Methoden

Es wurden 263 monolingual deutschsprachige (MON) und 645 multilinguale Kitakinder (MULT) im Alter von 5;0–5;11 Jahren bezüglich ihrer Deutschkenntnisse mit dem Kurztest „Kindersprachscreening“ (KiSS.2) untersucht. KiSS.2-Normwerte für Fünfjährige wurden durch das Studienteam entwickelt. Soziodemografische Merkmale der Kinder und ihrer Familien wurden mit KiSS.2-basierten erweiterten Fragebogen für Eltern und KitaerzieherInnen erfasst.

Ergebnisse

Ein Fünftel der MON und über zwei Drittel der MULT zeigten sich in KiSS.2 als sprachlich auffällig, d. h., ihre Ergebnisse lagen unterhalb der Normwerte. Die große Mehrheit der MULT erwies sich als sprachpädagogisch förderbedürftig. Die Anteile klinisch Abklärungsbedürftiger waren bei MON und MULT vergleichbar. Sprachpädagogischer Förderbedarf war mit eingeschränktem Deutsch-Input außerhalb der Kita assoziiert. Unter den Sprachkontaktvariablen waren es ausbleibende sprachliche Äußerungen beim Spielen, an denen sich klinischer Abklärungsbedarf am besten erkennen ließ. Die meisten Sprachauffälligen, v. a. MULT, wurden weder sprachpädagogisch noch -therapeutisch versorgt.

Diskussion

Da MULT mehr als die Hälfte aller hessischen Vorschulkinder ausmachen, kann davon ausgegangen werden, dass kurz vor der Einschulung die meisten hessischen Kinder sprachauffällig bleiben (in der aktuellen Studie 57 %). Es liegen Hinweise auf eine sprachpädagogische und -therapeutische Unterversorgung von 5‑jährigen Kindern, in erster Linie MULT, vor.

Clinicians' and Managers' Views and Experiences of Audiology and Speech-Language Pathology Service Provision for Culturally and Linguistically Diverse Families of Young Children With Hearing Loss

PURPOSE

This study aimed to gather the views and experiences of clinicians and managers on early intervention audiology and speech-language pathology services for culturally and linguistically diverse (CALD) families of children with hearing loss.

METHOD

This qualitative descriptive study involved 27 semistructured interviews with audiologists, speech-language pathologists, and managers working with CALD families of young children with hearing loss. Purposeful sampling was used to recruit participants from three hearing centers working with these families. Interviews were analyzed using thematic analysis.

RESULTS

Analysis of the data resulted in five themes: (a) There were perceived added complexities for CALD families in accessing and being involved in services and receiving information; (b) there were perceived family-provider relationship complexities, cultural differences, and service delivery challenges in working with CALD families; (c) clinicians and managers used various strategies for service provision of CALD families; (d) involving interpreters benefited service provision but was challenging at times; and (e) looking to the future and recommendations for clinical practice.

CONCLUSIONS

Current practices reflect some principles of family-centered care for CALD families of young children with hearing loss. Families and services may benefit from more support regarding family-provider partnerships, information materials and child assessments, working with interpreters, and center support for time and resources.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.20044427.

Dynamic assessment of multilingual children's word learning

BACKGROUND

Teachers and clinicians may struggle to provide early identification to support multilingual children's language development. Dynamic assessments are a promising approach to identify and support children's language development.

AIMS

We developed and studied a novel word learning task that is dynamic and language neutral. It makes use of multilingual children's abilities to apply language transfer, fast mapping and socially embedded language to the learning of new words.

METHODS & PROCEDURES

A total of 26 children attending kindergarten in French participated in this study. Within this group, 13 different home languages were spoken. Children took part in a dynamic assessment task of their word learning that consisted of a test-teach-retest task. Children's scores on this task were compared with their language abilities reported by their parents, amount of language exposure and scores on standardized tests of vocabulary. All tasks were delivered in French.

OUTCOMES & RESULTS

Children had higher accuracy for known words as compared with new words in the task, which may suggest transfer of knowledge from their first language. They also showed increased accuracy in identifying and naming the new words across the three trials, suggesting fast mapping of these new vocabulary items. Finally, the scores on the dynamic task correlated to children's vocabulary scores on the standardized tests, but not parent report of language development, or the amount of exposure to the language of school.

CONCLUSIONS & IMPLICATIONS

This novel dynamic assessment task taps into the process of vocabulary learning, but is less influenced by prior language knowledge. Together, these findings provide insight into early word learning by young multilingual children and proposes a conceptual model for identifying strategies to support second language acquisition.

WHAT THIS PAPER ADDS

What is already known on the subject Many barriers exist with regards to assessing the language abilities of multilingual children when a clinician aims to assess their language abilities in both languages. An alternative approach is to measure children's language processing abilities. What this paper adds to existing knowledge A novel dynamic and multilingual task was developed and implemented in this study. This task builds on children's word learning abilities that include cross-language transfer, fast-mapping, and socially imbedded learning. This multilingual task was found to tap into vocabulary learning but was not influenced by prior language knowledge. What are the potential or actual clinical implications of this work? Applying a task that focuses on language processing abilities is a promising strategy to capture language abilities in multilingual children. In addition, the dynamic nature of this tasks allows a clinician to identify scaffolding strategies that best support children's word learning.

Barriers to access and utilization of healthcare services for minority-language speakers with neurodevelopmental disorders: A scoping review

INTRODUCTION

Minority-language speakers in the general population face barriers to accessing healthcare services. This scoping review aims to examine the barriers to healthcare access for minority-language speakers who have a neurodevelopmental disorder. Our goal is to inform healthcare practitioners and policy makers thus improving healthcare services for this population.

INCLUSION CRITERIA

Information was collected from studies whose participants include individuals with a neurodevelopmental disorder (NDD) who are minority-language speakers, their family members, and healthcare professionals who work with them. We examined access to healthcare services across both medical and para-medical services.

METHOD

Searches were completed using several databases. We included all types of experimental, quasi-experimental, observational and descriptive studies, as well as studies using qualitative methodologies. Evidence selection and data extraction was completed by two independent reviewers and compared. Data extraction focused on the barriers to accessing and to utilizing healthcare for minority-language speakers with NDDs. The search process and ensuing results were fully reported using a diagram from the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping review.

RESULTS

Following the database search, a total of 28 articles met our final selection criteria and two articles were hand-picked based on our knowledge of the literature, for a total of 30 articles. These studies revealed that minority-language speakers with NDDs and their families experience several barriers to accessing and utilizing healthcare services. These barriers, identified at the Systems, Provider and Family Experience levels, have important consequences on children's outcomes and families' well-being.

DISCUSSION

While our review outlined several barriers to access and utilization of healthcare services for minority-language speakers with NDDs and their families, our findings give rise to concrete solutions. These solutions have the potential to mitigate the identified barriers, including development and implementation of policies and guidelines that support minority-language speakers, practitioner training, availability of referral pathways to appropriate services, access to tools and other resources such as interpretation services, and partnership with caregivers. Further research needs to shift from describing barriers to examining the efficacy of the proposed solutions in mitigating and eliminating identified barriers, and ensuring equity in healthcare for minority-language speakers with NDDs.

Sprachtherapeutische Versorgung 4-jähriger Kinder in Hessen: ein Überblick

Hintergrund

Eine verspätete Erkennung bzw. versäumte Intervention bei Sprachentwicklungsstörungen beeinträchtigen den schulischen und beruflichen Werdegang. Aufgrund ungünstiger soziodemografischer Bedingungen (mangelhafte Deutschkenntnisse der Eltern, niedriges familiäres Einkommen etc.) sowie medizinischer Auffälligkeiten sind zunehmend viele Kinder in ihrer Sprachentwicklung gefährdet.

Ziel der Arbeit

Im Rahmen einer hessischen Sprachstanderfassungsstudie wurde geprüft, inwiefern 4‑jährige Kinder mit (KMM) und ohne Migrationshintergrund (KOM) sprachtherapeutisch versorgt wurden, und wie diese Therapien motiviert waren.

Material und Methoden

Vierjährige Kindergartenkinder (n = 1384) wurden mit dem Sprachtest KiSS.2 untersucht. Beide Untergruppen (KMM und KOM) wurden hinsichtlich sprachbezogener Störungsbilder und sprachtherapeutischer Versorgung verglichen.

Ergebnisse

Insgesamt nahmen 8 % aller Kinder an Sprachtherapien teil. KMM waren fast doppelt so häufig klinisch abklärungsbedürftig wie KOM (21 % vs. 11 %). Bei KOM wurden dagegen mehr sprachbezogene Störungsbilder (z. B. häufige Mittelohrentzündungen) bereits vor der Studienteilnahme diagnostiziert. Klinisch abklärungsbedürftige KOM befanden sich daher häufiger in einer Sprachtherapie als KMM (37 % vs. 23 %).

Diskussion

Es fanden sich Hinweise für Diskrepanzen zwischen Sprachtherapiebedarf und sprachtherapeutischer Versorgung von bestimmten Untergruppen der 4‑jährigen Kinder. Evidenzbasierte, flächendeckende Sprachstanderfassungsprogramme können dazu beitragen, dass bei der Einteilung der Kinder in sprachförder- und sprachtherapiebedürftige weniger falsch-positive bzw. -negative Ergebnisse erzielt werden.

Identifying Bilingual Children at Risk for Language Impairment: The Implication of Children's Response Speed in Narrative Contexts

The purpose of the study was to examine whether monolingual adults can identify the bilingual children with LI on the basis of children’s response speed to the examiner. Participants were 37 monolingual English-speaking young adults. Stimuli were 48 audio clips from six sequential bilingual children (48 months) who were predominately exposed to Cantonese (L1) at home from birth and started to learn English (L2) in preschool settings. The audio clips for each child were selected from an interactive story-retell task in both Cantonese and English. Three of the children were typically developing, and three were identified as having a language impairment. The monolingual adult participants were asked to judge children’s response times for each clip. Interrater reliability was high (Kalpha = 0.82 for L1; Kalpha = 0.75 for L2). Logistic regression and receiver operating characteristic curves were used to examine the diagnostic accuracy of the task. Results showed that monolingual participants were able to identify bilingual children with LI based on children’s response speed. Sensitivity and specificity were higher in Cantonese conditions compared to English conditions. The results added to the literature that children’s response speed can potentially be used, along with other measures, to identify bilingual children who are at risk for language impairment.