Serving young children with communication disabilities from Latinx backgrounds and their families with equity: Provider perspectives.

INTRODUCTION: Latinx children with communication disorders from birth to age 5 and their families are increasingly served in United States (US) educational and medical settings where longstanding structural barriers threaten their access to equitable assessment and intervention. However, little is known about providers' perceptions serving this highly diverse population as they relate to reducing disparities in care for communication disorders. METHODS: This exploratory qualitative study interviewed 24 speech-language pathologists (SLPs) and early intervention (EI)/early childhood special education (ECSE) developmental specialists serving young Latinx children with communication disorders to offer targeted recommendations toward improving equity. The semi-structured interview included questions regarding communication assessment, diagnostics/eligibility, intervention, interpretation, translation, and solutions to enhance EI/ECSE. Interviews were coded with content analysis using elements of grounded theory, and responses from SLPs in medical versus education settings and from EI/ECSE developmental specialists were compared. Data triangulation was used to validate themes. RESULTS: Analysis revealed the following themes related to provider challenges and resources: family factors, provider factors, cultural and linguistic differences, assessment approaches, eligibility determinations, translation and interpretation, and institutional factors. Few variations in themes between provider types (SLPs vs. EI/ECSE developmental specialists) and settings (medical vs. educational) were found. Providers also offered several policy and practice solutions. CONCLUSIONS: Findings suggest minimal advances in improving equity for young Latinx children with communication disorders over prior decades. Results also indicate that providers may benefit from reflecting on their cultures and biases as well as systemic racism within EI/ECSE.

Psychometric Properties of the English-Spanish Vocabulary Inventory in Toddlers With and Without Early Language Delay.

PURPOSE: Despite the increasing population of dual language learners (DLLs) in the United States, vocabulary measures for young DLLs have largely relied on instruments developed for monolinguals. The multistudy project reports on the psychometric properties of the English-Spanish Vocabulary Inventory (ESVI), which was designed to capture unique cross-language measures of lexical knowledge that are critical for assessing DLLs' vocabulary, including translation equivalents (whether the child knows the words for the same concept in each language), total vocabulary (the number of words known across both languages), and conceptual vocabulary (the number of words known that represent unique concepts in either language). METHOD: Three studies included 87 Spanish-English DLLs (M age = 26.58 months, SD = 2.86 months) with and without language delay from two geographic regions. Multiple measures (e.g., caregiver report, observation, behavioral tasks, and standardized assessments) determined content validity, construct validity, social validity, and criterion validity of the ESVI. RESULTS: Monolingual instruments used in bilingual contexts significantly undercounted lexical knowledge as measured on the ESVI. Scores on the ESVI were related to performance on other measures of communication, indicating acceptable content, construct, and criterion validity. Social validity ratings were similarly positive. ESVI scores were also associated with suspected language delay. CONCLUSIONS: These studies provide initial evidence of the adequacy of the ESVI for use in research and clinical contexts with young children learning English and Spanish (with or without a language delay). Developing tools such as the ESVI promotes culturally and linguistically responsive practices that support accurate assessment of DLLs' lexical development. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.17704391.

Cultural and Linguistic Adaptations of Early Language Interventions: Recommendations for Advancing Research and Practice.

Purpose Speech-language pathologists are responsible for providing culturally and linguistically responsive early language intervention services for legal, ethical, and economic reasons. Yet, speech-language pathologists face challenges in meeting this directive when children are from racial, ethnic, or linguistic backgrounds that differ from their own. Guidance is needed to support adaptation of evidence-based interventions to account for children's home culture(s) and language(s). This review article (a) describes a systematic review of the adaptation processes applied in early language interventions delivered to culturally and linguistically diverse populations in the current literature and (b) offers a robust example of an adaptation of an early language intervention for families of Spanish-speaking Mexican immigrant origin. Method Thirty-three studies of early language interventions adapted for culturally and linguistically diverse children ages 6 years and younger were reviewed. Codes were applied to describe to what extent studies document the purpose of the adaptation, the adaptation process, the adapted components, and the evaluation of the adapted intervention. Results Most studies specified the purpose of adaptations to the intervention evaluation, content, or delivery, which typically addressed children's language(s) but not culture. Study authors provided limited information about who made the adaptations, how, and when. Few studies detailed translation processes or included pilot testing. Only one used a comprehensive framework to guide adaptation. A case study extensively documents the adaptation process of the Language and Play Every Day en español program. Conclusions Future early language intervention adaptations should focus on both linguistic and cultural factors and include detailed descriptions of intervention development, evaluation, and replication. The case study presented here may serve as an example. Increased access to such information can support research on early language interventions for diverse populations and, ultimately, responsive service provision.

Adaptation of a Caregiver-Implemented Naturalistic Communication Intervention for Spanish-Speaking Families of Mexican Immigrant Descent: A Promising Start.

Purpose Caregiver-implemented naturalistic communication interventions (CI-NCIs) support the communication abilities of young children with language disorders and enhance the communication behaviors of their caregivers. Yet, few CI-NCIs have been adapted and tested for feasibility with families who speak Spanish at home. This study addresses this gap in the literature by examining the social validity and preliminary outcomes of an adapted CI-NCI program with families who identified as Mexican immigrants and spoke Spanish. Method A multiphase cultural adaptation process enhanced the Language and Play Every Day program for Spanish-speaking Mexican immigrant families in the United States. Six families, including eight caregivers and eight toddlers, participated. Caregivers received coaching on the use of language-facilitating strategies within existing home routines. Multiple measures of the social validity of the intervention's goals, procedures, and outcomes were collected. Changes in caregivers' reported confidence, knowledge, and use of language-facilitating strategies and children's receptive and expressive communication were examined to determine preliminary outcomes. Results Overall, caregivers perceived many of the intervention's goals, procedures, and outcomes as socially valid and specified aspects of the intervention needing improvement. Caregivers and children showed modest but potentially clinically meaningful gains in their communication skills following the intervention despite wide individual variability. Conclusions Given some recommendations to further adapt the intervention, this CI-NCI appears to be feasible for supporting the communication development of children of Spanish-speaking Mexican immigrant descent. Thus, future research on the efficacy of the intervention is warranted. Supplemental Material https://doi.org/10.23641/asha.12269081.

Exploring the Cultural Validity of Parent-Implemented Naturalistic Language Intervention Procedures for Families From Spanish-Speaking Latinx Homes.

Purpose This study addressed the cultural, linguistic, and contextual validity of parent-implemented naturalistic language interventions for young children from Latinx homes. Parents' perspectives on the acceptability of commonly delivered intervention procedures were explored. Method Thirty-seven parents from Spanish-speaking Latinx backgrounds with children under the age of 6 years participated. Four focus groups were completed. Parents responded to 14 procedures regarding the intervention implementers, settings, activities, strategies, and language. Structural and emergent coding was used to explore procedural acceptability and parents' rationales for perceiving each procedure as acceptable, not acceptable, or neutral. Results Substantial intracultural variability in parents' acceptance of specific procedures and the reasons for their perspectives was observed. Parents' perspectives evinced both individualist and collectivist orientations toward child language development. Several suggestions regarding promising adaptations for early language interventions that may overlap with evidence-based parent-implemented naturalistic language intervention procedures emerged. Conclusion The findings highlight the variability within the Latinx community that is likely to impact the cultural validity of early language interventions for children and families from this background. Considerations for enhancing interventions to achieve cultural congruency and promote child outcomes are provided. Supplemental Material https://doi.org/10.23641/asha.12315713.

Normal and pathological human testes express hormone-sensitive lipase and the lipid receptors CLA-1/SR-BI and CD36.

Numerous studies have demonstrated the important role of cholesterol and cholesteryl esters in tumor cell proliferation and progression of cancer. However, few studies have focused on the role of lipid transporters and lipases in cancer development and progression. The present study examined the expression of hormone-sensitive lipase (HSL) and the scavenger receptors CLA-1/SR-BI and CD36 in normal human testis and in nontumor and tumor testicular disorders by immunohistochemistry and Western blotting analysis. In normal young testes, immunoreaction to CLA-1/SR-BI was found in the spermatid acrosomic vesicle and on the surface of Sertoli and Leydig cells. HSL was detected in spermatogonia, the Golgi region of spermatocytes, the nucleus of spermatids, and the cytoplasm of both Sertoli and Leydig cells. Elderly testes and testes with hypospermatogenesis showed a similar staining pattern to that of normal young testes except for CD36, which was expressed in Sertoli cells. Cryptorchid testes demonstrated intense labeling to HSL and weak labeling to SR-BI in Sertoli cells (nucleus and cytoplasm) and Leydig cells (cytoplasm). Seminiferous tubules with intratubular germ cell neoplasia exhibited intense immunolabeling to the 3 lipid receptors in the surface of neoplastic cells and to HSL in the nucleus. In seminoma and spermatocytic seminoma, neoplastic cells labeled to HSL but failed to stain with antilipid receptors; in the seminiferous tubules at the periphery of the tumour, Charcot-Böttcher crystalloids of Sertoli cells were strongly positive to CLA-1. Testes with mature teratoma showed a weak reaction to CD36 and SR-BI in some cells of enteric-type glands, and immature teratoma were exclusively immunolabeled with HSL. Western blotting analysis revealed that multiple bands were immunolabeled, with differences seen between normal and pathological testes. The results of this study indicate that the presence of lipid receptors (CLA-1/SR-BI) and hormone-sensitive lipase in Leydig cells suggests a role of these proteins in steroidogenesis. Also, these proteins seem to be involved in spermiogenesis, as their labeling in spermatids suggests. In nonmalignant and malignant pathologies, cholesterol metabolism is probably altered, and HSL labeling in neoplastic germ cell nuclei suggests a still-unknown function of this enzyme, probably related to cell cycle regulation.