Modeling Dimensionality of Bilingual Kindergarteners' Language Knowledge in Spanish and English.

PURPOSE: This study used structural equation modeling to investigate the dimensionality of language in Spanish-English bilingual kindergartners. Five theoretical models were compared, including (a) a unidimensional model; (b) a two-dimensional model by language (Spanish, English); (c) a three-dimensional model by domain of language (phonology, semantics, morphosyntax); (d) a second-order model organized first by language (Spanish, English), with each language dimension comprising three domain-specific dimensions (phonology, semantics, morphosyntax); and (e) a six-dimensional model with freely covarying language-specific domains. METHOD: Participants included 238 Spanish-English bilingual kindergartens, as identified by parent report of current language exposure and direct language measures. All participants completed a battery of phonology, semantics, and morphosyntactic test items in English and in Spanish. RESULTS: The six-dimensional covarying model constrained by domain and language provided the best fit for the data, with six separate factors for phonology, morphosyntax, and semantics in English and Spanish. The excellent model fit is supported by findings of a χ2 to df (degrees of freedom) ratio < 2 with no significance, comparative fit index > .95, standardized root-mean-square residual < .08, and root-mean-square error of approximation values ≤ .05. CONCLUSIONS: Results support emergent theories of bilingual language development. Application of the results to the evaluation and intervention of oral language abilities in bilingual children entering the formal education setting are considered. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25843846.

Validation of the Mediated Learning Observation Instrument Among Children With and Without Developmental Language Disorder in Dynamic Assessment.

PURPOSE: In this validation study, we examined the factor structure of the mediated learning observation (MLO) used during the teaching phase of dynamic assessment. As an indicator of validity, we evaluated whether the MLO factor structure was consistent across children with and without developmental language disorder (DLD). METHOD: Two hundred twenty-four children (188 typically developing and 36 DLD) from kindergarten to second grade completed a 30-min individual mediated learning session on narrative production. Performance during the session was rated using the 12-item MLO by clinicians on affect, behavior, arousal, and elaboration. Exploratory and confirmatory factor analyses were conducted to establish the factor structure and reliability of the MLO. RESULTS: Factor analysis of the MLO suggested a stable three-factor model with adequate fit indices across kindergarten and school-age samples, across both typically developing and DLD subgroups with good to excellent reliability. The final 11-item MLO (one item was removed due to low factor loading) comprises three subscales including (a) cognitive factor, (b) learning anticipation, and (c) learning engagement. CONCLUSIONS: The MLO is a valid and reliable instrument for assessing language learning skills in children with and without DLD during dynamic assessment. Practical implications and suggestions for future research addressing the utilization of MLO in dynamic assessment are provided.

Where to start: Use of the bilingual multidimensional ability scale (B-MAS) to identify developmental language disorder (DLD) in bilingual children.

PURPOSE: The identification of developmental language disorder (DLD) is challenging for clinicians who assess bilinguals. This paper introduces a protocol-based approach, the Bilingual Multidimensional Ability Scale (B-MAS), for expert raters to identify DLD in bilinguals. METHOD: Three bilingual speech-language pathologists (SLPs) reviewed 166 Spanish-English bilingual children's profiles, which included performance on direct (morphosyntax, semantics, and narrative tasks) and indirect (parent/teacher survey) measures in both languages. A multidimensional scale (0-5) was adopted to rate children's performance. A diagnosis of DLD was made if at least two raters assigned a summary rating of ≤2. RESULT: Analysis of the scores on the B-MAS resulted in the identification of 21 children as having DLD. Though different strategies were employed to make decisions, the three SLPs demonstrated high inter-rater agreement across different ratings (intraclass correlation coefficient values ranged from .83 to .90). CONCLUSION: For bilingual populations that are understudied and for which gold standards of assessment are not available, the B-MAS can be adopted as a starting point to study DLD or as a reference standard to develop new assessment tools in that population. Clinically, this protocol could be tailored and evaluated by a group of SLPs serving a large population of a particular bilingual group for diagnostic purposes.

An Exploration of the Nature of Vocabulary Change Following Language and Literacy Together Intervention.

PURPOSE: This exploratory study evaluates how bilingual first graders' vocabulary use in narrative changed after a Spanish-language intervention that focuses on connection between language and literacy. METHOD: Ten Spanish-English bilingual first graders produced three English and three Spanish narratives based on the Test of Narrative Language protocol pre- and postintervention. All samples were transcribed. Based on comprehensive word inventories, all words produced by the children were identified as being core words; Tiers 1, 2, and 3 words; and/or cognates in both languages. We also coded all utterances for use of internal state terms (ISTs). We evaluated total and unique production of these kinds of words. RESULTS: Postintervention children increased their total number of cognates and ISTs across languages. They also increased the unique core words, Tier 1 words, and cognates postintervention. They also used more of each of these kinds of words in Spanish-the language of intervention-than in English. CONCLUSIONS: Children make qualitative changes to their vocabulary postintervention. There is greater change in the use of core words and Tier 1 words in Spanish. These increases in productivity and variability were indicated by the number of unique words added to the children's repertoires in ways that supported narrative production.

Exploring Assumptions of the Bilingual Delay in Children With and Without Developmental Language Disorder.

PURPOSE: Bilingual children are both over- and under-identified with developmental language disorder (DLD). We propose that this may be a function of monolingual approaches that fail to consider the dynamic nature of bilingualism as well as assumptions of bilingual delay. We explored the extent to which bilingual children with and without DLD demonstrated mixed dominance as a function of exposure to English. We document patterns of performance in bilingual children with and without DLD on the Bilingual English-Spanish Assessment or Bilingual English-Spanish Assessment-Middle Extension in Spanish, English, and their best language scores. METHOD: A total of 595 (100 with DLD) Spanish-English bilingual children between the ages of 5 and 12 years were included in the analyses. We employed logistic regression to evaluate the probability of demonstrating mixed dominance across semantics and morphosyntax in Spanish and English by ability status. We then evaluated the association between English exposure and performance in Spanish, English, and the best language on semantics and morphosyntax measures. RESULTS: There were similar typically developing and DLD probabilities of Spanish or English dominance associated with high degrees of Spanish and English exposure. Mixed dominance was associated with both ability and exposure. Children with DLD demonstrated more mixed dominance from 0% to 60% English exposure. The patterns of mixed dominance were similar by ability when they had more than 60% exposure to English. There were significant associations between single language testing in Spanish and English with percentage of exposure for children with and without DLD. When the best score (comparing English and Spanish) was used, there were no significant associations with exposure for semantics or morphosyntax. CONCLUSIONS: These results inform researchers and clinicians about the nature of bilingual proficiency in children with and without DLD. Mixed dominance was observed in both groups but with different patterns at lower levels of English exposure in children with and without DLD. We also see that when children's best score is considered, all differences in performance along the bilingual continuum are related to ability not language exposure. This has implications for how to consider children's language test scores in making clinical decisions about bilingual children. PRESENTATION VIDEO: https://doi.org/10.23641/asha.23929470.

Understanding the Microstructure and Macrostructure Narrative Skills of Bilingual Adolescents in Relation to Their Language Experience.

PURPOSE: Narratives have been a useful tool for evaluating language skills in young bilingual children. This study extends that work to bilingual adolescents by (a) describing their narrative skills and (b) evaluating the role of current language experience on measures of narrative micro- and macrostructure across Spanish and English. METHOD: Sixty-five Spanish-English bilingual adolescents, ages 10-15 years, were administered the Test of Narrative Language (TNL) in English and Spanish. Language samples were transcribed and coded for elements of narrative microstructure. Parents provided information about participants' current language experience. RESULTS: Means and standard deviations were reported for microstructure composites, TNL comprehension subtests, and TNL production subtests in Spanish and English. Findings showed differential effects of current English experience on narrative performance across Spanish and English, such that experience significantly explained 12%, 10%, and 20% of the variance in participants' microstructure scores, narrative comprehension, and narrative production in Spanish, respectively. Language experience was unrelated to performance across all English narrative measures. CONCLUSIONS: Findings suggest that continued use of Spanish may be important for bilinguals' maintenance of the home language during adolescence, particularly on narrative tasks that require bilinguals to produce Spanish. However, experience is insufficient to explain the variability in bilinguals' narrative skills across Spanish and English.

A cross-linguistic approach to treating speech sound disorders in bilingual children.

The present study explores generalisation of production skills across languages when treating speech sound disorders in bilingual children. Early work suggests that treating shared sounds across languages may facilitate cross-linguistic generalisation. Thus, selecting shared sounds across languages as targets may have clinical advantages. In this study, we asked if cross-linguistic generalisation can be facilitated for targets using shared sounds in bilingual children with phonological delays from Spanish (L1) into English (L2) when treating only the L1. Two Spanish-English bilingual children between the ages of 5;0-5;3 with speech sound disorders participated in an intervention with shared sounds as targets. Each child received two sessions per week of therapy that included both linguistically-based and motor-based approaches. Accuracy of targets was assessed within and across languages using a single-subject case design. Results show increased accuracy of targets and generalisation of sounds across languages when treatment was administered only in the L1. Specific growth varied per target and child. The implications affect how we select treatment targets in bilingual children. Future studies should explore additional ways to select targets to increase generalisation of skills and replicate with additional participants.

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

PURPOSE: Semantic tasks evaluate dimensions of children's lexical-semantic knowledge. However, the relative ease of semantic task completion depends on individual differences in developmental and language experience factors. The purpose of this study was to evaluate how language experience and language ability impact semantic task difficulty in English for school-age Spanish-English bilingual children with and without developmental language disorder (DLD). METHOD: Participants included 232 Spanish-English bilingual children in second through fifth grade with (n = 35) and without (n = 197) DLD. Data included children's performance on the English Semantics subtest of the Bilingual English-Spanish Assessment-Middle Extension Field Test Version (BESA-ME), age of English acquisition, and percent English language exposure. Task difficulty, a measurement of the relative ease of task completion, was calculated for six semantic task types included on the BESA-ME. Multilevel regression modeling was conducted to estimate longitudinal growth trajectories for each semantic task type. RESULTS: Results showed that language ability and grade level drive semantic task difficulty for all task types, and children with DLD experienced greater difficulty on all task types compared to their typically developing peers. Longitudinally, semantic task difficulty decreased for all children, regardless of language ability, indicating that semantic task types became easier over time. While children made gains on all semantic tasks, the growth rate of task difficulty was not equal across task types, where some task types showed slower growth compared with others. English language exposure emerged as a significant predictor of semantic task difficulty while age of acquisition was not a significant factor. CONCLUSIONS: This study clarifies developmental profiles of lexical-semantic performance in bilingual children with and without DLD and supports clinical decision-making regarding children's English language learning.

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

PURPOSE: This systematic review provides a comprehensive summary of the diagnostic accuracy of English language sample analysis (LSA) measures for the identification of developmental language disorder. METHOD: An electronic database search was conducted to identify English publications reporting empirical data on the diagnostic accuracy of English LSA measures for children aged 3 years or older. RESULTS: Twenty-eight studies were reviewed. Studies included between 18 and 676 participants ranging in age from 3;0 to 13;6 (years;months). Analyzed measures targeted multiple linguistic domains, and diagnostic accuracy ranged from less than 25% to greater than 90%. Morphosyntax measures achieved the highest accuracy, especially in combination with length measures, and at least one acceptable measure was identified for each 1-year age band up to 10 years old. CONCLUSION: Several LSA measures or combinations of measures are clinically useful for the identification of developmental language disorder, although more research is needed to replicate findings using rigorous methods and to explore measures that are informative for adolescents and across diverse varieties of English. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.21183247.

Identifying Language Disorder in Bilingual Children Using Automatic Speech Recognition.

PURPOSE: The differential diagnosis of developmental language disorder (DLD) in bilingual children represents a unique challenge due to their distributed language exposure and knowledge. The current evidence indicates that dual-language testing yields the most accurate classification of DLD among bilinguals, but there are limited personnel and resources to support this practice. The purpose of this study was therefore to determine the feasibility of dual-language automatic speech recognition (ASR) for identifying DLD in bilingual children. METHOD: Eighty-four Spanish-English bilingual second graders with (n = 25) and without (n = 59) confirmed diagnoses of DLD completed the Bilingual English-Spanish Assessment-Middle Extension Morphosyntax in both languages. Their responses on a subset of items were scored manually by human examiners and programmatically by a researcher-developed ASR application employing a commercial speech-to-text algorithm. RESULTS: Results demonstrated moderate overall item-by-item scoring agreement (k = .54) and similar classification accuracy values (human = 92%, ASR = 88%) between the two methods using the best-language score. Classification accuracy of the ASR method increased to 94% of cases correctly classified when test items with poorer discrimination in the ASR condition were eliminated. CONCLUSION: This study provides preliminary support for the technical feasibility of ASR as a bilingual expressive language assessment tool. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.20249994.

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.

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.

A Longitudinal Investigation of the Semantic Receptive-Expressive Gap in Spanish-English Bilingual Children.

Purpose: Although a semantic receptive-expressive gap appears to be a universal feature of early bilingualism, little is known about its development. We sought to determine if the magnitude of the discrepancy between receptive and expressive standard scores changed over time in bilingual children's two languages. Method: In this longitudinal study, standardized receptive and expressive semantics tests of 106 Spanish-English bilingual children with TD were taken at kindergarten and first grade in both English and Spanish. We used a multivariate analysis approach to identify interactions and main effects. Results: Although both receptive and expressive standard scores improved across the year in both languages, the magnitude of the gap was similar for both languages at both time points. However, there was greater improvement in English than in Spanish. Expressive scores at the end of the year were similar to receptive scores a year earlier. Conclusions: The magnitude of this gap remains relatively constant at kindergarten and first grade in both English and Spanish, despite overall improvements in semantic performance in both languages. There is on average roughly a one year lag between receptive and expressive semantics skills. Clinicians should take caution in interpreting receptive-expressive semantic gaps.

Treatment for Anomia in Bilingual Speakers with Progressive Aphasia.

Anomia is an early and prominent feature of primary progressive aphasia (PPA) and other neurodegenerative disorders. Research investigating treatment for lexical retrieval impairment in individuals with progressive anomia has focused primarily on monolingual speakers, and treatment in bilingual speakers is relatively unexplored. In this series of single-case experiments, 10 bilingual speakers with progressive anomia received lexical retrieval treatment designed to engage relatively spared cognitive-linguistic abilities and promote word retrieval. Treatment was administered in two phases, with one language targeted per phase. Cross-linguistic cognates (e.g., rose and rosa) were included as treatment targets to investigate their potential to facilitate cross-linguistic transfer. Performance on trained and untrained stimuli was evaluated before, during, and after each phase of treatment, and at 3, 6, and 12 months post-treatment. Participants demonstrated a significant treatment effect in each of their treated languages, with maintenance up to one year post-treatment for the majority of participants. Most participants showed a significant cross-linguistic transfer effect for trained cognates in both the dominant and nondominant language, with fewer than half of participants showing a significant translation effect for noncognates. A gradual diminution of translation and generalization effects was observed during the follow-up period. Findings support the implementation of dual-language intervention approaches for bilingual speakers with progressive anomia, irrespective of language dominance.

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

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

Phonological predictors of nonword repetition performance in bilingual children.

INTRODUCTION: Previous research (Gibson et al., 2015; Summers, Bohman, Gillam, Peña & Bedore, 2010) has suggested an advantage in Spanish over English on nonword repetition tasks with Spanish-English bilingual children. However, comparing nonwords of equal syllable lengths across languages may not sufficiently account for phonological differences across languages. We compared Spanish-language nonword sets of different lengths to select a set that would be equivalent with respect to difficulty in English. We considered language-specific phonological structure and level of difficulty in evaluating nonword performance in 126 first- and second-grade, Spanish-English bilingual children. We predicted that adding 5-syllable words to the Spanish nonword set and monosyllabic words to the English set would result in comparable difficulty. METHOD: Participants repeated nonwords of increasing lengths in English of 1, 2, 3, and 4 syllables and in Spanish of 2, 3, 4, and 5 syllables. Percent phonemes correct was calculated for total sounds. A repeated measures ANOVA was used to compare accuracy across word lengths. RESULTS: Results indicated significant differences in overall means between languages when nonwords of equal word lengths were compared, but no significant differences in overall means when lengths of 1 - 4 syllables in English and 2 - 5 syllables in Spanish were used. Differences between languages varied at individual levels of complexity. CONCLUSIONS: The finding that level of word length affects performance may have implications for understanding the factors in clinical test development for bilingual children. Further research may benefit from assessing additional language variables and additional language combinations to extend findings.

Factors influencing US speech and language therapists' use of technology for clinical practice.

BACKGROUND: There is an increasing number of technological resources available to speech and language therapists (SLTs) for use in clinical practice, but the factors that influence SLTs' selection and use of such resources are not well understood. In related fields, technology acceptance models have been employed to explain users' adoption of technology and to inform the advancement of empirically supported technological resources. AIMS: To determine the factors that influence SLTs' use of technology for clinical practice by testing a model of their technology acceptance and use. METHODS & PROCEDURES: We surveyed 209 practising SLTs in the United States representative of the speech and language membership of the American Speech-Language-Hearing Association (ASHA). Participants completed a 38-item electronic survey representing four categories: (1) technology use, (2) technology attitudes and factors influencing technology use, (3) employment information and (4) demographics. Items measuring technology attitudes served as indicators of the research model, which mapped the primary relationships of a technology acceptance model. Survey data were collected before the Covid-19 pandemic. OUTCOMES & RESULTS: The research model accounted for 66% of the variance in SLTs' behavioural intention to use technology, which significantly and positively predicted the amount of time they reportedly spent using technology in the workplace. Subjective norms and attitudes towards technology use directly predicted the intention to use technology. Perceived usefulness and ease of use indirectly predicted intention to use technology. Survey respondents reported using technology during 48% (SD = 24%) of their overall weekly work hours on average, with a large majority reporting using technology at least once per week for planning (89% of respondents), assessment (66% of respondents) or intervention (90% of respondents). CONCLUSIONS & IMPLICATIONS: These findings statistically explain the relationships between SLTs' attitudes and their intention to use technology for clinical practice, contributing to our understanding of why SLTs adopt certain technologies. We also detail the nature and frequency of technology use in the clinical practice of SLTs. Future directions for this work include further exploring use categories, employing direct measurements of technology use and exploring the impact of recent changes in SLT service delivery due to the Covid-19 pandemic on SLTs' technology attitudes. What this paper adds What is already known on the subject Existing research about the adoption and use of technological resources by SLTs indicates that they select tools based on convenience, cost and recommendations by others. What this paper adds to existing knowledge This study is the first to develop and test a research model of SLTs' technology attitudes. The findings from model testing demonstrate the significant predictors of SLTs' behavioural intention to use technology for clinical purposes. Intent of use is related to how much SLTs use technology in the workplace. What are the potential or actual clinical implications of this work? The present findings can inform interventions targeting the design and adoption of electronic SLT resources that are empirically supported.

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

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

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

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

Language and Literacy Together: Supporting Grammatical Development in Dual Language Learners With Risk for Language and Learning Difficulties.

Purpose Early Interventions in Reading (Vaughn et al., 2006), the only literacy intervention with demonstrated effectiveness for U.S. dual language learners, was enhanced to support the development of oral language (vocabulary, grammar, and narrative) and literacy, which we refer to as "Language and Literacy Together." The primary focus of this study is to understand the extent to which grammatical skills of bilinguals with risk for language and/or reading difficulties improve in the Language and Literacy Together intervention. Method Fifteen first-grade dual language learners with risk for language and/or reading difficulties participated in an enhanced version of Early Interventions in Reading in Spanish. Children completed pre- and postintervention evaluations in Spanish and English, including grammatical testing from the Bilingual English Spanish Oral Screener (Peña et al., 2008) and narrative evaluation Test of Narrative Language story prompts (Gillam & Pearson, 2004; Gillam et al., n.d.). Data from six comparison participants with typical language skills who completed pre- and posttesting demonstrate the stability of the measures. Results The intervention group made gains in English and Spanish as evidenced by significant increases in their cloze and sentence repetition accuracy on the Bilingual English Spanish Oral Screener Morphosyntax subtest. They increased productivity on their narratives in Spanish and English as indexed by mean length of utterance in words but did not make gains in their overall grammaticality. Conclusions Structured intervention that includes an emphasis on grammatical elements in the context of a broader intervention can lead to change in the production of morphosyntax evident in both elicited constructions and narrative productivity as measured by mean length of utterance in words. Additional work is needed to determine if and how cross-linguistic transfer might be achieved for these learners.