Bilingual children with primary language impairment: 3 months after treatment.

BACKGROUND: Evidence on the treatment effectiveness for bilingual children with primary language impairment (PLI) is needed to advance both theory and clinical practice. Of key interest is whether treatment effects are maintained following the completion of short-term intense treatments. AIMS: To investigate change in select language and cognitive skills in Spanish-English bilingual children with PLI 3 months after children have completed one of three experimental treatment conditions. There are two main study aims. First, to determine if skills in Spanish, English and cognitive processing decline, improve or are maintained after treatment has been completed. Second, to determine if differential rates of change are a function of the type of treatment children received. METHODS & PROCEDURES: Participants were 48 children, aged 5:6-11:3, who spoke Spanish and English and were diagnosed with moderate to severe PLI. Participants received 6 weeks of treatment focused on English only (EO), bilingual skills in Spanish and English (BI) or nonlinguistic cognitive processing (NCP). Treatment effects reported in a previous study were determined by comparing pre- and post-treatment performance on a variety of language and cognitive measures. Here we re-administered each measure 3 months after completion of the experimental treatments. Hierarchical linear models were calculated for each measure using pre-, post- and follow-up testing scores to estimate change trajectories and compare outcomes between treatment conditions. OUTCOMES & RESULTS: Participants in all three treatment conditions either maintained skills or showed improvement even after treatment was discontinued for 3 months. Main findings included (1) comparable, positive rates of change on all English language outcomes for EO and BI conditions; (2) maintenance of Spanish language skills, and (3) modest improvements in NCP following the discontinuation of treatment. CONCLUSIONS & IMPLICATIONS: This study is the first to examine longer-term treatment effects for bilingual school-age children with PLI. Differences in rates of change between languages and between treatment conditions are discussed in terms of social and cognitive processes that impact children's language systems. The main findings have at least two implications for clinical practice: (1) therapy that emphasizes focused practice in language and cognitive processing skills may promote gains in children's language learning abilities; and (2) bilingual treatment does not detract from outcomes in English, the language of the majority community for study participants.

Lexical profiles of bilingual children with primary language impairment.

This study used lexical tasks to examine associations between languages, tasks, and age in bilingual children with primary language impairment. Participants (n = 41, mean age 8;8 years) lived in the United States, spoke primarily Spanish (L1) at home and English (L2) at school, and were identified with moderate to severe impairments in both languages. A total of eight tasks (four in each language) measured breadth of vocabulary knowledge (receptive and expressive vocabulary) and aspects of lexical processing (rapid automatic naming and nonword repetition). Correlational analyses revealed older children outperformed younger children on lexical tasks in L2 but not L1, as well as relative L2 dominance for most individuals and tasks. Positive associations were found between languages on processing-based tasks but not vocabulary measures. Findings were consistent with literature on typical bilingual learners, albeit with a notable increased risk of plateau in L1 growth. Results are interpreted within a Dynamic Systems framework.

A longitudinal study of lexical development in children learning Vietnamese and English.

This longitudinal study modeled lexical development among children who spoke Vietnamese as a first language (L1) and English as a second language (L2). Participants (n = 33, initial mean age of 7.3 years) completed a total of eight tasks (four in each language) that measured vocabulary knowledge and lexical processing at four yearly time points. Multivariate hierarchical linear modeling was used to calculate L1 and L2 trajectories within the same model for each task. Main findings included (a) positive growth in each language, (b) greater gains in English resulting in shifts toward L2 dominance, and (c) different patterns for receptive and expressive domains. Timing of shifts to L2 dominance underscored L1 skills that are resilient and vulnerable to increases in L2 proficiency.

Three treatments for bilingual children with primary language impairment: examining cross-linguistic and cross-domain effects.

PURPOSE: This study examines the absolute and relative effects of 3 different treatment programs for school-age bilingual children with primary or specific language impairment (PLI). It serves to expand the evidence base on which service providers can base treatment decisions. It also explores hypothesized relations between languages and cognition in bilinguals with PLI. METHOD: Fifty-nine school-age Spanish­English bilingual children with PLI were assigned to receive nonlinguistic cognitive processing, English, bilingual (Spanish­English), or deferred treatment. Participants in each of the 3 active treatments received treatment administered by nationally certified speech-language pathologists. Pre- and posttreatment assessments measured change in nonlinguistic cognitive processing, English, and Spanish skills, and analyses examined change within and across both treatment groups and skill domains. RESULTS: All active treatment groups made significant pre- to post-treatment improvement on multiple outcome measures. There were fewer significant changes in Spanish than in English across groups. Between-group comparisons indicate that the active treatment groups generally outperformed the deferred treatment control, reaching statistical significance for 2 tasks. CONCLUSION: Results provide insight into cross-language transfer in bilingual children and advance understanding of the general PLI profile with respect to relationships between basic cognitive processing and higher level language skills.

Nonlinguistic cognitive treatment for bilingual children with primary language impairment.

Substantial evidence points to the presence of subtle weaknesses in the nonlinguistic cognitive processing skills of children with primary (or specific) language impairment (PLI). It is possible that these weaknesses contribute to the language learning difficulties that characterize PLI, and that treating them can improve language skills. To test this premise, we treated two nonlinguistic cognitive processing skills, processing speed and sustained selective attention, in two Spanish-English bilingual children with PLI. The study followed a single-subject multiple baseline design, with both repeated measures and standardized pre- and post-testing as outcome measures. Results from the repeated measures tasks showed that both participants made gains in nonlinguistic cognitive processing skills as well as in Spanish and English. These results both replicate and extend prior work showing that nonlinguistic cognitive processing treatment can positively affect language skills in children with PLI.

Is there a cognate advantage for typically developing Spanish-speaking English-language learners?

PURPOSE: Cross-linguistic cognates are words that share form and meaning in two languages (e.g., helicopter-helicóptero); translation equivalents are words that share meaning but not form (e.g., house-casa). Research consistently demonstrates a performance speed and/or accuracy advantage for processing cognates versus noncognates in bilingual adults; studies with children are limited, with equivocal results. We investigated the potential for a cognate advantage for processing expressive and receptive vocabulary in the spoken (vs. written) modality in typically developing Spanish-speaking English-language learners (ELLs). METHOD: Thirty 8- to 13-year-old native Spanish-speaking children learning English as their second language completed standardized vocabulary tests in spoken English. Each test item was classified as a cognate or noncognate based on phonological overlap with its Spanish translation. Group and individual analyses were used to examine the effects of cognates. RESULTS: At the group level, children's test scores were higher for items that were classified as cognates as compared to noncognates of comparable difficulty. However, not all children demonstrated this cognate advantage. Age predicted significant amounts of variance in cognate performance on the receptive test. CONCLUSION: Overall, typically developing Spanish-speaking school-age ELL students demonstrated a cognate advantage. There was also considerable within-group variation in performance. Clinical implications are discussed, and directions for future study are provided.

Sustained attention in children with primary language impairment: a meta-analysis.

PURPOSE: This study provides a meta-analysis of the difference between children with primary or specific language impairment (LI) and their typically developing peers on tasks of sustained attention. The meta-analysis seeks to determine whether children with LI demonstrate subclinical deficits in sustained attention and, if so, under what conditions. METHOD: Articles that reported empirical data from the performance of children with LI, in comparison to typically developing peers, on a task assessing sustained attention were considered for inclusion. Twenty-eight effect sizes were included in the meta-analysis. Two moderator analyses addressed the effects of stimulus modality and attention-deficit/hypereactivity disorder exclusion. In addition, reaction time outcomes and the effects of task variables were summarized qualitatively. RESULTS: The meta-analysis supports the existence of sustained attention deficits in children with LI in both auditory and visual modalities, as demonstrated by reduced accuracy compared with typically developing peers. Larger effect sizes are found in tasks that use auditory-linguistic stimuli than in studies that use visual stimuli. CONCLUSIONS: Future research should consider the role that sustained attention weaknesses play in LI as well as the implications for clinical and research assessment tasks. Methodological recommendations are summarized.

Addressing clinician-client mismatch: a preliminary intervention study with a bilingual Vietnamese-English preschooler.

PURPOSE: This project examined receptive vocabulary treatment outcomes in the two languages of a bilingual preschooler with moderate to severe language impairment. METHOD: A series of single-subject experimental designs was used to compare English-only (EO) and bilingual (BI) approaches to receptive vocabulary treatment. The participant, Nam, was a boy age 3;11 (years;months) who was learning Vietnamese as a first language at home and English in his early childhood education program. Treatment was implemented by an EO interventionist using a computer interface and prerecorded audio files in Vietnamese and English. The dependent measure was the percentage of items that were correctly identified in each language. RESULTS: Combined studies revealed that the BI approach increased Nam's attention to task and was as effective as the EO approach for increasing his receptive vocabulary in English. Nam made vocabulary gains in both treatment conditions; receptive vocabulary gains were evident in both Vietnamese and English. CONCLUSION: This project showed that it is feasible for an EO clinician to promote gains in both the home and school languages of a BI child through creative collaborations with BI colleagues and the use of technology. Replication with additional participants and treatment activities is needed to make further generalizations.

Cross-language nonword repetition by bilingual and monolingual children.

PURPOSE: Identifying children with primary or specific language impairment (LI) in languages other than English continues to present a diagnostic challenge. This study examined the utility of English and Spanish nonword repetition (NWR) to identify children known to have LI. METHOD: Participants were 4 groups of school-age children (N = 187). There were 2 typically developing groups: proficient Spanish-English sequential bilinguals and monolingual English speakers. There were 2 groups of children with LI, one Spanish-English and the other monolingual English speakers. Children participated in both English and Spanish NWR. RESULTS: Children's NWR performance was significantly correlated across languages. In English NWR, the 2 groups with LI had lower accuracy at the longest syllable length than the 2 typically developing groups. In Spanish NWR, monolingual children with LI had lower repetition accuracy than bilingual children with LI and typical monolingual children, with all 3 groups outperformed by the typical bilingual group. Likelihood ratios indicated adequate diagnostic power only for English NWR in ruling out the typical bilingual children as showing LI. CONCLUSION: The results demonstrate that NWR performance relies on the dual influences of LI and native language experience. However, it remains possible that NWR is useful in a composite marker for LI.

Lexical and grammatical associations in sequential bilingual preschoolers.

PURPOSE: The authors investigated potential relationships between traditional linguistic domains (words, grammar) in the first (L1) and second (L2) languages of young sequential bilingual preschool children. METHOD: Participants were 19 children, ages 2;11 (years;months) to 5;2 (M = 4;3) who began learning Hmong as the L1 from birth and English as the L2 during early childhood. Measures were the number of different words (NDW) and mean length of utterance (MLU) produced during a story retell task and scores on picture identification, an independent measure of receptive vocabulary. Correlations were conducted to determine relationships among measures. RESULTS: In English, there were robust positive relationships between MLU and lexical measures (NDW, Picture Identification). In Hmong, more modest cross-domain associations were evident between lexical measures and MLU. There were positive cross-language links for NDW but more limited cross-domain correspondences between the L1 and the L2. CONCLUSIONS: In English, relationships between words and grammar were similar to those found in previous studies with monolingual and simultaneous bilingual toddlers. Weaker cross-domain associations in the L1 may reflect participants' greater development in Hmong or typological differences between the L1 and the L2.

Bilingual children with primary language impairment: issues, evidence and implications for clinical actions.

UNLABELLED: A clear understanding of how to best provide clinical serves to bilingual children with suspected or confirmed primary language impairment (PLI) is predicated on understanding typical development in dual-language learners as well as the PLI profile. This article reviews general characteristics of children learning two languages, including three that challenge the diagnosis and treatment of PLI; uneven distribution of abilities in the child's two languages, cross-linguistic associations within bilingual learners, and individual variation in response to similar social circumstances. The diagnostic category of PLI (also referred to in the literature as specific language impairment or SLI) is described with attention to how language impairment, in the face of otherwise typical development, manifests in children learning two languages. Empirical evidence related to differential diagnosis of PLI in bilingual children is then reviewed and issues related to the generalization of treatment gains in dual-language learners with PLI are introduced. LEARNING OUTCOMES: As a result of this activity, the careful reader will be able to (1) describe general characteristics of typically developing dual-language learners, (2) explain how primary language impairment (PLI) manifests in bilingual children, and (3) identify key clinical issues and approaches to assessment and treatment on bilingual PLI.

Common factors in speech-language treatment: an exploratory study of effective clinicians.

UNLABELLED: Research in related fields that employ behavioral interventions indicates that factors common to treatment programs may be more important to successful outcomes than specific components of a treatment. Applying this concept to speech-language pathology, we investigated one hypothesized "common factor," namely, the clinician who implements treatment. Data were collected from limited samples of speech-language clinicians in two surveys. In Study One, 79 participants responded to open-ended questions about the nature of effective clinicians. A thematic analysis of their responses resulted in three broad categories of characteristics: behaviors, traits, and acquisitions. These themes were incorporated into an online survey for Study Two, in which 158 clinicians rated the importance of 25 clinician qualities. Their ratings suggested that the clinician-client relationship may be particularly important to treatment outcomes. These preliminary findings provide a foundation for further research on the clinician's contribution to treatment efficacy. LEARNING OUTCOMES: Readers will be able to: (1) understand the concept of Common Factors; (2) describe the impact of clinicians on speech-language therapy outcomes as predicted by the Common Factors model; (3) list important characteristics of effective speech-language clinicians.

Sentence interpretation by typically developing Vietnamese-English bilingual children.

We examined developing bilinguals' use of animacy and word order cues during sentence interpretation tasks administered in each of their languages. Participants were 6- to 8-year-old children who learned Vietnamese as a first language and English as a second language (n = 23). Participants listened to simple sentences and identified the agent or "doer" of the action. English-only peers (n = 23) served as a comparison group. Results indicated that the bilingual group relied more on animacy than the English-only group when interpreting sentences in English and that the bilingual group used a blending or "amalgamation" of cues to interpret English and Vietnamese sentences. Significant within-group variation in cue preference was investigated as a function of age and proficiency in the first language and second language.

Bilingual children and communication disorders: a 30-year research retrospective.

We present a review of the empirical literature at the intersection of bilingualism and pediatric communication disorders. A computer search of six electronic databases was done to identify studies published in English since 1950 that directly investigated some aspect of speech, language, or cognitive performance in developing bilinguals and children with communication impairments. The computer search yielded 116 non-duplicated articles, the first published in 1978. An article review by the authors further reduced the number of studies meeting search criteria to 64. A majority of studies focused on primary developmental language impairment (LI) and children learning two languages sequentially. Spanish and English were the most frequent combination of languages for bilingual participants. Collective study findings are presented with respect to trends, clinical implications, and areas for future research.

Cross-language generalization following treatment in bilingual speakers with aphasia: a review.

The focus of this article is on the potential transfer or generalization of positive effects from a treated to an untreated language in bilingual or multilingual individuals with primary acquired aphasia. Twelve studies are reviewed: All were previously published in English in peer-reviewed journals. Half of these studies failed to account for spontaneous recovery. Results from the remaining case reports and single-subject studies are mixed, with four finding evidence for cross-language generalization under some conditions and two finding that improved language performance was restricted to the treated language. Collective findings are discussed within the broader literature in terms of factors to consider when planning for effective, efficient intervention with bilinguals with aphasia.

Primary or "specific" language impairment and children learning a second language.

We review empirical findings from children with primary or "specific" language impairment (PLI) and children who learn a single language from birth (L1) and a second language (L2) beginning in childhood. The PLI profile is presented in terms of both language and nonlinguistic features. The discussion of L2 learners emphasizes variable patterns of growth and skill distribution in L1 and L2 which complicate the identification of PLI in linguistically diverse learners. We then introduce our research program, designed to map out common ground and potential fault lines between typically developing children learning one or two languages, as compared to children with PLI.

Fast mapping by bilingual preschool children.

Previous studies show that young monolingual children's ability to 'fast map' new word forms is closely associated with both their age and existing vocabulary knowledge. In this study we investigate potential relationships between age, fast mapping skills and existing vocabulary knowledge in both languages of developing bilingual preschool children. Participants were twenty-six typically developing children, ages 3 ; 0 to 5 ; 3. All children learned Hmong as their primary home language (L1) and English as a second language (L2). Fast mapping and vocabulary knowledge tasks were administered in L1 and L2. For vocabulary knowledge, scores were comparable in L1 and L2; for fast mapping, scores were somewhat greater in L1 than L2. In contrast to previous findings with monolingual children, fast mapping performance was not related to age or existing vocabulary knowledge in either Hmong or English. There were, however, significant positive and negative cross-language correlations between L1 fast mapping and L2 vocabulary.

Corpora of Vietnamese texts: lexical effects of intended audience and publication place.

This article has two primary aims. The first is to introduce a new Vietnamese text-based corpus. The Corpora of Vietnamese Texts (CVT; Tang, 2006a) consists of approximately 1 million words drawn from newspapers and children's literature, and is available online at www.vnspeechtherapy.com/vi/CVT. The second aim is to investigate potential differences in lexical frequency and distributional characteristics in the CVT on the basis of place of publication (Vietnam or Western countries) and intended audience: adult-directed texts (newspapers) or child-directed texts (children's literature). We found clear differences between adult- and child-directed texts, particularly in the distributional frequencies of pronouns or kinship terms, which were more frequent in children's literature. Within child- and adult-directed texts, lexical characteristics did not differ on the basis of place of publication. Implications of these findings for future research are discussed.

A corpus-based analysis of Vietnamese 'classifiers' con and cái.

The purpose of this study is to examine the use of two common Vietnamese 'classifiers,' con (animacy) and cái (inanimacy) using language corpora data of over one million words. This information may contribute to an ongoing debate of whether Vietnamese 'classifiers' are a distinct word class or a subclass of nouns. Frequency and distributions were calculated using computer software. Lexical-semantic functions were manually analyzed for each occurrence. Findings indicated that con and cái were highly frequent and distributed across text genres. However, neither form consistently demonstrated a classifying function: con indicated animacy less than 24% of the time, and cái indicated inanimacy less than 65% of the time. Corpus-based analysis is a useful tool to make comparisons between prototypical and 'real-life' language use. If Vietnamese 'classifiers' are not consistently used as such, considering this group of words a subclass of nouns rather than a distinct word class may be more parsimonious.