`It's not just linguistically, there's much more going on': The experiences and practices of bilingual paediatric speech and language therapists in the UK.

BACKGROUND: Despite the high prevalence of bilingualism in the United Kingdom, few speech and language therapists (SLTs) are bilingual themselves. Most SLT research on bilingualism has generated knowledge to inform service delivery for bilingual clients, but few studies have investigated how being a bilingual SLT influences one's professional experiences and practices. Better understanding the unique positionality of bilingual SLTs can yield critical insights to meaningfully address issues of diversity, inclusion and equity in the profession. AIMS: To investigate the experiences and practices of bilingual paediatric SLTs in the United Kingdom through the lens of Cultural-Historical Activity Theory-International Classification of Functioning, Disability and Health (CHAT-ICF), a new theoretical framework developed to conceptualise the activities of professionals working in the field of disability. METHODS: In this qualitative study, 19 bilingual paediatric SLTs practising in the United Kingdom were interviewed individually. Participants were recruited through a snowball sampling strategy, and semi-structured interviews conducted online. The data were analysed using reflexive thematic analysis and following a hybrid inductive-deductive approach to map the results onto the CHAT-ICF framework. RESULTS: Six overarching components of the CHAT-ICF framework hosted the 12 sub-themes identified to capture the experiences and practices of bilingual SLTs: (1) Subject (intersectionality); (2) Tools (language skills, education, clinical resources); (3) Rules (systemic barriers, sense of responsibility); (4) Community (sense of inclusion); (5) Division of labour (parents, colleagues); and (6) Practice (empathy with children, holistic mindset, flexible approaches). The use of the CHAT-ICF theoretical lens revealed two fundamental structural phenomena: (1) the distribution of sub-themes across many components of CHAT-ICF demonstrated that being a bilingual SLT is a multifactorial experience; and (2) the chain reactions between sub-themes illustrated the dynamic nature of bilingual SLTs' experiences which can be harnessed to challenge marginalisation and promote equity in the profession. CONCLUSION & IMPLICATIONS: This is the first qualitative study to date to provide in-depth insights into the experiences and practices of bilingual SLTs in the United Kingdom. These insights can be mobilised to inform the meaningful inclusion of bilingual SLTs in workforce planning efforts and service development. Recommendations include using intersectional lenses, providing cultural and anti-racism awareness training to SLTs, developing more diverse clinical resources and flexible approaches for bilingual families, valuing bilingualism in recruitment processes and increasing accountability at the leadership level. Research giving voice to bilingual SLTs, and other underrepresented demographics in the SLT workforce, can catalyse action to promote a more diverse and inclusive profession in line with the Royal College of Speech and Language Therapists' strategic vision 2022-2027. WHAT THIS PAPER ADDS: What is already known on the subject Most research on bilingualism in speech and language therapy is focused on issues related to service provision and delivery for bilingual clients with little consideration for bilingual speech and language therapists' (SLTs) unique positionality. A few survey studies have shown that bilingual SLTs report significantly higher competency and greater confidence when working with clients who speak multiple languages, but there are significant gaps in understanding how bilingualism impacts other aspects of their professional experiences. What this paper adds to existing knowledge This is the first study to provide in-depth insights into the experiences and practices of bilingual SLTs in the United Kingdom. We show that being bilingual profoundly impacts many aspects of their professional experiences, including their clinical identity, skillset, sense of inclusion in the workplace, work relationships and clinical approaches. Bilingual SLTs expressed developing trust relationships with bilingual families and adopting flexible approaches to account for their clients' environmental factors, all of which can contribute to more equitable SLT services. This study also makes a novel contribution by proposing and using the Cultural-Historical Activity Theory-International Classification of Functioning, Disability and Health (CHAT-ICF) framework to conceptualise and investigate SLTs' experiences and practices. What are the potential or actual clinical implications of this work? This study provides evidence-based recommendations to inform progress towards the Royal College of Speech and Language Therapists' strategic vision 2022-2027 and the diversification of the profession. Actions to support bilingual SLTs and diversify the profession include shifting a rigid mindset of linguistic and cultural `competence' to self-growth and awareness, developing more diverse clinical resources and flexible approaches for bilingual families, valuing bilingualism in SLT recruitment processes and career progression and increasing accountability and leadership around issues of diversity in the workplace. The novel CHAT-ICF framework has the potential to be used to support therapists' reflexivity in their practice or structure audits of rehabilitation services. Intersectionality theories and transformative processes can catalyse positive change in clinical services and research around bilingualism.

Perspective-taking in deriving implicatures: The listener's perspective is important too.

Theories of meaning propose that listeners understand a speaker's implicit meaning thanks to mutually assumed norms of conversation that take into account what the speaker has said, as well as contextual factors, including what the speaker knows. Emerging psycholinguistic research shows that listeners derive a particular kind of implicit meaning, quantity implicatures, when their speaker is knowledgeable about the situation but tend to not derive it otherwise. In this article we focus on if and how listeners use the knowledge that is available only to themselves, i.e., the listener's perspective, while deriving implicatures. To do so, we explore the derivation of ad hoc quantity implicature in situations where the speaker does or does not have full knowledge, while, in the latter case, the listener has two types of privileged knowledge. Two versions of a study with neurotypical English-speaking adults show that listeners are influenced by their own perspective while deriving implicatures, depending on the type of knowledge available to them. We discuss the implications of these findings for models of pragmatic interpretative strategies.

Parental Report via a Mobile App in the Context of Early Language Trajectories: StarWords Study Protocol.

Social sciences researchers emphasize that new technologies can overcome the limitations of small and homogenous samples. In research on early language development, which often uses parental reports, taking the testing online might be particularly compelling. Due to logistical limitations, previous studies on bilingual children have explored the language development trajectories in general (e.g., by including few and largely set apart timepoints), or focused on small, homogeneous samples. The present study protocol presents a new, on-going study which uses new technologies to collect longitudinal data continuously from parents of multilingual, bilingual, and monolingual children. Our primary aim is to establish the developmental trajectories in Polish-British English and Polish-Norwegian bilingual children and Polish monolingual children aged 0-3 years with the use of mobile and web-based applications. These tools allow parents to report their children's language development as it progresses, and allow us to characterize children's performance in each language (the age of reaching particular language milestones). The project's novelty rests on its use of mobile technologies to characterize the bilingual and monolingual developmental trajectory from the very first words to broader vocabulary and multiword combinations.

Parental Perceptions and Decisions Regarding Maintaining Bilingualism in Autism.

A growing body of evidence suggests that bilingual exposure does not negatively impact children on the autism spectrum. This study sought to illuminate parents' perceptions and choices regarding maintaining bilingualism in autism. Semi-structured interviews were conducted with 16 family members in England and Wales. Data were analysed using interpretative phenomenological analysis (IPA). Although parents expressed positive attitudes towards bilingualism, these views were not always congruent with their language practices. Instead, several factors influenced decisions about language maintenance in autism, including the severity of the child's autism, advice received, and the importance of English as the dominant societal language. This article calls for greater support for families in making language decisions that are suitable for the individual child and their family.

A Distinction Between Linguistic and Social Pragmatics Helps the Precise Characterization of Pragmatic Challenges in Children With Autism Spectrum Disorders and Developmental Language Disorder.

Purpose Children with autism spectrum disorders (ASDs) and children with developmental language disorder (DLD) face challenges with pragmatics, but the nature and sources of these difficulties are not fully understood yet. The purpose of this study was to compare the competence of children with ASD and children with DLD in two pragmatics tasks that place different demands on theory of mind (ToM) and structural language. Method Twenty Spanish-speaking children with ASD, 20 with DLD, and 40 age- and language-matched children with neurotypical development were assessed using two pragmatics tasks: a linguistic pragmatics task, which requires competence with structural language, and a social pragmatics task, which requires competence with ToM as well. Results For linguistic pragmatics, the ASD group performed similarly to the DLD and language-matched groups, and performance was predicted by structural language. For social pragmatics, the ASD group performed lower than the DLD and language-matched groups, and performance was predicted both by structural language and ToM. Conclusions Children with ASD and children with DLD face difficulties in linguistic pragmatics tasks, in keeping with their structural language. Children with ASD face exceptional difficulties with social pragmatics tasks, due to their difficulties with ToM. The distinction between linguistic and social pragmatic competences can inform assessment and intervention for pragmatic difficulties in different populations.

Generalizing About Striking Properties: Do Glippets Love to Play With Fire?

Two experiments investigated whether 4- and 5-year-old children are sensitive to whether the content of a generalization is about a salient or noteworthy property (henceforth "striking") and whether varying the number of exceptions has any effect on children's willingness to extend a property after having heard a generalization. Moreover, they investigated how the content of a generalization interacts with exception tolerance. Adult data were collected for comparison. We used generalizations to describe novel kinds (e.g., "glippets") that had either a neutral (e.g., "play with toys") or a striking property (e.g., "play with fire") and measured how willing participants were to extend the property to a new instance of the novel kind. Experiment 1 demonstrated that both adults and children show sensitivity to strikingness in that striking properties were extended less than neutral ones, although children extended less than adults overall. The responses of both age groups were significantly different from chance. Experiment 2 introduced varying numbers of exceptions to the generalization made (minimal: 1 exception; maximal: 3 exceptions). Both adults and children extended both types of properties even in the face of exceptions, but to a lower degree than in Experiment 1. Striking properties were extended less than neutral ones, as in Experiment 1. We observed that the greater the number of exceptions, the lower the rates of extension we obtained, for both types of properties in adults, but only with striking properties in children. Children seemed to keep track of varying numbers of exceptions for striking properties, but their performance did not differ from chance. The findings underscore that 4- and 5-year-old children are sensitive to strikingness and to exception tolerance for generalizations and are developing toward an adult-like behavior with respect to the interplay between strikingness and exception tolerance when they learn about novel kinds. We discuss the implications of these results with regards to how children make generalizations.

Bilingualism and language similarity modify the neural mechanisms of selective attention.

Learning and using multiple languages places major demands on our neurocognitive system, which can impact the way the brain processes information. Here we investigated how early bilingualism influences the neural mechanisms of auditory selective attention, and whether this is further affected by the typological similarity between languages. We tested the neural encoding of continuous attended speech in early balanced bilinguals of typologically similar (Dutch-English) and dissimilar languages (Spanish-English) and compared them to results from English monolinguals we reported earlier. In a dichotic listening paradigm, participants attended to a narrative in their native language while ignoring different types of interference in the other ear. The results revealed that bilingualism modulates the neural mechanisms of selective attention even in the absence of consistent behavioural differences between monolinguals and bilinguals. They also suggested that typological similarity between languages helps fine-tune this modulation, reflecting life-long experiences with resolving competition between more or less similar candidates. The effects were consistent over the time-course of the narrative and suggest that learning a second language at an early age triggers neuroplastic adaptation of the attentional processing system.

Relations Between Bilingualism and Autistic-Like Traits in a General Population Sample of Primary School Children.

Some evidence suggests that bilingualism improves communication and cognitive skills which are often impaired in autism. However, diagnosing autism in bilinguals may suffer a cultural bias, which can affect the investigation of bilingualism and autism. Therefore, the current study investigates relations between autistic-like traits (ALTs) and bilingualism in a general population sample of 394 children (M age = 8;3). Within the high-scoring group on the ALT measure, monolinguals had significantly higher ALT scores than bilinguals. There were no differences between monolinguals and bilinguals in the low-scoring group. Across the whole sample, age and structural language skills accounted for 35% variance in ALTs, while bilingualism had no effect on ALTs. Furthermore, structural language skills explained more variance in ALTs among bilinguals than among monolinguals.

The school experiences of bilingual children on the autism spectrum: An interpretative phenomenological analysis.

BACKGROUND: With growing numbers of bilingual children on the autism spectrum in UK classrooms, the interaction between autism and bilingualism is becoming a pressing issue for practitioners, researchers and families. In this study, we report the school experiences of bilingual, autistic children in the UK through their own voice with focus on five aspects of their school life. METHOD: Using interpretative phenomenological analysis (IPA) as a methodological framework, semi-structured, computer-assisted interviews were conducted with 11 children aged 7 to 14 from across England and Wales. Interviews were carried out in English and took place in mainstream schools or the children's home, depending on their preference. RESULTS: Results indicate that, while children's school experiences vary widely, there were commonalities in this population's identity formation, including being bilingual, and their classroom experiences. Most notably, children educated in more multilingual environments (i.e. in schools with larger multilingual populations) expressed more positive views about multilingualism than those in more monolingual settings. In line with previous studies, limited social circles and classroom anxiety were present in participants' school experiences. IMPLICATIONS: The findings of this paper suggest that giving autistic children from bilingual backgrounds opportunities to explore their linguistic identities in the classroom may enhance their experiences of school. Further research should focus on parents' and practitioners' attitudes and perspectives towards the support available for this population.

Using interpretative phenomenological analysis in autism research.

Qualitative studies within autism research are gaining prominence, yet there is little evidence about the usefulness of particular qualitative approaches in reflecting the perspectives and experiences of autistic participants. This short report serves to introduce interpretative phenomenological analysis as one among a range of qualitative approaches to autism research. We argue that certain features of interpretative phenomenological analysis, including its commitment to an equality of voice and researcher reflexivity, may help to illuminate the experiences of autistic individuals. The procedures of interpretative phenomenological analysis are presented through the lens of 10 studies into autistic people's experiences, and a case is made for the suitability of this approach within qualitative autism research.

Resisting attraction: Individual differences in executive control are associated with subject-verb agreement errors in production.

We propose that attraction errors in agreement production (e.g., the key to the cabinets are missing) are related to two components of executive control: working memory and inhibitory control. We tested 138 children aged 10 to 12, an age when children are expected to produce high rates of errors. To increase the potential of individual variation in executive control skills, participants came from monolingual, bilingual, and bidialectal language backgrounds. Attraction errors were elicited with a picture description task in Dutch and executive control was measured with a digit span task, Corsi blocks task, switching task, and attentional networks task. Overall, higher rates of attraction errors were negatively associated with higher verbal working memory and, independently, with higher inhibitory control. To our knowledge, this is the first demonstration of the role of both working memory and inhibitory control in attraction errors in production. Implications for memory- and grammar-based models are discussed. (PsycINFO Database Record

Cross-linguistic patterns in the acquisition of quantifiers.

Learners of most languages are faced with the task of acquiring words to talk about number and quantity. Much is known about the order of acquisition of number words as well as the cognitive and perceptual systems and cultural practices that shape it. Substantially less is known about the acquisition of quantifiers. Here, we consider the extent to which systems and practices that support number word acquisition can be applied to quantifier acquisition and conclude that the two domains are largely distinct in this respect. Consequently, we hypothesize that the acquisition of quantifiers is constrained by a set of factors related to each quantifier's specific meaning. We investigate competence with the expressions for "all," "none," "some," "some…not," and "most" in 31 languages, representing 11 language types, by testing 768 5-y-old children and 536 adults. We found a cross-linguistically similar order of acquisition of quantifiers, explicable in terms of four factors relating to their meaning and use. In addition, exploratory analyses reveal that language- and learner-specific factors, such as negative concord and gender, are significant predictors of variation.

Practitioner Review: Multilingualism and neurodevelopmental disorders - an overview of recent research and discussion of clinical implications.

BACKGROUND: Language and communication skills are essential aspects of child development, which are often disrupted in children with neurodevelopmental disorders. Cutting edge research in psycholinguistics suggests that multilingualism has potential to influence social, linguistic and cognitive development. Thus, multilingualism has implications for clinical assessment, diagnostic formulation, intervention and support offered to families. We present a systematic review and synthesis of the effects of multilingualism for children with neurodevelopmental disorders and discuss clinical implications. METHODS: We conducted systematic searches for studies on multilingualism in neurodevelopmental disorders. Keywords for neurodevelopmental disorders were based on Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition categories as follows; Intellectual Disabilities, Communication Disorders, Autism Spectrum Disorder (ASD), Attention-Deficit/Hyperactivity Disorder, Specific Learning Disorder, Motor Disorders, Other Neurodevelopmental Disorders. We included only studies based on empirical research and published in peer-reviewed journals. RESULTS: Fifty studies met inclusion criteria. Thirty-eight studies explored multilingualism in Communication Disorders, 10 in ASD and two in Intellectual Disability. No studies on multilingualism in Specific Learning Disorder or Motor Disorders were identified. Studies which found a disadvantage for multilingual children with neurodevelopmental disorders were rare, and there appears little reason to assume that multilingualism has negative effects on various aspects of functioning across a range of conditions. In fact, when considering only those studies which have compared a multilingual group with developmental disorders to a monolingual group with similar disorders, the findings consistently show no adverse effects on language development or other aspects of functioning. In the case of ASD, a positive effect on communication and social functioning has been observed. CONCLUSIONS: There is little evidence to support the widely held view that multilingual exposure is detrimental to the linguistic or social development of individuals with neurodevelopmental disorders. However, we also note that the available pool of studies is small and the number of methodologically high quality studies is relatively low. We discuss implications of multilingualism for clinical management of neurodevelopmental disorders, and discuss possible directions for future research.

The effect of childhood bilectalism and multilingualism on executive control.

Several investigations report a positive effect of childhood bilingualism on executive control (EC). An issue that has remained largely unexamined is the role of the typological distance between the languages spoken by bilinguals. In the present study we focus on children who grow up with Cypriot Greek and Standard Modern Greek, two closely related varieties that differ from each other on all levels of language analysis (vocabulary, pronunciation, grammar). We compare the EC performance of such bilectal children to that of English-Greek multilingual children in Cyprus and Standard Modern Greek-speaking monolingual children in Greece. A principal component analysis on six indicators of EC revealed two distinct factors, which we interpreted as representing working memory and inhibition. Multilingual and bilectal children exhibited an advantage over monolinguals that was evident across EC factors and emerged only after statistically controlling for their lower language proficiency. These results demonstrate that similar EC advantages as previously reported for 'true' bilingual speakers can be found in bilectal children, which suggests that minimal typological distance between the varieties spoken by a child suffices to give rise to advantages in EC. They further indicate that the effect of speaking more than one language or dialect on EC performance is located across the EC system without a particular component being selectively affected. This has implications for models of the locus of the bilingual advantage in EC performance. Finally, they show that the emergence of EC advantages in bilinguals is moderated by the level of their language proficiency.

Communicative Development in Bilingually Exposed Chinese Children With Autism Spectrum Disorders.

PURPOSE: We examined the association of bilingual exposure with structural and pragmatic language development in Chinese children with autism spectrum disorders (ASDs). METHOD: The parents of 54 children with ASD exposed to 1 (n = 31) or 2 (n = 23) Chinese languages completed (a) a questionnaire to evaluate their child's competence in structural language and pragmatic ability in their dominant language (Children's Communication Checklist-Second Edition; Bishop, 2006), and (b) a questionnaire to assess their child's social functioning (Social Responsiveness Scale; Constantino & Gruber, 2005; Wang, Lee, Chen, & Hsu, 2012). In addition, parents completed thorough interviews regarding the linguistic environment of their children (Language Environment Interview; Hambly & Fombonne, 2011). RESULTS: Multivariate analyses of variance revealed that bilingually exposed children with ASD did not demonstrate significantly different performance on any standard measure relative to their monolingual peers. CONCLUSIONS: The findings suggest that bilingual language exposure is not associated with additional challenges for the development of the dominant language in children with ASD. The lack of negative associations in our sample is not likely to be due to the comparatively early diagnosis and/or intervention that are available in other countries. We discuss implications for decisions regarding the linguistic environment of children with ASD.

Which are the best predictors of theory of mind delay in children with specific language impairment?

BACKGROUND: The relationship between language and theory of mind (ToM) development in participants with specific language impairment (SLI) it is far from clear due to there were differences in study design and methodologies of previous studies. AIMS: This research consisted of an in-depth investigation of ToM delay in children with SLI during the typical period of acquisition, and it studied whether linguistic or information-processing variables were the best predictors of this process. It also took into account whether there were differences in ToM competence due to the degree of pragmatic impairment within the SLI group. METHODS & PROCEDURES: Thirty-one children with SLI (3;5-7;5 years old) and two control groups (age matched and language matched) were assessed with False Belief (FB) tasks, a wide battery of language measures and additional information-processing measures. OUTCOMES & RESULTS: The members of the SLI group were less competent than their age-matched peers at solving FB tasks, but they performed similarly to the language-matched group. Regression analysis showed that overall linguistic skills of children with SLI were the best predictor of ToM performance, and especially grammar abilities. No differences between SLI subgroups were found according to their pragmatic level. CONCLUSIONS & IMPLICATIONS: A delay in ToM development in children with SLI around the critical period of acquisition is confirmed more comprehensively, and it is shown to be more strongly related to their general linguistic level than to their age and other information-processing faculties. This finding stresses the importance of early educational and clinical programmes aimed at reducing deleterious effects in later development.

Taking the epistemic step: toward a model of on-line access to conversational implicatures.

There is a growing body of evidence showing that conversational implicatures are rapidly accessed in incremental utterance interpretation. To date, studies showing incremental access have focussed on implicatures related to linguistic triggers, such as 'some' and 'or'. We discuss three kinds of on-line model that can account for this data. A model built around the notion of linguistic alternatives stored in the lexicon would only account for linguistically triggered implicatures of the kind already studied and not so-called 'particularised' implicatures that are not associated with specific linguistic items. A second model built around the idea of focus alternatives could handle both linguistically triggered implicatures and so-called particularised implicatures but would be insensitive to the role that information about the speaker's mental state plays in deriving implicatures. A third more fully 'Gricean' model takes account of the speaker's mental state in accessing these implications. In this paper we present a visual world study using a new interactive paradigm where two communicators (one confederate) describe visually-presented events to each other as their eye movements are monitored. In this way, we directly compare the suitability of these three kinds of model. We show hearers can access contextually specific particularised implicatures in on-line comprehension. Moreover, we show that in doing so, hearers are sensitive to the relevant mental states of the speaker. We conclude with a discussion of how a more 'Gricean' model may be developed and of how our findings inform a long-standing debate on the immediacy of on-line perspective taking in language comprehension.

Pragmatic tolerance: implications for the acquisition of informativeness and implicature.

Recent investigations of the acquisition of scalar implicature report that young children do not reliably reject a sentence with a weak scalar term, e.g. 'some of the books are red', when it is used as a description of a situation where a stronger statement is true, e.g. where all the books are red. This is taken as evidence that children do not interpret the sentence with the implicature that the stronger statement does not hold. We propose that (a) these tasks cannot differentiate between actual implicature derivation and mere sensitivity to violations of informativeness; and that (b) children's apparent failure is not due to lack of competence (whether with informativeness or implicature) but due to their tolerance of pragmatic violations. We report three studies with 5-to-6-year-old English-speaking children and adults employing utterances involving scalar and non-scalar expressions. These show that both age-groups are competent with informativeness, but also tolerant of pragmatic infelicity. These findings have implications for the well-established literature on whether children are aware of ambiguity in referential communication tasks.

Are children with Specific Language Impairment competent with the pragmatics and logic of quantification?

Specific Language Impairment (SLI) is understood to be a disorder that predominantly affects phonology, morphosyntax and/or lexical semantics. There is little conclusive evidence on whether children with SLI are challenged with regard to Gricean pragmatic maxims and on whether children with SLI are competent with the logical meaning of quantifying expressions. We use the comprehension of statements quantified with 'all', 'none', 'some', 'some…not', 'most' and 'not all' as a paradigm to study whether Spanish-speaking children with SLI are competent with the pragmatic maxim of informativeness, as well as with the logical meaning of these expressions. Children with SLI performed more poorly than a group of age-matched typically-developing peers, and both groups performed more poorly with pragmatics than with logical meaning. Moreover, children with SLI were disproportionately challenged by pragmatic meaning compared to their age-matched peers. However, the performance of children with SLI was comparable to that of a group of younger language-matched typically-developing children. The findings document that children with SLI do face difficulties with employing the maxim of informativeness, as well as with understanding the logical meaning of quantifiers, but also that these difficulties are in keeping with their overall language difficulties rather than exceeding them. The implications of these findings for SLI, linguistic theory, and clinical practice are discussed.