Promoting early language development in the Arab world and Sustainable Development Goals 3, 4, 10 and 17.

PURPOSE: This commentary describes a multi-national project which addresses gaps in the design and delivery of health and education services in Arabic-speaking countries in relation to early language development, with a focus on Egypt, Jordan, Lebanon and the Palestinian Territories. This includes: (1) co-production with early years professionals and NGOs of approaches to support early language development; (2) development and standardisation of tools to identify monolingual and multilingual Arabic-speaking children at risk of poor language development; and (3) examination of language development in refugee communities. RESULT: The importance of inter-professional partnership and the inclusion of families in planning support for oral language development is highlighted. Arabic versions of the Communicative Development Inventory (CDI) Toddler were developed, and data collected from 1074 Egyptian, Jordanian and Palestinian monolingual infants aged 8-30 months. Data from 201 age-matched Palestinian infants in Lebanese refugee camps highlight inequalities resulting from limited maternal educational opportunities. Data from 230 multilingual Lebanese 2-year-olds enable the interpretation of CDI scores as a function of language exposure. CONCLUSION: This work contributes to the promotion of robust language development for all Arabic-speaking children. This commentary focusses on sustainable development goal (SDG) 3, SDG 4, SDG 10 and SDG 17.

Cultural and Linguistic Practice with Children with Developmental Language Disorder: Findings from an International Practitioner Survey.

BACKGROUND: The cultural and language diversity across many European countries presents a range of challenges and opportunities for speech and language therapists and other practitioners working with children with developmental language disorders (DLD) and their families. OBJECTIVE: The aim of this study was to explore practitioners' perceptions of cultural and linguistic differences in response to children with DLD across different countries. METHODS: A survey was developed by practitioners and researchers working with children with DLD across Europe and beyond as part of the work of Cost Action IS1406. Data from 1,358 practitioners from 8 European countries - Ireland, UK, Bulgaria, Poland, Croatia, Spain, Norway and Sweden - and 2 neighbour countries - Turkey and Lebanon - were included in the present analyses, which address two groups of questions. The first focuses on practitioners' perceptions of the way that parents think about cultural differences and their relationship to language development in their children. The second concerns the extent to which practitioners consider themselves to have the skills to work with children from other cultures and using different languages. RESULTS/CONCLUSIONS: Most countries present a similar profile with intermediate results about their perception of cultural issues, but Lebanon and Turkey are the group with the most positive responses. In terms of bilingual issues most practitioners indicated that they only worked in their country's primary language. The only country where this was not the case was Lebanon. Professionals from Spain and Lebanon form a subgroup in terms of their confidence to work with different cultural/language groups. The paper highlights both the universal importance of cultural and linguistic competence in managing young children's needs and indicates that in most cases professionals do not think they have the necessary expertise to work with cultural and linguistic diversity.

Supporting language development in Lebanese preschools: SLT and pre-KT practice and perception of roles.

BACKGROUND: Speech and language therapists (SLTs) are increasingly engaging in school-based interventions targeting children with language difficulties. Collaborative work between teachers and SLTs has shown to be beneficial in fostering language development in all children. Both groups of professionals have different but complementary roles in offering language support, according to children's needs. Effective collaboration between SLTs and teachers requires both parties to understand their roles and practices in schools. However, little is known about language support practices in Lebanese preschools and the roles of SLTs in these contexts. AIMS: (1) To explore the perceptions and reported practices among preschool teachers (pre-KTs) to support language development; (2) to investigate the current practices of SLTs in preschools; and (3) to understand pre-KTs' and SLTs' perceptions of the SLTs' role in Lebanese preschools. METHOD & PROCEDURES: Using a quantitative method, the study reports the results of two questionnaires (one for pre-KTs and one for SLTs) that were developed based on a review of the academic literature and adapted to the contextual realities. Questionnaires were completed in hard or soft copy by pre-KTs and through an online survey by SLTs. OUTCOMES & RESULTS: The questionnaires were completed by 1259 out of 1442 pre-KTs from 175 Lebanese preschools, and by 200 out of 391 SLTs from across Lebanon. First, the findings show that both professional groups recognize they have a role in supporting language development. Second, differences in reported practices were identified regarding language strategies for children with communication needs. In particular, pre-KTs reported less use of specific language strategies targeting children with language difficulties, while SLTs reported that their practices in schools remain primarily focused on children with communication needs. Finally, the analysis of perceptions showed a lack of acknowledgement of the SLTs' role in the prevention of communication and language disorders among all children. CONCLUSIONS & IMPLICATIONS: This study provides an overview of the perceptions and reported practices of language development support in Lebanese preschools. The majority of SLTs and pre-KTs acknowledge their role in supporting language development. However, the slight differences in perceptions of SLT roles in prevention interventions highlight the necessity for SLTs to promote their active involvement in services targeting all children. Future research will investigate how SLTs are beginning to reconceptualize their role in intervention for preschool children. This will help to better define SLTs' roles and responsibilities in educational settings and foster effective professional collaboration. What this paper adds What is already known on the subject Collaboration between teachers and SLTs has been shown to be beneficial in supporting language among all children. The way SLTs and pre-KTs view each other's roles could result in more effective professional collaboration. The SLT profession in Lebanon emerged about 20 years ago, yet SLTs are still struggling to define a framework for the scope of their practice in Lebanese preschools and to increase awareness of the relevance of their intervention in language. What this paper adds to existing knowledge The results revealed that there are major agreements between pre-KTs and SLTs concerning the support of language development in preschools. However, the findings highlight slight differences in the perception of the SLTs' role in the prevention of communication, language and literacy disorders in educational settings. It seems that their role is more commonly acknowledged for children with identified language and communication needs. Moreover, despite the strong agreement between both professionals on the role of the SLT to target all children, SLTs' practices in preschools are still mostly limited to meeting only referred and diagnosed needs in children. What are the potential or actual clinical implications of this work? This study's findings contribute to a better understanding of the perceptions regarding the roles and practices of both groups of professionals in language development. The differences in how the SLTs' roles are perceived could lead to a more difficult implementation of collaborative language practices in preschools. It is therefore necessary to ensure a better understanding of the roles played by professionals, who could receive the relevant training in undergraduate education programmes. There is also a pressing need to provide a clearer definition of SLTs' roles in educational settings by reconceptualizing them into a preventive approach in collaboration with teachers.

Age of acquisition of 299 words in seven languages: American English, Czech, Gaelic, Lebanese Arabic, Malay, Persian and Western Armenian.

We present a new set of subjective Age of Acquisition (AoA) ratings for 299 words (158 nouns, 141 verbs) in seven languages from various language families and cultural settings: American English, Czech, Scottish Gaelic, Lebanese Arabic, Malaysian Malay, Persian, and Western Armenian. The ratings were collected from a total of 173 participants and were highly reliable in each language. We applied the same method of data collection as used in a previous study on 25 languages which allowed us to create a database of fully comparable AoA ratings of 299 words in 32 languages. We found that in the seven languages not included in the previous study, the words are estimated to be acquired at roughly the same age as in the previously reported languages, i.e. mostly between the ages of 1 and 7 years. We also found that the order of word acquisition is moderately to highly correlated across all 32 languages, which extends our previous conclusion that early words are acquired in similar order across a wide range of languages and cultures.

Working with the parents and families of children with developmental language disorders: An international perspective.

BACKGROUND: The relationship between parental input and child language development has had a complex history. It has become clear that indirect parent training for the parents of children with delayed language development is an important feature of interventions offered by speech and language therapists in the anglophone countries. Yet we know less about how this type of approach is realised in other countries. METHODS: In this paper we report the results of a survey of practice undertaken as part of the work of COST Action IS1406, a European Union (EU) funded research network. The focus of this paper is specifically on parent-related questions and responses referring to children under the age of twelve. The survey was devised by members of the Action and circulated electronically during the summer of 2017. In all, 4024 practitioners responded from 60 countries, the majority of whom came from EU member countries. FINDINGS: Respondents to the survey indicated that indirect therapy is commonly carried out via the parent in the early years and via teachers later. A range of professional groups, in addition to speech and language therapists, is likely to adopt this approach; including teachers, pedagogues and psychologists. A variety of interventions is reported, some of which have a reasonable evidence-base underpinning them. It is interesting to see the widespread involvement of fathers and other family members in interventions. Finally, the fact that practitioner characteristics (age, experience, location of practice etc.) are not related to the use of indirect techniques points to the universal recognition of the value of these approaches. CONCLUSIONS: Despite the very different traditions in the practice of intervention across countries, there is clearly a widespread recognition of the importance of indirect approaches to intervention and specifically those focusing on parents. The mixture of family members being involved in interventions is a very promising indication of the role sharing commonly associated with the contemporary family. Yet the number of specific intervention approaches identified is relatively small given the number of respondents. There is a need for a better understanding of what exactly practitioners are doing when they involve parents in intervention or carry out parent-child interaction interventions and how well these interventions work in routine practice. This also has implications for the application of evidence-based practice and the precise nature of the interventions concerned (advice to parents, video interaction training etc.).

Assessing Lebanese bilingual children: The use of Cross-linguistic Lexical Tasks in Lebanese Arabic.

Since norms for vocabulary acquisition in Lebanese bilingual children (L1: Lebanese, L2: French and/or English) do not yet exist, clinical assessment based on normative data and using appropriate tools remains difficult for speech and language therapists. The current study focuses on exploring and comparing lexical performances of typically developing Lebanese bilingual children (32 Bi-TD, aged 5;7 to 6;9) and those with specific language impairment (10 Bi-SLI, aged 5;9 to 7;10), using Cross-Linguistic Lexical Tasks (LITMUS-CLT, COST Action IS0804, 2011) in Lebanese Arabic language (CLT-LB), specific to the Lebanese context. The results confirm that typically developing children have better lexical skills, especially expressive skills, than their peers with specific language impairment. Expressive and receptive performance by both groups of children was found to depend on word class (nouns and verbs). Bi-TD children were more accurate at naming and recognising verbs than the Bi-SLI group. The results of these lexical tasks reveal aspects of the nature of bilingual lexical variation, as well as similarities and differences between the Bi-TD and Bi-SLI groups.