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.

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.

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.

Preposition accuracy on a sentence repetition task in school age Spanish-English bilinguals.

Preposition knowledge is important for academic success. The goal of this project was to examine how different variables such as English input and output, Spanish preposition score, mother education level, and age of English exposure (AoEE) may have played a role in children's preposition knowledge in English. 148 Spanish-English children between 7;0 and 9;11 produced prepositions in English and Spanish on a sentence repetition task from an experimental version of the Bilingual English Spanish Assessment Middle Extension (Peña, Bedore, Gutierrez-Clellen, Iglesias & Goldstein, in development). English input and output accounted for most of the variance in English preposition score. The importance of language-specific experiences in the development of prepositions is discussed. Competition for selection of appropriate prepositions in English and Spanish is discussed as potentially influencing low overall preposition scores in English and Spanish.

Assessment of language impairment in bilingual children using semantic tasks: two languages classify better than one.

BACKGROUND: Significant progress has been made in the identification of language impairment in children are bilingual. Bilingual children's vocabulary knowledge may be distributed across languages. Thus, when testing bilingual children it is difficult to know how to weigh each language for diagnostic purposes. Even when conceptual scoring is used in vocabulary testing, bilingual children may score below that of their typical monolingual peers. AIMS: The primary aim was to evaluate the classification accuracy of two approaches (total semantics score and two-dimensional bilingual coordinate score) that combined lexical-semantic knowledge across two languages. We investigated the classification accuracy of the English and Spanish semantics subtest using the experimental version of the Bilingual English Spanish Assessment (BESA) with bilingual children with and without language impairment. METHODS: A total of 78 bilinguals with balanced exposure to English and Spanish (15 with language impairment, 63 with typical development) participated. Children were between 4;0 and 6;11 years old. Discriminant function analysis explored the extent to which these children were accurately classified when combining Spanish and English subtests. OUTCOMES & RESULTS: Discriminant analysis yielded above 85% correct classification for balanced bilingual children for both approaches. CONCLUSIONS & IMPLICATIONS: For the most accurate assessment and diagnostic decision-making for bilinguals, approaches that consider both languages together are recommended.

Influence of current input-output and age of first exposure on phonological acquisition in early bilingual Spanish-English-speaking kindergarteners.

BACKGROUND: Although some investigations of phonological development have found that segmental accuracy is comparable in monolingual children and their bilingual peers, there is evidence that language use affects segmental accuracy in both languages. AIMS: To investigate the influence of age of first exposure to English and the amount of current input-output on phonological accuracy in English and Spanish in early bilingual Spanish-English kindergarteners. Also whether parent and teacher ratings of the children's intelligibility are correlated with phonological accuracy and the amount of experience with each language. METHODS & PROCEDURES: Data for 91 kindergarteners (mean age = 5;6 years) were selected from a larger dataset focusing on Spanish-English bilingual language development. All children were from Central Texas, spoke a Mexican Spanish dialect and were learning American English. Children completed a single-word phonological assessment with separate forms for English and Spanish. The assessment was analyzed for segmental accuracy: percentage of consonants and vowels correct and percentage of early-, middle- and late-developing (EML) sounds correct were calculated. OUTCOMES & RESULTS: Children were more accurate on vowel production than consonant production and showed a decrease in accuracy from early to middle to late sounds. The amount of current input-output explained more of the variance in phonological accuracy than age of first English exposure. Although greater current input-output of a language was associated with greater accuracy in that language, English-dominant children were only significantly more accurate in English than Spanish on late sounds, whereas Spanish-dominant children were only significantly more accurate in Spanish than English on early sounds. Higher parent and teacher ratings of intelligibility in Spanish were correlated with greater consonant accuracy in Spanish, but the same did not hold for English. Higher intelligibility ratings in English were correlated with greater current English input-output, and the same held for Spanish. CONCLUSIONS & IMPLICATIONS: Current input-output appears to be a better predictor of phonological accuracy than age of first English exposure for early bilinguals, consistent with findings on the effect of language experience on performance in other language domains in bilingual children. Although greater current input-output in a language predicts higher accuracy in that language, this interacts with sound complexity. The results highlight the utility of the EML classification in assessing bilingual children's phonology. The relationships of intelligibility ratings with current input-output and sound accuracy can shed light on the process of referral of bilingual children for speech and language services.

Effects of Age of English Exposure, Current Input/Output, and grade on bilingual language performance.

This study evaluates the effects of Age of Exposure to English (AoEE) and Current Input/Output on language performance in a cross-sectional sample of Spanish-English bilingual children. First- (N = 586) and third-graders (N = 298) who spanned a wide range of bilingual language experience participated. Parents and teachers provided information about English and Spanish language use. Short tests of semantic and morphosyntactic development in Spanish and English were used to quantify children's knowledge of each language. There were significant interactions between AoEE and Current Input/Output for children at third grade in English and in both grades for Spanish. In English, the relationship between AoEE and language scores were linear for first- and third-graders. In Spanish a nonlinear relationship was observed. We discuss how much of the variance was accounted for by AoEE and Current Input/Output.

Dual language intervention for bilinguals at risk for language impairment.

Selecting the initial language of intervention for bilingual children at risk for language impairment is challenging for clinicians, as both the home and academic languages are important for children's successful communication. In this project, six Spanish-English bilingual first graders at risk for language impairment participated in an 8-week intervention program targeting vocabulary, morphosyntax, narrative, and literacy skills in both Spanish and English. Children completed 24 small-group sessions (three times a week). One group received Spanish intervention first, then English, and another group received English first, then Spanish. The systematic use of both languages in intervention resulted in overall gains in vocabulary and narrative skills in this short-term intervention. Language condition groups differed in performance on oral narratives and semantics. Clinical recommendations for selecting the initial language of intervention are discussed.

Story retelling by bilingual children with language impairments and typically developing controls.

BACKGROUND: To date there is limited information documenting growth patterns in the narratives of bilingual children with and without primary language impairment (PLI). AIMS: This study was designed to determine whether bilingual children with and without PLI present similar gains from kindergarten to first grade in the macro- and microstructure of stories told in Spanish and English. METHODS & PROCEDURES: In this longitudinal study, 21 bilingual children identified with PLI were each matched to a bilingual typically developing (TD) peer on age, sex, non-verbal IQ and language exposure. During their kindergarten and first-grade years, children retold stories from wordless picture books in Spanish (L1) and English (L2). OUTCOMES & RESULTS: Overall, TD children outperformed those with PLI on measures of macro- and microstructure at both time points. For the macrostructure measure, the TD group made significantly larger improvements in both languages from kindergarten to first grade than the PLI group. For microstructure, the TD children made more gains on their Spanish retells than their English retells. However, the PLI children's microstructure scores did not differ from kindergarten to first grade in either language. We found that macrostructure scores in Spanish at kindergarten predicted macrostructure scores in English at first grade when English experience was held constant. However, this same relationship across languages was not evident in microstructure. CONCLUSIONS & IMPLICATIONS: TD and PLI children differed in the development of narrative macro- and microstructure between kindergarten and first grade. The TD bilinguals transferred conceptually dependent narrative skills easily, but then had to learn independently the nuances of each language to be successful using literate language. Because most children with PLI need more exposure to establish strong connections between their L1 and L2, they had more difficulty transferring their knowledge of literate language forms from one language to another.

The relation between language experience and receptive-expressive semantic gaps in bilingual children.

The purpose of the current study was to explore the influence of language experience on the presence of the receptive-expressive gap. Each of 778 Spanish-English bilingual children screened pre-kindergarten in Utah and Texas were assigned to one of five language experience groups, ranging from functionally monolingual to balanced bilingual. Children's scores from the language screener semantics subtest administered in both Spanish and English were standardized, and receptive and expressive semantic scores were compared. Children presented with a meaningful gap between receptive and expressive semantic knowledge in English but not Spanish. This gap increased as target-language exposure decreased. Results indicate that current language experience plays a dominant role in influencing the appearance and magnitude of the receptive-expressive gap.

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.

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.

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.

Semantic development in Spanish-English bilingual children: effects of age and language experience.

This study examines semantic development in 60 Spanish-English bilingual children, ages 7 years 3 months to 9 years 11 months, who differed orthogonally in age (younger, older) and language experience (higher English experience [HEE], higher Spanish experience [HSE]). Children produced 3 associations to 12 pairs of translation equivalents. Older children produced more semantic responses and code switched more often from Spanish to English than younger children. Within each group, children demonstrated better performance in the more frequently used than the less used language. The HEE children outperformed the HSE children in English and the HSE children outperformed the HEE children in Spanish. These effects of age and language experience are consistent with predictions of the revised hierarchical model of bilingual lexical organization.

The relationship of phonological skills to language skills in Spanish-English-speaking bilingual children.

These two studies investigate the relationship between phonological production skills and performance in other domains of language in Spanish-English-speaking bilingual children. We examine the relationship between scores on a single-word phonology test and language measures selected from formal testing and narrative samples in Spanish and English. The first study explores the language and phonology scores of 186 children (mean age = 5 years, 9 months) who represent a range of language ability levels. Phonology scores in both languages were most strongly correlated with performance on the Spanish morphosyntax subtest of the bilingual English-Spanish assessment and grammaticality of utterances in English narratives. The second study focuses on 12 children with low or high phonology skills selected from those who participated in the first study. Children with higher phonological production accuracy in both languages produced grammatical structures of low-phonetic salience with greater accuracy than children with lower phonological skills.

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.

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.

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.

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.