•working with a (mono-, bi-, or multilingual) child when you and the child have no language(s) in common

•working with a bi-/multilingual child – focusing on Spanish-English families in the U.S.

•working with an English-speaking child whose dialect differs from yours or from a dialect that is privileged in their school or community – focusing on AAE and other race-adjacent issues in Georgia schools

•Administer the Intelligibility in Context Scale (ICS) in a language you do not know through an interpreter

•https://www.csu.edu.au/research/multilingual-speech/home

•Administer a single-word articulation test in a language you do not know without an interpreter

https://phonodevelopment.sites.olt.ubc.ca/

•administer and interpret a dynamic assessment for a made-up rule (Dr. Brown’s protocol is on eLC)

•explain dynamic assessment to a Spanish-speaking parent using prepared bilingual sentences

•https://sites.google.com/pdx.edu/multicsd/spanish-english-podcasts?authuser=0

Speech Assessment for Children Who Do Not Speak the Same Language(s)

as the Speech-Language Pathologist

(based heavily on McLeod, Verden, et al., 2017, AJSLP – an international view of assessing motoric speech production abilities and phonological patterns when the clinician does not speak any of the child’s languages, with an emphasis here on English-speaking SLPs)

1. Visibility, Preparation, and Caseload Management

Make Interpreters Routine

·      ask about the systems in place for identifying interpreters and translators as part of your job-search process

·      ask for training about how interpreters and translators are scheduled as part of your on-boarding in a new position

·      ask for interpreter/translator plans to be on department meeting agendas

·      include interpreter/translator costs in your budget for your private practice

Establish Routine Working Relationships with Interpreters and Translators

·      if you are in private practice, communicate with existing companies/individuals in your community routinely

·      depending on your work setting, establish a list of trained individuals, or individuals who are willing to seek training, from within your school or from relevant community groups who could accept occasional hourly work assignments

Actively Manage Potential Future Referrals in the School/Community

·      educate relevant groups in your setting to maximize necessary referrals, reduce overreferrals of typical bi-/multilingual children, and reduce underreferrals of children who have speech disorders

Actively Manage Current Referrals

·      you are not required to follow every referral with a complete direct assessment

o   the Intelligibility in Context Scale, a conversation about specific concerns, and/or a plan for future checks might be all that is needed

§  https://www.csu.edu.au/research/multilingual-speech/ics

2. Assessment Steps for a Child, when a complete assessment is warranted and the primary concerns are related to speech production (versus language-based concerns)

Use bilingual and translated materials, have a translator to work with, have an interpreter to work with, and/or use the child’s caregiver as your model.

Case History and Language History

·      Obtain information about the child’s overall developmental and medical history

·      Obtain caregivers’ general views about the onset, cause, or meaning of the child’s speech abilities or speech problems; obtain general information about the caregivers’ or the extended family’s short-term and long-term speech-related goals for the child

·      Obtain a comprehensive language-exposure and language-use history from caregivers (which languages has the child heard, from whom, when; which languages did or does the child speak, with whom, when).

Caregiver Report of Current Speech and Language Abilities and Concerns

·      receptive language abilities (all languages, all domains, spoken and written)

·      expressive language abilities (all languages, all domains, spoken and written)

·      speech abilities (all languages; artic/phonology, voice, fluency)

·      intelligibility (have caregiver complete ICS for all languages the child uses)

o   https://www.csu.edu.au/research/multilingual-speech/ics

Assess Child’s Speech-Sound Production in Single Words

Transcribe while listening so you can ask for repetitions; record also for later analyses

If possible, use single-word task materials that have been prepared in the language you know and in the child’s other language(s)

o   http://www.csu.edu.au/research/multilingual-speech/speech-assessments

o   https://phonodevelopment.sites.olt.ubc.ca/

If you cannot find appropriate materials, find a phonetic inventory for the language and find phonotactic constraint and syllable structure information for the language, then assess using sounds and nonsense syllables.

·      Collaborate with your interpreter ahead of time to check for inappropriate combinations (!)

Assess Child’s Speech-Sound Production, Voice, and Fluency from Connected Speech

If you have single-word testing materials with target transcriptions, ask the child to make up sentences that use 2-3 of those words (through the interpreter, use “Tell me which one is bigger than the other one,” or use a carrier phrase that can be interpreted, such as “Here is a red ___”). Transcribe the child’s production of the words you can identify in the sentence-level context.

Listen for voice and fluency issues as the child converses with a caregiver.

·      Substantial research has shown that voice quality ratings and measures of stuttered speech can be completed in unfamiliar languages.

Assess oral mechanism and hearing using typical procedures. Assess expressive and receptive language abilities using language-sampling or language-testing procedures, if needed.

3. Stimulability Testing

If phonemic accuracy is a concern, complete stimulability testing by re-using the translated items.

If voice or fluency are of concern, complete stimulability testing by modeling the possible change (e.g., higher pitch or reduced loudness for voice; rhythmic, smoothed, or slower speech for fluency).

4. Linguistic Analyses

Complete independent analyses (phonetic inventory) and relational analyses (articulatory and phonological pattern differences from adult model) of the child’s speech-sound productions.

If the child is bi-/multilingual, use linguistic information to develop at least three categories of phonemes: L1, L2, and L1+L2 (potentially L3, L2+L3, L1+L2+L3)

·      Analyze those phonemes that are used in both/all languages separately from those used in only one language.

·      Do not interpret transfer between languages as errors in initial analyses.

Summarize voice quality ratings or speech fluency data. Describe voice or fluency impressions.

5. Further Input from Caregivers

Discuss your initial findings (not interpretation or recommendations yet) with caregivers. Ask specifically if the data you have developed seem to be addressing the original concern.

·      Caregivers are the experts about their language and about their children.

·      The SLP is the expert about identifying, assessing, and treating speech disorders.

·      Caregivers decide to pursue or not pursue intervention for their child.

6. Develop Possible Recommendations; then Present, Discuss, Suggest, or Seek Recommendations for Intervention

After discussing the data with the caregivers and listening to their interpretations and requests, develop at least one set of possible interpretations and recommendations.

Depending on the cultural norms, then work with the caregivers in a range of ways to suggest your recommendations as one possible interpretation, present your recommendations, and/or seek their suggestions for their child based on your data.

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Our in-class example task: Articulation testing in Bulgarian

http://www.csu.edu.au/research/multilingual-speech/ics

http://phonodevelopment.sites.olt.ubc.ca/bulgarian-word-list-in-order-with-translation_2012/

http://phonodevelopment.sites.olt.ubc.ca/bulgarian_phonologytest_ignatova_marinovatodd_bernhardt_stemberger_oct15_englishversion/

Speech and Language Assessment and Diagnostic Decision-Making

for Bi-/Multilingual Children

based heavily on Castilla-Earls et al., 2020, AJSLP

(emphasis on possible language disorders in Spanish-English bilingual children in the U.S.,

and assuming that you as the SLP are comfortable in Spanish, English, or both;

if the family is monolingual and you do not share that language,

you’ll work with an interpreter and/or a translator)

1. Language Abilities and Concerns: Questionnaires and Interviews

·      importance of parent concern (Restrepo and colleagues, 1990s)

·      ask about all four modalities, and ask about each language plus the combination:

o   “Describe your child’s talking in Spanish”

o   “...listening and understanding in Spanish”

o   “...reading in Spanish”

o   “...writing in Spanish”

o   then repeat for “in English” and for “when they are mixing some Spanish and some English”

§  if the parent does not know about the child’s use of English, do a similar interview with a teacher or another relevant adult

·      ask parents to describe child’s speech and language behaviors in these areas; follow up by asking if that behavior concerns the parents and why

·      use your expertise to begin considering if that behavior seems problematic to you

·      ask “Do other people understand your child?” (Intelligibility in Context Scale)

2. Bilingual Speech and Language Sample Analysis

·      Speech-sample analyses of in all languages and in all combinations the child uses

o   phonetic inventories, syllable structure inventories/constraints

·      Language-sample analysis in all languages and in all combinations the child uses

o   narrative structure, syntax, morphology, semantics

3. Evaluation of Learning Potential

·      Dynamic Assessment with you

·      MTSS/RTI with the team

4. Consider standardized tests last and only if they would be helpful

·      Use a standardized test only if an appropriate test exists that will provide a reliable and valid answer to a remaining question that you still have and need answered about this child after evaluating all the information from Steps 1-3.

Treating Phonological Disorders in Bi/Multilingual Children

Goldstein and Fabiano, 2007, ASHA Leader

[emphasis is on children who unquestionably have articulation and/or phonological disorders and who are also bilingual]

Basic principle: Design phonological treatment programs with longterm goals of intelligibility and age-appropriate or adult-like competence for the languages the client uses.

Basic principle: Select specific treatment targets by assessing the child’s specific speech production profile and the child’s needs as a speaker, then select the language or languages of intervention for those targets.

The questions are not “Which language do I treat?” or “What language do I treat in?”

The questions are “What targets does this child need my help with, to improve their communication abilities in their environments?” and

“How can I best treat those targets?”

The Bilingual Target-Selection Approach

·      this approach suggests that we would begin with, or focus on, the targets, goals, or structures that exist in both languages and that the child uses incorrectly in both languages (i.e., choose targets from the overlapping center of the Venn diagram)

·      the bilingual approach means addressing targets that are used in both languages, but a bilingual target-selection approach does not require treating a bilingual target in both languages or by using one or the other of the languages

§  This is one of the situations where transfer from one language to another does occur, so measure in both and in any mix the child uses

will usually be combined with

The Cross-Linguistic or Language-Specific Target-Selection Approach

·      a language-specific approach recognizes that languages differ; thus, the emphasis here is that we would begin with, or focus on, targets, goals, or structures that exist only in one language, regardless of the other language, when their occurrence in the one language interferes with the child’s intelligibility in that language (and when the child’s productions cannot be explained as acceptable transfer from the other language)

·      similarly, we might focus on targets/goals/structures that occur in both languages but are more common for the child in one language or are more salient/important in one language

·      in practice, we often address language-specific targets in the one relevant language

• …will produce /s/ correctly in at least 80% of single words…

• …will produce the grapheme “s” as the phoneme /s/ or /f/ in at least 80% of single words and produce the grapheme “s” as the phoneme /k/ in no more than 10% of single words…

• …will produce words typically written in most American Englishes using the grapheme “s” in ways that are similar to the ways members of his immediate family produce them…

•Hamilton (2020):

•The goal of individual SLP therapy is to increase the ability of children with disorders to use speech and language effectively.

•If the child's native dialect is X, it is not the SLP’s job to turn that child into a speaker of  Y.

•In addition to providing treatment for children with disorders, SLPs should collaborate with teachers to develop culturally and linguistically responsive teaching practices for the school, so that all children can access the MAE curriculum while maintaining their cultural-linguistic identities.

•https://doi.org/10.1044/leader.FTR1.25012020.46

with an individual child:
ignoring dialect will result in inaccurately low test scores

with an individual child:
but also do not accept any feature from a list of possibilities as if it were necessarily dialectal for any single child

•Unmodified scoring of children who speak AAE results in very low specificity (i.e., counting dialectal features as "errors" overidentifies too many children as having disorders, because of how our tests are made) but •Hendricks and Adolf (2018) modified CELF-5 scoring to count any response that could have been a feature of AAE as if it were a correct/acceptable response for that child...  the result was that both sensitivity AND specificity were poor!

•Hamilton (2020):

•The goal of individual SLP therapy is to increase the ability of children with disorders to use speech and language effectively.

•If the child's native dialect is X, it is not the SLP’s job to turn that child into a speaker of Y.

•

•Question referrals that you know are unnecessary; educate your colleagues

•If you are working with an individual child, use the basic techniques you know and from today:

•Talk to parents and teachers about how the child communicates in that child’s world; use dynamic assessment; analyze speech and language samples using thoughtful applications of what a true disorder would include for this child; ignore tests that were designed for other purposes or for other children; use bilingual (Venn diagram) or dialect-specific target selection criteria thoughtfully; recognize when individual SLP therapy is the correct tool and when the child needs something else

•Hamilton (2020):

•The goal of individual SLP therapy is to increase the ability of children with disorders to use speech and language effectively.

•If the child's native dialect is X, it is not the SLP’s job to turn that child into a speaker of Y.

•

•But in schools, we are also required to consider the adverse educational impact of the child’s abilities – and using speech and language effectively in schools includes using spoken and written language as tools for learning.

•Washington, Branum-Martin, Sun and Lee-James (2018): Children with the highest dialect density… in first grade may still be producing densities as high as 70% in fifth grade.  These are the children at greatest risk for reading problems.

https://sites.google.com/ttsd.k12.or.us/2022-ortii-conf-recordings

Craig et al AAE An examination of the relationship dialect shifting reading outcomes

the ability to shift between AAE and “GAE” predicts reading

•Use the DELV, because distance from MAE can matter to educational outcomes

•Language sample

•Listen to caregivers

•Dynamic assessment

•

•Similarly: Washington suggests options that could include teaching children to actively mediate spoken AAE and written MAE

•Here's one example of how to do it – What would the SLP's role be in this school? https://oraal.uoregon.edu/society

In addition to providing treatment for children with disorders, SLPs should collaborate with teachers to develop culturally and linguistically responsive teaching practices for the school, so that all children can access the MAE curriculum while maintaining their cultural-linguistic identities."

•But, next level…

•“Culturally sustaining pedagogies must extend the previous visions of asset pedagogies by demanding explicitly pluralist outcomes that are not centered on White middle-class, monolingual/monocultural norms and notions of educational achievement” (Alim & Parris, 2017, p. 12, in Paris & Alim, 2017).

•In other words: Question the premise! But this is also where Anne has to fall back into cultural humility… I simply do not know what is right for other people.  All I can do is encourage you to be informed and intentional with your individual clients and as you work with your school as a whole.