Assessing Bilingual Children for Language Impairments in Linguistic Minority Contexts - SAC-OAC's Blog Communiqué Post
I have recently written a post for Speech-Language and Audiology Canada's blog; SAC-OAC Communiqué. I had a lot of fun writing it and collaborating with the SAC Communiqué team was a real pleasure! I definitely plan on writing more posts for their blog! I encourage all SLPs and Audiologists to give it a try. This article was just posted on their blog today! However, in order to view it on their website, you need to be an SAC member or associate. I decided to cross-post it here (with their permission of course) for the non-members out there who may want to read it!
Here it is:
Feature image caption: Chantal works with a child on the "oi" sound in French.
I have been working as a speech-language pathologist in Northern Ontario for over 12 years and I still can’t quite grasp all of the implications that arise due to the linguistic context in which we live. As a graduate student, I did not fully appreciate the complexity of second or dual language acquisition. It wasn’t until I was confronted with my first caseload in 2002 that it became very clear to me that I didn’t have the knowledge required to work in this bilingual context.
The caseload, primarily comprised of bilingual children (English-French) enrolled in French-medium schools, represented a huge challenge to me as I had no way of knowing if the difficulties they were experiencing were due to a language impairment or if they simply lagged behind due to their dual-language learning.
Studies have shown that bilingual children have fewer vocabulary words in each of their languages when compared to their monolingual peers. For this reason, I knew I couldn’t use that as a marker for language impairment. Assessment tools available at the time were all standardized on monolingual populations, making them very difficult to use as well.
In many studies, the inclusion criterion for language impairment is two or more scores at or below 1.5 standard deviations from the mean. However, we need to pay attention to the population on which the tests are standardized. Psychometrically speaking, we always need to make sure that we are comparing apples to apples. It became very clear to me that we did not have any resources available for the assessment of English-French or French-English bilingual children residing in a linguistic minority context, as is the case in most provinces outside of Quebec.
Luckily, in 2009, a French translation of the Clinical Evaluation of Language Fundamentals – Fourth Edition (CELF-4) was published: Évaluation clinique des notions langagières fondamentales : Version pour francophones du Canada (CELF CDN-F). However, the CELF CDN-F standards were developed using participants from Quebec, a province in which French is the majority language. I should also note that the inclusion criterion for the standardization sample allowed bilingual children to participate. Specifically, children had to speak French at home more than 50% of the time and they had to be residents of Canada for at least two years. This allowed Franco-dominant children and even immigrant children to participate in the standardization study (Wiig et al, 2009). In the standardization sample, 38% of the children were exposed to a European language, 23% to an Asian language and 8% were exposed to English. Similarly, the English versions of this test — the CELF-4 and now the CELF-5 — were standardized on primarily English-speaking children in the United States. However, approximately 15% of the participants were exposed to another language in the home (e.g., 77% Spanish, 4% Asian languages).
These are two examples of widely-used tests that include very few children in their standardization process who have similar linguistic backgrounds to the minority language learners we are seeing. For this reason, the demographic characteristics of these samples made me question whether the use of these tools was appropriate for English-French and French-English kids living in a linguistic context where English is the majority language. Many studies have shown that bilingual children are often missed or misdiagnosed, in part due to the use of tests that are not standardized on a population with a similar linguistic profile. Given these facts, which tests/tools should S-LPs be using to assess children we suspect have a language impairment?
Image caption: Chantal in a group session working on oral and written language skills with the help of a tablet.
This questioning led me to pursue my doctoral studies in 2007 in order to better understand this very complex population. Professionally, I have since come a long way in better understanding all that is entailed in studying bilingual children in linguistic minority contexts, both with and without language impairments. In fact, part of my doctoral dissertation was published in the Canadian Journal of Speech Language Pathology and Audiology (CJSLPA) (Mayer-Crittenden et al., 2014). This was the first study to compare the linguistic competencies of Franco-Ontarian children to those of French Quebecers. The results showed that on a linguistic level, French Quebecers outperformed monolingual Franco-Ontarians, and that Franco-dominant bilingual children obtained lower scores than the monolingual children on many levels, such that the use of Quebec-based standards for Franco-Ontarians is questionable. However, a post hoc comparison produced no significant differences between monolingual French Quebecers and Franco-Ontarians. I am currently collecting more data to better understand the differences between these two groups.
More recently, my colleagues and I conducted a study (Mayer-Crittenden et al., under review) indicating that 33% of the English-French children in French-medium schools were misdiagnosed as language impaired when in fact they were in the process of acquiring two languages. This study also showed that, of the tools used, following directions and recalling sentences were the best markers for identifying English-French bilinguals with a developmental language disorder (DLD). For the French-English bilinguals, a receptive measure of morphology and syntax, a receptive vocabulary measure, a narrative task, recalling sentences, following directions and non-word repetition (NWR) were among the markers on which children with DLD obtained scores below the cut-off, which justified their continued use with this population. Furthermore, although non-word repetition has been shown to be a useful tool in identifying children with language impairment, it was not one of the best markers in our study. For this reason, I am currently working on a study with a colleague from England to develop a quasi-universal non-word repetition test that could be used with French-English and English-French children. I hope to have results within the next few months.
All of the data presented in this article is considered preliminary because in many cases, the sample sizes were small. This is all too often the reality when studying a minority language. Still, my colleagues and I are striving to develop norms and standards that can be applied to linguistic minority populations and more specifically, Franco-Ontarian children as well as English-dominant children learning French in French-medium schools.
In an effort to inform my fellow S-LPs, teachers, parents and the general public about the complexity of the matter, I started a blog called Bilingualism in Ontario: Communication disOrders and Typical Development (BOOT) (www.botte-boot.com) in March 2015. On this blog, I have written about the characteristics of language impairments, related helpful resources and several other subjects. More recently, I had a guest blogger write a post on spelling mistakes and how we can go about reducing their frequency. The blog has gotten lots of attention and I have since extended the website to include useful links and resources when working with children who are learning two languages or who are having difficulty learning one language in a linguistic minority context. Please feel free to visit the site and post comments or questions. I would be more than happy to read your comments and answer your questions.
Remember to like my Facebook page (at the very top of this page) if you want to receive notifications about upcoming posts.
by Chantal Mayer-Crittenden, 2015