Multilingual Matters for Clinicians. Disclosure Statements. Agenda. Teresa Signorelli, PhD, CCC-SLP. Yeah Not So Much

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1 Multilingual Matters for Clinicians What all professionals need to know working with minority-language speakers Teresa M. Signorelli, PhD, CCC-SLP Marymount Manhattan College June 2016 Disclosure Statements Teresa Signorelli, PhD, CCC-SLP Financial Disclosures: Teresa Signorelli is employed by Marymount Manhattan College but is receiving no stipend for this talk Non-Financial Disclosures: Teresa Signorelli is seeding the scholarship for a Marymount Manhattan student being promoted at the event 1 2 Yeah Not So Much Agenda What You Need to Know What You Need to Do Case Studies Additional Resources How would you feel? 3 4

2 Who s Doin What? Who speaks a language other than English? INDIVIDUALS WITH DISABILITIES EDUCATION IMPROVEMENT ACT Who is teaching bilinguals and/or ESL Children? Who is teaching students from different socio-economic or cultural backgrounds? (IDEA) 2004 Considerations for Culturally and Linguistically Diverse Speakers 5 6 Federal & State Regulations IDEA Part B Issue Brief (ASHA): No racially or culturally discriminatory assessment Use native language for assessment unless it is clearly not feasible Lack of English proficiency is not consideration for disability National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health Care Use Interpreters Individualized Education Plan (IEP) meetings as needed Develop IEPs with sensitivity to language needs regarding limited proficiency in English Diverse-Students/ State Regulations: Bilingual Extension of the TSSLD in NY State FINAL REPORT U.S. Department of Health and Human Services, OPHS Office of Minority Health 7 8

3 CLAS Final Report Because culture and language are vital factors in how health care and education services are delivered and received, it is important [to] understand and respond with sensitivity to the needs and preferences that culturally and linguistically diverse patients/consumers bring to the health encounter. (pg. 1) The standards are also intended for use by: Policymakers, accreditation and credentialing agencies, purchasers, patients, advocates, educators, and the general health care community. (pg. 4) There are 14 standards falling into mandated, guideline, and recommendation categories CLAS Final Report Four Mandated Standards (4, 5, 6, & 7) Based on Title VI of the Civil Rights Act (1964) Standard 4. Health care organizations must offer and provide language assistance services, including bilingual staff and interpreter services, at no cost to each patient/consumer with limited English proficiency at all points of contact, in a timely manner during all hours of operation. Standard 5. Health care organizations must provide to patients/consumers in their preferred language both verbal offers and written notices informing them of their right to receive language assistance services. Standard 6. Health care organizations must assure the competence of language assistance provided to limited English proficient patients/consumers by interpreters and bilingual staff. Family and friends should not be used to provide interpretation services (except on request by the patient/consumer). Standard 7. Health care organizations must make available easily understood patient-related materials and post signage in the languages of the commonly encountered groups and/or groups represented in the service area MODEL PROGRAMS FOR LEP/ELLs: CLOSING THE ACHIEVEMENT GAP NYS Model Programs for LEP & ELLs GOAL: Close achievement gap for LEP/ELLs NY State suggests implementing nationally proven programs New York State LEP-ELLs8-08.html Use their Contract for Excellence (C4E) funding Assist LEP/ELLs to attain English proficiency Limited English Proficient (LEP) English Language Learners (ELLs) 11 Meet State academic and student achievement standards 12

4 NYS Model Programs for LEP & ELLs NYS Model Programs for LEP & ELLs Model Programs can address program areas and services: School districts are obligated to run LEP/ELL programs and services class size reduction No Child Left Behind Act time on task New York State (NYS) laws and regulations teacher/principal quality initiatives; middle and high school restructuring; full-day Pre-kindergarten and Kindergarten Regulations of the Commissioner C.R. Part 117, C.R. Part 100, C.R. Part 200, C.R. Part 154, C.R. Part 80, Education Laws 3204 and 3602, and Article VII in New York State. model programs for English Language Learners experimental programs. See Appendix for resources in Model Programs document Why We Have Special Considerations for Culturally and Linguistically Diverse Speakers Mistakes from Marketing

5 Mistakes from Marketing Mistakes from Marketing Higher Stakes with Children Relative to Business Monolingual & Multilingual Speaker Differences Ignorance has led to poor, if not mal-practice in education and rehabilitation unbalanced referral of minority language speakers

6 Bilingualism Myths and Why They Exist Many Americans are not bilingual Unfamiliar with the phenomenon Struggled learning a second language Late start. Less-than-Positive Consequences of Bilingualism (Bialystok, 2009) Unequal Lexicon Across Languages Children may look delayed if only one language is considered Adults often lower in rapid recall tasks Competition between languages for attention Dispelling the Myths: Did you know? Globally Monolingualism is atypical Multilingualism is the norm Bi- and monolinguals develop language at the same general way and rate Multilingualism Does Not Cause Delays or Disorders Maintaining bilingualism: Does not inhibit language improvement in communicatively impaired or delayed children Has been shown to facilitate the most improvement in communication (De Houwer, 1999) Dispelling the Myths: Did you know? Dispelling the Myths: Did you know? Minority language children learn English BETTER AND FASTER if parents use the home language Relative to monolinguals, bilingual children have increased or better cognitive strategies Multilingual equal proficiency in all languages Different languages Different settings cognitive flexibility perceptual skills (e.g., find something in the background) Code Switching = Normal, sophisticated, and pragmatically appropriate in many (BUT not all) bilingual communities classification skills (i.e., earlier) understanding of symbolism (e.g., that words are symbols for objects, concepts, feelings; tokens can have multiple names) 23 (Marian et al., 2009) 24

7 Dispelling Bilingualism the and Myths: Cognitive Did Development you know? Positive Consequences of Bilingualism Bilingualism is related to better problem solving skills (Bamford & Mizokawa, 1991) Knowledge of foreign languages promotes knowledge of native language structure and vocabulary (Curtain & Dahlberg, 2004) Research with adults suggests that bilingualism facilitates word learning (Papagano and Vallar, 1995) Increased years of foreign language study correspond to increased math and verbal SAT scores (The College Board SAT, 2004) Dispelling the Myths: Did you know? Positive Consequences of Bilingualism Better ability to manage (inhibit) irrelevant information (Bialystok, Craik, Klein, and Viswanathan, 2004) Clinical Relevance Inhibition is linked to a number of disorders Potential relevance for attention deficits, frontal lobe impairments Alzheimer s Dementia delayed in bilinguals up to 4+ years relative to monolinguals (Craik, Bialystock, and Freedman, 2010) Who is an appropriate provider? All Clinicians Potentially Requisite Competencies Services in Child s Dominant Language Provider must have Native or native-like proficiency Knowledge and skills Meet legal requirements Services in Child s Second Language Provider must have Knowledge of features and developmental characteristics of language and dialect/s Knowledge of cultural and linguistic influences Collaboration with appropriately trained interpreters/translators ASHA Knowledge and Skills Needed by Speech-Language Pathologists and Audiologists to Provide Culturally and Linguistically Appropriate Services (2004) Cultural Competence Language Competencies Language, Sociolinguistic, & Cultural influences Articulation & Phonology Resonance, Voice, & Fluency Swallowing Hearing & Balance 27 28

8 Requisite Competencies Identification & Assessment Foundational Content Assessment Tools Differential Diagnosis ASHA Knowledge and Skills Needed by Speech-Language Pathologists and Audiologists to Provide Culturally and Linguistically Appropriate Services (2004) Management 29 Cultural Competence Language and culture are inextricably linked Cultures differ as languages differ ASHA Calls for Professionals to: be sensitive to cultural and linguistic differences that affect assessment, diagnosis, and teaching/learning understand the influence of traditions, customs, values, and beliefs might have on educational outcomes realize potential impact acculturation (or lack thereof) on assessment, diagnosis, and teaching/learning be present to one s own limitations, values, and potential biases 30 Cultural Competence ASHA Calls for Professionals to: ensure strategies and materials do not violate families values bridge the gap between home culture and the learning environment consult with related professionals having the appropriate cultural-linguistic background as needed uphold ethical obligation regarding culturally and linguistically appropriate services 31 Interpreters & Translators with Appropriate Knowledge and Skills Interpreters may significantly affect scores (e.g., Casas et al., 2012) Accurate translations/interpretation Familiarity with and respect for culture, linguistic community, and communicative environment Proper interview techniques Professional ethics. Understanding of privacy and confidentiality (e.g., FERPA, HIPAA) Principals of assessment/intervention for test validity Suggested Resource Language Interpreters and Translators Bridging Communication With Clients and Families (Langdon, 2002) 32

9 Distinguishing Typical From Disordered Sociolinguistic and Cultural Considerations Note potential for Bias Ethnographic Interviewing Family/community perspective Speech & Language Considerations Bilingual Development Normal Errors & Shared Characteristics w/ Language Impairment Basic Interpersonal Communication Skills (BICS) Cognitive Academic Language Proficiency (CALP) Proper Assessment Federal and Local Mandates Best Practices Pit falls with formal and translated tests Alternative assessment methods 33 Distinguishing Typical From Disordered Understand bilingual language development Every bilingual experience is unique Variability in the amount and quality of exposure Types of experiences Definition: Language & Linguistics Bilingualism is commonly defined as the use of at least two languages by an individual. It is a fluctuating system in children and adults whereby use of and proficiency in two languages may change depending on the opportunities to use the languages and exposure to other users of the languages. It is a dynamic and fluid process across a number of domains, including experience, tasks, topics, and time. (ASHA 2004) 34 Distinguishing Typical From Disordered Language & Linguistics Types of Bilingualism (ASHA) Simultaneous Bilingualism occurs when a young child has had significant and meaningful exposure to two languages from birth. Ideally, the child will have equal, quality experiences with both languages. Sequential Bilingualism occurs when an individual has had significant and meaningful exposure to a second language, usually after the age of 3 and after the first language is well established. These second language learners are referred to as "English language learners" in U.S. schools. Distinguishing Typical From Disordered Performance Language & Linguistics Sequential Bilinguals: Second Language Learners (L2) Basic Interpersonal Communication Skills (BICS) Everyday language/conversation Can take 3 to 5 years to master Benefit of Context (facilitate communication) 35 36

10 Distinguishing Typical From Disordered Performance Language & Linguistics Sequential Bilinguals: Second Language Learners (L2) Cognitive Academic Language Proficiency (CALP) Language of academics/higher order functions Can take 5 to 7 years to master Challenge: Reduced context. Communication more difficult Distinguishing Typical From Disordered Performance Language & Linguistics BICS & CALP Suggested Resource See work by Jim Cummins Cummins, J., (1999) BICS and CALP: Clarifying the Distinction Distinguishing Typical From Disordered Distinguishing Typical From Disordered Language & Linguistics Language & Linguistics There are very normal language behaviors L2 speakers exhibit that mimic disordered language behaviors We must be aware of these false positives for disordered language INTERFERENCE or TRANSFER from L1 to L2 English: I am hungry We must be aware of these false positives for disordered language SILENT PERIOD Children often focus on listening and comprehension when first exposed to a language Verbal output may decrease notably as a result Spanish: Tengo hambre (I have) (hunger) Bilingual child says: I have hunger 39 40

11 Distinguishing Typical From Disordered Language & Linguistics More potential false positives CODE-SWITCHING: Changing languages within and across phrases or sentences Tengo mucha hambre. I can t wait to eat! LANGUAGE LOSS: L1 skills are lost if not reinforced This subtractive bilingualism can harmful Cognitively Linguistically Social-emotionally Distinguishing Typical From Disordered Language & Linguistics Normal Simultaneous Bilingual behaviors may provoke false positives Bilinguals often experience unequal distribution of languages use - Topic A in Language 1 - Topic B in Language 2 - Meals in Language 1 - Bath time in Language 2 - Home in Language 1 - School in Language 2 Developmental Mixing (*) Blow it + sopla (blow) Soplit Put on + pantalones (pants) Putelone 41 * Examples courtesy of Sylvia Y. Walters 42 Distinguishing Typical From Disordered Shared Characteristics of Normal L2 and Language Impaired Speakers (Seitel & Garcia, ASHA 2009) Distinguishing How We Distinguish Typical From Typical Disordered From Disordered Communication Shared Characteristics of Normal L2 and Language Impaired Speakers (Seitel & Garcia, ASHA 2009) Short attention Distractibility Daydreams Appears confused Uses gestures Infrequently output Speaks in single words or phrases Difficulty sequencing ideas/events Comments inappropriately Poor recall Poor comprehension Poor vocabulary Poor syntax Poor pronunciation Confuses similar sounding words Seitel & Garcia referenced Ortiz & Maldonado (1986, as cited in Kayser, 1998) and Roseberry-McKibben (1995) Seitel & Garcia referenced Ortiz & Maldonado (1986, as cited in Kayser, 1998) and Roseberry-McKibben (1995) 43 44

12 Distinguishing Typical From Disordered Language & Linguistics Understand the speech community s feelings and definitions of typical relative to disordered communication Critical Elements of Parent/Caregiver Interview Regard: Family history Detailed Language History Skills relative to peers Can weigh heavily in diagnosis decisions Premorbid status in case of brain injury The Ethnographic Interview TRADITIONAL APPROACH: Professional drives the agenda Professional viewed to know what information is important to collect The Ethnographic Interview Ethnographic Q&A Principals ETHNOGRAPHIC APPROACH: Fosters patient/family setting agenda Understanding a patient's cultural perspective Use over Meaning Instead of saying, What do you mean that it s hard to comprehend people in conversation? Family has valuable information of which clinician may be unaware. Open ended questioning Say Describe the environments in which having conversations is difficult? Clear descriptions of daily life experiences Facilitates good decision making Explain purpose for the interview to family Be Open Ended Instead of saying, Does your daughter use words to communicate? Build rapport Help assure the best data are collected Say, In what ways does your daughter tell you her wants and needs? 47 48

13 Ethnographic Q&A Principals Restate. Don t Rephrase or Interpret. Restating may prompt more detailed information. If parent says, All my free time is spent tending to my son s needs Instead of saying, That must be difficult. Ethnographic Question & Asking Q&A Principals Summarize to Validate Understanding and Direct Accurate Intervention Planning Say, Before we move to the next topic, I want to make sure I understand your concerns. You said Say, Your son s needs take up a lot of your free time. Parent may add, Yes, I can t help my other children with their homework, get the laundry done or dinner prepared Ethnographic Q&A Principals Ethnographic Q&A Principals Beware of Bombarding with Question Sequence Instead of saying, You mentioned reading with your child at home is difficult. Is this all the time? Can you change your schedule to find some down-time? Do you have books to read? Do you have a library card? Are there other people who can read with him? Say, You mentioned reading with your child at home is difficult. Would you describe the situations that are difficult for you. Beware of Leading Questions. Beware, Yes/No queries can often be leading If a student tells you they are struggling with an activity Instead of saying, What don t you like about the activity? Say, Tell me what you think about this activity? Beware of Why Questions. They can sound presumptive and critical Instead of saying, Why is your son absent from school? Say, What keeps your son from attending school regularly? 51 52

14 Language History Interview ALWAYS, ALWAYS include information about the languages and/or dialects a child uses. Report: Exposure by gross percent 70 : 30 :: Spanish : English With whom Spanish with Parents and grandparents daily English with 7 y/o cousin who visits on weekends Hears French from babysitter who watches child Sunday mornings What situations Spanish and English at home (75:25%) Spanish spoken actively with family English hear passively via television English/Spanish at Daycare five days a week (80:20% respectively) Resources Hammer et al. (2012) article Predicting Spanish-English Bilingual Children s Language Abilities in JLSHR Li et al. (2006) Language history questionnaire: A Web-based interface for bilingual research in Behavioral 53 Assessment Tool Limitations VERY FEW appropriately standardized tests exist Translated tests used for INFORMAL PROBING ONLY Translated Tests Fraught with Problems Different developmental milestone sequences Different linguistic structures across translations Different cultural experiences There are NO NORMATIVE DATA from which to calculate scores Any scores generated from the test s norms are MEANINGLESS!!Do not report scores from translated tests!! 54 Assessment Paradigms Better alternatives to standard approaches Dynamic Assessment Portfolio Assessment Narrative Assessments Structured Observation Academic and social language sampling Interview assessment tools Good Option for Multilingual and Multicultural children - Want of appropriate formal tests Dynamic Assessment - Formal tests may misdiagnose/misinform - Want of experience - Cultural/Linguistic differences - Typically developing children tend to improve - Genuinely impaired children tend not to and/or struggle to improve - More accurate language impairment identification in ML/MC children (Peña et al. 2006) 55 56

15 DA: Background and Theoretical Bases Assessment Approaches - TRADITIONAL: Compare child to peers. Static - DYNAMIC: Compare child to his/herself. Natural-like setting Vygotsky s Model of Cognitive Development - Zone of Proximal Development - Knowledge develops in social interactions and when culturally relevant - Support decreases for new information as skill internalizes Photo Credit: DA: Background and Theoretical Bases Vygotsky Diagnostic Assessment Connection Work in Zone of Proximal Development Assess the following: NATURE of change DEGREE of change SIZE ZPD Independent Skill Set Beyond Skill Set Overviews of Dynamic Assessment Methods Dynamic Assessment of Diverse Children: A Tutorial V.F. Gutierrez-Clellen and E. Peña Lang Speech Hear Serv Scho, 2001, 32 Alternative Assessment of Language and Literacy in Culturally and Linguistically Diverse Populations S.P. Laing & A. Kamhi Lang Speech Hear Serv Scho, 2003, 34 TESTING-THE-LIMITS See J. Carlson and K. Wiedl GRADUATED PROMPTING See B. Bain and L. Olswang TEST-TEACH-RETEST See C.S. Lidz & E. Peña 59 DA Method: TESTING-THE-LIMITS Modify traditional testing procedures Simple Feedback: indicate correctness to child Elaborated feedback: give reason why a response is incorrect and explain task s underlying principals Verbalization: children describe test question and how they came to their conclusion Ascertain progress readiness (relative to communication disorder) Be weary of validity and reliability issues when deviating from standard delivery 60

16 DA Method: TESTING-THE-LIMITS DA Method: GRADUATED PROMPTING Sample Cases of Task/Stimulus Variability (Laing & Kamhi, 2003) Lower SES African American children performed worse relative to Caucasian peers with traditional (picture stimuli) relative to manipulatives. Performance on par when executed within thematic tasks. (Fagundes et al., 1998) Present hierarchy of pre-determined prompts to establish ZPD Readiness for greater task difficulty informed by responses to different degrees of prompting Measure learning aptitude by degree of skill transfer to other contexts Laing & Kamhi Suggestions Replace black and white picture stimuli with three dimensional shapes in the context of a Simon Says tasks to provide context for lower SES African American Children Have children pretend to be robots when recalling sentences 61 Advantage over [Test-re-test] (Patterson et al., 2013) Shorter time, over brief single session Less examiner training w highly [structured?] prompts Potentially good screening option Evidence of predicting language and literacy performance (Bridges and Catts, 2011) 62 DA Method: TEST-TEACH-RETEST ASHA Practice Portal Dynamic Assessment Multi Media Guide MULTI-STEP. ACTIVE. INTERACTIVE - 1. Test 2. Teach 3. Re-Test - Focus = Learning process in the ZPD AIMS - Identify skills - Ascertain learning potential - Help determine difference from disorder TWO PRINCIPAL OUTCOMES - Determination of language difference or disorder - Intervention targets (Need be ) Test-Teach-Re-Test Framework TEST Assess present performance TEACH Mediated Learning Experience (MLE) Facilitate strategy development Observe how child changes and learns RE-TEST Re-test child Compare pretest and post test performance Assess strategy transfer or lack thereof 63 64

17 Mediated Learning Experience (MLE) Components of the MLE Goal of the MLE is to empower a child to be an independent and self-directed learner The MLE affords the clinician Time to observe how child learns Opportunities to train and foster learning strategies Components of the MLE Intentionality Meaning Transcendence Component Techniques Rationale Intentionality Meaning - Share the intention to change the child s learning skills - Tell the child your target - Give the rationale for the MLE - Direct focus to what is important - Point out important aspects or features of the activity - Ignore what is irrelevant or unimportant Create Awareness Helps child understand what is important and why Competence 65 Adapted from ASHA Practice Portal Chart Link cited above 66 Components of the MLE Sample MLE Component Techniques Rationale Transcendence Competence - Bridge ideas & events beyond the immediate task - Introduce of abstract concepts - Use questions such as, Where else have you? What would happen if?, and Did you ever?" - Review strategies and develop a plan - Cue child to think about how they will employ strategies or skills - Discuss appropriate times to use various skills Helps Child Think Critically and Hypothetically Fosters Active Learning, Self-Monitoring and Self-Regulation Component Intentionality Meaning Sample Script Hi Michael. Today we are going to work on saying a special phrase, does not. The phrase does not is important because, in English, it s the way speakers let others know if something has happened, it helps us form questions, and it helps emphasize important things. Adapted from ASHA Practice Portal Chart Link cited above 67 Adapted from ASHA Practice Portal Chart Link cited above 68

18 Component Transcendence Competence Sample Scrip Sample MLE Can you think of things you mom does not like? Imagine how you would tell someone. Do you hear your teacher use the word does when she tell you what is not happening? It s important to show what someone does not like or when something does not work. How can you make sure you use the phrase, does not so people understand well. You can stop and think before talking or think about how you said something after. Adapted from ASHA Practice Portal Chart Link cited above 69 Mediated Learning Experience (MLE) Determining language difference from disorder can be based on MODIFIABILITY How does child respond to information and the process? How well are skills transferred? How much and what type of clinician effort and prompting is needed? 70 Determining Outcomes of the MLE Measurement Responsivity Transfer Examiner Effort Behaviors - General response to intervention - Attention to task, to verbal information - Ease correct response vs. repeatedly giving the wrong answer - Does child transfer skills learned in mediation to other tasks? - What is the speed and quality of generalization? - Does transfer persist or do skills need to be re-taught a few days later? - How taxing is mediation for the clinician during and following interaction - Does the clinician have a sense of fatigue? 71 Judging Modifiability Learning Strategies Checklist (Lidz, 1991; Pena, 1993) 3-point scale 13 items Attention, discrimination, planning, self-regulation/awareness, application, motivation Modifiability Scale (Lidz, 1991) 3 & 4-point scales 3 items: Examiner effort, responsiveness to intervention, transfer Kapantzoglou et al. (2012) had success with 72

19 Judging Modifiability Peña s (2000) Modifiability Scale and Learning Strategies Checklist Judging Modifiability Learning Strategies Checklist Components (Peña 2000) EXAMINER EFFORT CHILD RESPONSIVITY 0 Extreme 0 None at all Modifiability Scale 1 High- Moderate 1 Slight 2 Moderate 2 Moderate 3 Slight 3 High Attention/Discrimination Initiated focus w minimal cues Maintained focus w minimal cues Respond to relevant cues/ignore irrelevant cues Comparative Behavior Comments on features of the task Uses comparative behavior to select items Able to talk about same/different Point Values 0 None of the time 1 Some of the time TRANSFER 0 Low 1 Medium 2 High Planning Talks about overall goal Talks about plan 2 Most of the time Self Regulation/Awareness Waits for instructions Seeks help when has difficulty Self corrects Self rewards Judging Modifiability Peña s (2000) Modifiability Scale and Learning Strategies Checklist Learning Strategies Checklist Components Point Values 0 None of the time Test-Teach-Retest: Word Learning, Single Session Kapantzoglou et al., 2012 Task: Novel word-learning Mitigates experiential bias Children w language impairment difficulty learning new words Transfer Applies strategies within a task Applies strategies across tasks Motivation Perseveres even when frustrated Shows enthusiasm 1 Some of the time 2 Most of the time Participants: 4 to 5 y/o Predominantly Spanish Bilinguals with typical and disordered language 75 Kapantzoglou et al.,

20 Test-Teach-Retest: Word Learning, Single Session Intervention Materials 3 novel objects from different semantic categories given CVCV nonword labels (Undeterminable animal, seeds, bubble level) familiar objects (flower, pizza, sunglasses) Methods One, 30 to 40 minute Test Teach Retest Session Pretest = Named all six items MLE: Taught nonwords in scripted structured play (Lidz, 1991). Script was for consistency, but allowed feedback based on child s responses (Pena et al. 2001) Modifiability gauged via Learning Strategies Checklist & Modifiability Scale Test-Teach-Retest: Word Learning, Single Session Results Typical and children w language impairment discriminated successfully, albeit not perfectly (78%) Typical language children faster than disordered language children making phonological and semantic associations. Kapantzoglou et al., Kapantzoglou et al., Test-Teach-Retest: Narratives Test-Teach-Retest: Narratives Background Two experiments Peña et al. (2006) First determined equality of pre/post-test stories Authors wanted to assess viability of DA as a classification protocol Establish presence, or not, of potential bias of pretest measures Methods (Experiment 2) 1 st and 2 nd graders with and without a language impairment Three groups: Children w language impairment Typical language who participated in an MLE Control group of typical language children NO MLE Pre/Post test: Child thought of story while looking at wordless picture book Child then told story looking at pictures MLE: Two, 30 minute narrative skill and strategy sessions to increase length and complexity of narratives 79 Peña et al. (2006) 80

21 Test-Teach-Retest: Narratives Results LI group significantly less pre- to posttest change TLC more modifiable, related better stories Classification via Pretest Measure: Acceptable only for some. Case x Case: African Am./Latino misclassified Classification via Posttest: Fair. Higher sensitivity to pretest Classification via MLE: Most accurate of the three Overall accuracy best combining MLE and Posttest measures DAPPLE Dynamic Assessment of Preschoolers Proficiency in Learning English Assessment protocol in development < Sixty minute administration estimate Test-Teach-Test Learn vocabulary, Sentence Structure, Phonology Preliminary results promising to help differentiate typical from language disordered bilingual children Discriminating Disorder from Difference Using Dynamic Assessment in Bilingual Children. N. Hasson, B. Camilleri, B. Jones, C. Smith, B. Dodd Child Language and Therapy, 2013, 29 Peña et al. (2006) Assessing Multilingual Speakers Reports should ALWAYS include Information about the child s linguistic and cultural environment/s Statements regarding how diagnosis and decisions were made via clinical/professional judgment CASES STUDIES: IDEA and/or Best Practices Not Followed HIPAA/FERPA Warning: Identifying Information has been modified to secure patient/student privacy There are ethical concerns in reporting scores from psychometrically flawed assessment tools like translated or inadequately designed/normed tests 83 84

22 International Adoptee Kindergarten Age - International Adoptee Background not fully clear due to adoption circumstances English suspected to be third language Found abandoned in home at age 1.5 years of age No food, water, electricity Possible Turkish speaking home Brought to Russian Orphanage. First exposure to Russian Adopted at 3.5 years of age Adoptive family arranged for local tutor to speak English w child a few weeks before moving to US International Adoptee Testing: Arrival in JUNE Bilingual (Russian/English) Speech-Language and Psychological Evaluations General cognitive functioning was within normal limits Delayed speech & language skills Appropriate protocols followed Arrived in US in June of year X International Adoptee Testing: Six Mos. Later in January English-only SLP & Psych Reassessment Only six months regular exposure to English No caveats about English only testing multilingual/cultural background traumatic childhood Erroneously diagnosed with delays/disorder INAPPROPRIATE PROTOCOLS FOLLOWED Psychologist s Especially Inappropriate Actions Diagnosing out of purview: speech & language disorder including DSM code Erroneously stated should have better English language skills with six months exposure 87 International Adoptee Clinical & Educational History Placed in classroom with severely impaired children with autism Child having intact cognitive and linguistics skills could not function well Family pulled child from setting and home schooled child Received speech-language therapy with monolingual clinicians in English until September while not harmful, not considered appropriate Meant for habilitation of clinical needs, not to teach English ESL and language enrichment activities would have been more appropriate 88

23 International Adoptee Clinical & Educational History In September began speech-language therapy with bilingual-trained clinician Diagnostic therapy to differentially diagnose true language disorder from second-language learning Learned skills at good rate Determined to have normal language functioning and to have been misdiagnosed by untrained professionals following inappropriate protocols Discharged from therapy at end of fall semester International Adoptee Clinical & Educational History Bilingual SLP encouraged family to engage child in language rich activities social activities to practice English skills with peers reading New assessment: Qualified for Gifted and Talented program Family, nonetheless, had to fight to remove misdiagnosis Failure to follow best practices resulted in Time lost toward appropriate habilitation and socialization Additional financial burden to family Child Developmental Delay, Early English Learner 3 y/o Bilingual Developmental Delay Background History & Timeline Bilingual, Spanish-dominant home Spanish at home from birth until age 2.5 Parents, grandparents, babysitter Formal introduction to English in daycare at age 2.5 (January) Some English used at home - approximately 15% of the time Formal Evaluations at age 3 years (June) Entered preschool (September) Child Developmental Delay, Early English Learner Reports/Evaluations - Initial SLP Eval - Educational Eval - Secondary SLP Eval - Social History - Developmental Pediatric Eval Contacted Bilingual SLP with concerns of improper assessments and placements (October) - Individual Education Plan 91 92

24 Child Developmental Delay, Early English Learner All assessments, with the exception of one SLP evaluation were performed in English The reports, rightly indicated child came from a Spanish dominant or speaking home Reports often mentioned: Child produced Spanish output Child could not be tested second to non-compliance Not uncommon for a child in a testing situation, interacting with an unfamiliar adult in unfamiliar setting, speaking a less familiar language. Though, not noted by professionals Child Developmental Delay, Early English Learner Spanish background and output completely ignored by the professionals making decisions and diagnoses about the cognitive-linguistic development and functioning. No caveats to interpret the findings with caution as the children were not assessed in their dominant language. Outcomes of English-based reports revealed a fraction of the child s cognitive-linguistic capabilities The evaluations were largely invalid according to IDEA and best practices Child Developmental Delay, Early English Learner The educational and remedial provisions did not appropriately consider the child s bilingual status and fell short of needs Recommendations were for English-based interventions and settings Of particular concern was the wholly INAPPROPRIATE recommendation for the family not to use Spanish Potentially detrimental cognitively and social-emotionally Failure to follow best practices resulted in Time lost toward appropriate habilitation Additional financial burden to family Potential uneasy relationship with family and school district Test Your Knowledge What s your multicultural IQ? leid= Cultural Competence Checklist: Personal reflection l-competence-checklist-personal- Reflection.pdf#search=%22Cultural%22 Cultural Competence Checklist: Policies and Procedures l-competence-checklist-policies- Procedures.pdf#search=%22Cultural%

25 Assessing Multilingual Speakers Sources for Foundational Content Build knowledge and skills In Sum ASHA State Regulation Boards Departments of Education Local State Federal Professional Organization and Associations Center for Applied Linguistics National Association for Bilingual Education National Center for Bilingual Research National Clearinghouse for Bilingual Education Related Research Journals International Journal of Bilingualism ERIC Educational Resources Information Center Brain and Language The Modern Language Journal Review of Educational Research Bilingualism can mimic language impairment children need home language to learn a second language Pit falls of standardized testing Dynamic Assessment Great Option Great Resources PLEASE Introduce Yourself If You Want to Link-In: Thank You What are your questions? PLEASE Introduce Yourself If You Want to Link-In: 99