Houston 146 Years Later 10/10/2012. Dual Language Learning for Children with Hearing Loss Assessment and Intervention.

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1 Dual Language Learning for Children with Hearing Loss Assessment and Intervention Michael Douglas, MA, CCC-SLP, LSLS, Cert. AVT Current Population Reports, Series P , PopulationProjections of the United States, by Age, Sex, Race, and Hispanic Origin:1993 to retrieved from Houston 146 Years Later We have a problem 1

2 Demographics Why Support the home language for Children with HI? Demographic-Social-Ethical.Possible? Why Support the Home Language? Current Population Reports, Series P , PopulationProjections of the United States, by Age, Sex, Race, and Hispanic Origin:1993 to retrieved from (Mehra, Eavy & Keamy, 2009) 2

3 (ASHA, 2004) Parent-Child Bond! Why Support Bilingualism? Why Support the Home Language? Children with typical hearing There is no scientific reason to believe that children can not develop more than one language early in life (Genesee, 2008) Strengthening the home language can facilitate development of the second language. (Kohnert, et al, 2005) Therapy studies on bilingual children with language impairment yield equal results as monolingual children with language impairment (Gutierrez-Clellen et al, 2008) 3

4 Why Support the Home Language? What we know about children with hearing impairment. Waltzman, Robbins, Green & Cohen, 2003 McConkey-Robbins, Green & Waltzman, 2004 Guiberson, 2005 Thomas, El Kashlan & Zwolan, 2008 Rhoades, Perusse, Douglas, Zarate, 2008 Douglas, 2011 Douglas, Cantu, Kirby, & Zarate, 2011 Teschendorf et al. (2011) Yim, 2011 Montreal Oral School for the Deaf Why Support the Home Language? Meets Consumer Demand Survey: 35 Spanish-speaking-only parents of children with HI (Douglas, 2011) 25 preferred a bilingual therapist who spoke their native language 4 said working with an interpreter was acceptable 6 indicated either option was acceptable 4

5 Why Support the Home Language? Meets Consumer Demand Survey: 35 Spanish-speaking-only parents of children with HI (Douglas, 2011) 0indicated they would like to receive services from someone who did not speak their native language fluently Knowledge Prerequisites to Assessment Assess biases and let them go Understand the importance of supporting the anchor language Dispel myths about bilingual development between departments and the community Become culturally competent learn customs and the language! Knowledge Prerequisites to Assessment Know the advantages of speaking more than one language Understand the capabilities of children with HL Understand and Identify Bilingual Phenomenon Maintain awareness of obstacles towards bilingualism Understand decisions that need to be made when Conducting Assessment Providing Intervention 5

6 Bias Effects Genesee, 1996, 2000, 2001, 2003 Rhoades, 2007 Assessing Biases 7 children severe-profoundly deaf Monolingual minority language home All discouraged to speak home language Reported parents feelings Behavior Assessment Checklist of the children Parent Child Interaction Assessment Assessing Biases All parents reported feeling embarrassed and sad about the deafness Other feelings: sadness, frustration, depression 2 reported being afraid to speak to their child 3 had elevated behaviors in the withdrawal domain 4 had elevated behaviors in aggression 6 had reported parent child relationship problems 6

7 Importance of supporting the anchor language Pearson, 2008 Genesee, 2003 Supporting the Anchor Language yrs int. 7 yrs int. 6 yrs int. 3 yrs int. 2 yrs int. English Group Myths True or False? 7

8 Become Culturally Competent Learn Customs and the Language Douglas, 2011 Advantages of speaking more than one language Rhodes, 2008 Understand and Identify Bilingual Phenomenon 8

9 Normal Hearing Bilingual Phenomenon Silent Period One Word One Concept Transfer (forward and backward) Code Switching The 20% rule Subtractive Bilingualism Observe Bilingual Phenomenon Code Switching: Mira!, there water Transfer Alla+ right there = ayer Emergence of moving away from oneword, one concept Abre (Spanish for Open) is said abe then Notice how the child changes his utterance from Spanish to English spontaneously Obstacles Lack of bilingual teachers, therapists and interpreters Lack of sufficient immersion in two languages Inadequate language base Previous country infrastructure Late intervention Parents paralyzed by grief Family support and motivation level 9

10 Obstacles Co-occurring disorders Poor Memory Personality of the child and parents Low Parent Participation Assessment Considerations Considerations and Resources for Assessment and Intervention TSHA 2003, Douglas,

11 Linguistically Diverse Populations Simultaneous bilingualism Sequential bilingualism Fluency in one language with significant exposure to another Use of more than one dialect Limited English Proficient Assessment Considerations Case History Home Language Survey CHIP Auditory Potential Language of assessment Assessment procedures Interpretation of assessment Determining language (s) of intervention Intervention Models Case History Medical Neuropsychological Audiological Developmental Speech and Language Development/proficiency Social/emotional/behavioral Educational Environment 11

12 Family s country of origin Length of time the child has been in the United States IF, When and how the child acquired the languages Pattern of language use in the home The extent and nature of his exposure to each language. Academic and educational placement Future plans of the family. Are they staying in the country? Home Language Survey A daily log can be used to help determine amount of exposure in each language CHIP Chronological Age Duration of Deafness Medical and Radiological Status Presence of Other Disabilities Audiology Status Social, Emotional, Behavioral, Expectations Educational Environment Auditory Potential Establish CA, HA, IA, etc. 12

13 Language Proficiency BICS and CALP Basic Interpersonal Communication Skills (BICS) Face-to-face, context-embedded communication Achieving proficiency (70%) in BICS typically requires a minimum of 1 to 2 years of exposure to the second language (Cummins, 1992) Cognitive Academic Language Proficiency (CALP) 1) Denotes the ability to understand and utilize the language skills required in academic settings 2) With support of the individuals native language in bilingual education programs, the development of CALP skills can take anywhere from 5 to 7 years to develop(cummins, 1992). 3) Without such support, CALP skills may require 7 to 10 years to develop (Peregoy & Boyle, 1997). 13

14 Language Proficiency Activity What is your BICS? What is your CALP? 14

15 Determining Dominance Public Law and Title VII of Public Law 95 Conduct Assessment in the Native Language or Languages IDEA 2004 Assessment should be provided and administered in the child s native language or other mode of communication 15

16 Assess Each Language May include informal language sample or norm reference testing Infant Assessment Assessment Procedures 16

17 Assessment Procedures I Trained bilingual speech-language pathologist fluent in the individual s native language and English If this option clearly is not feasible, the following options should be considered: IITrained monolingual speech-language pathologist assisted by trained bilingual ancillary examiner III Trained monolingual speech-language pathologist assisted by trained interpreter Assessment Procedures Use of Standardized Assessment Language exposure, use, and proficiency in both languages View with caution List strengths and weaknesses Criterion Reference Assessment Procedures SOLOM 17

18 Informal Assessment Procedures Speech and Language sampling Dynamic assessment/stimulability probing Processing dependent measures Structured observation Narrative assessment Assessment Procedures Sensitive to Language Impairment Non-word repetition performance Sentence repetition tasks Spontaneous Language Samples Structured Probes Standardized Instruments 18

19 Language Assessment Translations should ONLY be completed to assess specificnative languageskills. Original test norms must NEVER be used. Language Assessment SOME Translated skills can be used as an informal probes Results of translated skills may be utilized in conjunction with some criterion-referenced measures Speech Assessment Formal and informal Complete assessment in both languages Consider each phonological system 19

20 Informal Speech Assessment (Taelman, Durieux, & Gillis) Phonological Mean Length of Utterance PMLU Proportion of Whole-Word Proximity PWP PMLU Choose 25 age-appropriate words. Assign one point for each consonant and vowel in the word. Each correctly produced consonant is assigned an additional point. Ex. The child s production of /pun/ of spoon is 5 points out of 7 possible points PWP The ratio between the PMLU for the target words in the sample and the child s PMLU for the same sample. Calculate the PMLU for each word in the list. Obtain a total. Ex. PMLU for spoon is 7. A child s response of /pun/ is 5. The PWP is (5:7) or.71 20

21 Speech Assessment Sounds of L1 + Sounds of L2 = Accented Speech Not Articulation Impairment Interpretation IDEA 2004 Distinction between impairment and difference Diagnosis of an impairment cannot be made due to Limited English Proficiency Diagnosis of an impairment cannot be made based on a single measure Diagnosis requires a variety of assessment tools and strategies 21

22 Communication Impairment vs. Language Difference Hearing Impairment issues Bilingual issues Bilingual Development Potential for benefit of services Impairment vs. Difference Integrating Information Hearing Impairment Language Learning Bilingual Issues Impairment vs. Difference Hearing Impairment Issues Information from CHIP Audiology Information Compare language age to hearing and or intervention age If this seems tenuous, note pre and post treatment data 22

23 Impairment vs. Difference Hearing Impairment Issues Rate of Learning Month of progress for every month of intervention, some may close the gap after 8-10 years(buhler, et al, 2007) Steady rates compared to children with typical hearing (Dorman et al., 2007) Ability to close the gap after a period of 4 years (Rhoades & Chisolm, 2000) Impairment vs. Difference Bilingual Issues Handout Bilingual L1 L2 23

24 Impairment vs. Difference Typical Bilingual Development Handout Impairment vs. Difference Bilingual Development Phases of Language Learning Handout Other Considerations for Assessment: Potential to Benefit from Services Considering Simultaneous vs. Sequential Development 24

25 Factors Supporting Bilingual Learning Early identification and fitting Immediate, early intervention Early implantation Excellent speech perception; access to soft conv. speech Absence of additional disabilities Intact anchor language Good parent involvement Familial motivation for multi-language learning Exposure to rich and complex language models IN BOTH LANGUAGES Opportunities to practice each language meaningfully Possible Concerns for Bilingual Learning Late age of identification/intervention Late age of CI with limited auditory development pre-ci Poor detection and speech perception skills Presence of more than one disability Evidence of a struggle to acquire an anchor language Clinical red flags for slow auditory progress post CI Lack of family commitment for multi-language learning. Determining Potential to Benefit through Dynamic Assessment Procedures Video Tape Examples Hi or Low Modifiability? 25

26 Dynamic Assessment: Fast Mapping Sharing Results through Parent Counseling Share results with the family while mentioning bilingual and hearing impairment issues along with prognostic indicators Discuss concerns that can change, and those that may slow or prevent progress In severe cases, take careful consideration to the amount of resources and time needed to help the child communicate 26

27 Summary Serving this population requires some special preparation and on going learning Assess in all languages the child is exposed to the extent that is possible Informal assessment is just as meaningful if not more than formal assessment No one assessment can diagnose, a host of factors need to be considered before developing an appropriate plan 27