Cross-linguistic and multilingual aspects of speech sound disorders in children

American Speech-Language-Hearing Association Convention – San Diego – 17-19 November 2011

Sharynne McLeod, Ph.D. - Charles Sturt University, Australia http://geology.com/world/world-map.shtml

Seminar outline 1. Why an SLP should care about languages other than English 2. Multilingual speech acquisition a) Bi-dialectal speech acquisition in Jamaica 3. Assessment and analysis Assessment of the speech of a) children in Turkey b) Spanish-English bilingual children in the USA c) children in Hong Kong d) children in Malta 4. Intervention for multilingual children with SSD

Learner outcomes  Describe aspects of typical and atypical speech during multilingual acquisition.  Acknowledge differences between culturally appropriate assessment practices for multilingual children in different countries.  Describe approaches to intervention for multilingual children with speech sound disorders.

Declarations  Session was invited by ASHA Speech Sound Disorders in Children Convention Committee  Speakers have based their presentations on chapters in the following book  McLeod, S. & Goldstein, B. A. (Eds). (2012). Multilingual aspects of speech sound disorders in children. Bristol, UK: Multilingual Matters.

Under-referral of bilingual children with speech sound disorder 2-year study of 250 children in UK  “There is evidence that bilingual children with speech disorders are being overlooked.”  Referrals for concerns about speech sounds  58% of monolingual children vs. 26% of bilingual  Referrals for concerns about expressive language  22% of monolingual children vs. 35% of bilingual Stow, C., & Dodd, B. (2005). A survey of bilingual children referred for investigation of communication disorders: A comparison with monolingual children referred in one area in England. Journal of Multilingual Communication Disorders, 3(1), 1-23.

Multilingual children in SLP clinics “There is no reason why bilingualism should lead to a greater or lesser need for speech and language therapy (SLT). If there are proportionately more or less bilingual than monolingual children receiving SLT then this difference may be an indication of inequality” (Winter, 2001, p. 465) Winter, K. (2001). Numbers of bilingual children in speech and language therapy: Theory and practice of measuring their representation. International Journal of Bilingualism, 5(4), 465-495.

Brian A. Goldstein, Ph.D. – Temple University, PA, USA Sharynne McLeod, Ph.D. – Charles Sturt University, Australia

“As SLPs increasingly assess and treat children from varying linguistic backgrounds, knowledge of typical acquisition must expand beyond descriptions of developmental milestones based predominantly on studies of English…” (Davis, 2007, p. 51). Davis, B. (2007). Applications of typical acquisition information to understanding of speech impairment. In S. McLeod (Ed.), The International guide to speech acquisition (pp. 50-54). Clifton Park, NY: Thomson Delmar Learning.

Studies of multilingual children’s speech acquisition (written in English)  Include combinations of the following languages:  Arabic, Cantonese, Dutch, English, Farsi, French, German, German, Gujarati, Hindi, Hungarian, Italian, Maltese, Mirpuri, Norwegian, Pakistani heritage languages, Putonghua, Romanian, Russian, Samoan, Spanish, Swedish, Urdu, Welsh

Multilingual speech acquisition  In comparison to monolingual children, multilingual children exhibit speech sound skills that are  positive transfer: more advanced than their monolingual peers.  negative transfer: less advanced than their monolingual peers.  cross-linguistic transfer  Speech sound skills are not simply mirror images of each other in the two languages but are distributed somewhat differently in each constituent language, owing to the phonotactic properties of the languages being acquired. (Goldstein & McLeod, 2011, p. 84) Goldstein, B. A. & McLeod, S. (2012). Typical and atypical multilingual speech acquisition. In S. McLeod & B. A. Goldstein (Eds.) Multilingual aspects of speech sound disorders in children. Bristol, UK: Multilingual Matters.

Positive transfer  Occurs when children learning more than one language have enhanced skills compared with monolingual peers  Commensurate skills (Fabiano-Smith & Goldstein, 2010)  Examples in typical children  Maltese-English (Grech & Dodd, 2008)  Russian-English (Gildersleeve-Neumann &Wright, 2010)  Spanish-German (Kehoe, Trujillo, & Lleó, 2001)  Spanish-English (Fabiano-Smith & Goldstein, 2010)  Examples in children with speech sound disorders  Italian-English (Holm & Dodd, 1999b)  Mirpuri-English, Urdu-English (Holm, Dodd, Stow, & Pert, 1998)  Spanish-English (Goldstein, 2000)

Negative transfer  Occurs when multilingual children’s speech and language acquisition is less advanced than for monolingual children  Examples in typical children  Spanish-English (Fabiano-Smith & Goldstein, 2010; Gildersleeve, Davis, and Stubbe, 1996; Gildersleeve-Neumann, Kester, Davis, & Peña, 2008; Goldstein & Washington, 2001)  Cantonese-English (Holm & Dodd, 1999a)

Cross-linguistic transfer  Found in typically developing multilinguals (Holm & Dodd, 2006) and those with SSD (e.g., Goldstein, Bunta, Lange, Burrows, Pont, & Bennett, 2008)  ≈ 1% (Fabiano & Goldstien, 2005)  Bi-directional  use of Spanish during English production; for example:  /v/ → [b]; /vot/ → [bot]  /ʃ / → [ʧ ]; /fɪʃ / → [fɪʧ ]  use of English during Spanish productions; for example:  /r/ → [ɹ ]; /ropa/ → [ ɹ opa]  /ɾ / → [ɚ ]; [floɾ / → [floɚ ]  Monolingual children also use sounds not in their ambient language (Smit, 1993)

Factors influencing multilingual speech acquisition  “Whether it is a question of French or Scandinavian children, of English or Slavic, or Indian or German, or of Estonian, Dutch or Japanese children, every description based on careful observation repeatedly confirms the striking fact that the relative chronological order of phonological acquisitions remains everywhere and at all times the same... the speed of this succession is, in contrast, exceedingly variable and individual ...” (Jakobson, 1968, p. 46, emphasis added)  SUBSEQUENTLY FOUND NOT TO BE TRUE

Three factors influencing multilingual speech acquisition  Phonetic complexity (ease of production): the articulatory difficulty/ease producing a sound  Functional load: how often a sound contrasts with other phonemes (Meyerstein, 1970)  For example, in English /ð/ (voiced th) has a low functional load (since it is in only a few words); in Greek it has a high functional load  Phonetic frequency: how often a sound occurs  For example, in English /ð/ has high phonetic frequency, since words such as the, this, that are frequent (Ingram, 2011)

Phonetic complexity, functional load, phonetic frequency  Child’s age of emergence of sounds  Chinese : predicted by phonetic frequency  English: best predicted by functional load  Accuracy of production  English: best predicted by phonetic complexity  Dutch: not predicted by phonetic complexity  Late acquisition of complex consonants  Arabic: predicted by phonetic complexity Stokes, S. F., Klee, T., Carson, C. P., & Carson, D. (2005). A phonemic implicational feature hierarchy of phonological contrasts for English-speaking children. Journal of Speech, Language, Hearing Research, 48(4), 817-833.

One generalization  “Phonemes with high functional load in a language will be acquired earlier by both typically developing children and by children with phonological deficits” (Ingram, 2012) Ingram, D. (2012). Cross-linguistic and multilingual aspects of speech sound disorders in children. In S. McLeod & B. A. Goldstein (Eds.), Multilingual aspects of speech sound disorders in children (pp. 3-12). Bristol, UK: Multilingual Matters.

Multilingualism does not cause speech and language impairment  “A disorder in bilinguals is not caused by bilingualism or cured by monolingualism” (Kohnert, 2008)  “Being monolingual in a bilingual family or community exacerbates a weakness, turning a disability into a handicap” (Kohnert, 2008, pp. 143-144)

Karla N. Washington – University of Cincinnati, USA

Outline An introduction to Jamaican Creole (Jamaican Patois) – Phonology Speech and language services Research on Jamaican Creole speech and language acquisition Jamaican Creole – A sample

Jamaican Creole - Introduction  Two polar language varieties co-exist in Jamaica:  Jamaican English (the acrolect, high status)  Putatively the Queen’s English  Considered to be the Official Language  Used formally both in written and oral forms  Jamaican Creole (the basilect, low status)  An oral language, resulting from multiple etymologies: English, West African, French languages  Considered to be the National Language  Used informally

The Jamaican Diaspora  This movement has facilitated the introduction of Jamaican cuisine, music, and language to new immigrant countries, like the United States. Mi de ya ha HASHA hiina San Diiyego Ackee & Saltfish – Reggae Music – Language – National Dish Bob Marley Jamaican Creole

Jamaican Creole - Phonology  Jamaican Creole phonology consists of 33 different phonemes  21 consonant sounds (/ɵ/ and /ð/ are not present)  12 vowel sounds (long , short, diphthongs)  Orthographically similar to Jamaican English consonants, with voiced and voiceless cognates  Dissimilar to Jamaican English due to:  /h/ deletion or insertion (e.g., hand  [an])  Labialization (e.g., boy  [bʷai] )  Use of different vowels (e.g., /aa/  maaga “skinny”)

Jamaican Creole - Phonology Consonants /m, n, ŋ, b, d, v, z, ʤ, ɹ, j, l, w/ /p, k, t, f, s, h, ʧ/ voiced voiceless Vowels /i, e, a, o, u/ short /ii, aa, uu/ long / ai, ia, ua, au/ diphthongs Harry (2006)

Speech and Language Services  Government-funded speech and language services are not available in Jamaican schools  Registered and regulated professionals with a Master’s degree in speech therapy or more advanced degree in speech pathology provide access to these services  In other migrant countries Jamaican Creole- speaking children with speech sound disorders are likely to receive services in the local variety of English rather than in Jamaican Creole

Speech and Language Services Thoughts on Assessment ... 1. Consider difference versus disorder  Familiarize self with sounds/patterns of Jamaican Creole 2. Conduct interviews (e.g., parents, teachers)  Background information about development of L1 (i.e., Jamaican Creole)  Information on classroom performance/behaviour 3. Consider that children might code switch  Your presence may cause children to change their productions 4. Collect a speech sample  Observation in the classroom/clinic 5. Use of formal articulation (and phonology) measures  Broad and narrow transcription

Research on Jamaican Creole  Jamaican Creole is an oral language, thus little is known about its acquisition  Dearth of research on acquisition, none from a speech-language perspective  Information on the number of Jamaican Creole-speaking children with speech sound disorders is therefore not known

Research on Jamaican Creole This type of information is needed to guide speech-language service provision Jamaican Creole is a distinguishing part of Jamaican culture  A further investigation of this language and its people is needed

Jamaican Creole – A Sample  Context  The Yallahs River in St. Thomas, Jamaica overflowed its banks as a result of heavy rainfall  Some roads were washed away, including one specific bridge  People on the scene were interviewed by a news team  An interview was conducted with a “memorable” local named Clifton Brown, who highlighted the dangers of trying to cross the washed away bridge  A musical “re-mix” of this interview was created: “Nobody Canna Cross It”

http://www.cbsnews.com/8301-504784_162-20071653-10391705.html

Thank you! /tæŋk ʊ nʊ / Received Pronunciation

Sharynne McLeod, Ph.D. Charles Sturt University, Australia

The International Classification of Functioning, Disability and Health (ICF)

ICF is endorsed and/or used by  American Speech-Language-Hearing Association (ASHA)  Scope of Practice in Speech-Language Pathology (ASHA, 2001)  Preferred Practice Patterns for the Profession of Speech- Language Pathology (ASHA, 2004a)  Scope of Practice in Audiology (ASHA, 2004b)  Quality of Communication Life Scale (Paul et al., 2004)  Royal College of Speech and Language Therapists (RCSLT)  Canadian Association of Speech-Language Pathologists and Audiologists (CASLPA)  Speech Pathology Australia (SPA)

Assessing structure and function of oromusculature and hearing mechanism  Children who have been born in another country may not have had developmental health checks  Test hearing and oromusculature structure and function  Oromusculature assessment  Include consideration of whether there is a cleft lip/palate (including a bifid uvula or submucosal cleft)  Diadochokinesis (DDK): Normative information for  English (Williams & Stackhouse, 2000)  Brazilian Portuguese (Wertzner, Alves, & de Oliveira Ramos, 2008)  Thai (Prathanee, Thanaviratananich, & Pongjanyakul, 2003) etc.  Possibly examine swallowing and feeding functioning

Assessing speech function: SLPs’ assessments with multilingual children  Most always used  Informal assessment procedures  English-only standardized tests  Few used  Standardized tests in child’s first language  Developed local norms  Similar results in 2 countries  USA (Skahan, Watson, & Lof, 2007)  Australia (Baker & McLeod, 2011; Williams & McLeod, 2011) Skahan, S. M., Watson, M., & Lof, G. L. (2007). Speech-language pathologists' assessment practices for children with suspected speech sound disorders: Results of a national survey. American Journal of Speech-Language Pathology, 16(3), 246-259. Williams, C. J. & McLeod, S. (2011, in press). Speech-language pathologists’ assessment and intervention practices with multilingual children. International Journal of Speech-Language Pathology, 14(3).

Assessing speech function: Articulation/phonology tests  Monolingual speech assessments in  Arabic, Cantonese, Dutch, Finnish, French, German, Greek, Hungarian, Israeli Hebrew, Japanese, Korean, Maltese, Norwegian, Portuguese, Putonghua, Samoan, Spanish, Swedish, Turkish  Bilingual speech assessments in  Maltese-English  Spanish-English  Pakistani-heritage languages (Mirpuri, Punjabi, Urdu)-English  Russian-German, Turkish-German

Assessing speech function: Designing measurement tools  Conceptualization  Purpose  Intended population  Target skill  Scope  Operationalization: Testing a test  Reliability: Does the test provide a consistent measure?  Validity: Does the test measure what it claims to?  Item analysis  Sensitivity and specificity  Standardization (see McCauley & Swisher, 1984) McCauley, R., & Swisher, L. (1984). Psychometric review of language and articulation tests for preschool children. Journal of Speech and Hearing Disorders, 49, 34-42. McLeod, S. (2012). Translation to practice: Creating sampling tools to assess multilingual children’s speech. In S. McLeod & B. A. Goldstein (Eds.) Multilingual aspects of speech sound disorders in children. Bristol, UK: Multilingual Matters.

Analysis: Difference vs. disorder 1. Describe the patterns used by the speaker 2. Identify ways these patterns differ from typical speakers  A multilingual child with a speech sound disorder will exhibit characteristics of disorder in all languages  The types of errors may differ across languages (Yavaş & Goldstein,1998)  e.g., more final consonant deletion in English than in Spanish (Goldstein & Washington, 2001) 3. Determine the impact of any disordered patterns on communication 4. Provide information for developing intervention goals 5. Provide a basis for assessing changes during intervention Grunwell, P. (1982). Clinical phonology. Rockville, MD: Aspen Systems. Scarpino, S. E., & Goldstein, B. A. (2012). Analysis of the speech of multilingual children with speech sound disorders. In S. McLeod & B. A. Goldstein (Eds.), Multilingual aspects of speech sound disorders in children (pp. 196-206). Bristol, UK: Multilingual Matters.

Body function: Dynamic assessment of speech  Dynamic assessment identifies learning potential  Dynamic speech assessments typically involve systematic assessment of stimulability of sounds  (Glaspey & Stoel-Gammon, 2007)  When working with multilingual children  test-teach-test is better for differential diagnosis between difference and disorder  testing the limits and graduated prompting are best used for determining readiness for intervention progress  (Gutiérrez-Clellen & Peña, 2001) Gutiérrez-Clellen, V. F., & Peña, E. (2001). Dynamic assessment of diverse children: A tutorial. Language, Speech, and Hearing Services in Schools, 32(4), 212-224.

Activities and participation: Parent report measures  FOCUS (Focus on the Outcomes of Communication Under Six) (Thomas-Stonell et al., 2010)  1. My child’s speech is clear.  26. My child makes friends easily.  27. My child is comfortable when communicating.  28. My child can communicate independently.  29. My child needs help to be understood by other children.  Intelligibility in Context Scale (McLeod et al., 2011)  Do you understand your child?  Do your child’s friends understand your child? Thomas-Stonell, N. L., Oddson, B., Robertson, B., & Rosenbaum, P. L. (2010). Development of the FOCUS (Focus on the Outcomes of Communication Under Six), a communication outcome measure for preschool children. Developmental Medicine and Child Neurology, 52,47-53 McLeod, S., Harrison, L. J. & McCormack, J. (2011, in press). Intelligibility in Context Scale: Validity and reliability of a subjective rating measure. Journal of Speech, Language, and Hearing Research.

Activities and participation: “How do you feel about the way you talk?” Monolingual English-speaking children’s insights into becoming bilingual at 4 time points (over 15 months): 1 x before moving; 3 x after moving to Germany Samantha Time 1 Time 2 Time 3 Time 4 Bowser       “nervous”   Samantha: “I get frustrated because I repeat myself over and over again and try and speak the best German I can and it doesn’t work out and it gets really frustrating.” (time 4) McLeod, S. (2011, January). Becoming bilingual: Children’s insights about sequential bilingualism. Asia Pacific Society for the Study of Speech, Language and Hearing, Christchurch, New Zealand.

Activities and participation: Time 2 (English “Draw yourself talking to someone” + ???) Time 1 (English) Time 3 Time 4 (German + (German) English) McLeod, S. (2011, January). Becoming bilingual: Children’s insights about sequential bilingualism. Asia Pacific Society for the Study of Speech, Language and Hearing, Christchurch, New Zealand.

Environmental factors: Language competency and use  For each language spoken it is useful to map  the length of time the language has been spoken,  proficiency in the language,  its frequency of use, and the  the context the language is used (Stow & Dodd, 2003)  language history of the countries the child has lived in (and, where they intend to live) Stow, C., & Dodd, B. (2003). Providing an equitable service to bilingual children in the UK: A review. International Journal of Language and Communication Disorders, 38(4), 351–377.

Environmental factors: Bilingual Dominance Scale (for adults)  Quick scale with 12 questions  If you have a foreign accent, which language(s) is it in?  If you had to choose which language to use for the rest of your life, which language would it be?  Focuses on “percent of language use for both languages, age of acquisition and age of comfort for both languages, and restructuring of language fluency due to changes in linguistic environments” (p. 273)  Validated on 102 Spanish-English bilingual adults Dunn, A. L., & Fox Tree, J. E. (2009). A quick, gradient Bilingual Dominance Scale. Bilingualism: Language and Cognition, 12(3), 273-289.

Environmental factors: Scales of language use for children  5 point scales  Language competency  0 = cannot speak the indicated language  4 = native-like proficiency with few grammatical errors  Language use  0 = the child never heard or used the particular language  4 = the language was heard and used by the child a great deal  (Bunta et al., 2009; Goldstein & Bunta, 2010; Peña, Bedore, & Rappazzo, 2003)  Percentage of use  Asked parents to calculate % of use over a week  including activities, language used and conversational partners.  (Goldstein, Bunta, Lange, Rodriguez, & Burrows, 2010)

Environmental factors: Alberta Language and Development Questionnaire  Method for quantifying multilingual children’s early milestones, language use, preferences, and family history  Not specific to a particular language/cultural group  Psychometrically validated measure  139 typical Canadian children +29 with language impairment  The scoring criteria allows for consideration of children who have experienced war, trauma, or lack of funds.  If a child scores less than 1.25 standard deviations below the mean their score is more consistent with a child with language impairment than a typically developing child. Paradis, J., Emmerzael, K., & Duncan, T. S. (2010). Assessment of English language learners: Using parent report on first language development. Journal of Communication Disorders, 43(6), 474-497.

Impact of environmental and personal factors on assessment (1)  Consider  Generalized socio-cultural factors alongside  Individual beliefs and practices and  Families’ cultural perspectives  These will impact  parent-child interactions  family acknowledgment of disability  access to and engagement with SLP services

Impact of environmental and personal factors on assessment (2)  Formality of testing  Impacts dialect density in African American English (Seymour & Seymour, 1977; Stockman, 2008)  Samoan has a formal and colloquial register with different consonants in each register (Ballard & Farao, 2008)  Code switching  Pakistani heritage-English (Pert & Letts, 2006)  Maltese-English (Grech & Dodd, 2008)  Engagement with stimuli  Children may not touch items (Friend & Keplinger, 2008) Gould, J. (2009). There is more to communication than tongue placement and 'show and tell': Discussing communication from a speech pathology perspective. Australian Journal of Linguistics, 29(1), 59-73.