Multilingual and Multicultural Affairs Committee … · Code switching occurs when bilingual...
Transcript of Multilingual and Multicultural Affairs Committee … · Code switching occurs when bilingual...
Multilingual and Multicultural Affairs Committee
1
FAQs for Parents
We are raising our child bilingually at home, but we are worried that it may cause a delay in
language development. We would like to know if a bilingual child is necessarily going to be
delayed. In other words, is delay normal in bilinguals?
Bilingual children’s language development is similar to the development of children learning a
single language (Paradis, 2010). Bilingualism itself does not cause language delay (Lowry,
2018). In infancy, bilingual children are sensitive to differences in languages. This indicates a
very early ability for language learning. Bilingual infants begin producing their first syllables and
words roughly at the same time as children learning a single language. There is also a similar
pattern of learning vocabulary and grammar. However, bilingual development may often look
like it is delayed because a child’s total language proficiency is distributed over two languages.
If a child is learning a second language or two languages simultaneously, vocabulary
development (learning words) may appear to show a delay. Indeed, when the vocabulary of each
language is measured separately, it tends to be smaller than the vocabulary of a monolingual
child (Hoff et al., 2012). However, when this child’s vocabulary abilities are assessed in both
languages, vocabulary is found to be within the typical range or even larger than that of a
monolingual child. Vocabulary development in any language is highly associated with the
amount of input the child has received in that language (Thordardottir, 2011; Hoff et al., 2012;
Pearson, 2007). Input affects early grammar development in a similar manner (Thordardottir,
2015a). Many times, exposure is uneven, and bilinguals vary from each other in terms of
language production, with very uneven proficiency across their two languages (children vary in
whether their home language or the community language is stronger, and this can change over
time).
Parents raising bilingual children should pay extra attention to give enough support especially for
the native or minority language because the child may not receive much input in that language in
other settings. In addition, it is important that parents understand that assessment of a child’s
vocabulary should ideally assess for the native language and the second language. If a child is
assessed only one language, this will not show the true size of the child’s vocabulary
knowledge. (See Conceptual Scoring in the Speech Language FAQ). Nevertheless, assessment
procedures have been developed that estimate overall vocabulary from the measurement of one
language alone coupled with information on exposure to each language (Thordardottir, 2015b).
Bilingual children might be less accurate than same-age monolinguals on some grammatical
aspects as compared to their monolingual peers, such as verb tense (e.g., eat/ate), verbal
inflections (e.g., works, worked), plurals (e.g., book/books), or gender (e.g., he/she)(Paradis,
2010). In languages with rich morphology bilingual children might show differences on
adjective-noun and determiner-noun agreement (e.g., in Spanish: el conejo), case morphology
(e.g., in Russian: slon, slona, slonu; in German: Der Clown, Dem Clown) and aspect
morphology (e.g., Russian: pil, vypil) . These divergences from monolinguals have been
attributed to cross-linguistic influence, the influence from L1 on L2 and vice versa from L2 on
L1 (e.g., Cuza, & Pérez 2015, Scharff Rethfeldt 2011, Meir et al., 2017), or alternatively, simply
to slight delays in the grammatical development of each language because of divided exposure
(Thordardottir, 2015b).
Multilingual and Multicultural Affairs Committee
2
Code switching occurs when bilingual speakers combine words or phrases from both languages
spoken. This is not a sign of a language delay. Instead, this is part of the typical development of
bilingual speakers and a natural part of bilingualism for both children and adults (Roseberry-
McKibbin, & Brice, 2018). Overall, bilingual preschool children have been found to learn each
of their languages in a similar sequence as monolingual speakers of these languages (De
Houwer, 2006; Thordardottir, 2015a)
We are bilingual parents, but are considering raising our child monolingually at home, using
only the societal language. However, we speak the societal language with a strong accent
(having immigrated as adults) and are more proficient in our native language. Is this a good
idea?
Children who are exposed to two languages from birth typically become highly proficient in both
languages, provided they receive abundant and continuous exposure to both. In addition, children
who later learn the societal or majority language at school are likely to learn that language with
little difficulty and to succeed in school given a strong base in their first language and adequate
support and exposure to the second language.
For bilingual language learners, language development depends on the quality and quantity of
social interaction with native speakers of both languages (Hoff & Core, 2013;Thordardottir,
2011, 2015, 2019). Quality means that the language spoken must be spoken with accuracy, ease,
and fluency. The quantity factor is provided when the parents provide children with frequent
interaction in the language they speak with the child with fluency and ease. Quantity means that
language interaction between adults and children must be frequent. Given that bilingual parents
have a good command of their native language, they are best able to provide children with these
quality factors in that language.
Some bilingual children are exposed to two languages within their home, and some are exposed
to one language at home, and the societal language in a daycare or preschool setting. In the
preschool years, the amount of exposure to each language has been found to exert a far greater
influence on the acquisition of each language than how old the child is when bilingual exposure
starts (Thordardottir, 2019; Unsworth, 2016). This gives parents flexibility in terms of when to
introduce a second language, such as in a daycare or preschool setting. Parents who talk with
children about their past experiences, using their native languages, help their children connect
with the parents’ culture. Stories also provide children with understanding narratives (stories),
which are an important skill in early academic development.
Retention of the first language (L1) can be challenging without sufficient exposure and shift in
language dominance can be rather rapid, even with a native language with high status (Scheidnes
& Tuller, 2016). Maintaining the first language is even more challenging in minority language
environments, when the language has few speakers and low status in the society. Keeping a
minority language in use involves special effort. Sometimes children’s native language may be
lost (Polinsky, 2007), a process known as language attrition. This process can occur when
children are isolated from or not exposed to their native language. This attrition can also happen
to different degrees, depending on the possibilities and motivation to use the language.
Multilingual and Multicultural Affairs Committee
3
Parents speaking other than their native language at home has not been discovered to bring better
results in child’s second language learning, but rather it has been shown to affect L1 retention
(Place & Hoff, 2011).
When should I seek professional help if my bilingual child does not speak or shows
performance which is low for his age when compared to his bilingual peers?
You should seek help as soon as possible if you feel your child is struggling with language
compared to what you would have expected or compared to other children developing in a
similar language environment.
However, keep in mind that young bilingual children can look delayed because each of their
languages represents only part of their language knowledge.
A language disorder must appear in both languages to determine a true disorder. If there are
other languages that have been learned, assessment must consider all languages that a child has
learned or is in the process of learning. If concerns are present, seek professional help. If
difficulties appear only in the second language being learned, this does not indicate a disorder.
However, if communicative difficulties in either language persist for a long time, some type of
support may be necessary.
My child is three years old and we have been raising him bilingually at home. We try to follow
the “one-parent-one-language” (OPOL) rule, but we have noticed that our son mixes the two
languages together when he speaks. Is this a sign that he has a language disorder?
Where each parent has a different native language, a one-parent-one language strategy can be a
good option to ensure that the child gets the desired amount of exposure to each language.
However, it is not necessary for the child’s language learning that parents separate the two
languages.
Raising a child according to the OPOL principle does involve great and often demanding efforts,
as societal influences may work against caregivers’ interests and ability to raise children actively
bilingual (Hammer et al., 2004). Overall, the OPOL strategy does not guarantee balanced
bilingualism (DeHouwer, 2007). There is high variation among families and what factors affect
language use by families (Yamamoto, 2001). In some migrant families, maximal engagement
with the minority language may be more successful than the OPOL principle (Marinova-Todd,
Bradford Marshall, & Snow, 2000).
Code switching may occur for several reasons. First, a word may not be currently accessible or
pulled from memory to communicate a thought or idea. Second, children may use code switching
to ask an adult for help in finding a correct word to label something or express an idea. Third,
code switching or mixing has been found to be used to produce longer and more complex
sentences by bilingual speaking children. Fourth, code switching occurs more frequently when a
child is telling a story. Code switching has a positive aspect, as it shows that a bilingual child has
the ability to use words from both languages being learned.
Multilingual and Multicultural Affairs Committee
4
In summary, code switching is a typical language behavior found in bilingual speakers of any
age. Code switching does not indicate linguistic incompetence. Instead, code switching may be
seen as a marker of linguistic competence.
We are bilingual parents and mix the two languages (code switch) very often. Is it okay to
speak both languages to the child and code switch?
Code switching is a typical pattern for both bilingual children and adults and is not a disorder.
In many cases, both parents may be bilingual and may themselves code-switch when talking to
each other or to the child. This does not harm the child’s learning.
Codeswitching is not used solely for lexical deficiencies, but for pragmatic, social and cultural
reasons. Adults use code switching to enrich conversations and interactions. It is a valuable tool
that may allow a bilingual family to make their conversations richer and more understandable.
Frequently, children will follow the patterns spoken by adults in their environment.
At what age should we expose our child to a second language? Should we wait until our child
gets control of the home language first, or should we start as early as possible?
Evidence shows that young learners may acquire native-like mastery of a second language given
continued regular exposure to both languages. By age 4, children become more aware of the
language to be used in interaction (Paradis, 2010). A positive aspect of early learning of a second
language is that it gives the child a greater amount of time for practice in using the second
language. This will likely lead to adult mastery of the language. There is some evidence, that for
some language domains, it might be beneficial to start early as possible. On the other hand, some
domains might develop faster at an older age, and the introduction of L2 at a later age might
help better retention of L1, depending on the circumstances (Blom & Bosma, 2016). Sensitive
periods for learning language domains have been found (Granena & Long, 2012), including
phonology (pronunciation of sounds), syntax (sentence structure), semantics (words), and
pragmatics (the use of language in interaction). In the educational domain, better learning occurs
early for L2 phonology, later for lexis and collocation (the lexicon of a language or vocabulary
and the arrangement of grammatical terms in a sentence), and morphosyntax in the mid-teen
period of learning.
Within the preschool years, the amount of exposure is far more important than the age of first
bilingual exposure (Thordardottir, 2019, Unsworth, 2016). Therefore, parents have considerable
flexibility in their choices as to when to start exposing their child to a second language.
Additionally, introducing a second language is often dependent on when it is needed and natural
for varying reasons (e.g., movement to another country or entry into school).
Which language should I use with my child if the language spoken in the school is different
from the one spoken at home ? Should we drop the home language and use only one
language? What would happen if we, the parents, drop the home language, but the
grandparents continue to use it with the child?
Multilingual and Multicultural Affairs Committee
5
Maintaining a child’s native language while being educated in the school language is positive for
many reasons, the most obvious one is knowledge of more languages and ability to communicate
with the native language community. The number of different sources of input by second (L2)
speakers has been positively related to vocabulary and grammar development in L2 (Place &
Hoff, 2011).
Parents vary in how important it is to them to keep their native language. It is important for
parents to understand that continuing to speak that language will not hurt the child’s ability to
learn the societal language. It is essential to encourage a family to communicate in their native
language or languages to preserve their culture and the child’s bilingual or multilingual skills.
This will allow the child to understand and speak the family’s language, along with
understanding of and participation in the family’s culture and community. Many times,
preserving L1 is also essential to parent-child-dialogue.
There are two suggested approaches for language use for the family. The “One Person-One
Language” approach applies to families where each parent speaks a different language. Tis
approach consists of each parent consistently speaking their own native language to the child.
For example, if one parent’s native language is Italian and the other’s language is French, each
parent would use that language exclusively in communication with their child.
The “Minority Language at Home” approach applies to families in where both parents speak the
same language. It consists of both parents speaking only their native language in communication
with the child. For example, if the parents’ native language is Arabic, this is the language that
would be used in communication at home with their child. These two approaches may actually
be overlapping, depending on the native languages of the parents and whether one of them is
(majority) language of the society. There may also be overlap in cases where only the
grandparents continue to speak the native language. With time, many families find that use of the
societal language within the home tends to increase as all family members live daily experiences
in that language. Even at that point, use of the native language typically continues as well.
Outside experiences are essential, such as the playground and playgroups, so that children gain
additional experience with the second language.
Our five-year-old is bilingual and has been diagnosed with a developmental language
disorder. We have been advised to speak only one language to him at home — the language of
school. This will be difficult, since his older sister and brother speak two languages and we are
a bilingual family. Should we follow this advice?
This advice comes from the incorrect belief that learning two languages is beyond the capacity of
children with language or learning disorders. Research provides no evidence that children with
language disorders cannot become bilingual. Instead, there is evidence that children with Down
Syndrome (Kay-Raining Bird et al, 2005), autism spectrum disorders (ASD), dyslexia, and a
developmental language disorder (DLD) (Paradis, 2010) have become bilingual speakers and
readers. Previous research shows that bilingualism does not impede language development in
children with DLD (Gutiérrez-Clellen et al., 2008; Morgan et al., 2013; Paradis et al., 2003,
among others); children with ASD (Gonzalez-Barrero & Nadig, 2018; Hambly & Fombonne,
2012; Kay-Raining Bird et al. 2012; Meir & Novogrodsky, 2019), children with Down
Syndrome (Bird et al.,2005), children with William Syndrome (Perovic & Lochet, 2015) and
Multilingual and Multicultural Affairs Committee
6
children with Hearing Impairments (Bunta, et al., 2016). However, DLD and bilingualism both
may have the effect of slowing down language development. Thus, even though the endpoint
(highest level of proficiency attained) may not be affected by bilingualism in children with DLD,
bilingual children with DLD may be farther behind monolingual peers in each language than
monolingual children with DLD at some points in development (Thordardottir & Brandeker,
2013). Therefore, children with DLD will require adequate support to be successful in a bilingual
situation (Paradis et al., 2018).
Rather than discontinuing the home language, which would deprive the child of the ability to
develop that language, parents are advised to continue to use their home language with the child,
but they would also be well advised to provide abundant experiences in that language such as by
interactive reading or other language activities.
We planned for our son to attend an immersion school where he can learn through a second
language - different from the language we speak at home - and grow up bilingually. But our
son has been diagnosed with a developmental language disorder. Does this mean he is not a
good candidate for immersion education?
Even children who have speech and language disorders are able to acquire two languages. As
stated above, studies have shown that many children with a developmental language disorder
also have no greater difficulty learning a second language than they have in learning one, given
frequent exposure to this language. Research shows that English-speaking children with
language delay in French immersion schools in Canada had similar academic achievements with
English-speaking children with delay in English-only schools (Paradis, 2018). These findings
show that learning through a second language did not affect children’s academic success. In this
case, however, one of the languages of school is also the home language. Findings on academic
success are somewhat more mixed in some immigrant environments (Thordardottir, 2017). In
any case, it is essential to ensure that the school provides the support necessary for children’s
academic progress and success, with more frequent language interaction in the school language
and support with learning difficulties.
My daughter is fluent in her home language but finds it difficult to acquire the school
language. Could there be a delay (impairment) in the second language only?
The average second-language learner may require two years to acquire. Basic Interpersonal
Communication Skills (BICS). This type of learning occurs in interaction conversation in which
situations context is provided as well as non-verbal cues to support verbal language (Baker,
2011). Cognitive Academic Language Proficiency (CALP) refers to academic language. It may
take children five to seven years or longer to achieve the language consistent with the needs for
academic success (Vogl, 2013; Thordardottir, 2017). It is not infrequent for children to have
difficulty with CALP, as difficulties may appear in reading, writing, spelling, and other
academic areas. Awareness of the normal progress in learning a second language is necessary to
determine if there is a true disorder. If CALP skills are taking long to develop, some type of
tutoring or special education may be required to ensure that the child benefits from school.
Multilingual and Multicultural Affairs Committee
7
References
Baker, C. (2011). Foundations of bilingual education and bilingualism. Bristol, UK:
Multilingual matters.
Bird, E. K. R., Cleave, P., Trudeau, N., Thordardottir, E., Sutton, A., & Thorpe, A. (2005). The
language abilities of bilingual children with Down syndrome. American Journal of Speech-
Language Pathology.
Blom, E., & Bosma, E. (2016). The sooner the better? An investigation into the role of age of
onset and its relation with transfer and exposure in bilingual Frisian-Dutch children. Journal of
Child Language, 43, 581-607.
Bunta, F., Douglas, M., Dickson, H., Cantu, A., Wickesberg, J., & Gifford, R. H. (2016). Dual
language versus English‐only support for bilingual children with hearing loss who use cochlear
implants and hearing aids. International journal of language & communication disorders, 51(4),
460-472.
De Houwer, A. (2005). Early bilingual acquisition: Focus on morphosyntax and the Separate
Development Hypothesis. In J. Kroll & A. de Groot (Eds.), Handbook of bilingualism:
Psycholinguistic approaches (pp. 30-48). New York: Oxford University Press.
De Houwer, A. (2007). Parental language input patterns and children's bilingual use. Applied
Psycholinguistics, 28(3), 411-424.
Gonzalez‐Barrero, A. M., & Nadig, A. (2018). Bilingual children with autism spectrum
disorders: The impact of amount of language exposure on vocabulary and morphological skills at
school age. Autism Research, 11(12), 1667-1678.
Gutiérrez-Clellen, V. F., Simon-Cereijido, G., & Wagner, C. (2008). Bilingual children with
language impairment: A comparison with monolinguals and second language learners. Applied
psycholinguistics, 29(1), 3-19.
Hambly, C., & Fombonne, E. (2012). The impact of bilingual environments on language
development in children with autism spectrum disorders. Journal of Autism and Developmental
Disorders, 42(7), 1342-1352.
Hammer, C. S., Miccio, A. W., & Rodriguez, B. L. (2004). Bilingual language acquisition and
the child socialization process. In B. A. Goldstein (Ed.), Bilingual language development and
disorders in Spanish-English speakers (pp. 21–50). Baltimore, MD: Paul H. Brookes.
Hoff, E., Core, C., Place, S., Rumiche, R., Senor, M., & Parra, M. (2012). Dual language
exposure and early bilingual development. Journal of Child Language, 39, 1-27.
Hoff, E. & Core, C. (2013). Input and language development in bilingually developing children.
Seminars in Speech and Language, 34(4), 215-226.
Hoff, E, & Core, C. (2015). What clinicians need to know about bilingual development. Seminar
Speech Language, 36 (2), 89-99.
Kay‐Raining Bird, E., Lamond, E., & Holden, J. (2012). Survey of bilingualism in autism
spectrum disorders. International Journal of Language & Communication Disorders, 47(1), 52-
64.
Kay-Raining Bird, E., Cleave, P., Trudeau, N., Thordardottir, E., Sutton, A., & Thorpe, A.
(2005). The language abilities of bilingual children with Down Syndrome. American Journal of
Speech Language Pathology, 14, 187-199.
Lowry, L. (2018. Bilingualism in young children: separating fact from fiction. Hanen Center.
Available at http://www.hanen.org/Helpful-Info/Articles/Bilingualism-in-Young-Children--
Separating-Fact-fr.aspx.
Multilingual and Multicultural Affairs Committee
8
Lutz, A. (2004). Dual language proficiency and the educational attainment of Latinos.
Migraciones Internacionales, 2 (4), 95-122.
Marinova-Todd, S., Bradford Marshall, D. & Snow, C.E. (2000). Three misconceptions about
age and L2 learning. TESOL Quarterly, 34 (1), 9-34.
Meir, N. & Novogrodsky. R. (2019). Syntactic abilities and verbal memory in monolingual and
bilingual children with High Functioning Autism (HFA). First Language. Available at
https://doi.org/10.1177/0142723719849981
Morgan, G. P., Restrepo, M. A., & Auza, A. (2013). Comparison of Spanish morphology in
monolingual and Spanish–English bilingual children with and without language
impairment. Bilingualism: Language and Cognition, 16(3), 578-596.
Paradis, J. (2010). COST Action IS00804 on the official COST website. Language impairment in
a multilingual society: linguistic patterns and the road to assessment. Available at http://bi-
sli.org/index.htm.
Paradis, J., Crago, M., Genesee, F., & Rice, M. (2003). French-English Bilingual Children With
SLI. Journal of Speech, Language, and Hearing Research, 46(1), 113-127.
Paradis, J., Govindarajan, K., & Hernandez, K. (2018). Bilingual Development in Children with
Autism Spectrum Disorder from Newcomer Families. Available at Available at
https://era.library.ualberta.ca/items/d53d7b1b-c4d6-4d2f-a595-3ac2ecd8a52c/view/229ca8a8-
b060-473d-89a5-93cfc7b9e652/Bilingual-20ASD_FINAL_SummaryReport_05MAR2018.pdf.
Pearson, B. (2007). Social factors in childhood bilingualism in the United States. Applied
Psycholinguistics, 28, 399-410.
Perovic, A., & Lochet, S., (2015). Grammatical morphology in bilingual Williams syndrome: A
single case study. A poster presented at bi-SLI 2015 conference, François-Rabelais University,
Tours: France.
Place, S., & Hoff, E. (2011). Properties of dual language exposure that influence 2-year-olds’
bilingual proficiency. Child Development, 82, 1834-1849.
Roseberry-McKibbin, C., & Brice, A. (2018). Acquiring English as a second language: what's
"normal," What's Not. Available at
https://www.asha.org/public/speech/development/easl.htm#normal
Scheidnes, M., & Tuller, L. (2016). Assessing successive bilinguals in two languages: A
longitudinal look at English-speaking children in France. Journal of Communication Disorders,
64, 45-61.
Thordardottir, E. (2019). Amount trumps timing in bilingual vocabulary acquisition: Effect of
input in simultaneous and sequential school-age bilinguals. International Journal of
Bilingualism, 23(1), 236-255.
Thordardottir, E. (2015a). The relationship between bilingual exposure and morphosyntactic
development. International Journal of Speech Language Pathology, 17 (2), 97-114.
Thordardottir, E. (2015b). Proposed diagnostic procedures and criteria for Cost Action Studies
on Bilingual SLI. In Armon-Lotem, S., J. de Jong & N. Meir (Eds.), Methods for assessing
multilingual children: Disentangling bilingualism from language impairment. Bristol, UK:
Multilingual Matters.
Thordardottir, E. (2011). The relationship between bilingual exposure and vocabulary
development. International Journal of Bilingualism, 14 (5), 426-445., DOI:
10.1177/1367006911403202
Thordardottir, E., & Brandeker, M. (2013). The effect of bilingual exposure versus language
impairment on nonword repetition and sentence imitation scores. Journal of Communication
Multilingual and Multicultural Affairs Committee
9
Disorders, 46, 1-16.
Vogl, L. (2013). Tips for assessing bilingual children as a monolingual SLP, ASHA Leader.
Available at https://blog.asha.org/2013/11/26/leisha-vogle-assessing-bilingual-children-as-a-
monolingual-slp/.
Yamamoto, M. (2001). Language Use in Interlingual Families: A Japanese-English Socio-
linguistic Study. Clevedon, UK: Multilingual Matters.
Multilingual and Multicultural Affairs Committee
10
FAQs for Speech-Language Therapists
When can developmental language disorder be determined for bilinguals?
Bilingualism can be defined in many ways. Terminology that has to do with age of onset of
languages include concepts of simultaneous and sequential/successive bilingualism (Goldstein,
2019). If language is introduced before age 3, then the child is typically considered a
simultaneous bilingual. If the second language has been introduced after age 5 (and often after
age 3), then the child is typically considered a sequential bilingual (Paradis, Genesee, & Crago,
2011) or children with early second language acquisition (De Houwer, 2009).
These labels are problematic when attempting to classify a bilingual child’s strengths and
weaknesses or language dominance. Although language dominance is most often used to indicate
greater skill in one language over the other, bilingualism exists in a continuum, meaning that
bilingual children may possess skills that are superior in one language, with other skills superior
in another language (Goldstein, 2019; Thordardottir, 2011, 2015, 2019). This is related to the
fact that languages develop according to different schedules, and also to the fact that children
live different experiences in each of their language environments. The difference between
simultaneous and sequential is far from clear, also in terms of developmental features. Age of
onset for languages, input, language dominance, distributed language skills and weaknesses and
strengths across language domains need to be considered. It also needs to be taken into
consideration, that language dominance might change. For example, when a child becomes more
proficient in a new language, these skills may exceed those of his or her native/first language.
The most essential consideration is that early identification of a disorder is essential to ensure
successful language development and academic progress. First of all, the child’s family should
be asked if difficulties have been observed and if this child’s development differs from that of
siblings and peers of the same age. It is also important that children’s progress be compared with
other bilingual learning children, and not with monolingual learners who have been exposed
exclusively to the language in question from birth.
A developmental language disorder (DLD) is ideally diagnosed only when both languages are
assessed, given that a DLD will appear in all languages spoken by the child. Obtaining
information on the child’s development and abilities in both languages is crucial for an
evidence-based diagnosis. However, in reality, a formal assessment of both languages is often
not feasible for various reasons and is not undertaken (Thordardottir & Topbas, 2019). Some of
the difficulties that have been reported in obtaining a diagnosis of a bilingual child include the
following: (a) the scarcity of standardized tests that lack of bilingual norms; (b) the challenge of
the number of bilingual clinicians who are able to administer and analyze assessment tools, and
(c) the absence of information regarding a child's exposure to languages in question and
exposure effects on test performance. Bilingual assessment, therefore, frequently involves a
combination of formal assessment and more informal observations. Procedures have also been
proposed that estimate the likelihood that a language impairment exists based on formal
measurement of only one language, given that this scenario is common in clinical practice
(Thordardottir, 2015b). Collecting a comprehensive case history as much as possible is
recommended aside formal and informal assessment.
Multilingual and Multicultural Affairs Committee
11
Identification of a communication disorder in a bilingual individual requires careful
consideration of numerous factors that influence language. A true communication disorder will
be evident in each language used by an individual; however, a skilled clinician will appropriately
account for the process of language development, language loss, the impact of language
dominance fluctuation, and the influence of dual language acquisition and use when
differentiating between a disorder and a difference. Language dominance may fluctuate across an
individual’s lifespan based on use, input and language history (Kohnert, 2012).
The Factors that May Play a Role in Learning a New Language and Maintaining the First
Language
Because of the movement of families across the globe, children are required to learn a new
language when entering the new environment. The age of exposure to a second language
environment has been found to be a strong predictor of language proficiency in the new language
(Bylund, 2009). However, the quantity and quality of input are considered even more important
factors (Thordardottir, 2019; Unsworth, 2016). It is common that children can possess different
language abilities in their languages and across language domains (Montrul, 2013). Some
children can also be stronger in general in the new language and some children in their first
language. This can also change over time.
Retention of L1 can be challenging without sufficient exposure and shift in language dominance
can be rapid, even if the native language is one of high status in general (e.g. Scheidnes & Tuller,
2016). Maintaining the language is even more challenging in a minority language environment,
when the language has few speakers and low status in the society. Keeping a minority language
in use involves special effort. Sometimes children’s native language may be lost (Polinsky,
2007). This process is known as language attrition due to the loss of a native language. This
process can occur when children are isolated from or not exposed to their native language. This
attrition can also happen in different degrees, depending on the possibilities and motivation to
use the language. In many cases, there may not be loss of L1 skills, but slowed continued
progress in L1 progress. Bilingual instruction has been shown to protect native language skills
and may be important for language maintenance (Castilla-Earls, Francis, Iglesias, & Davidson,
2019). Research also shows that exposure is a valid indicator of dominance of relative
proficiency in each language (Köpke & Genevska-Hanke, 2018) and attrition may be only
temporary if there is a quick return to more balanced use of the native and new language. It is
positive to encourage families to continue to use their native language when communicating with
children learning a new language, as there are positive factors in bilingualism.
Research has shown that bilingual instruction has been shown to protect native language skills
and may be important for language maintenance (Castilla-Earls, Francis, Iglesias, & Davidson,
2019). Research also shows that exposure is a valid indicator of dominance of relative
proficiency in each language (Köpke & Genevska-Hanke, 2018) and attrition may be only
temporary if there is a quick return to more balanced use of the native and new language. It is
also positive to encourage families to continue to use their native language when communicating
with children learning a new language, as there are positive factors in bilingualism.
Multilingual and Multicultural Affairs Committee
12
Children who are proficient in both their native and second languages have improved educational
outcomes in terms of school completion rates, grades, achievement test scores, educational
aspiration, and personal adjustment (Bedore, 2010). Additionally, the use of the native language
has no negative consequences when learning a new language (Levey, Cheng, & Langdon, 2013).
International research has also shown that bilingualism may lead to significant enhancements in
certain cognitive abilities when compared with monolingual children (Bialystok 2006; Chin &
Wigglesworth, 2007; Kovacs & Mehler, 2009). At the same time, it is important to be aware that
not all children placed in bilingual contexts become highly proficient in both languages
(Thordardottir, 2017). In summary, it is important to encourage the use of the native language,
along with opportunities for using both the native and new language.
Typologies of languages have been shown to affect learning a new language through cross-
linguistic influence (Jarvis & Pavlenko, 2008; Fabiano-Smith & Goldstein, 2010). Linguistic
typology classifies languages according to their structural and functional features. For example,
typological classification is shown in words in English (SVO), Chinese (SVO ), and Japanese
(SOV). Second language learners may have difficulty with the acquisition of case marked
languages if the first language lacks these functions (Yager et al., 2015). On the other, languages
sharing many grammatical or phonological features or for example cognates are easier to learn
together.
Languages differ in many different ways, as following in these examples.
Italian Vado al cinema stasera [I] go to the cinema tonight
Spanish Salieron a las ocho [They] left at eight
French Nous sommes partis à huit heures We left at eight o'clock
English I am going to the cinema tonight
Russian Ja idu vecherom v kino I go [in the] evening to [the] cinema.
There are languages that have fixed word orders like English (subject-verb-object (SVO): John
likes Mary), and there are languages with free word orders, like Russian. In English, “likes John
Mary” (VSO) is ungrammatical, while in Russian all combinations are grammatical (e.g., SVO,
OVS, SOV, VSO, VOS, OSV). Languages also differ with respect to the placement of
adjectives: before or after the noun (e.g., English: a long pencil / a blue pencil; French: un long
crayon ‘a long pencil’, but ‘un crayon bleu’ ‘a pencil blue’).
Practitioners must be aware of morphological and syntactic differences across languages when
assessing bilingual or multilingual speakers. One example of these differences is presented
below from the West‐African language Gbe, with every word expressed by a single morpheme.
Mí tò kpá dó ná Yetì (jí) We are building a fence for Yeti
The languages Finnish, Turkish, Hungarian, and Bantu have words that consist of multiple
morphemes, as shown in the example from Finnish that illustrates the word house.
House Talo My house Talo/ni In my house Talo/ssa/ni
Multilingual and Multicultural Affairs Committee
13
In Italian and Russian, endings added to verbs change the verb for person, as shown in Italian for
the subjects of the verb parlare (to speak).
Parlo, parli, parla I speak, you speak, he/she speaks
There are also syntactic differences across languages. For example, some languages drop
pronouns (pro-drop languages) while some do not (non-pro-drop languages). Examples of pro-
drop languages (Italian and Spanish) and non-pro-drop languages (French and English) are
shown below.
Italian Vado al cinema stasera [I] go to the cinema tonight
Spanish Salieron a las ocho [They] left at eight
French Nous sommes partis à huit heures We left at eight o'clock
English I am going to the cinema tonight
Case involves marking of a noun or noun phrase for its syntactic and/or semantic role in a
sentence in the following ways: Nominative case (used for a noun or pronoun when it is the
subject of a verb, such as Sharon ate a cookie), dative case (to indicate the indirect object or
recipient of an action, such as He gave a biscuit to the dog), and instrumental case (to indicate
that a noun is the instrument or means that allows the subject to achieve or accomplish an action,
such as Sharon wrote a letter with a pen). English expresses the instrumental function through
the use of the words with, by, or then followed by a noun that indicates the instrument (e.g., I
wrote the note with a pen).
There are languages in which case is absent, such as Vietnamese and English. In this case,
grammatical relations are expressed by word order and/or function words (e.g., prepositions,
such as in, on, under, and between) or morphological markers attached to verbs (e.g., walk +ed).
In Tamil, eight case markers are found next to postpositions (a word or morpheme placed after
the word it governs that assigns case, such as ward in upward). German has a rich morphology
that allows for subject-less constructions as well as for passivization of intransitive verbs
resulting in subject less sentences (e.g. Hier wird getanzt [Dancing is done here]. Within a
sentence, diverse cases may be realized (e.g. subject: Die Frau hat dem Jungen den Ball
gegeben [The woman NOM has the boy DAT the ball ACC given].
Many languages mark a category of grammatical gender. German has three genders for nouns,
which also involves adjectives and articles (e.g. singular Im Garten steht der schöne Baum. [In
the garden stands the beautiful tree] plural Im Garten stehen die schönen Bäume [In the garden
stand the beautiful trees]. French and Spanish have two genders (masculine and feminine). The
German word for moon is masculine (der mond), while the Spanish word for moon is feminine
(la luna). In addition, grammatical gender is not present in some languages.
Because languages differ so much in their structures, it is important to compare the language
performance of bilingual children to norms for that language in terms of the sequence of
development. Even though bilingual children will not follow monolingual norms in terms of the
speed of development, simultaneous bilinguals do follow a language-specific sequence of
Multilingual and Multicultural Affairs Committee
14
development in each language (Thordardottir, 2015a). For this reason, bilingual children should
not necessarily be expected to have acquired the same grammatical structures in both languages.
Second language learners may use more explicit learning strategies than younger bilinguals,
comparing the structures of both languages. Children with language impairment may have
difficulty with several aspects of the new language for vocabulary, syntactic structure, and
morphology (Boerma, Wijnen, Leseman, & Blom, 2017; Blom et al., 2013).Consequently,
comparison and careful consideration are needed when interpreting assessment results from
bilingual speakers, with factors in both assessment and intervention.
Difficulties might be attested not only in the acquisition of the second language in bilingual
children, the above-mentioned factors might also affect the acquisition and maintenance of the
first language (e.g., Anderson, 2012; Cuza & Pérez-Tattam, 2015; Montrul & Sánchez-Walker,
2013). Under the influence (direct or indirect) of the second language, children might have some
problems with morphology in the first language.
Bilingual children might go through attrition in their first language (loss of some grammatical
properties) or incomplete acquisition of certain grammatical properties. For example, bilingual
children might have difficulties with gender marking in L1 (e.g., Anderson, 2012; Rodina &
Westergaard, 2017). Bilingual children who acquire L1 with rich morphology in tandem with L2
which has sparse case morphology might be less accurate in producing the correct cases in their
L1 (e.g., Janssen & Meir, 2018). The first language (the minority language) seems to be more
vulnerable to reduced input and bilinguals show smaller vocabularies in their first language as
compared to monolinguals in the country of origin (e.g., Mieszkowska et al., 2017).
What are guidelines for the assessment of bilingual-speaking children?
Assessment must determine areas of strength and weakness in both languages and across
language domains: syntax, semantics, morphology, pragmatics, and phonology. Shift in skills
over time should also be observed; it should also be kept in mind, that balanced bilinguals with
equally strong competence in their two languages are rare (Baker, 2011).
Goldstein (2019) has provided guidance for the assessment of bilingual speaking children. The
following history areas must be considered for evidence-based assessment.
● Understand the culture of the family and the community
● Determine the age of acquisition: is the child a simultaneous or sequential bilingual? (see
however the discussion of this factor above).
● Determine how often and with whom each language is used and how well each language
is used
The case history provides an opportunity to learn about the child’s exposure to languages and
environments in which each language is used. Information regarding who speaks which
language, the frequency in which language is spoken, and the environments in which the
languages are spoken are important. In addition, knowledge of a child’s language development in
the native language (or other languages learned or spoken) is important. An interview of family
members is an important component of the assessment process. Once a child’s history is
Multilingual and Multicultural Affairs Committee
15
completed, assessment can begin. The difficulty in utilizing standardized tests with bilingual
children is that normative references are largely available for only monolingual children
(Rimikis, Smiljanic, & Calandruccio, 2013. Because bilingual children are a tremendously
heterogeneous population, the development of a “bilingual norm” may not be possible
(Thordardottir, 2015).
Once a child’s history is completed, assessment can begin. The difficulty in utilizing
standardized tests with bilingual children is that normative references are largely available for
monolingual children.
It is important for speech-language pathologists (SLPs) to acquire the knowledge, skills, and
attitudes required to competently evaluate and address the language needs of bilingual children.
As an SLP establishes a rapport with a child, seeking opportunities to communicate with the
primary caregiver, case managers, and cultural brokers in the community is valuable. Clinical
strategies include successful work with interpreters, selection of appropriate tests and assessment
tools, and accessing resources about the language proficiency of primary languages spoken at
home are essential (McNeilly, 2019).
Because there are so few standardized tests available to use with bilingual children, informal
assessment is often the only approach that is available. However, the direct application of
monolingual norms with bilingual children leads to over-diagnosis of bilingual children (Bedore
& Peña, 2008), although it can be appropriate in some cases, notably for children with a strong
dominance in one language (Thordardottir, 2011). Procedures have been proposed that use
different cut-off criteria for bilingual children, prorating the cut-off values based on the child’s
particular exposure history (Thordardottir, 2015b). Comparison of each language with
monolingual norms will also provide an idea of dominance and of functioning in a monolingual
environment (Thordardottir, 2017). One approach is to use standardized tests in an informal
way. In this approach, the examiner administers the stimulus items from a test without using the
scores required to determine an overall score that is required by the test. When this mode of
testing is used, it is important to employ item analysis to determine which items on the test
present difficulty.
It is important to acknowledge cultural differences in test taking skills. Not all children will have
experience taking tests; when testing these children, more explanations may need to be provided,
practice items and stimuli may need to be repeated and reword test items reworded. It may also
be necessary to test beyond the test’s ceiling (i.e., above the point where administration of the
test would stop if it were being scored according to the instructions in the test manual). The
examiner may also ask children to explain their answers in order to determine if they have
understood the question. It is necessary to keep in mind that modifications of this kind invalidate
any norms that come with the test, as children in the norming sample were administered the test
following a strict protocol (Thordardottir, 2015). Other methods of informal assessment are the
use of parent questionnaires, comparing data from the child being evaluated with published data
on similar children, and the analysis of narratives/conversational samples. One possibility to
consider is also using more criterion referenced approaches (Baker, 2011), where the child is
profiled on specific language skills and her/his development are assessed comparing her/him to
her/himself. It is important to keep in mind that formal tests were not designed to be used as
Multilingual and Multicultural Affairs Committee
16
informal measures, and that some normative reference bases are required to interpret informal
data. While these informal approaches are often the only methods available, it must be
emphasized that they represent approximations that are subject to a larger error margin than are
carefully designed tests that are appropriate for the population being tested.
The narrative approach to assessment is a useful and positive approach for language assessment.
Narratives can provide information about a child’s knowledge of vocabulary, grammatical
structures, and story structure (Squires et al., 2014). However, it is essential to consider the
cultural differences in the style and structure of narratives when assessing children from different
language backgrounds (Bliss & McCabe, 2011). Narratives can be described in terms of the
structure of the entire story (macrostructure) and the specific types of words and sentences that
make up the story (microstructure). School-age children typically create stories that include
macrostructure elements (characters, setting, an initiating event, plans developed in response to
the initiating event, actions to carry out the plans, a consequence, and internal responses felt by
the characters in response to the initiating event or consequence (Stein, 1988). Children with
typical language development are more successful in narrative production than children with a
developmental language disorder (DLD). Findings also showed that the presence of
macrostructure scores in a child’s native language in kindergarten act to predict macrostructure
scores in L2 in the first grade. In fact, a number of recent studies have found the macrostructure
of narratives to be fairly unaffected by bilingualism (e.g. see Gagarina et al, 2016: the Special
Issue “Narrative Abilities of Bilingual Children” in Applied Psycholinguistics) – therefore,
pronounced difficulty in telling a story is a sign of language difficulty or impairment, depending
on its severity.
Dynamic Assessment is another alternative assessment method (Gillam, Pena, Bedore, Bohman,
& Mendez-Perez, 2014; Gutiérrez-Clellen & Peña, 2001). The goals of dynamic assessment are
to profile learners’ abilities; to observe learners’ modifiability; to induce active, self-regulated
learning; and to inform intervention. What dynamic assessment allows the assessor to tap future
skills or the child’s modifiability (i.e., change through mediation). Modifiability involves three
factors: child responsiveness (how the child responds to and uses new information); examiner
effort (quantity and quality of effort needed to make a change); and transfer (generalization of
new skills). All three factors are critical in determining if a child fails on a task because of
experience or ability. The format for dynamic assessment is test-teach-retest. In the test phase,
the examiner determines the child’s areas of weakness and the base level of functioning, without
any aid or assistance. In the teach phase, the assessor models the target behaviors and strategies
in meaningful contexts, makes the child aware of how the strategies are to be applied, allows the
child to lead some of the time, and increases demands as the skills are mastered. In order to
determine how the child has progressed after the ‘teach’ phase, s/he is retested, measuring
examiner effort (i.e., how much aid is needed by individuals to maximize their performance),
child responsiveness (i.e., how rapidly the child changes in response to teaching), and transfer
(i.e., the generalization of the task to other tasks and other domains). Dynamic assessment has
been used successfully to differentiate children’s lack of experience from their lack of ability.
Thus, it is a positive approach for assessment of bilingual speaking children.
A young bilingual child’s vocabulary can be assessed by using total vocabulary and conceptual
scoring (Gross, Buac, & Kaushanskaya, 2014; Pearson, Fernandez, Levedag & Oller, 1997). An
Multilingual and Multicultural Affairs Committee
17
example of total vocabulary scoring follows when a Spanish/English-speaking child’s
vocabulary skills are assessed for describing a picture of a ball through the use of code mixing to
convey meaning (striped, round, big, red): “Striped” . . . “round” . . . “grande” . . .“rossa.” If this
child were scored for only English, the score would be “2.” If credited for the child’s native
language (Spanish) and second language (English), the score would be “4.” If only one language
is considered, the child’s true vocabulary knowledge would not be considered.
Conceptual vocabulary scoring is frequently undertaken using the Mac-Arthur-Bates parent
report checklist that refers to the number of concepts the child has produced a word for,
regardless of language. Thus, if the child has said pajama in French and also in English, that
word counts only once towards the conceptual vocabulary score. Studies, across several
languages, have indicated that conceptual vocabulary should be roughly comparable to
monolingual vocabulary norms (Pearson et al., 1993), with variation expected across particular
languages and a child’s knowledge in languages (Thordardottir, Rotherberg, Rivard, & Naves,
2006).
Tests that target language processing rather than language knowledge (vocabulary size or
syntactic structures) have been shown to accurately distinguish children with and without DLD,
for both bilingual and monolingual speakers (Armon-Lotem & Meir, 2016; Thordardottir &
Brandeker, 2013Fleckstein et al., 2018; Hamann & Abed Ibrahim, 2017; Chiat & Polišenská,
2016; Summers, Peña, Bedore, Gillam, & Bohman, 2010). These tests include nonword
repetition and sentence imitation. Nonword repetition involves the ability to perceive, store,
recall and reproduce phonological sequences. Children with DLD are much more greatly
affected by word-length than are TD children, and in this respect, DLD children clearly differ
from both monolingual and bilingual children with TD (Thordardottir & Brandeker, 2013)
Given that formal assessment in two languages is often beyond the means of practicing clinicians
working with diverse multilingual populations, Thordardottir (2015b) proposed a scoring method
in which formal test results are interpreted using different criteria depending on the child’s
amount of previous exposure to the language being assessed. For this purpose, history
information is used to determine whether the language being assessed is the child’s stronger
language, one of about equally strong languages or the child’s weaker language. The cut-off
score used for determining a likely presence of language impairment (compared to the
monolingual norms of the test) is then adjusted in a different way depending on this
classification. This method is based on the strong relationship that has been demonstrated
between amount of language exposure and language proficiency.
A number of assessment measures have been developed expressly for bilingual assessment, and
continued work is underway to provide data on such tasks across many languages. COST Action
IS1804 produced perhaps the most ambitious attempts to date at developing equivalent measures
across a large number of languages. These measures, referred to as LITMUS tasks (Language
Impairment Testing in Multilingual Settings, Armon-Lotem, de Jong & Meir, 2015), including
tests of sentence imitation, nonword repetition, narration, and more, and also a bilingual version
of a parent questionnaire that can be used to estimate the likelihood of a language impairment
based on various factors.
Multilingual and Multicultural Affairs Committee
18
What are the best approaches to intervention for bilingual children?
For bilingual children, the purpose of intervention is to systematically improve their
communication skills in both languages through intervention carried out by a culturally and
linguistically competent professional. To do so, a six-step process for intervention is proposed
that is highly recommended for bilingual children: choose goals, choose targets, choose the goal
attack strategy, choose the intervention approach, choose the language of intervention, and
monitor progress.
There is a fairly small, but growing research base on the efficacy of treatment and assessment for
bilingual children. Taken together, available studies indicate that targeting both languages in
some way is beneficial in that it supports both languages and does not slow down overall
learning. No studies to date have indicated that a monolingual treatment is superior
(Thordardottir, 2010, 2017). Current studies have also indicated that, in order to advance both
languages, both must be directly targeted. For particular language structures, such as vocabulary
items or syntactic structures, the evidence is clear that teaching targets in one language does not
give rise to these same targets in the other language (Thordardottir et al., 2015: Restrepo et al.
2013). However, carry-over to the other language has been shown for more abstract skills that
draw on a common underlying metalinguistic awareness, such as incorporating more complex
sentences (that have already been acquired) into narratives (Peterson et al., 2006; Thordardottir,
2017). In actual clinical practice, a direct focus on both languages may not be feasible due to
lack of personnel. Bilingual treatment has been created through a collaboration with parents,
with mixed results (Tsybina & Erics-Brophy, 2010; Thordardottir et al., 2015). An important
consideration in this respect appears to be the necessity to ensure that a strong focus is included
on both languages.
For children who speak a first and a second language (thus with fairly late introduction of the
second language), main approaches have been described: a Bilingual Approach (with skills
common to both languages receiving attention) or a Cross-linguistic Approach (with attention
directed at specific linguistic features or social uses of each language separately) (Kohnert,
2010). Within both of these approaches, it is essential to maintain a child’s first language to
allow children to communicate and learn from family and friends and to maintain their native
culture, values, and beliefs.
Bilingual approach: The approach supports goals that address areas common to both
languages, along with errors found with equal frequency in both languages. Two bilingual
approaches have been described (Gutierrez-Clellen, 1999). The first consists of the native
language being maintained and strengthened in the child’s home while the therapist works
with the academic second language. The second consists of the concurrent translation of
sentences in one language that are repeated in the other language. In one program, children
were provided with lessons in bilingual books that introduced narrative and new vocabulary
items in their native language. The following day, the same material was presented in the
school language. Some SLTs have used the two language in one session. Others have used
both languages in different sessions. It is important to assess learning to determine the best
approach.
Multilingual and Multicultural Affairs Committee
19
Cross-linguistic approach: This approach focuses on the linguistic skills unique to each
language, with targets on errors noted in a specific language. Support for this approach
comes from studies that have shown that in order to advance basic skills in a particular
language, that language needs to be directly targeted (Thordardottir et al., 2015; Restrepo et
al., 2013). Indeed, basic skills such as vocabulary items and syntactic structures do not
transfer directly from one language to the other. Also, because each language of a young
bilingual child is acquired according to the specific schedule of that language (Thordardottir,
2015b), the items that need to be worked on may differ markedly between the two
languages. Intervention focusing on a particular language has been done in different ways,
for example by targeting the two languages in different sessions (Thordardottir, Ellis
Weismer & Smith, 1997; Restrepo et al, 2013) or in different settings by the SLP and the
parent (Tsybina & Eriks-Brophy, 2010).
Carryover and generalization are important factors in learning. To assure carryover or
generalization of intervention goals, the SLT may also provide children with support for
repeating what was learned during the session. SLTs can also ask family members to repeat in
their own language what was learned in L2 in the therapy session to promote the use of both
languages. Another approach is to ask a child to teach the SLT one word from L1 in each
session. This acts to contribute to a sense of acceptance.
It may also be important to request an interpreter if the SLT requires this support. Collaboration
with interpreter requires that the SLT remain responsible for planning the session, selecting
culturally relevant materials, and appropriately administering assessment and treatment (ASHA,
2018). The skills necessary for an interpreter is proficiency in the child's language, familiarity
and a positive attitude the child’s culture, and understanding the importance of following the
guidance of the SLT (ASHA, 2004). However, it is important to note that research is lacking on
the efficacy of the use of interpreters or on the specific roles that they should assume in therapy.
Assessment Tests
There are also some published assessment tools for bilinguals. There are tests and word lists
developed to assess children's articulation and phonology in a variety of other languages.
.
• The Bilingual-English-Spanish-Assessment test (BESA) was developed for Spanish-
speaking children’s assessment (Peña, Gutiérrez-Clellen, Iglesias, Goldstein, & Bedore,
2018).
• Pearson Publications (2018) has also offered a site with a wide range of assessment
devices.
• Sources for assessment are presented by McLeod, Verdon, and Bowen (2013) and
McLeod & Verdon (2017).
• Charles Sturt University (2019) presents over 200 studies that address cross-linguistic
speech acquisition.
• McLeod (2019) offers a compilation of data on typical speech development for English
speaking children, designed to be used by speech-language pathologists.
Multilingual and Multicultural Affairs Committee
20
• McLeod (2013) also offers information on speech sound acquisition in a book chapter
that provides developmental information, in addition to an international guide to speech
acquisition (McLeod, 2007).
• McLeod and Verdon (2014) also offer a review of 30 speech assessments in 19 languages
and Grech and McLeod (2012) offer information on multilingual speech and language
development and disorders.
• McLeod, Harrison, and McCormack (2012) present information on children’s
intelligibility, with a description of a measure of children’s functional intelligibility.
• Hua and Dodd (2006) offer information on phonological development and disorders in
children, based on a multilingual perspective.
• Hambly, Wren, McLeod, & Roulstone (2013) offer information on the influence of
bilingualism on speech production. Guidelines for school-based assessment are offered
by Caesar & Kohler (2007).
• Information on approaches to teaching within bilingual and multilingual classrooms are
offered by Levey and Polirstok (2011).
• A multilingual device, termed Speakaboo (2019) for phonological assessment across
several languages has been developed for practitioners who do speak the child’s native
language.
The following information on bilingualism is also available on the following websites for the
public.
• The Advantages of Being Bilingual
https://www.asha.org/public/speech/development/The-Advantages-of-Being-Bilingual/
• Learning Two Languages.
https://www.asha.org/public/speech/development/Learning-Two-Languages/
• Second Language Acquisition.
https://www.asha.org/public/speech/development/Second-Language-Acquisition/.
References
American Speech-Language-Hearing Association (ASHA, 2004). Collaborating with Interpreters
and Translators. Available at http://www.asha.org/practice/multicultural/InterpreterTranslator/
American Speech-Language-Hearing Association (ASHA, 2018). Available at
https://www.asha.org/PRPSpecificTopic.aspx?folderid=8589935334§ion=Key_Issues
Anderson, R. (2012). First Language Loss in Spanish-Speaking Children. Patterns of Loss and
implications for clinical purposes. In B. A. Goldstein (Ed.), Bilingual language development and
disorders in Spanish-English speakers (2nd ed., pp. 193-213). Baltimore: Paul H. Brookes
Publishing Co.
Armon-Lotem, S., de Jong, J., & Meir, N.(Eds) (2015). Assessing multilingual children:
Disentangling bilingualism from language impairment. Bristol. UK: Multilingual Matters.
Armon‐Lotem, S., & Meir, N. (2016). Diagnostic accuracy of repetition tasks for the
identification of specific language impairment (SLI) in bilingual children: evidence from Russian
and Hebrew. International journal of language & communication disorders, 51(6), 715-731.
Bedore, L. M. (2010). Choosing the language of intervention for Spanish- English bilingual
preschoolers with language impairment. Evidence-based Practice Briefs, 5 (1), 1-13.
Multilingual and Multicultural Affairs Committee
21
Bedore, L. M., & Pena, E. D. (2008). Assessment of bilingual children for identification of
language impairment: Current findings and implications for practice. International Journal of
Bilingual Education and Bilingualism, 11(1), 1-29.
Bialystok, E. (2006). The impact of bilingualism on language and literacy development. In
Bhatia, T.K., & W.E. Ritchie (Eds.) The handbook of bilingualism (pp. 577-601). Malden, MA:
Blackwell Publishing.
Bliss, L. S., & McCabe, A. (2011). Educational implications of narrative discourse. In S.
Levey & S. Polirstok (Eds.), Language development: understanding language diversity in the
classroom (pp. 209–226). Los Angeles, CA: Sage.
Blom, E., de Jong, J., Orgassa, A., Baker, A., and Weerman, F. (2013). Verb inflection in
monolingual Dutch and sequential bilingual Turkish-Dutch children with and without SLI.
International Journal of Language and Communication Disorders. 48, 382–393. doi:
10.1111/1460-6984.12013
Boerma, T., Wijnen, F., Leseman, P., and Blom, E. (2017). Grammatical morphology in
monolingual and bilingual children with and without language impairment: the case of Dutch
plurals and past participles. Journal of Speech, Language, and Hearing Research, 60, 2064–
2080. doi: 10.1044/2017_jslhr-l-16-0351
Bylund, E. (2009). Effects of age of L2 acquisition on L1 event conceptualization patterns.
Bilingualism: Language and Cognition, 12(3), 305-322.
Castilla-Earls, A, Francis, D., Iglesias, A., & Davidson, K. (2019). The impact of the Spanish-
to-English proficiency shift on the grammaticality of English learners. Journal of Speech,
Language, and Hearing Research, 62, 1–16.
Caesar, L. G., & Kohler, P. D. (2007). The state of school-based bilingual assessment: Actual
practice versus recommended guidelines. Language, Speech, and Hearing Services in Schools,
38(3), 190-200.
Charles Sturt University (2019). Multilingual Children’s Speech. Available at
http://www.csu.edu.au/research/multilingual-speech/speech-acquisition.
Chiat, S., and Polišenská, K. (2016). A framework for crosslinguistic nonword repetition tests:
effects of bilingualism and socioeconomic status on children’s performance. Journal of Speech,
Language, Hearing Research, 59, 1179-1189.
Chin, N.B., & Wigglesworth, G. (2007). Bilingualism: An advanced resource book. London:
Routledge.
Cuza, A., & Pérez-Tattam, R. (2016). Grammatical gender selection and phrasal word order in
child heritage Spanish: A feature re-assembly approach. Bilingualism: Language and
Cognition, 19(1), 50-68.
De Houwer, A. (2009). Bilingual first language acquisition. Multilingual Matters. Bristol, UK.
Thordardottir, E. (2017). Implementing Evidence Based Practice with limited evidence: The case
of language intervention with Bilingual children. Revista de Logopedía, Foniatría y Audiología,
34 (4), 164-171.
Fabiano-Smith, L. & Goldstein, B. (2010). Phonological acquisition in bilingual Spanish-English
speaking children. Journal of Speech, Language, and Hearing Research, 53, 160–178.
Fleckstein, A., Prévost, P., Tuller, L., Sizaret, E., & Zebib, R. (2018). How to identify SLI in
bilingual children: a study on sentence repetition in French. Language Acquisition, 25(1), 85-
101.
Gagarina, N., Klop, D., Tsimpli, I. M., & Walters, J. (2016). Narrative abilities in bilingual
children. Applied Psycholinguistics, 37(1), 11-17.
Multilingual and Multicultural Affairs Committee
22
Gillam, R. B., Pena, E. D.., Bedore, L. M., Bohman, T. M., & Mendez-Perez, A. (2014).
Identification of Specific Language Impairment in Bilingual Children: Assessment in English.
Journal of Speech, Language, and Hearing Research, 57, 2208-2220.
Goldstein, B. Charles Sturt University (2018). Speech assessments. Available at
http://www.csu.edu.au/research/multilingual-speech/speech-assessments A. (2019). Bilingual
children’s language development: assessment and intervention (pp. 207-226). In S. Levey (Ed.).
Introduction to language development. San Diego, CA: Plural Publishing.
Grech, H. & McLeod, S. (2012). Multilingual speech and language development and disorders.
In D. Battle (Ed.). Communication disorders in multicultural and international populations (4th
ed.) (pp. 120-147). St Louis, MI: Elsevier.
Gross, M., Buac, M., & Kaushanskaya, M. (2014). Conceptual scoring of receptive and
expressive vocabulary measures in simultaneous and sequential bilingual children.
American Journal of Speech-Language Pathology, 23, 574–586.
Gutierrez-Clellen, V. F. (1999). Language Choice in intervention with bilingual children.
American Journal of Speech-Language Pathology, 8, 291–302.
Gutiérrez-Clellen. F., & Peña, E. (2001). Dynamic assessment of diverse children: a tutorial.
Language, Speech, and Hearing Services in Schools, 32, 212–224.
Hambly, H., Wren, Y., McLeod, S., & Roulstone, S. (2013). The influence of bilingualism on
speech production: A systematic review. International Journal of Language and Communication
Disorders, 48(1), 1-24.
Hamann, C., & Abed Ibrahim, L. (2017). Methods for identifying specific language impairment
in bilingual populations in Germany. Frontiers in Communication, 2, 16.
Hua, Z., & Dodd, B. (2006). Phonological development and disorders in children: A
multilingual perspective. Cleavdon, UK: Multilingual Matters.
Iluz-Cohen, P. & Walters, J. (2012). Tenning stories in two languages: Narratives of bilingual
preschool children with typical and impaired language. Bilingualism, Language and Cognition,
15, 58-74.
Janssen, B., & Meir, N. (2018). Production, comprehension and repetition of accusative case by
monolingual Russian and bilingual Russian-Dutch and Russian-Hebrew-speaking
children. Linguistic Approaches to Bilingualism.
Jarvis, S. & Pavlenko, A. (2008). Crosslinguistic influence in language and cognition.
London/New York: Routledge
Kohnert, K. (2010). Bilingual children with primary language impairment: issues, evidence and
implications for clinical actions. Journal of Communicative Disorders, 43(6), 456–473.
Kohnert, K. (2012). Processing skills in early sequential bilinguals. In B. Goldstein (Ed.),
Bilingual language development & disorders in Spanish-English speakers. Baltimore, MD:
Brookes.
Köpke, B., & Genevska-Hanke, D. (2018). First Language Attrition and Dominance: Same or
Different? Frontiers in Psychology, 06. Available at
https://www.frontiersin.org/articles/10.3389/fpsyg.2018.01963/full
Kovacs, A.M., & J. Mehler, J. (2009). Cognitive gains in 7-month-old infants. Proceedings of
the National Academy of Sciences, 106(16), 6556-6550.
Levey, S., & Polirstok, S. (Eds.). (2011). Language Development: Understanding Language
Diversity in the Classroom. Los Angeles, CA: SAGE Publications,
Multilingual and Multicultural Affairs Committee
23
Levey, S., Cheng, L-R L, & Langdon, H. W. (2013). The relationship between ethical principles
and clinical practice in working with culturally and linguistically diverse (CLD) populations: A
tutorial. Speech and hearing Review, 11, Taiwan, CN.
McLeod (2007). The international guide to speech acquisition. Clifton Park, NY: Thomson
Delmar Learning.
McLeod, S. (2013). Speech sound acquisition. In J. E. Bernthal, N. W. Bankson & P. Flipsen Jnr
(Eds.), Articulation and phonological disorders: Speech sound disorders in children (7th ed., pp.
58-113). Boston, MA: Pearson.
McLeod (2019). Children’s speech acquisition. Available at
http://www.csu.edu.au/__data/assets/pdf_file/0006/227652/Speech-acquisition-summary.pdf
McLeod, S., Harrison, L. J. & McCormack, J. (2012). Intelligibility in Context Scale: Validity
and reliability of a subjective rating measure. Journal of Speech, Language, and Hearing
Research, 55, 648-656.
McLeod and Verdon (2014). A review of 30 speech assessments in 19 languages other than
English. American Journal of Speech-Language Pathology, 23, 708-723
McLeod, S., & Verdon, S. (2017). Tutorial: Speech assessment for multilingual children who do
not speak the same language(s) as the speech-language pathologist. The International Expert
Panel on Multilingual Children’s Speech. American Journal of Speech-Language Pathology, 26,
691–708.
McLeod, S., Verdon, & Bowen, C. (2013). International aspirations for speech-language
pathologists’ practice with multilingual children with speech sound disorders: Development of a
position paper. Journal of Communication Disorders, 46(4), 375-387.
McNeilly, L.G. (2019). Strategies Utilized by Speech-Language Pathologists to Effectively
Address the Communication Needs of Migrant School-Age Children, Folia Phoniatrica et
Logopaedica 71,127-134.
Meir, N., Walters, J. & Armon-Lotem, S. (2017). Bi-directional cross-linguistic influence in
bilingual Russian-Hebrew speaking children. Linguistic Approaches to Bilingualism, 7(5), pp.
514–553. doi:10.1075/lab.15007mei
Mieszkowska, K., Łuniewska, M., Kołak, J., Kacprzak, A., Wodniecka, Z., & Haman, E. (2017).
Home language will not take care of itself: vocabulary knowledge in trilingual children in the
United Kingdom. Frontiers in psychology, 8, 1358.
Montrul, S. (2013). Bilingualism and the heritage language speaker. In T. K. Bhatia & W. C.
Ritchie (Eds.), The handbook of bilingualism and multilingualism (pp. 168-189). Blackwell
Publishing Ltd.
Montrul, S., & Sánchez-Walker, N. (2013). Differential object marking in child and adult
Spanish heritage speakers. Language Acquisition, 20, 109-132.
Paradis, J., Genesee, F., & Crago, M. (2011). Dual language development and disorders: s
handbook on bilingualism and second language acquisition (2nd ed.). Baltimore, MD: Brookes.
Pearson Publications. Available at http://images.pearsonclinical.com/images/8380A-
2013Spanish_Buyers_Guide_DM_HQ_HL.pdf.
Pearson, B., Fernández, S., Lewedeg, V., & Oller, K. (1997). The relation of input factors to
lexical learning by bilingual infants. Applied Psycholinguistics, 18, 41-58.
Petersen, D., Thompsen, B., Guiberson, M. & Spencer, T. (2006). Cross-linguistics interactions
from second language to first language as the result of individualized narrative language
intervention with children with and without language impairment. Applied Psycholinguistics, 37,
703-724.
Multilingual and Multicultural Affairs Committee
24
Peña, Gutiérrez-Clellen, Iglesias, Goldstein, & Bedore (2018). Bilingual-English-Spanish-
Assessment (BESA). Brooks Publishing, Baltimore, MD. Available at
https://products.brookespublishing.com/Bilingual-English-Spanish-Assessment-BESA-
P1044.aspx.
Polinsky, M. (2007). Reaching the end point and stopping midway: different scenarios in the
acquisition of Russian. Russian Linguistics, 31(2), 157-199.
Restrepo, M. A., Morgan, G.P. & Thompson, M. S. (2013). The efficacy of a vocabulary
intervention for dual-language learners with language impairment. Journal of Speech, Language
and Hearing Research, 56, 248-265.
Rimikis, S., Smiljanic, R., & Calandruccio, L. (2013). Nonnative English speaker performance
on the basic English lexicon (BEL) sentences. Journal of Speech, Language, and Hearing
Research, 56, 792–804.
Rodina, Y., & Westergaard, M. (2017). Grammatical gender in bilingual Norwegian–Russian
acquisition: The role of input and transparency. Bilingualism: Language and cognition, 20(1),
197-214.
Speakaboo (2019). Available at https://www.kentalis.nl/zoeken?query=speak+a+boo.
Squires, K. E., Lugo-Neris, M. J., Peña, E. D., Bedore, L. M., Bohman, T. M., & Gillam, R. B.
(2014). Story retelling by bilingual children with language impairments and typically developing
controls. International Journal of Language & Communication Disorders, 49(1):
Stein N. L. (1988). The development of children’s storytelling skill. In: Franklin M. B., Barten S.
S., editors. Child language: A reader. New York, NY: Oxford University Press; 1988. pp. 282–
297.
Summers, C., Bohman, T. M., Gillam, R. B., Peña, E. D., & Bedore, L. M. (2010). Bilingual
performance on nonword repetition in Spanish and English (2010). International Journal of
Language and Communication Disorders, 45(4),480-93.
Thordardottir, E. (2010). Towards evidence-based practice in language intervention for bilingual
children. Journal of Communication Disorders, 43, 523-537.
Thordardottir, E., & Brandeker, M. (2013). The effect of bilingual exposure versus language
impairment on nonword repetition and sentence imitation scores. Journal of Communication
Disorders, 46, 1-16.
Thordardottir, E. (2015). Proposed diagnostic procedures and criteria for Cost Action Studies on
Bilingual SLI. In Armon-Lotem, S., J. de Jong & N. Meir (Eds.), Methods for assessing
multilingual children: Disentangling bilingualism from language impairment. Bristol, UK:
Multilingual Matters.
Thordardottir, E., Ménard, S., Cloutier, G., Pelland-Blais, E., & Rvachew, S. (2015).
Effectiveness of monolingual L2 and bilingual language intervention for children from minority
language groups: A randomized control trial. Journal of Speech, Language and Hearing
Research, 58 (2), 287-300.
Thordardottir, E., Rothenberg, A., Rivard, M.-E., & Naves. R. (2006). Bilingual assessment:
Can overall proficiency be estimated from separate measurement of two languages? Journal of
Multilingual Communication Disorders, 4 (1), 1-21.
Thordardottir, E., & Topbas, K. (2019). The social and cultural context of intervention for
children with Developmental Language Disorder (Chapter 5). In J. Law, C. McKean, C.-A.
Murphy and E. Thordardottir (Eds.). Managing children with language impairment: Theory and
Multilingual and Multicultural Affairs Committee
25
practice across Europe and beyond. Oxon, UK: Routledge.
Tsybina, I. and A. Eriks-Brophy, Bilingual dialogic book-reading intervention for preschoolers
with slow expressive vocabulary development. Journal of Communication Disorders, 43(6), 538-
556.
Yager, L., Hellmold, N., Hyoun-A Joo, Putnam, M. T., Rossi, E., Stafford, C., & Salmons, J.
(2016). New Structural Patterns in Moribund Grammar: Case Marking in Heritage German.
Frontiers in Psychology, 6, 1-10. Available at https://doi.org/10.3389/fpsyg.2015.01716.
FAQs for Teaching in a Diverse Classroom
Group learning
Groups that consist of students who speak the language of learning and teaching (LoLT) within
the classroom and second language (L2) learners allow students to gain experience in
communicating in the second language. These groups can be organized with structured tasks
(e.g., a project) or unstructured tasks (e.g., interviews among students that target favorite
activities or other informal topics).
The group context allows L2 learners to interact with first (L1) or majority language speakers. In
this way, language exposure occurs within a task, along with allowing informal interaction
among students. Given that L2 learners’ social language skills are acquired earlier than academic
language skills, group interaction provides a positive context for social interaction. This
interaction among students link to Vygotsky’s sociocultural theory that knowledge is constructed
in interactions (Green, 2014).
Group learning increases exposure to different thinking strategies. Moreover, different
perspectives are shared, which enhances world views. In so doing, learners develop respect for
other learners’ perspectives and realize that their world views are valued too. The teacher
scaffolds the discussion so that the L2 learner is able to contribute to the task at hand. The L1
learners are able to model language structures in context, during a task/activity.
Content-based Instruction and language instruction approach
Content based instruction (CBI) is a teaching approach that focuses on learning language through
learning about information on a particular classroom topic (Cenoz, 2015; Stroller, 2008).
Learning language occurs through group interaction and discussion, rather than teacher
instruction or lecture. In this approach, steps consist of choosing a subject of interest, finding
sites with information on this subject (e.g., websites, books, videos, or images), and forming
small groups to focus on the subject. Within groups, students will be encouraged to discuss
information. The final goal is for the group to create a report or presentation. In this approach,
students are able to produce the language associated with the task while addressing a language
objective in the class. As education reflects the sociopolitical situation, it should not be taken for
granted that all students speak the same L1 or share the same culture and this must be considered
when implementing CBI (Cenoz, 2015).
Multilingual and Multicultural Affairs Committee
26
In lower grades, a content-based approach can consist of students creating a graphic presentation
(e.g., pictures or images) of the lifecycles of butterflies. The corresponding language approach
consists of verbal explanations and labels. Later, students can be asked to verbally explain the
graphic representation and guided in using connective terms to develop narrative skills (e.g.,
first, next, then).
In higher grades, topics can address science or math problems. In one high school classroom,
instruction integrated math with a functional task. The small group task required students to
calculate clothing costs given a percentage of discount. This strategy demonstrates the
integration of content and language, Genesee and Lindholm-Leary (2013) state that CBI allows
for language to be learned within meaningful contexts.
Pre-teaching of concepts is essential. The teacher can pre-teach the vocabulary or concepts so
that a foundation is created before the content-based instruction follows (Wium, 2015). This
provides all learners with an understanding, upon which new concepts can be built. Pre-teaching
is useful strategy, as diverse learners may present with different levels of competence in the
language of learning and teaching [LoLT]. Pre-teaching of vocabulary concepts benefits both
oral discussion and literacy lessons (Wium, 2015).
Create a positive learning environment
Create a positive view of diversity and differences. Tell students “good try” if errors occur,
rather than focus on errors. This will aid the students’ learning as a positive environment is
essential to eliminate anxiety and negative feelings.
Teachers should display sensitivity to diverse learners’ contributions, with barriers to learning
are avoided. The teacher can use language elicitation strategies of expansion to model language
structures. Forced alternatives also give L2 learners the choice of the target word, providing them
with the feeling of owning their response. The quality of the teacher’s feedback to a learner’s
response is important (Pascoe, Harty & le Roux, 2015) and will encourage the learner to develop
confidence her/his replies.
Classroom goals and lessons
Posting information on topics, goals, and lessons on walls, with labels presented in native
languages spoken in the classroom will enhance learning. This approach will value all languages,
making all children feel welcome and proud of their native languages, while embracing the
LoLT. It also allows the learners to hear the phonology of the different languages.
Depending on the grade of the learner, phrases in the LoLT that are on the walls will provide
support for the L2 learner when writing in the school language. Learners can also be encouraged
to have their personal word dictionaries that they make up according to the activity they are
engaged in. This will help them to be independent when these words are needed for written
activities in subsequent lessons (Moonsamy & Durbach, 2016). Provide bilingual tools in the
classroom, such as dictionaries. Picture dictionaries are available for younger aged classrooms in
Multilingual and Multicultural Affairs Committee
27
a number of different languages (e.g., Spanish, Korean, Vietnamese, and a number of other
languages).
Within the classroom, sessions devoted to the school language allow greater exposure and
experience with the second language to second language learners. During these sessions, spoken
language can be accompanied by visual supports to aid comprehension. Other sessions can be
devoted to bilingual lesson learning. Allowing students to express ideas and lesson content in the
language they chose to use. Such exchanges will support the learner in their transition into the
LoLT. This will also act to create a positive learning environment.
Code switching
Within the classroom, treat code switching as a positive way for students to communicate. This
is a device used to request help in finding a target word in a second language or a means for
creating a longer and complex sentence. “Code switching follows the ‘agreed upon’ community
rules. It occurs to enhances meaning, emphasize a shift in topic, conveys humor, ethnic solidarity
and attitude towards the listener (Owens, 2014, p.178). When assessing, note code switching and
the context (audience), as you would with non-linguistic cues. Code switching will depend on the
individual’s mastery of the two languages.
Background knowledge
It is important to not assume background knowledge. Within the diverse classroom, students
have different experiences, culture, language, and knowledge. These are factors that play an
important role in learning. Each learner brings their world view to their learning and this
experience bridges new learning with prior knowledge (Moonsamy & Durbach, 2016). Learners
who have not had a particular experience should be allowed to develop the experience, through
video clips, film and pictures.
Informal assessment of learning skills
Informal and ongoing assessment (formative assessment) allows monitoring of students’ learning
This can take place through some of the strategies described earlier: informal quizzes, or
submission of best and least learned information or material at the end of a class. Younger
students can be given a list of learning goals or topics and asked to put a plus or minus sign next
to those best or least learned. In higher grades and college classrooms, students can be provided
with sample questions for exams and quizzes to provide monitoring and ongoing assessment of
successful learning.
Universal Design for Learning (UDL)
Universal Design for Learning (UDL) addresses the variability associated with students’ learning
and the diversity found across the world’s classrooms (CAST, 2011; CAST, 2018a, 2018b,
2018c; Ralabate, 2011: Ralabate et al., 2012). UDL provides ways to remove barriers to
students’ learning for those with/without disabilities from primary school through college. UDL
also uses a formative approach to learning, based on continued assessment of students’ learning.
Multilingual and Multicultural Affairs Committee
28
In contrast, traditional approaches to learning utilize summative assessment (e.g., quizzes,
exams, and a final exam) that assesses learning at discrete points. However, a final exam is
offered too late in the academic year of a course to offer support for learners’ difficulties.
UDL guidelines provide ways for Multiple Means of Representation (multiple ways that
information can be presented), Multiple Means of Action and Expression (multiple ways that
students can act and express learning), and Multiple Means of engagement (multiple ways that
students can be engaged within a classroom) (CAST, 2011).
Multiple Means of Representation: Information can be presented in videos with text and
sound, vocabulary items and main ideas can be highlighted, verbal directions can be
presented with images and text for children who learn better through visual, auditory, or
tactile means.
Multiple Means of Action and Expression: Students are given the opportunity to share
what they have learned, to ask questions and tell stories or draw pictures about their personal
experiences, or to retell a story from a book that was read to them. They are given ways to
express their learning through the means that are available to them through verbal or other
means.
Multiple Means of Engagement: Children have different interests, cultural and language
backgrounds, and experiences. Some are shy. Awareness of these differences allows a
teacher to consider ways to engage children’s participation within the classroom. Thus,
children can be engaged through the opportunity to present through drawing, recording, or
through verbal means of engagement.
I read to the children in my classroom. Can the Universal Design for Learning help me read
successfully so that children are engaged and learn?
The following model was used in a preschool class that followed UDL guidelines. The teacher
read a book about a child who comes to school without food in his lunchbox and other children
each share a piece of food from their own lunchboxes. Before reading the story, students were
introduced to the vocabulary words used in the book (Multiple Means for Representation).
During this task, students were asked questions by use of the vocabulary words in the story: have
you have ever been surprised, shared, or forgotten something (Multiple Means for Action and
Expression and Multiple Means for Engagement). Vocabulary words were also accompanied
by pictures to demonstrate the meaning of words. In summary, vocabulary words are presented
before reading a story, children are engaged by asking questions regarding the vocabulary words
(e.g., forgotten – have you ever forgotten anything? Lost – have you ever lost anything). The goal
is to engage children to support their interest.
I teach in a high school class. How can I use the Universal Design for Learning (UDL) in my
classroom?
Multilingual and Multicultural Affairs Committee
29
The following UDL guidelines can be used in high school and college classrooms to ensure that
barriers are removed for variable and diverse learning skills.
Multiple Means of Representation: PowerPoint presentations, videos, handouts, and posts
in the classroom or on a webpage can be used to address visual and auditory learning. Posts
and discussion about goals for specific lessons in the classroom can be used, along with
consistent and frequent feedback to students on their learning skills.
Multiple Means of Action and Expression: Encourage the formation of small groups to
discuss material related to the lectures, as recommended earlier in this section. Each group
can appoint a speaker to express questions, conclusions, or issues that emerge during
discussion. Students can be asked to anonymously turn in questions at the end of a class.
This is a formative assessment approach that allows identification of students’ strengths and
weaknesses in learning and removes the anxiety associated with speaking in a classroom
(Multiple Means of Engagement).
Multiple Means for Engagement: Students can be provided with sample questions for
exams and quizzes to prepare them for the material to be studied and learned. Sample
questions from a final exam allow students to understand the scope of the classroom
learning goals. Practice quizzes can be used with questions that are similar to those in the
actual quiz to prepare students for later learning goals. The opportunity to retake a quiz can
be offered if learning requires further study, based on findings that students are able to
achieve higher scores on retakes through awareness of what they did not understand or learn.
Are there any technological apps or devices that are available for the classroom? Some of my
students have visual problems, some have difficulty with memory, and others have problems
expressing themselves.
UDL emphasizes the need for accessible information for students with disabilities (large print,
technical devices and apps, and interpreters), and multiple formats (computers or software,
graphic organizers, manipulatives, and PowerPoint). High-tech (e.g., computers, iPads, videos)
or low-tech (e.g., picture cards or alphabet boards) approaches can used within the classroom.
Computers allow enlarged text for students with visual difficulties. Students with reading
disorders can be offered text-to-speech software. Assistive features can be built into an iPad for
students who require support for visual, hearing, motor, or literacy needs. The following are
some of the technological supports that allow teachers to remove barriers for children’s learning.
Dyslexia Toolbox (www.readingrockets.org/literacyapps/dyslexia-toolbox) allows students
with dyslexia a variety of assistive technology features.
Kidspiration (www.inspiration.com/Kidspiration) is software for early grade learners that
uses pictures, text, numbers, and spoken words for vocabulary, word recognition, reading
comprehension, writing, and critical thinking skills. This software can be downloaded and
used for all areas of study.
Scene and Heard (www.therapy-box.co.uk/scene-and-heard ) is an app that can be used for
storytelling and images for those who require larger context. The app provides a
Multilingual and Multicultural Affairs Committee
30
communication book make, color coded visual timetable, and options for adding audio and
video to a program or task. This app can be downloaded to an iPad.
Smart Notebook (https://education.smarttech.com/products/notebook) allows an instructor
to create learning activities though animation. Students can use desktop computers, tablets,
laptops, or any other device to engage in and complete the activities created the instructor.
With the use of this program, classroom tasks can address a variety of topics (e.g., match,
science, shapes, language tasks, and any task chosen by the instructor).
SmartPen. (http://livescribe.com/en-us). This pen captures the audio and ties it to written
notes on special paper. The recording can then be played back with a simple touch of the
pen on the paper
ModMath (www.modmath.com ) is a free iPad app that provides students with dyslexia and
dysgraphia to solve math problems without use of a pencil.
MyTalkTools (https://mytalktools.com/dnn/) is an app for students with communication
difficulties. This app allows students to communicate by the creation of words, sounds, and
pictures.
Stop, Breathe & Think (https://app.stopbreathethink.org ) is an app that addresses the
users’ feelings and moods.
Voice Dream Reader (http://voicedream.com) is an app that benefits students with reading
disabilities and an attention-deficit/hyperactivity disorder (ADHD) is This app allows
students to highlight text which can then be read to them.
For students with an autism spectrum disorder (ASD), there a number of apps for children with
the diagnosis of autism spectrum disorder (https://educationalappstore.com/best-apps/5-best-
autism-apps-for-iphone-and-ipad).
References
Autism Spectrum Disorder sites. https://www.educationalappstore.com/best-apps/5-best-autism-
apps-for-iphone-and-ipad
American Speech-Language-Hearing Association. (2001). Guidelines for developing formative
assessment plans for implementation of new standards for the certificate of clinical competence.
Cenoz, J. (2015). Content-based instruction, and content and language integrated learning: the
same or different? Language, Culture and Curriculum. 28:1, 8-24, DOI:
10.1080/07908318.2014.1000922. http://doi.org/10.1080/07908318.2014.1000922
Council of Academic Accreditation in Auditory and Speech-Language Pathology and Council
for Clinical Certification. Available at https://caa.asha.org/resources/formative-assessment-plans.
CAST (2018a). UDL and the learning brain. Wakefield, MA: Author. Retrieved from
http://www.cast.org/our-work/publications/2018/udl-learning-brain-neuroscience.html
CAST (2018b). Understood: making an online parents' resource about learning and attention
issues. Available at http://www.cast.org/our-work/capacity-building/case-stories/understood-
making-online-parents-resource-learning-attention-issues.html# .WzOWvtVKiUk
CAST (2018c). Available at http://www.cast.org/about#.WykfLFVKiUk
CAST (2011). Universal Design for Learning Guidelines. Wakefield, MA: Author.
Retrieved from http://udlguidelines.cast.org
Dalton, E. M., Mckenzie, J. A., Kahonde, C., 2012, ‘The implementation of inclusive education
Multilingual and Multicultural Affairs Committee
31
in South Africa: Reflections arising from a workshop for teachers and therapists to introduce
Universal Design for Learning’, African Journal of Disability 1(1), Art. #13, 7 pages.
http://dx.doi. org/10.4102/ajod.v1i1.13.
Dyslexia Toolbox. http://www.readingrockets.org/literacyapps/dyslexia-toolbox
Genesee, F. & Lindholm-Leary, K. (2013). Two case studies of content-based language
education. Journal of Immersion and Content-based Language Education, 1, 3-33.
http://doi:10.1075/jicb.1.1.02gen
Green, L. (2014). Thinking students: how children and adolescents develop as thinkers. In L.
Green’s (Ed.) Schools as Thinking Communities. Pretoria: Van Schaik Publishers.
Greenberg, K. (2005). Cognitive Enrichment Advantage: teacher handbook. KCD Harris and
Associated Press.
Hartmann, E. (2015). Universal design for learning (UDL) and learners with severe support
needs. International Journal of Whole Schooling, 11(1). 54-67.
Kidspiration. http://www.inspiration.com/Kidspiration
Levey, S. (2008). Evidence-based analysis of formative assessment. Perspectives on
Issues in Higher Education, 11(1), 29-35
Levey, S., & Sola, J. (2013). Speech-language pathology students' awareness of
differences versus disorders. Contemporary Issues in Communication Sciences and Disorders,
40, I8-14
Lynch, M. (2017). 7 must have app and tools for students with learning disabilities. Available at:
https://www.thetechedvocate.org/7-must-app-andtools-students-learning-disabilities
Madrazo, G. M., Jr., & Motz, L. L. (2005). Brain research: implications to diverse learners.
Science Educator, 56-60.
Meyer A., Rose, D. H., & Gordon, D. (2014). Universal Design for Learning: Theory &
Practice. Wakefield, MA: CAST.
ModMath. http://www.modmath.com
Moonsamy, S., & Kathard, H. (2015). Speech-language Therapy in the School Context (Eds.).
Pretoria: Van Schaik Publishers.
Moonsamy, S. & Durbach, F. (2016). Language & Literacy Assessment & Support. In M. Nel,
N. Nel & A. Hugo (2nd Ed). Learner Support in a Diverse Classroom. Pretoria: Van Schaik
Publishers.
MyTalkTools. https://www.mytalktools.com/dnn
Moran, M. J. (2007). Competence and the development of technical skills. In A. M. Guilford, S.
V. Graham, & J. Scheuerle (Eds.), The speech-language pathologist: From novice to expert (pp.
77-88). Upper Saddle River, NJ: Pearson.
Owens, R. (2014). Language Disorders: A Functional Approach to Assessment and Intervention,
Sixth Edition. Boston, MA: Pearson.
Pascoe, M., Harty, M. & Le Roux, J., 2015, ‘Language, literacy and learning in the classroom’,
in S. Moonsamy & H. Kathard (Eds.), Speech-language therapy in a school context: Principles
and Practices, pp. 175–195, Van Schaik, Pretoria.
Ralabate, P. K. (2011). Universal design for learning: meeting the needs of all students. The
ASHA Leader, August 2011, 16, 14-17.
Ralabate, P., Hehir, T., Dodd, E., Grindal, T., Vue, G., Eidelman, H., Karger, J., Smith, F., &
Carlisle, A. (2012). Universal design for learning: Initiatives on the move: Understanding the
impact of the Race to the Top and ARRA funding on the promotion of universal design for
learning. Wakefield, MA: National Center on Universal Design for Learning.
Multilingual and Multicultural Affairs Committee
32
Rao, K, & Meo, G. (2016). Using universal design for learning to design standards-based
lessons. SAGE Open,6(4), 1-12.
Scene and Heard. https://www.therapy-box.co.uk/scene-and-heard
Scott, S. S., McGuire, J. M., & Foley, T. E. (2010). Universal design for instruction: a
framework for anticipating and responding to disability and other diverse learning needs in the
college classroom. Equity and Excellence in Education, 40-49.
Smart Notebook. https://education.smarttech.com/products/notebook
SmartPen. http://www.livescribe.com/en-us.
Stoller, F.L. (2008). Content-based instruction. In N. Van Deusen-Scholl & Hornberger (Ed).
Encyclopedia of language and education, vol. 4: Second and foreign language education (pp59-
70). NY: Springer.
Stop, Breathe & Think. https://app.stopbreathethink.org
Teacherswithapps (2017). Available at https://www.teacherswithapps.com/50-best-ipad-apps-
for-reading-disabilities.
United Nations Refugee Agency. Figures at a glance 2017. Retrieved from
http://www.unhcr.org/figures-at-a-glance.html Accessed in:24/10/2017
Voice Dream Reader. http://www.voicedream.com
Wium, A. (2015). Supporting teachers in emergent literacy. In S. Moonsamy & H. Kathard (Ed).
Speech-language Therapy in a School context: Principles and Practices. Pretoria: Van Schaik
Publishers.
Multilingual and Multicultural Affairs Committee
33
FAQs for Aphasia and Alzheimer’s Disease
A woman of 65 age, who was a Moroccan-English-French trilingual speaker, recently had a
Progressive Primary Aphasia (PPA). She migrated from Morocco to the USA in her 30s.
Should we look for a bilingual or trilingual speech-language pathologist (SLP) to work with
her? She lives in the USA.
If a bilingual or trilingual SLP is not available, it is essential to appoint a translator or an
interpreter whose services are professional and reliable. A translator or a family member may be
used who is trained to provide appropriate support. Interviews with the family should determine
the individual’s experience in each language, such as the age of acquisition and the level of
proficiency that has been achieved in each language. This information is essential to establish the
individual’s knowledge prior to the neural injury. In this way, it may be possible to determine the
preference of the individual being treated.
In the case of an acquired language disorder, an SLP who lacks one or more of the languages
spoken by the client, intervention in one of the individual’s languages may generalize to the
languages that are not treated (Goral, Levy, & Kastl, 2010; Kiran & Roberts, 2010; Kiran,
Sandberg, Gray, Ascenso, & Kester, 2013; Kurland & Falcon, 2011; Miertsch, Meisel, & Isel,
2009). However, the non-treated language may also interfere with the language being used in
intervention (Goral, Naghibolhosseini, & Conner, 2013; Keane & Kiran, 2015). This problem
may be determined once intervention begins.
Differential recovery may occur for the case of a neurodegenerative disease for an individual
who has acquired different languages across her life. In the case of an individual who has
acquired a Moroccan Dialect as the first language, Modern Standard Arabic as a second
language, French as a third language, and English as a fourth language, therapy in French or
English will probably help the recovery of Arabic. In the diglossic situation (when two dialects
or languages are used), there is the potential to enable a systematic investigation of recovery
patterns in between L1 (Moroccan Dialect) and L2 (Modern Standard Arabic). When languages
are close or related, cross-linguistic transfer can occur, as when a speaker applies knowledge
from one language to another. In therapy, generalizations from L2 to L3 or L3 to L4 depends on
the presence of cognates and non-cognates in the target language. Cognates are words in two
languages that share a similar meaning, spelling, and pronunciation. Cognate examples from
Spanish and English consist of accident/accidente, cause/causa, and importance/importancia. In
therapy, individuals can be made aware of cognates for understanding or learning a second
language.
Do multilinguals (speakers of more than two languages) with Progressive Primary or
Secondary Aphasia always recover the first language they learned or their most dominant
language before the aphasia better than their second or weaker language?
Differential, selective, or successive recoveries would result from problems caused by a focal
lesion in the case of progressive primary aphasia (PPA). An example of a diglossic situation can
be illustrated by Moroccan Arabic, with various spoken dialects specific to each speech
community (low or medium) and modern standard Arabic (MSA) that has formal linguistic
Multilingual and Multicultural Affairs Committee
34
variety (or "high"). Structural characteristics (e.g., syntax and semantics) are primary and allow
us to measure the relationship between the two languages spoken by the bilingual/multilingual
individual. There are languages that share many structural features, while other languages are
more distant from one another. Indeed, when both languages are structurally close, they can rely
on the same processing processes (Moroccan Arabic and Classical Arabic). This is not the case
for two languages that are more distant from one another in structure, such as English and Arabic
(Khamis-Dakwar & Froud, 2012).
Studies on language recovery in vascular and degenerative aphasia give us different conclusions.
It’s known that explicit knowledge is affected by pathologies that affect memory processing,
such as Alzheimer's disease. In contrast, a stroke allows knowledge to remain intact.
Multilingualism as a competence that is part of the “cognitive reserve” (the mind's resistance to
damage of the brain). Multilingual and polyglossic aphasia individuals contrast with those with
Alzheimer's disease. The aphasic individuals have greater explicit memory while preserving
implicit knowledge, such as the knowledge of L1 (Dakwar, Ahmar, Farah, & Froud, 2018).
Is it important to know the language history of bilingual/multilingual persons before the
aphasia to understand their aphasic symptoms?
It has been emphasized many times that it is essential to include all the patient's languages in the
assessment of his or her language skills, provided that the patient consents and collaborates
during a very lengthy investigation. In this interview, it is important to ask when the individual
acquired the language or languages that are spoken, along with the individual’s speaking
proficiency in these language or languages. An assessment in each of the languages, however,
requires the availability of appropriate, normed, validated, equivalent, and comparable tests for
each language. If the SLP lacks the individual’s languages, an interpreter or family members
may be consulted.
What are Bilingual Approaches to Intervention for Aphasia?
Given the growing number of the bilingual population across the globe, clinicians must be aware
of the factors involved in cross linguistic therapy (Ansaldo & Saidi, 2014). Centeno (2008)
presented tasks for intervention with bilinguals to address recovery that consist of cognitive
training, the use of cognates, and multi-modality stimulation through the use of speaking,
writing, and reading. Multimodality stimulation facilitates access to preserved cognitive abilities
in either language of a bilingual aphasic individual (Gil & Goral, 2004).
Lorenzen & Murray (2008) present additional intervention tasks for bilingual individuals with
aphasia: the general stimulation approach (Watamori & Sasnuma, 1976), phonemic cueing
(Roberts, de la Riva, & Rhéaume, 1997), cueing hierarchy treatment (Galvez & Hinckley, 2003),
reading and naming treatments that focus on shared aspects of languages (Kiran & Edmonds,
2004; Laganaro & Venet, 2001), cognate therapy approach (Kiran & Tuchtenhagan 2005;
Kohnert, 2004; Lalor & Kirsner, 2001; Roberts & Deslauriers, 1999), compensatory strategies
capitalizing on dual language abilities (Lorenzen & Murray, 2008), and the use of one language
to cue another (Goral, Levy, Obler, & Cohen, 2006).
Multilingual and Multicultural Affairs Committee
35
Intervention Approaches and Factors for Bilingual/Multilingual Speakers with Aphasia
Based on research, the following factors have been shown to play a positive role in intervention
relative to therapy approaches and factors that contribute to progress. Some intervention
approaches have been adapted to a variety of different languages, such as melodic intonation
therapy (MIT), while other approaches can be adapted to different language speakers, such as
MIT and Promoting Aphasics' Communication Effectiveness (PACE). In addition, the other
approaches are appropriate for all language speakers (e.g., semantic, cognitive, and restorative
approaches).
Cognates: The first area to consider in intervention for bilingual clients are cognates (e.g., “tiger”
in English and “tigre” in French). Another area of language to consider are clangs, a type of
homophone (e.g., “bell” as metal object that rings and “bel” as a word denoting beauty).
Noncognates are words that share meaning but not phonology (e.g., “butterfly” in English and
“Mariposa” in Spanish). Evidence is shown for word recognition and translation for cognates,
with generalization from the treated first language to the untreated second language only for
cognates (Kohnert, 2004). In addition, there is evidence for faster response time for cognates as
compared to noncognates in picture naming, word recognition, and word translation.
(Ansaldo & Saidi, 2014)
Cross-Linguistic Transfer: Cross-linguistic transfer of therapy effects (CLTE) are as reported
when therapy is provided in the postmorbid stronger language or when proficiency after stroke is
equivalent in both languages (Ansaldo & Saidi, 2014). Research has also shown that transfer
across languages has been found in Indo-European languages, regardless of the particular
language learned (Goral, Levy, & Kastl, 2010; Kiran & Iakupova, 2011; Kohnert, 2004;
Miertsch, Meisel, & Isel, 2009).
Semantic Intervention: Evidence shows better CLTE through the use of a semantic approach.
Semantic intervention consists of lexical semantic retrieval strategies through word recognition,
semantic association, and cueing (Kohnert, 2004). In this program, intervention begins with the
use of the client’s native language within two sessions in the first week. The second week
follows this pattern through the use of the client’s second language. A one-week interval is
scheduled between these sessions. All productions are accepted and encouraged if produced in
the first or second language learned. The words used in intervention are incorporated in both
written and spoken language. Tasks included the identification of pictures of intervention items,
matching written words with pictures, generation of semantic associations to target words (e.g.,
words with their pictured referent; generating semantic associations (rose, flower, red, smell,
garden, water), the completion of cloze tasks (She sweeps the floor with a ___________),
writing the names of dictated training words; and confrontation naming with varied levels of
cues (such as phonological cues and carrier phrases) (Kohnert, 2004, p. 299). The potential for
CLTE from the treated to the untreated language depends on the word type, the degree of
linguistic overlap between languages, the type of therapy approach, pre- and postmorbid
language proficiency, and the status of cognitive abilities (Ansaldo & Saidi, 2014, p. 1).
The Restorative Approach: The objectives of the restorative approach are to restore and improve
altered linguistic functions following the stroke. It is a set of strategies for learning, reconstructing
Multilingual and Multicultural Affairs Committee
36
the language of individuals with aphasia implemented on the basis of speech and language
assessment, as shown in Schuell’s intensive auditory stimulation approach (Schuell, Jenkins, &
Jiminez-Pabon, 1964). In this approach, the auditory modality is the foundation, with task
difficulty increased over time. Stimuli and tasks must be repeated to be effective, with adequacy
of stimulation determined by the individual’s ability to provide a response. Maximum responses
must be elicited. In addition, sessions should begin with familiar and easily accomplished tasks.
Melodic Intonation Therapy (MIT): Melodic Intonation Therapy (MIT) is a rehabilitative
procedure with a neurobehavioral rationale (Albert, Sparks, & Helm, 1973; Sparks, Helm, &
Albert, 1974; Sparks & Holland, 1976). This approach has been successful in intervention with
varied linguistic populations, such as English, Romanian, Persian, and Japanese (Seki and
Sugishita, 1983; Popovici and Mihailescu, 1992; Baker, 2000; Bonakdarpour, Eftekharzadeh, &
Ashayeri, 2003), and Italian (Cortese, Riganello, Arcuri, Pignataro, & Buglione, 2015). In
addition, MIT has been adapted to French (Van Eeckhout & Bhatt, 1984), Arabic (Al-Shdifat,
Sarsak, & Ghareeb, 2018), and other languages spoken across the world. This approach has proven
to be effective in the application to other languages. This is an essential factor, given the growing
number of immigrants and refugees across the globe and the necessity to adapt to the needs of
these populations. MIT uses a melodic and rhythmic approach in working with individuals with
non-fluent aphasia (Norton, Zipse, Marchina, & Schlaug, 2009). MIT begins with singing 2-3
syllable phrases with progress to longer utterances. Stressed syllables are sung on higher pitches,
with unaccented syllables on lower pitches. This approach begins with frequently used words (e.g.,
water) and social phrases (How are you?). MIT can be applied to various languages spoken by the
individual given intervention, taking account of stress patterns that differ across languages.
The Cognitive Approach: It is known that aphasia is frequently accompanied by deficits of
attention, short-term memory (STM) and working memory (WM), and that such memory
impairments may negatively influence language abilities and treatment outcomes. Consequently,
treating STM and WM impairments in PWA should not only remediate these memory impairments
but also play a positive role in their response to language therapy programmes (Murray, 2012). To
address attention, sessions followed a pattern of traditional language treatment (e.g., treatment
tasks progressed from matching letters to picture-word matching to matching colors and shapes
and copying and recalling designs (Lincoln & Pickersgill,1984). Findings were improved language
and nonverbal reasoning. To address working memory, 17 weeks of sentence repetition was used
in intervention (Francis, Clark, & Humphreys,2003). Intervention began with two function words
(e.g., go, had) to address auditory memory and semantic recall. The next step consisted of longer
utterances that utilized a progression to more complex stimuli.
Promoting Aphasics' Communication Effectiveness (PACE): This approach is based on the
relationship between the PWA and the clinician. Promoting Aphasics' Communication
Effectiveness (PACE) is a treatment designed to improve conversational skills. The positive aspect
of the PACE program is that it can be adapted to any language used in a bilingual therapy approach.
Given the positive effect of cognates in bilingual approaches to aphasia, the clinician can use
cognates in the use of the PACE approach. In this approach, the PWA and clinician take turns as
the message sender or receiver. Picture prompts for conversational messages are hidden from the
listener, and the speaker uses his or her choice of modalities for conveying messages (Davis &
Wilcox, 1981). The clinician is aware of the pictures used in this task, but the PWA is only aware
Multilingual and Multicultural Affairs Committee
37
of the picture that is revealed to him or her. The client can use spoken language, gesture,
pantomime, drawing, or pointing to communicate the topic within the picture. The clinician models
the various methods of communication (e.g., gesture, etc.) to provide a guide for the client.
Computer-Based and Augmentative and Alternative Communication (AAC): AAC is an approach
that involves supplementing or replacing natural communication modalities with picture
communication symbols, line drawings, Blissymbols, and tangible objects and/or manual signs,
gestures, and finger spelling. AAC includes speech-generating communication devices
(Beukelman & Mirenda, 2005). Computer-based treatment involves the use of computer
technology (e.g., touchscreen tablets) and/or software programs to target various language skills
and modalities (Kurland,Wilkins, & Stokes, 2014). Simple picture boards can also be used in
intervention, with pictures chosen by client and family to enhance communication.
Technological Approaches to Aphasia: There has been an emergence of non-invasive brain
stimulation, specifically Transcranial Magnetic Stimulation (TMS) and Transcranial Direct
Current Stimulation (tDCS), as potential treatments for post-stroke aphasia. Much remains
unknown about how these techniques cause clinical improvement or about their long-term
efficacy, side-effects, and safety (Torres, Drebing, & Hamilton, 2013). Specific treatment
protocols will vary, based on each individual’s unique language profile and communication needs
with respect of his mono-lingual, bilingual or multi-lingual status. The goal of each treatment
should be achievable and functional with an emphasis to maximize quality of life and
communication participation and success with the best generalization to daily life activities.
What are the problems with those diagnosed with Alzheimer’s Disease? Are there any
solutions to supporting these problems?
Alzheimer’s disease (AD) comprises 60–80% of all dementia cases in the world (Alzheimer’s
Association, 2015). Research has been pointing to bilingualism as a viable means for delaying or
preventing Alzheimer’s disease. Strong epidemiologic evidence has been shown individuals who
maintain an active social, mental, and physical engagement contribute against the onset of
dementia (Craik, Bialystok, & Freedman, 2010). Evidence has also shown that lifelong
bilingualism is a further factor contributing to cognitive reserve, which acts to compensate other
brain pathologies (Craik et al., 2010).
Alzheimer’s dementia presents with decline in various areas of function that include
memory/orientation, reasoning, visuospatial ability, word retrieval, and behavior changes. Most
types of dementia get worse over time and do not have a cure (Korytkowska & Obler, 2016).
However, those with dementia can be provided with opportunities to engage in activities and
social interaction (National Collaborating Centre for Mental Health, 2007). Visual and hearing
tests should be provided to assure successful interaction. Finally, augmentative approaches can
be used, such as picture boards, to assist communication.
It is important to inform caregivers that communication must be adapted to the difficulties found
in this disorder. Given slowed processing of spoken language, communication must consist of
slowed speech and simple sentences to aid comprehension (Small, Gutman, Makela, &
Hillbouse, 2003). It is also recommended that speakers repeat utterances to aid comprehension.
Multilingual and Multicultural Affairs Committee
38
In addition, yes/no questions are more effective than open-ended questions (e.g., WH questions,
such as who, what, where, and why).
References
Al-Shdifat, K.G., Sarsak, J., & Ghareeb, F. A. (2018). Exploring the efficacy of melodic
intonation therapy with Broca’s aphasia in Arabic. South African Journal of Communication
Disorders, 65(1). Available at
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6018128/pdf/SAJCD-65-567.pdf
Albert, M. L., Sparks, R. W., & Helm, N. A. (1973). Melodic intonation therapy for aphasia.
Archives of. Neurology. 29, 130-131
Alzheimer’s Association. (2015). Alzheimer’s disease facts and figures. Alzheimer’s &
Dementia, 11(3), 332.
Ansaldo, A. I., & Saidi, L. G. (2014). Aphasia therapy in the age of globalization: cross-
linguistic therapy effects in bilingual aphasia. Behavioural Neurology. Available at
https://www.researchgate.net/publication/307706935_Aphasia_Therapy_in_the_Age_of_Globali
zation_Cross-Linguistic_Therapy_Effects_in_Bilingual_Aphasia
Baker, F. A. (2000). Modifying the melodic intonation therapy program for adults with severe
non-fluent aphasia. Music Therapy. Perspectives, 18, 110-114.
Beukelman, D., & Mirenda, P. (2005). Augmentative and alternative communication.
Bonakdarpour, B., Eftekharzadeh, A., & Ashayeri, H. (2003). Melodic intonation therapy in
Persian aphasic patients. Aphasiology, 17, 75-95.
Centeno, J. G. (2008). Multidisciplinary evidence to treat bilingual individuals with aphasia.
Perspectives on Communication Disorders and Sciences in Culturally and Linguistically Diverse
(CLD) Populations.66-71.
Cortese, M. D. , Riganello, F., Arcuri, F., Pignataro, L. M., & Buglione, I. (2015). Frontiers in
Human Neuroscience. Available at
https://www.frontiersin.org/articles/10.3389/fnhum.2015.00520/full.
Craik, F. I. M., Bialystok, E., & Freedman, M. (2010). Delaying the onset of Alzheimer disease:
Bilingualism as a form of cognitive reserve. Neurology, 75(19), 1726-1729.
Dakwar, R. K., Ahmar, M., Farah, R., & Froud, K. (2018). Diglossic aphasia and the adaptation
of the Bilingual Aphasia Test to Palestinian Arabic and Modern Standard Arabic. Journal of
Neurolinguistics, 47, 131-144.
Davis, G. A., & Wilcox, M. J. (1981). Incorporating parameters of natural conversation in aphasia
treatment: PACE therapy. In R. Chapey (Ed.), Language intervention strategies in adult aphasia
(pp. 169–193). Baltimore, MD: Williams & Wilkins.
Goral, M., Levy, E. S., & Kastl, R. (2010). Cross-language treatment generalisation: A case of
trilingual aphasia. Aphasiology, 24(2), 170–187.
Francis, D. R., Clark, N., & Humphreys, G. W. (2003). The treatment of an auditory working
memory deficit and the implications for sentence comprehension abilities in mild receptive
aphasia. Aphasiology, 17, 723-750.
Galvez, A., & Hinckley, J. (2003). Transfer patterns of naming treatment in a case of bilingual
aphasia. Brain and Language, 87(1), 173-174.
Gil, M., & Goral, M. (2004). Nonparallel recovery in bilingual aphasia: Effects of language
choice, language proficiency, and
Multilingual and Multicultural Affairs Committee
39
treatment. International Journal of Bilingualism, 8, 191-219.
Goral, M., Levy, E. S., Obler, L. K., & Cohen, E. (2006). Cross-language lexical connections in
the mental lexicon: Evidence from a case of trilingual aphasia. Brain and Language, 98, 235-247
Goral, M., Naghibolhosseini, M., & Conner, P. S. (2013). Asymmetric inhibitory treatment
effects in multilingual aphasia. Cognitive Neuropsychology, 30(7–8), 564–577.
Katz, R. C., & Wertz, R. T. (1997). The efficacy of computer-provided reading treatment for
chronic aphasic adults. Journal of Speech, Language, and Hearing Research, 40(3), 493-507.
Keane, C., & Kiran, S. (2015). The nature of facilitation and interference in the multilingual
language system: Insights from treatment in a case of trilingual aphasia. Cognitive
Neuropsychology, 32(3–4), 169–194.
Khamis-Dakwar, R., & Froud, K. (2012). Aphasia, language, and culture: Arabs in the US.
Aspects of Multilingual Aphasia, 8, 275-288.
Kiran, S., & Iakupova, R, (2011). Understanding the relationship between language proficiency,
language impairment and rehabilitation: evidence from a case study. Clinical Linguistics and
Phonetics, 25(6-7), 565-583.
Kiran, S., & Edmonds, L. A. (2004). Effect of semantic naming treatment on crosslinguistic
generalization in bilingual aphasia. Brain and Language, 91(1), 75-77.
Kiran, S., & Roberts, P. M. (2010). Semantic feature analysis treatment in Spanish-English and
French English bilingual aphasia. Aphasiology, 24(2), 231–261.
Kiran, S., Sandberg, C., Gray, T., Ascenso, E., & Kester, E. (2013). Rehabilitation in bilingual
aphasia: Evidence for within- and between-language generalization. American Journal of
Speech-Language Pathology, 22(2), S298–309.
Kiran, S., & Tuchtenhagen, J. (2005). Imageability effects in normal Spanish–English bilingual
adults and in aphasia: Evidence from naming to definition and semantic priming tasks.
Aphasiology, 19(3-5), 315-327.
Korytkowska, M., & Obler, L. K. (2016). Speech-Language Pathologists (SLP) Treatment
Methods and Approaches for Alzheimer's Dementia. Perspectives of the ASHA Special Interest
Groups, 1(2). 122-128.
Kohnert, K. (2004). Cognitive and cognate-based treatments for bilingual aphasia: A case study.
Brain and Language, 91, 294-302.
Kohnert, K. (2004). Cognitive and cognate-based treatments for bilingual aphasia: a case study.
Brain and Language, 91(3). 294-302.
Kurland, J., Wilkins, A. R., & Stokes, P. (2014). iPractice: Piloting the effectiveness of a tablet-
based home practice program in aphasia treatment. Seminars in Speech and Language, 35(1), 51.
NIH Public Access.
Kurland, J., & Falcon, M. (2011). Effects of cognate status and language of therapy during
intensive semantic naming treatment in a case of severe nonfluent bilingual aphasia. Clinical
Linguistics & Phonetics, 25(6–7), 584–600.
Laganaro, M., & Overton Venet, M. (2001). Acquired alexia in multilingual aphasia and
computer-assisted treatment in both languages: Issues of generalization and transfer. Folia
Phoniatrica et Logopaedica, 53, 135-144.
Lincoln, N. B., & Pickersgill, M. J. (1984). The effectiveness of programmed instruction with
operant training in the language rehabilitation of severely aphasic patients. Behavioral
Psychotherapy, 12, 237-248.
Lorenzen, B., & Murray, L. L. (2008). Bilingual aphasia: A theoretical and clinical review.
American Journal of Speech-Language Pathology, 17, 299-317.
Multilingual and Multicultural Affairs Committee
40
Miertsch, B. J. M. Meisel, J. M., & F. Isel, F. (2009). Non-treated languages in aphasia therapy
of polyglots benefit from improvement in the treated language. Journal of Neurolinguistics,
22(2),135-150.
Murray, L. L. (2012). Direct and indirect treatment approaches for addressing short-term or
working memory deficits in aphasia. Aphasiology, 26(3-4), 317-337.
National Collaborating Centre for Mental Health (2007). Dementia: A NICE-SCIE Guideline on
Supporting People with Dementia and Their Careers in Health and Social Care. NICE Clinical
Guidelines, 42. Leicester (UK): British Psychological Society.
Andrea Norton, A., Zipse, L., Marchina, S, & Schlaug, G. (2009). Melodic intonation therapy:
shared insights on how it is done and why it might help. Annals of the New York Academy of
Science, 431–436.
Popovici, M., & Mihailescu, L. (1992). Melodic intonation in the rehabilitation of Romanian
aphasics with bucco-lingual apraxia. Romanian Journal of Neurological Psychiatry 30, 99-113.
Rau, M. T., & Fox, L. E. (2009). Treatment approaches to aphasia: Contributions of VA clinicians.
Aphasiology, 23(9), 1101-1115.
Roberts, P. M., de la Riva, J., & Rhéaume, A. (1997). Effets de l’intervention dans une langue
pour l’anomie bilingüe. Presentation at the annual Canadian Association of Speech-Language
Pathology and Audiology conference, Toronto, Canada.
Roberts, P. M., & Deslauriers, L. (1999). Picture naming of cognate and non-cognate nouns in
bilingual aphasia. Journal of Communication Disorders, 32(1) 1-22. Sparks, R., Helm, N., &
Albert, M. (1974). Aphasia rehabilitation resulting
Schuell, H., Jenkins, J. J., & Jiminez-Pabon, E. (1964). Aphasia in adults. New York: Harper &
Row.
Seki, K., & Sugishita, M. (1983). Japanese-applied melodic intonation therapy for Broca aphasia.
No to Shinkei 35, 1031-1037.
Small, J. A., Gutman, G., Makela, S., & Hillbouse, B. (2003). Interventions for persons
with Alzheimer's disease: Strategies for maintaining and enhancing communicative success.
Journal of Speech, Language, and Hearing Research, 46, 353-367.
Sparks, R., Helm, N., and Albert, M. (1974). Aphasia rehabilitation resulting from melodic
intonation therapy. Cortex, 10, 303-316.
Sparks, R. W., & Holland, A. L. (1976). Method: melodic intonation therapy for aphasia.
Journal of Speech and Hearing Disorders, 41, 287-297
Torres, J., Drebing, D., & Hamilton, R. (2013). TMS and tDCS in post-stroke aphasia: Integrating
novel treatment approaches with mechanisms of plasticity. Restorative Neurology and
Neuroscience, 31(4), 501-515.
Van Eeckhout, P., & Bhatt, P. (1984). Rythme, intonation, accentuation: la rééducation des
aphasies non-fluentes sévères. Rééducation Orthophonique, 22, 311-27.
Watamori, T., & Sasnuma, S. (1976). The recovery process of a bilingual speakers with aphasia.
Journal of Communication Disorders, 9, 157-166.