Developmental Language Disorders in A Pluralistic Society: Chapter Objectives

5
Developmental Language Disorders

in a Pluralistic Society
“My fellow Americans, we are and always will be a nation of immigrants. We were strangers
once, too. And whether our forebears were strangers who crossed the Atlantic, or the Pacific,
or the Rio Grande, we are here only because this country welcomed them in, and taught
them that to be an American is about something more than what we look like, or what our
last names are, or how we worship. What makes us Americans is our shared commitment to
an ideal—that all of us are created equal, and all of us have the chance to make of our lives
what we will.”
—Barack Obama, President of the United States, November 20, 2014
CHAPTER OBJECTIVES
Readers of this chapter will be able to do the following: do not unduly disadvantage English language learners
1. Describe the cultural considerations to bear in mind (ELLs).
when working with families from different cultural and 4. Describe intervention issues and strategies for clients
language backgrounds. with cultural and language differences.
2. List five guiding principles for evaluating language and 5. Discuss the role of the speech-language pathologist (SLP)
communication in children with cultural and linguistic in working with interpreters.
differences.
3. Identify English language measures that discriminate lan-
guage difference from language disorder and, therefore,
INTRODUCTION serve. Therefore, we need to consider general approaches

Of all the chapters in this book, this chapter is the one that to assessment, diagnosis, and treatment that will allow us to
has probably undergone the most significant revision for this fulfill our roles as speech-language pathologists (SLPs) and
new edition. Why the dramatic changes? Well, in America, as enhance child language while celebrating the diversity that
in every major Western country of the world, society has be- our multicultural society brings.
come increasingly international and multicultural. Today, There can be no doubt that the cultural composition of
our society is so pluralistic that it is impossible to encompass American society is changing. United States census forecasts
the range of cultures and backgrounds that clinicians might predict that over the next 50 years, the proportion of the US
encounter in just one chapter, so consider this an introduc- population from “minority” communities will rise from 37% to
tion to a topic that merits further inquiry. A second consid- 57% (US Census, https://www.census.gov/programs-surveys/
eration has been the proliferation of research into emerging popproj.html). Interestingly, over this period there will be
bilingualism, or the considerations that arise when children no one “majority” community, with continuing increases in
are learning more than one language, and very often the first Latino, African-American, and Asian citizens. It is also antici-
language is not the language of the mainstream culture. This pated that by the time the 2020 census is conducted, more than
body of work has highlighted both the potential advantages half of the nation’s children will come from nonwhite, non-
and possible challenges of growing up with exposure to mul- Western European, non–English-speaking backgrounds. This
tiple languages and cultural experiences. As clinicians, the proportion is expected to continue to grow so that by 2060, just
major challenge is in distinguishing a cultural or linguistic 36% of all youth younger than 18 years old will be single-race
difference from a clinically significant disorder (Norbury & non-Hispanic white, compared with 52% today.
Sparks, 2013). Thus, our goal with this chapter is to equip It is not just large urban areas that have become more di-
readers with a “toolkit” that will enable clinicians to approach verse; children from different cultural and linguistic commu-
the assessment and treatment of children from any culture nities are well represented across the nation’s school systems.
and background. In many cases, clinicians will not know a In 2006 to 2007, approximately 24% of all public school stu-
great deal about the culture and language of the clients they dents attended schools where the combined enrollment of
148
CHAPTER 5 Developmental Language Disorders in a Pluralistic Society 149
Black, Hispanic, Asian/Pacific Islander, and American Indian/ America and other Western countries because they want a
Alaska Native students was at least 75%, compared with 16% better life for themselves and for their children. Some come
of public school students in 1990 to 1991 (Planty et al., 2009), to escape civil war, or repressive or intolerant societies in
and 40% of children in American schools were from cultur- their homelands. Others want a chance to participate in our
ally and linguistically diverse backgrounds. Approximately prosperity and engage in our pursuit of happiness. However,
21.9% of children and adolescents in the United States speak the opportunity to participate in the economic and political
a language other than English in their home (US Census, freedom that our countries afford should not have to entail
https://www.census.gov/topics/population/language-use/ giving up all that was unique about the cultures from which
data.html), whereas only 6% of speech-language pathologists they came. It may be vital for young children to maintain a
(SLPs) met American Speech-Language-Hearing Association sense of cultural identity, one that includes a different lan-
(ASHA) certification as bilingual service providers (ASHA, guage, in order for them to participate in family traditions,
2016). At the time of writing, the vast majority of children communicate with grandparents and other relations, and feel
and adolescents in the United States, who speak a language a sense of belonging with their family’s community. For all of
other than English in their homes, have Spanish as their first us, the achievement of participation in mainstream life is a
language (72.3%; US Census Bureau, 2014). tug-of-war between opposing aspirations—the desire, on one
Similar trends are seen in other predominantly white, hand, to enjoy the benefits of engagement in the wider soci-
Western, English-speaking nations. For instance, in the United ety and the need, on the other hand, to maintain our cultural
Kingdom, the proportion of school-aged children learning heritages and links to our past and our roots.
English as an additional language (EAL) has increased from As clinicians, we help balance these desires by trying to pro-
7.6% in 1997 to 16.2% in 2013 (Strand, 2015). However, unlike vide access, through effective communication, to the opportu-
the US, there is no one dominant linguistic community; more nities a society has to offer without depriving clients of the
than 300 different languages are spoken by this group, who communication styles and strategies of their home cultures. A
represent cultural communities from around the world. A culturally competent clinician strives to understand the experi-
practicing SLP in the East End of London might serve a pre- ences and expectations of particular cultures, respect these, and
school classroom of 30 children, 27 of whom speak a language use this information to guide assessment and intervention prac-
other than English at home, of which there are 25 different tices. This is not always easy, especially when cultural and lin-
languages. This is the challenge that SLPs face every day—to guistic differences collide with the expectations of mainstream
appreciate the vibrant possibilities of the diversity that makes culture. The dilemmas faced in providing a culturally compe-
up our multifaceted civilization and to contribute to our clients’ tent service are illustrated in the following case study.
ability to participate in it. Appreciation entails understanding,
sensitivity, and respect for the many ways people look at the CASE STUDY
world and use communication, given their differences in cul-
José is an outgoing, energetic first grader who moved to the
ture and experience. Contributing means that we use every
United States from Mexico at the beginning of kindergarten.
tool available to ensure that all clients—regardless of cultural
He loves playing soccer with friends on the playground, chat-
background—get the most informed, most effective assessment ting in the cafeteria at lunch, and drawing during art class.
of their difficulties and the most efficient, sensitive support in Although he enjoys school and is quick to make friends, he
maximizing their potential for successful communication. often does not follow directions, has difficulty keeping up
with class discussions, and is behind in reading. The class-
room teacher notes that he is often found wandering around
THE CULTURALLY COMPETENT CLINICIAN the classroom, engaging in off-task behaviors like sharpening
ASHA (2016) defines the culturally competent clinician as his pencil. He was referred by his teacher for a speech-lan-
one who has achieved acceptance and respect for cultural dif- guage evaluation to determine whether his difficulties are
ference, continues to engage in self-assessment regarding related to a developmental language disorder (DLD). Through
an interpreter, Jose’s mother reports that he has four siblings
culture, pays careful attention to the dynamics of difference,
living at home, where they speak only Spanish. He hears
works to achieve continuous expansion of cultural knowl-
English at school, but he plays mainly with Spanish-speaking
edge and resources, and employs a variety of adaptations to friends in his neighborhood. She has never had any concern
service models. When they have achieved cultural compe- about his development, and he met all of his major develop-
tency, clinicians effectively use their cultural knowledge dur- mental milestones at about the same time as his siblings.
ing interviewing, assessment, and treatment. But what is Jose’s teacher reports that she is concerned about his speak-
culture, and how does it impact client communication? ing and listening skills, as well as his reading. Jose often
misses information she presents orally, and he is not keeping
What Is Culture? up with his peers or the curriculum. In regards to his reading,
The term culture refers to the ways of thinking, talking, un- he is not yet able to decode words, although he knows all of
derstanding, and relating to others that are characteristic of his letter names and many of the sounds that correspond.
Jose’s teacher and mother would both like to know whether
groups of people with a shared history. Cultures evolve to
he qualifies for and would benefit from special educational
serve a purpose: to make groups coherent and to preserve
services through the speech-language pathologist (SLP).
their values and beliefs over time. In general, people come to
150 SECTION I Topics in Childhood Language Disorders
Language Difference or Language Disorder? 3. Language impairment, adequate background

The previous case study underscores one of the key distinc- 4. Language impairment, limited experience
tions SLPs are asked to make: Is Jose presenting with a Distinguishing between 2 and 3 can be extremely chal-
language difference, or is his slow progress in the classroom lenging. In order to understand what profile best describes
indicative of a language disorder? You’ll remember that we a particular child, the SLP needs to gather information
defined disorder in Chapter 1 as a significant discrepancy in from a number of different sources, and almost certainly
language skills relative to what would be expected for a cli- needs to engage with family members that have different
ent’s age or developmental level. This can be very difficult cultural expectations and different levels of English lan-
to determine in Jose’s case. Should we measure his skills in guage proficiency. This may necessitate working through
Spanish? If so, do we have suitable assessments available in an interpreter or a bilingual coworker in order to commu-
Spanish, with normative data from children like Jose, who nicate effectively with families. It may also be the case
are learning two languages at the same time? Is there any- that the standardized tests of language we commonly use
one on the team who speaks Spanish, who can administer are not fit for our purposes here (Paradis, Schneider, &
these tests and interpret the results? Or should we focus Duncan, 2013a). When there are no available instruments
more on Jose’s progress in English, given that English is the in the child’s primary language, we may need to adapt the
language of instruction, and English is the current barrier materials we use or interpret our findings in a different
to academic success and social integration? The latter is way. These options are discussed in more detail as we go
very likely to reveal differences between Jose’s performance through the chapter, but it is clear that an awareness of
and that of monolingual English speakers of the same age, different cultural practices and an understanding of the
but could assessment over time suggest a problem with similarities and differences in language development in
learning that affects both languages? emerging bilinguals compared with monolingual peers is
A language difference reflects a rule-governed language essential when considering whether a child is exhibiting a
style that deviates in some way from the standard usage of language difference or disorder.
the mainstream culture, but it is not indicative of a limi- One further word of caution. There is nearly as much
tation in the capacity to learn language. In Jose’s case, the diversity within a cultural group as there is between each
difference in English usage his teacher has noted may mainstream. Knowing a little about cultural expectations
simply reflect more limited exposure to English and lim- of social communication and language can allow us to
ited exposure to “academic” English in particular. If so, we engage with families in more sensitive ways, so long as we
would anticipate that after a period of consistent expo- are careful not to stereotype anyone on the basis of cul-
sure, Jose would catch up with his monolingual peers. In tural background. In addition to the commonalities that
this case, we certainly wouldn’t want to label Jose as exist within each cultural group, some general tendencies
having a disorder, because this could cause Jose and his in communicative style are common across traditional
family considerable concern and worry. We also do not cultures. Awareness of the possibility of these differences,
want to expend costly therapy resources on children who too, can help us to be cognizant of the cultural factors
are typically developing. However, it may take between that operate when we assess and remediate communica-
4 to 6 years of exposure to reach monolingual levels tion skills in children whose cultural backgrounds and
of English language proficiency (Paradis & Jia, 2017)! perspectives diverge from our own.
Furthermore, Jose is not progressing at school, and this
could lead to difficulties farther down the line. This raises
a more general question of whether SLPs have a role in
supporting the language development of children with
language differences.
It is important to remember that some children from
culturally different backgrounds do have language disor-
ders; in fact, there is no reason to expect that prevalence
rates are different in other countries with different lan-
guages and cultures. When a language disorder is suspected
in a child from a culturally and linguistically different
(CLD) background, the SLP’s job is to provide remediation
in a culturally sensitive way. But many children from cultur-
ally different backgrounds who are referred for language
assessment do not have disorders, only limited exposure
and experience with the language of instruction. Roseberry-
McKibbin (2014) presented these possibilities as follows:
1. Typical language-learning ability, adequate experience Cultural sensitivity is needed when working with families
2. Typical language-learning ability, limited experience whose backgrounds differ from the clinician’s.
Assessment of Different English structure or unit of language is differentially represented, used,

Language Dialects or acquired within and across different dialects. Dialect univer-
Jose’s case reflects a common situation in which the child sal aspects are those in which the structure or unit of language
speaks one language at home and a different language at is similarly represented, used, or acquired within and across
school. But what about children who are English language different dialects. Oetting and colleagues illustrated these
learners (ELLs), and also speaking a different dialect of what features with reference to relevant clause usage in AAE.
has been called “standard American English?” A dialect is a Dialect-specific aspects of relative clause use included zero-
particular form of a language that is characteristic of a specific marking of subject relative clauses and the use of what in ob-
region or social group, and it is unequivocally a difference, not ject relative clauses (e.g., “Maybe there’s a crawfish in there [
a disorder. Dialects may vary from standard English with re- pinched him on the tail; I ain’t got a sister what I can fight much,”
gard to vocabulary, grammar, and phonology. The United Oetting et al., 2016, p 7). Typically developing speakers of AAE
Kingdom is famed for its rich diversity of regional dialects, overtly mark subject relative clauses at a much lower rate than
which readily identify where in the country a speaker is from, peers (86% versus 100%), but this is entirely consistent with us-
and very often their social class. These variations can at times age by adult speakers of their language. Dialect-universal aspects
make it difficult for interlocutors from different regions to of language were evident, because the children’s use of overt
understand each other, even though both are speaking English! markers varied by the syntactic function of the marker and the
The situation is not quite so stark in America, but never- humanness of the antecedent in ways that are consistent with
theless there are recognized dialects of American English, and standard American English dialect. For example, the children
the characteristics of these dialects may sometimes be inter- produced more of their [ markers in object relatives (78%)
preted as a linguistic deficit. Therefore, it is critical to know than in subject relatives (22%). Knowing the pattern of dialect-
what the differences are in order to identify typical dialectal specific and dialect-universal aspects facilitates identification of
variation from atypical features that may be indicative of children with possible language disorder even by their produc-
language disorder. Oetting, Lee, and Porter (2013) discuss tion of “contrastive” grammatical structures.
early attempts to identify contrastive and non-contrastive An advantage of this approach to assessment is that relevant
grammatical structures of non-standard dialects. Contrastive information can be obtained from language samples, which
structures vary both across and within dialects, while non- can be used to evaluate all aspects of a child’s grammatical
contrastive structures do not. Therefore, contrastive struc- system through application of coding systems such as the In-
tures can give rise to ambiguity within the decision-making dex of Productive Syntax (Scarborough, 1990). Although the
process, because it is often unclear whether the source of the scoring system was designed for standard American English
structure relates to dialect differences or is a marker for lan- speakers, it has also been shown to be appropriate for AAE
guage disorder. For example, Oetting and colleagues (2013) speakers (Oetting et al., 2010).
report that optional marking of the auxiliary “are” (e.g., In sum, children speaking non-standard dialects of AAE
“They are eating” versus “They  eating”) is a legitimate may often produce structures that are reminiscent of lan-
grammatical utterance for speakers of African American guage disorder in standard American English dialects. We
English (AAE) but is considered to be a clinical marker of must be careful not to assume that these productions are
language disorder in standard American English speakers. deviant; understanding the dialect-specific and dialect-
One option is to identify non-contrastive structures that universal patterns of use within the culture is important to
should be present in both standard and non-standard dia- distinguishing difference from disorder. Sampling these
lects. The Diagnostic Evaluation of Language Variation structures in a wide range of linguistic contexts gives a good
(DELV) (Seymour, Roeper, & deVilliers, 2005) was developed picture of whether the child’s production is consistent with
as a valid and reliable assessment that allows the clinician to expectations of his or her language community.
identify AAE speakers with language disorder regardless of
the dialect of the child. It does this by assessing performance
on non-contrastive grammatical structures, such as use of
BILINGUALISM
articles, demonstratives, locatives here and there, negation, More than half of the world’s population speaks two or more
prepositions, and pronouns. The DELV is available in both languages. There are a number of ways to conceptualize bilin-
screening and full diagnostic forms and also provides items gualism, as outlined in Box 5.1. It can be helpful to consider
that identify speech delays in AAE speakers. Based on exten- the child’s profile of bilingualism, because this gives useful
sive research of both typical and delayed development in AAE insights into the length of exposure to English in the home.
(Bland-Stewart & Pearson, 2006; Pearson, 2004), the DELV For the most part, we will be discussing ELLs, for whom the
provides clinicians with at least one tool for diagnosing lan- language spoken at home (which we will call L1) is not the
guage disorders in AAE speakers. language of the mainstream culture, or the language of in-
Oetting and colleagues (2013) extend this work to con- struction (which we will call L2, although for most readers
sider the ways in which individual grammar structures may of this book, L2 will most likely be English). In the United
present both dialect-specific and dialect-universal aspects of Kingdom, the term English as an additional language (EAL) is
language. Dialect-specific features are those in which the commonly used, emerging bilingual has also been put forward
BOX 5.1 Descriptions of Bilingualism Group means mask considerable within group heteroge-
neity, though, and children can, of course, be at different
• Simultaneous bilingualism—the acquisition of two lan- stages along the road to speaking a second language with
guages at the same time, typically with both languages in-
native-like proficiency. Consideration of English language
troduced prior to the age of 3
proficiency is important because proficiency in the language
• Sequential bilingualism—a second language introduced af-
ter age 3, at which time some level of proficiency has been of instruction is associated with academic attainment in
established in the primary language, also referred to as suc- monolingual children (Dockrell, Ricketts, Palikara, Charman, &
cessive bilingualism or second language acquisition Lindsay, 2012; Norbury et al., 2016). A handful of studies
• Dual language learners—individuals learning two languages have demonstrated that the academic attainment gap be-
simultaneously from infancy or who are learning a second tween ELLs and monolingual peers varies as a function of
language after the first language English language proficiency (Goldfeld, O’Connor, Mithen,
• English language learners (ELLs)—language minority stu- Sayers, & Brinkman, 2014; McLeod, Harrison, Whiteford, &
dents in the United States who are learning English, the Walker, 2016; Whiteside, Gooch, & Norbury, 2016). For ex-
majority language, for social integration and educational ample, Whiteside and colleagues (2016) asked class teachers
purposes
to provide ratings of English language proficiency, academic
From Paradis, Genesee, & Crago. (2011). Dual language development attainment, and social, emotional, and behavioral develop-
and disorders: A handbook on bilingualism and second language ment for 782 children learning EAL and 6,485 monolingual
learning. Baltimore: Paul H. Brookes Publishing Company children at the end of their first year of school. Data from
national education assessments were available for the same
children 2 years later (ages 6 to 7). Lower English language
as a term that puts both languages on a more even footing, proficiency at school entry was associated with greater social,
and some reports refer to children with cultural and language emotional, and behavioral difficulties and a lower likelihood
differences. There may be subtle differences in these terms, of meeting education targets at the end of the first school
but for the most part we are talking about children who are year. In addition, English language proficiency at school entry
growing up in homes where parents are fluent in L1 and significantly predicated academic attainment 2 years later.
where L2 exposure may be variable, at least until the child Furthermore, when ELLs were compared with monolingual
starts formal schooling. peers with equivalent English language proficiency scores at
school entry, they displayed fewer social, emotional, and be-
Educational Experiences of English havioral difficulties and were equally likely to meet curricu-
Language Learners lum targets in the first school year, and were actually more
We start with education because this is the point at which likely to meet curriculum targets 2 years later! ELLs who were
differences in English language proficiency may become underachieving initially were also more likely to make greater
more noticeable to individuals outside of the child’s family, academic progress over the 2-year period, relative to mono-
and where these differences begin to impact on children’s lingual peers with comparable English language proficiency
social and educational experiences. One puzzle for practitio- at intake.
ners and researchers alike is that although there are many These findings demonstrate that exposure to more than
documented advantages to bilingualism (not least the super one language certainly doesn’t hinder and may even enhance
advantage of being able to speak more than one language!) academic performance, provided children have a level of
(Engel de Abreu, Cruz-Santos, Tourinho, Martin, & Bialystok, English language competence sufficient to access the school
2012; Yow et al., 2017), as a group, children exposed to lan- curriculum. Therefore, it is important to encourage families
guages other than English (or the language of instruction in to continue to provide rich interactions and experiences in
other non-English speaking countries) score more poorly on their first language. At the same time, findings from this study
state administered measures of academic attainment (Strand, suggest that boosting English language proficiency at school
2015) and are more likely to be referred for special educa- improves social, emotional, and behavioral development and
tional needs concerns (Lindsay & Strand, 2016). These disad- reduces the attainment gap between children learning ELLs
vantages are most pronounced in the early years and slowly and their monolingual peers.
attenuate over time. For example, Strand (2015) examined Parents, teachers, and clinicians alike often wonder how
the UK National Pupil Database and reported that only 63% long it will take children to become fully proficient in a sec-
of ELLs met curriculum targets at age 5 compared to 73% of ond language. But what do we mean by proficiency? Consider
monolingual children. In contrast, at 16 years old, there was Jose, who has been learning English for at least a year.
no significant difference between ELLs and monolingual Because of his young age, his parents and teachers may be
peers in the number of core exams achieving A to C grades expecting Jose to acquire English at an incredibly rapid rate.
(60.9% versus 58.3%). It is likely that improvements in aca- Clearly, Jose has learned a great deal of English, as evidenced
demic attainment mirror improvements in English language by his ability to interact on the playground and in the cafete-
proficiency for these pupils; longitudinal studies have dem- ria. Yet Jose’s teacher notes that his English language skills
onstrated that it can take typical ELLs 7 years or more of full are not yet comparable to those of other first graders, and he
time education to master English (Paradis & Jia, 2017). is having difficulty in reading and class discussions. When
considering how long it might take for Jose to become fully

proficient in English, it is helpful to make a distinction be-
tween Conversational Informal Language Fluency (CILF)
and Formal Academic Language Fluency (FALF; Roseberry-
McKibbin, 2014), because these two categories of language
proficiency follow different timelines.
CILF refers to context-embedded oral language that is
used in casual, informal conversation. The language Jose uses
on the playground to negotiate team membership or in the
cafeteria to request pizza instead of a hamburger would be
considered CILF. CILF is the language of social interactions
that occur in the here-and-now where both speakers have
access to real-world situational cues. FALF refers to the for-
mal oral and written language competencies that are the cur-
rency of academic learning and expression. FALF requires the Speech-language pathologists (SLPs) often have clients from
cultural backgrounds different from their own.
speaker to operate in context-reduced conditions, where a
reality is not shared by the speakers and there are no extra-
linguistic cues to support meaning making. In Jose’s first- is family-centered. This practice involves helping families to
grade classroom, a discussion of the ancient pyramids and identify concerns, priorities, and resources for their child and
how they were made would require FALF. Without full FALF, including them as integral members of the intervention team
students may struggle to keep up with the reading and writ- (Donahue-Kilburg, 1993; Hidecker et al., 2009; Pedersen &
ing demands in the classroom, even if they demonstrate ad- Vining, 2009). Family-centered practice with families whose
equate CILF. cultural background differs from our own operates on ex-
Proficiency in CILF is generally found to take less time to actly the same principles. We must respect the concerns and
acquire than academic language, or FALF, although the actual priorities of families whose experiences and values diverge
amount of time can vary between children depending on a from ours, just as we do those of families whose beliefs are
variety of factors. Initially, it was estimated that CILF was more familiar to us. As both Hwa-Foerlich and Westby
acquired in 2 to 3 years and FALF in 5 to 7 years of exposure (2003) and Peña and Fiestas (2009) pointed out, differences
to a second language (Cummins et al., 2006). More recent in beliefs and values about learning, parenting, and disabili-
work has shown that the timeframe for acquisition of a sec- ties can lead to confusion and misunderstanding. Therefore,
ond language varies across children depending on a variety of we need to be aware of how our own assumptions and expec-
factors. In a review of these factors, Paradis (2016) reported tations affect our interactions with CLD families (Kohnert,
that sources of this variation include children’s age at the 2008). Goldstein and Iglesias (2006) and Roseberry-McKibben
beginning of the exposure to a second language, with older (2008) suggested the strategies for culturally sensitive family-
children developing English language proficiency more rap- centered practice that are summarized in Box 5.2.
idly than children exposed to English at a younger are. Other A critical question that many families ask is: “Should we
factors include maternal education, characteristics of the L1, be speaking English at home?” This is an easy question to
and richness of the linguistic environment. These factors are answer: Parents should speak the language they speak most
considered in the next section. fluently and which eases communication. An impressive
In Jose’s case, the task at hand is to determine whether or body of work by Paradis and colleagues (Paradis, 2016; Para-
not his difficulty with oral and written linguistic tasks relying dis & Jia, 2017; Paradis & Kirova, 2014) demonstrates that
on FALF is a result of a language-learning disorder. It is pos- language input is critical to growth in English language pro-
sible that Jose has developed some competence in CILF but is ficiency during the early school years but perhaps not in the
yet to fully develop FALF due to inadequate exposure. It is way you might think. English use at home is not a strong
also possible that a language-learning disorder is inhibiting predictor of growth in English language proficiency, largely
his acquisition of FALF in both his native language and the because many parents (particular mothers) may not be fluent
English of his classroom. To resolve this uncertainty, clini- English speakers themselves (Paradis & Kirova, 2014). Like
cians need to gather information from families if possible, monolingual children, maternal education is a significant
assess the child’s first language competence using appropri- predictor of English language development in children from
ately translated and normed instruments, and/or gather in- different cultural and linguistic backgrounds. However, in
formation about the child’s English language proficiency. The this work, maternal education was also associated with moth-
following sections cover each of these options in more detail. ers choosing to speak L1 to their children at home. Paradis
and colleagues argue that it is the richness of language use
and the quality of parent-child interaction in general, rather
WORKING WITH FAMILIES than the quantity of English words and grammar to which
As we see in the following chapters about working with the child is exposed, that has the greatest impact on child
young children, the best practice in child language disorders language development, in any situation. Further reassurance
BOX 5.2 Strategies for Developing

Obtaining Interview Data
Culturally Sensitive Family-Centered Just as we need to gather data on hearing, speech-motor, and
Practice nonverbal skills for every client suspected of a language dis-
order, we need to gather these data on children with CLD,
Be sure family members (and in many families, family mem- obtaining information about a child’s medical, language,
bers other than parents will be involved) understand the
feeding, and developmental and language history regarding
purpose of each assessment or intervention session.
Attempt to involve family members in making decisions about
both the child and other family members (Pruitt et al., 2010);
assessment methods and interpretation, intervention tar- interviewing parents about current skills in communication
gets and procedures, and so on. and related areas; and finding out about family concerns and
Match assessment and intervention goals to family priorities. priorities are important parts of the assessment for each child
Allow ample time for questions after each session, and be we see. For the CLD child, however, these tasks become more
prepared to answer the same question different ways for complicated, because the SLP and the client’s parents may
different family members if necessary. not speak the same language. One solution to this problem is
Research the language and culture of each client (using to employ interpreters or bilingual coworkers.
sources like those cited in this chapter) to make use of Bilingual individuals can often interpret between clini-
culturally appropriate practices. cians and parents, giving the clinician access to crucial infor-
Team up with people from the cultural community who can
mation about clients. Not everyone who is bilingual can be an
act as both language and cultural interpreters.
Read about the family’s culture.
interpreter, though. Interpreting for clinical purposes re-
Visit student homes. quires special skills. Kayser (1991) suggested that interpreters
Consider family value systems when setting goals; for ex- need to have at least a high school education, an ability to
ample, independence is highly valued in our culture, relate to people with disabilities, and strong linguistic and
even for young children. Families from more traditional literacy skills in both languages. They should be able to say
cultures may not think young children need to be inde- things in different ways and retain chunks of information
pendent and may reject intervention that aims to in- while interpreting. Lynch and Hanson (2004b) point out that
crease independence, such as using a remote switch for the interpreter needs to be able not only to translate from one
a young physically handicapped child to turn on the TV language to another but also to interpret cultural cues and
himself. convey the nonverbal aspects of the message, as well as its
Invite students to share aspects of their culture with other
words. Interpreters also need to have good command of
students.
Learn some basic communication (simple phrases, common
medical and educational vocabulary and be able to rephrase
words) in the student’s home language. terms for parents. They must be trained to maintain confiden-
Learn to pronounce students’ and family members’ names as tiality and neutrality. Langdon (2002) advocates following
they are pronounced in the home language, not as they are a three-step process that includes briefing, interaction, and
“Americanized.” debriefing (BID) in preparing interpreters for a session. This
process is summarized in Box 5.3. ASHA (2014) recom-
Based on Goldstein, B., & Iglesias, A. (2006). Issues of cultural and
linguistic diversity. In R. Paul & P. Cascella (Eds.): Introduction to
mended using professional interpreters from language banks,
clinical methods in communication disorders (2nd ed., pp. 261-280.) bilingual professional staff from other disciplines, or bilingual
Baltimore: Paul H. Brookes; Roseberry-McKibbin, C. (2008). Multi- teachers’ aides or paraprofessionals as interpreters. In excep-
cultural students with special language needs. Oceanside, CA: tional circumstances a family member or close friend may
Academic Communication Associates. need to interpret, perhaps because of family preference or
BOX 5.3 Langdon’s Briefing, Interaction,

comes from studies of simultaneous bilinguals, or children and Debriefing Process for Working with
exposed to two languages from birth, who present with lan- Interpreters
guage disorder. Again, research consistently demonstrates
that exposure to two languages from birth does not make Briefing: Clinician and interpreter review client’s background
information and outline the purpose of the session.
language disorder more severe, nor does the presence of
Interaction: Each team member addresses the client or family
language disorder make learning two languages impossible
when speaking, even when through the interpreter (“Are
(Paradis & Kirova, 2014). Some might even argue that you . . . ” rather than, “Ask Ms. X if she . . . ”). The clinician
exposure to two languages might be a protective factor, in must always be present with the interpreter, to monitor
that bilingualism might “tune” attention or executive control task presentation and client/family reactions.
processes (cf. Yow et al., 2017). Benefits to children with lan- Debriefing: Clinician and interpreter review the session and
guage disorder have yet to be reported, but it is clear that develop a follow-up plan. Clinician should give interpreter
exposure to two languages does no harm. Thus, we should feedback on performance and seek interpreter’s impres-
encourage rich, fun, and rewarding communication between sions of client/family responses.
parents and children, in whatever language they find most Langdon, H. (2002). Language interpreters and translators. ASHA
comfortable. Leader, 7(6), 14-16.
because even after considerable effort a suitable professional measures of English language proficiency (expressive gram-
interpreter cannot be found. However, ASHA reminds us that mar, narrative macrostructure, and non-word repetition).
this situation may represent a conflict of interest, and as such More examples of questions to use in discussion with family
the reliability of the interpretation, transliteration, and/or (either through interview or questionnaire) can be found at
translation may be compromised. This may be especially true the Leaders Project (http://www.leadersproject.org/2013/03/01/
in high stakes situations, such as mediation, evaluations, or assessment-materials-parent-interviews/). Delayed early lan-
situations where cognitive capacity might be in question. guage milestones (particularly L1) and a positive family history
Furthermore, children are unlikely to possess the emotional should be seen as important “red flags” for language disorder,
maturity and sensitivity necessary to provide translation to as opposed to difference.
family members, particularly regarding the provision of ser-
vices. ASHA guidelines for working with interpreters can be ASSESSING CULTURALLY AND
found at: http://www.asha.org/PRPSpecificTopic.aspx?folderid=
8589935334
LINGUISTICALLY DIFFERENT CHILDREN
Interpreters function essentially as paraprofessionals un- Children with CLD may be both under-represented and
der the direction of the SLP, with the clinician maintaining over-represented on the caseloads of SLPs (Bedore & Peña,
responsibility for decisions in assessment and intervention. It 2008). Language disorder may be under-identified in ELLs,
is important, however, that they understand the rationale and because practitioners may attribute poor language to the
procedures being used in the interview and that time is spent process of acquiring an additional language and thus may
with them before the parent conference discussing the infor- wait for children to become proficient in English before
mation the clinician hopes to obtain. They can be asked to language impairment is diagnosed (Bedore & Peña, 2008;
review the clinician’s questions for cultural appropriateness Paradis, Schneider, & Duncan, 2013a). As noted by Paradis,
and to help find alternative ways to get information that Schneider, and Duncan (2013a), this delay in diagnosis means
families may be uncomfortable giving. that those children with CLD who really do have an underly-
Family interviews are an excellent way for the clinician to ing language disorder will not receive the support they need
get a really good picture of what daily life is like, what is im- until they are older, if at all. As noted, Demie (2013) esti-
portant to the family, and what key contexts and people are mated that it takes 5 to 7 years for a child with CLD to
involved in the child’s life (Westby, 1990). This information become fully fluent in English, to the extent that they can
will be vital in formulating a plan for intervention. Such in- engage with a curriculum delivered in English without any
terviews can also serve to start probing the child’s language additional support. Furthermore, Paradis and Jia (2017) esti-
and communication skills in L1, and any associated behaviors mated that it takes typically developing children with CLD
(including nonverbal communication behaviors, such as ges- between 4 to 6 years of English exposure to perform within
ture) that may indicate an underlying language disorder. monolingual norms on English language measures. For a
Westby (1986) suggested that a good interview question to child with language disorder, this is a very long time to wait
begin with in obtaining history information on CLD clients for intervention, especially given the impact of language
is: “Is this child like your other children or different in some deficits on social inclusion and academic attainment.
way?” Interpreters translating parents’ answer to such a ques- However, over-identification of language disorder in chil-
tion should understand and have discussed with the clinician dren with CLD is also possible. One reason is that typically
the kinds of differences that will contribute to a decision developing children who are in the process of learning Eng-
about a language disorder so that these can be reliably con- lish often make errors characteristic of monolingual, English-
veyed to the clinician. speaking children with language disorder, particularly with
Questionnaires are also a useful means of gathering infor- inflectional morphology to mark grammatical tense (Paradis,
mation about the child’s early developmental milestones, any 2005; Paradis, Rice, Crago, & Marquis, 2008). Another reason
family history of language, learning or literacy difficulties, the for over-identification is an over-reliance on standardized
child’s current proficiency in L1, the family’s use of L1 and L2 tests that are often plagued by biases that reduce their validity
in the home (with whom and for what purposes), and the for assessing these children fairly. Qi (2006) pointed out that
child’s behavior, interests, and activity patterns (Paradis, children from CLD backgrounds often score lower on stan-
Schneider, & Zdorenko, 2011). The questionnaire developed dardized tests because they are unfamiliar with test-taking
by Paradis and colleagues is available for use from their situations or lack experience with the concepts and knowl-
website (Paradis et al., 2011) and has been extensively used edge contained in the standardized tests. It may seem less of
in research (https://www.ualberta.ca/linguistics/cheslcentre/ a problem to over-identify children, because at least it means
identifying-language-impairment-in-esl). In general, CLD they are getting support for English language learning. How-
children with language disorder obtain lower scores in all ever, over-identification is an issue because it puts unneces-
domains relative to CLD children who are typically develop- sary further strain on speech and language services (Hasson,
ing. Although the questionnaire on its own is insufficient to Camilleri, Jones, Smith, & Dodd, 2013) and may cause undue
make a clinical diagnosis (see also Tuller, 2015), Paradis and worry in parents about their child’s development.
colleagues (2013a) reported improved diagnostic discrimina- ASHA’s Issues Brief on CLD Students (2006; Appendix 5.1)
tion when the questionnaire was used in conjunction with indicates that the prevalence of communication disorders in
CLD populations should be no higher than in English-only requires sensitivity to pragmatic, experiential, and dialectical
populations (around 7%; see also Kohnert, 2010) and the In- differences that must be evaluated before deciding whether a
dividuals with Disabilities Education Act (IDEA) makes pro- disorder is present. It is also possible that a child can be
visions for ensuring that over-identification of minority pop- English-dominant and still have a culturally different com-
ulations is not occurring in the schools. Nevertheless, the munication style. At best, standardized tests of English can
misdiagnosis of children with CLD highlights uncertainty rule out disorder if the child scores within the expected
concerning when to refer children with CLD and how to iden- range. If a child obtains a poor score, however, this is in no
tify those with language disorder (Bedore & Peña, 2008). In- way sufficient evidence of disorder. That is because the lan-
terviews and questionnaires completed by SLPs from the UK, guage of ELLs shares many features of monolingual DLD, as
the US, and Australia have indicated that they have limited we saw earlier. In addition, the degree of language dominance
resources to appropriately assess ELLs and identify those who may depend on a number of factors, including the task or test
have an underlying language disorder (Caesar & Kohler, 2007; materials, the testing environment (home or school), and the
Mennen & Stansfield, 2006; Williams & McLeod, 2012). As language skills of the examiner, as well as the abilities of the
such, children with EAL are at high risk for misdiagnosis of child in either language (Kohnert, 2013). For these reasons,
language disorder (Bedore & Peña, 2008; Kohnert, Windsor, & Kohnert (2013) advises that we think of language dominance
Ebert, 2009; Paradis, 2010). as a continuum, rather than an either/or profile. Further-
more, as discussed in Chapter 2, standardized tests do not
Establishing Language Dominance provide all the information we need to answer these ques-
As a first step toward determining whether there is a language tions in a CLD child, just as they do not for any other child.
difference or disorder, we need to identify the child’s domi- Particularly for the CLD child, however, standardized mea-
nant language. That is, we need to determine whether the sures should be supplemented with criterion-referenced and
child’s primary language is English or some other language. other nonstandardized information to obtain a full picture of
The reason that establishing language dominance is impor- the child’s communication skills.
tant concerns our responsibility to do least-biased assess- It is generally recommended that language disorder is only
ment. The IDEA (Part B)—the federal law that guarantees a diagnosed in children with CLD following assessment in
free, appropriate public education in the least restrictive both languages, preferably using measures that are normed
setting to every child regardless of handicapping condition— on bilingual children (Bedore & Peña, 2008; Kohnert, 2013;
requires that testing be provided in the language or other Paradis, Emmerzael, & Duncan, 2010). One reason is that
mode of communication in which a child is most proficient. language knowledge is distributed across the languages chil-
If we only test a CLD child in English, all we may find out is dren speak (Kan & Kohnert, 2005; Peña, Bedore, & Zlatic-
that he or she has less proficient English skills. We won’t Giunta, 2002), thus assessment in both languages leads to a
know whether the child really has a language disorder or better understanding of a bilingual child’s overall language
simply hasn’t yet had the opportunity to develop proficiency ability (Paradis et al., 2010) than assessment of only one of
in English. IDEA regulations issued in 2006 emphasize that the child’s languages. Naturally, if English is not the more
evaluation of CLD students does not necessarily need to in- dominant language, scores in English will be lower than those
clude standardized testing, but must take place “in the form in the dominant language, but comparing performance in the
most likely to yield accurate information on what the child two gives the clinician an idea of whether the child is pro-
knows and can do academically, developmentally, and func- gressing adequately for age in the home language and where
tionally.” Although this does not necessarily mean that assess- gaps in English proficiency are found. Moreover, as an under-
ment must be administered in the home language, it does lying language disorder should manifest in both languages of
mean that we need know whether the home language or Eng- a bilingual child, dual language assessment helps practitio-
lish is the child’s stronger communication modality in order ners to distinguish whether language difficulties experienced
to decide which will yield the most valid information. in one language likely go beyond limited exposure to a more
Kayser (1995) provided some suggestions for establishing fundamental deficit in language learning (Bedore & Peña,
language dominance in CLD children. Observation is one 2008; Paradis et al., 2010). As Appendix 5.2 shows, there are a
method. Here the clinician would observe the child in the variety of tests available in a range of languages for children
classroom and in less formal settings, such as the lunchroom with CLD, but particularly for use with Spanish-English bi-
or playground, and chart communicative behaviors in each. lingual children (e.g., Bedore, Peña, Gillam, & Ho, 2010;
Heavy reliance on gestures in situations requiring English or Lugo-Neris, Peña, Bedore, & Gillam, 2015; Peña, Bedore, &
a preponderance of the home language in informal situations Kester, 2016). If the clinician has a child who is dominant in
would suggest that English is not dominant for this child. one of these languages on the caseload, testing may be carried
(Note: It also tells you something about the integrity of the out by a trained native speaking paraprofessional or speech
child’s social communication competencies!) A second assistant who can report results to the SLP for interpretation.
method is the use of structured questionnaires to assess lan- Nevertheless, there are many contexts in which standard-
guage dominance. ized assessment in two languages may not be possible, as in
If English is found to be the dominant language, testing many large, culturally diverse cities. For example, in London
in English can proceed, but with caution! Testing in English over 300 different languages are spoken by school-aged
children (NALDIC, https://naldic.org.uk/the-eal-learner/ performance on different aspects of language for typically

research-and-statistics/). In these contexts, language assess- developing ELLs relative to monolingual typically developing
ments are simply not available for all the languages repre- peers. Comparison of these two groups allows us to identify
sented, nor are there sufficient SLPs, interpreters, or bilinguals tests that maybe biased against children with CLD, and thus
coworkers to administer or interpret the results. Moreover, may over-estimate language disorder in this population. We
where assessment measures are available in different lan- then consider performance of typically developing ELLs ver-
guages, they are almost always normed on monolingual sus those with known or suspected language disorder. This
children (Bedore & Peña, 2008) and thus may over identify comparison allows us to identify English language instru-
children growing up as emerging bilinguals. For these rea- ments that may be particularly sensitive to identification of
sons, many SLPs may continue to rely on standardized, children with possible underlying DLD. Finally, direct com-
monolingual-normed English languages tests when assessing parisons of ELLs with DLD and monolingual children with
children with CLD, despite recommendations against this DLD are fairly rare, but this comparison allows us to establish
approach (Caesar & Kohler, 2007; Williams & McLeod, 2012). whether there are particular language constructs that may be
We’ll talk later about the profiles of English language strength especially challenging for bilingual children with language
and deficit that may indicate language disorder, but once disorder. Remember, though, that scores on tests are merely
again, use of standardized measures with this population signposts, and consideration should be given to other indica-
should always be supplemented with other nonstandardized tors, such as parent report and evidence of functional impact.
information to obtain a full picture of the child’s communi- Vocabulary. Vocabulary knowledge can be extremely vari-
cation skills and needs. able within ELLs, just as it is for monolingual language learn-
ers. However, Bialystok and colleagues (2010) reported that
Assessment in L1 even those ELLs who are fluent in English typically perform
Using Standardized Tests with Culturally more poorly than monolingual peers on standardized tests of
and Linguistically Different Children receptive vocabulary, and that this gap persists throughout
When assessing CLD children’s communication in L1 and L2 childhood. Consistent with this, both Boerma, Leseman,
(English), we have basically the same methods available as Timmermeister, Wijnen, and Blom (2016) and Thordardottir
discussed in Chapter 2—standardized tests, developmental and Brandeker (2013) found that although typically develop-
scales, criterion-referenced procedures, dynamic assessment, ing bilingual children outperformed bilingual peers with
and behavioral observation. All of these methods are valuable language impairment on a measure of receptive vocabulary,
to us when assessing children with CLD. We must be cautious they performed comparably to monolingual children with
about the potential of standardized tests alone to identify language disorder. Furthermore, in a cross-sectional study of
high numbers of false-positives, or children who obtain lower children 6, 7, and 8 years old, Verhoeven and colleagues
than expected scores on the test despite the fact that they do (2011) found that measures of receptive and expressive vo-
not have an underlying language impairment. Thus, when cabulary did not discriminate between bilingual children
children with CLD obtain a low score on a standardized test, with language disorder and typically developing bilingual
we must ask whether the child’s language performance: peers at 6 and 7 years old.
• Is considered below expected levels by the individual’s One issue with using vocabulary measures diagnostically
cultural community is that dual language learners frequently have distributed
• Operates outside the norms of acceptability for that com- vocabulary; in other words, vocabulary in either language is
munity smaller than the vocabulary of a monolingual child, but
• Calls attention to itself or interferes with communication when the two languages are combined, total vocabulary
within that community equals or exceeds that of monolingual children (Cote &
• Results in functional impairments for the client Bornstein, 2014). For this reason, knowledge of vocabulary in
If so, a language disorder is more likely to exist (Paradis, both languages is particularly important (Peña, Bedore, &
2016). Let’s consider now what profile of skill and deficit Kester, 2016). Nevertheless, English vocabulary measures can
on English language assessment has been associated with be helpful in identifying lexical-semantic gaps, and this infor-
language disorder in children with CLD. mation can be used in planning intervention or education
supports.
Using English Language Assessments: Patterns Syntax and grammar. Acquisition of English morphology
of Performance in Emerging Bilinguals with shows the slowest growth in ELLs. In fact, morphology use by
and without Developmental Language Disorder ELLs may still be lagging behind monolingual peers 61⁄2 years
One of the challenges of using standardized English language after first exposure to English (Paradis & Kirova, 2014;
measures with children with CLD is that ELLs very often have Paradis, 2016). As a result, many syntactic errors mimic those
asynchronous patterns of English language proficiency (Par- seen in DLD. For example, ELLs tend to produce more general
adis, 2016) and that when they make errors, their errors all purpose (GAP) verbs, such as “she’s doing paper” meaning
very often mimic the sorts of deficits evident in the language “she’s cutting the paper” and tend to omit grammatical mor-
profiles of monolingual children with DLD (Kohnert, 2013). phemes. Although length of exposure to English does not
In the sections that follow, we first consider the profile of always predict proficiency in English morphosyntax, the type
of language that constitutes L1 can make a difference. For BOX 5.4 Narrative Genre Descriptions
instance, Blom, Paradis, and Duncan (2012) reported that
Recast/recount: Retells events and experiences from the
children with first languages with rich verb inflections devel-
past, with sequential chronology and consistent point of
oped proficiency with English morphosyntax more rapidly
view. Example: Summarizing a section of a textbook.
than children exposed to isolating languages, such as Canton- Event cast: Verbal replies or explications of activities or proce-
ese. Once again, however, attention to error patterns can be dures that are currently being done or are planned. Exam-
informative. Typically developing ELLs are likely to over- ple: Telling how to bake a pie, explaining what will happen
regularize irregular verbs (“he goed to the park”), whereas on a field trip.
ELLs with learning disability do not (Paradis, 2016). Also, Account: Shares an experience. Example: Telling about your
length of exposure to English does not predict proficiency in vacation.
ELLs with learning disability as it does in typical learners Story: Fictional account of people (or animals or inanimate
(Paradis, 2016), resulting in slower growth and more persis- objects that take on human characteristics) who must over-
tent deficits (Whiteside & Norbury, 2017). Furthermore, come some problem that has social or moral significance to
the culture. Example: The Three Little Pigs.
ELLs with DLD demonstrate limited carry-over of learned
skills from L1 to L2. These findings suggest that difficulty Adapted from Goldstein, B. (2000). Cultural and linguistic diversity
making use of language input may be a signature of language resource guide for speech-language pathology. San Diego: Singular
disorder in children with CLD, as it is in monolingual Publishing Group; Heath, S. (1986). Taking a cross-cultural look at
narratives. Topics in Languages Disorders, 7(1), 84-94; Kayser,
children with DLD. It also suggests that explicit instruction H. (2002). Bilingual language development and language disorders.
in English grammar will be a cornerstone of intervention In D. E. Battle (Ed.): Communication disorders in multicultural popu-
programs. lations (3rd ed., pp. 114-157). Boston: Butterworth-Heinemann.
Sentence repetition. Sentence repetition has been identi-
fied as a potential nonbiased measure of language in bilingual
children, and, as we have seen, is sensitive to language disor- to produce each genre. Goldstein (2000) and Heath (1986)
der in monolingual children (Conti-Ramsden, Botting, & described four basic narrative genres: recasts/recounts, event
Faragher, 2001; Riches, 2012) and is included as a measure of casts, accounts, and stories. Descriptions of each type are
expressive grammar in most diagnostic batteries, including summarized in Box 5.4.
Tomblin and colleagues (1997). Monolingual and bilingual These genres are used for different purposes and to differ-
children with DLD show comparably impaired sentence rep- ent degrees in high- and low-context cultures. High-context,
etition accuracy (Thordardottir & Brandeker, 2013; Tsimpli, traditional cultures expect children to use recast/recounts to
Peristeri, & Andreou, 2016). However, typically developing retell events with extensive verbal imitation, role-playing, and
bilingual children also often show deficits in sentence repeti- use of present tense. Low-context cultures, such as those of
tion accuracy relative to typically developing monolingual the classroom, use them to summarize succinctly, using past
peers (Komeili & Marshall, 2013a; Polišenská, Chiat, & Roy, tense. Event casts are used frequently in low-context cultures
2015; Whiteside & Norbury, 2017). Thus, sentence repetition to explain activities or series of events that are being planned
measures may over-identify language impairment in bilin- or will take place in the future. They are very prone to meta-
gual children, particularly as success on this test is heavily linguistic or metacognitive commentaries, in which the
dependent on knowledge of English morphosyntax and lexi- speaker talks about the language being used or thinks out loud
cal phonology (Polišenská et al., 2015). However, typically about how best to convey the ideas. These types of narratives
developing bilingual children differ from both monolingual are used often in classroom communication but are rarely
and bilingual children with language disorder in their sen- expected of children in high-context, traditional cultures. Ac-
tence repetition error patterns (Komeili & Marshall, 2013b; counts are used in both high- and low-context cultures to
Meir, Walters, & Armon-Lotem, 2015). Those with language share experiences. Low-context cultures require that they have
disorder tend to omit function words or grammatical tense a predictable progression of events so that the listener can
markers, whereas typical ELL error patterns included addi- anticipate what is coming. In low-context situations in which
tions and substitutions of function words. Thus, with careful these narratives are used, such as the show-and-tell situation
analysis of error patterns, sentence repetition tasks may dis- in school, accounts are judged by not only their truth value
tinguish typically developing ELLs from those with potential but also by their degree of organization. In high-context cul-
language disorder. tures, less stress is on organization. Stories are used by both
Narrative. Narratives differ from conversation in that high- and low-context cultures, but they differ across cultures
they are monologues that are tied into cohesive units by in terms of their internal organization and focus. Although
linguistic markers and thematic unity. Like conversation, most cultures expect children to listen to stories, cultures dif-
narratives are important communicative structures used by fer in the degree to which children are expected to tell stories.
all cultures to accomplish specific communicative purposes. In some traditional high-context cultures, only elders or oth-
High- and low-context cultures differ in narrative style, ers with high status are expected to be storytellers.
though. They contrast in the degree to which the various Goldstein (2000) and Hester (1996) discussed the different
narrative genres are used, in the way in which narratives are structures that stories can have in high- and low-context
organized, and the extent to which children are expected cultures. Low-context cultures tend to have a storytelling style
that Gee (1985), Michaels and Collins (1984), and Tannen (Boerma et al., 2016; Cleave et al., 2010; Rezzonico et al.,
(1982) referred to as “topic-centered.” These stories have a linear 2015). Other studies have found that bilingual children with
progression that follows the story-grammar model (Stein & language disorder show poorer narrative macro-structure
Glenn, 1979), in which an initiating event or problem motivates than typically developing bilingual peers (Paradis, Schneider,
a character to develop a plan and carry out an attempt to solve & Duncan, 2013b; Squires et al., 2014), although there are
the problem. The problem is resolved one way or another, and notable exceptions (Iluz-Cohen & Walters, 2012; Tsimpli
some form of external evaluation of the resolution (“and they et al., 2016).
lived happily ever after”) takes place. High-context cultures tend Differences between elements of narrative production
to use a more topic-associated style of narrative organization. may also be informative. Typically developing ELLs tend to
This style is more anecdotal than linear. Westby and Vining demonstrate advantages in macrostructure (story grammar)
(2002) reported that topic-associated stories consist of segments relative to vocabulary, grammatical complexity on sentence
in which the overall theme may be implicit but never stated. length measures for the same story (Paradis & Kirova, 2014).
Focus of person, place, and time often shifts, and relationships One implication is that depressed scores on all elements of
must be inferred by the listener. These stories are longer than narrative may therefore help identify language disorder in
topic-centered narratives and may appear to the naive listener to bilingual children, although narrative measures must be used
have no beginning, middle, end, or central point. Westby (1989a) in combination with other measures (Boerma et al., 2016;
cited Kaplan’s (1966) diagrammatic representation of the differ- Paradis et al., 2013b).
ent forms that topic-associated narrative can take, and these Skill in producing and understanding topic-centered nar-
appear in Figure 5.1. Fiestas and Peña (2004) found that bilin- ratives has been shown to be closely related to literacy devel-
gual children did include elements of story grammar in their opment and to success in school (Bishop & Edmundson,
stories in both English and Spanish, although there were differ- 1987; Boudreau, 2006; Boudreau & Hedberg, 1999). Children
ences in the particular elements included in each language. from high-context cultures with little experience of this nar-
These cultural differences in oral narrative traditions can rative style may encounter difficulties in the many academic
further cloud the distinction between language difference tasks that require processing and producing these narratives.
and language disorder. However, narrative production tasks, As Westby (2005) pointed out, topic-centered narratives
are generally considered a less-biased measure of language in form a bridge between high-context, oral language styles and
bilingual children (Boerma et al., 2016; Cleave, Girolametto, the low-context, literate language style of the classroom for
Chen, & Johnson, 2010). Specifically, typically developing mainstream, as well as for culturally different children. More-
bilingual children do not differ from monolingual peers in over, Fiestes and Peña (2004) argue that narrative production
narrative macro-structure, which concerns the inclusion of requires children to manage cognitive load in planning ex-
key story elements within the narrative (Boerma et al., 2016; tended discourse, and thus is a good way to assess higher-
Hipfner-Boucher et al., 2014; Rezzonico et al., 2015; Rodina, level cognitive-linguistic skills. They report data indicating
2016; Whiteside & Norbury, 2017). One reason for this is that that narrative is a valid and relevant task for assessing higher-
exposure to culturally and linguistically rich oral narrative level language skills in bilingual children. When assessing
traditions help the child with CLD to develop story grammar narrative development in clients, it is important to be aware
skills in L1 that are then transferred to L2 (Paradis & Kirova, of the possible problems children from traditional cultures
2014). Assessment of story grammar does not penalize chil- can have with topic-centered narratives. Rojas and Iglesias
dren for semantic or grammatical errors, providing the infor- (2006; 2009) provide guidance on eliciting and scoring nar-
mation is conveyed. Thus, ELLs can capitalize on L1 strengths rative samples from Spanish-speaking children, for example.
to deliver quality narratives in L2. For all children with CLD we want to be careful not to imply
Moreover, monolingual and bilingual children with language that the topic-associated narrative styles with which the client
disorder show comparably impaired narrative macro-structure is familiar are wrong. Rather, we want to encourage students
Topic-centered Topic-associated
FIGURE 5.1 Narrative structures across cultures. (Adapted from Westby, C. [1989]. Cultural
variations in storytelling. Paper presented at the National Convention of the American Speech-
Language-Hearing Association. St Louis; and Kaplan, R. [1966]. Cultural thought patterns in inter-
cultural education. Language Learning, 16, 1-2.)
to learn an additional style to be used when telling stories in particularly high risk of reading comprehension deficits. Fur-
the classroom or mainstream setting. thermore, the findings suggest that interventions targeting oral
Literacy. As with monolingual children, oral language language skills should have positive impacts on reading com-
skills provide an important foundation for the development prehension.
of literacy skills in children with CLD (Melby-Lervåg &
Lervåg, 2014). As with language, similarities between orthog- Use of Processing-Dependent Measures on Emerging
raphies in L1 and L2 (English) may facilitate development of Bilinguals with Expected Language Disorder
decoding skills; here it is important to bear in mind that or- Processing-dependent tasks, which require minimal use of
thographies vary considerably with respect to orthographic prior knowledge or experience, have been developed as one
“depth” or the extent to which there are consistent one-to- way of circumventing the biases associated with standardized
one mappings between letters and sounds. English is a fairly English language assessment. Examples of processing-dependent
opaque language, making decoding somewhat more chal- tasks include various memory tasks, such as digit span (re-
lenging for many learners (including many monolingual peating a series of numbers in random order), working
English speakers!). We also need to remember that some oral memory (children hear a sentence, are asked to tell whether it
languages do not have a written tradition, for example, is true, and then recall the last word in the sentence), and non-
American sign language (ASL; written form is English), word repetition (repeating nonsense words varying in length
Cantonese (written form is Mandarin), and some West from two to four syllables that have no resemblance to familiar
African languages (for example, Yoruba, in which standard English words). These tasks are thought to be less biased, be-
orthographies have only emerged in the last 40 to 50 years). cause they do not depend on knowledge of culturally deter-
A systematic, meta-analytic review of 82 studies docu- mined information, such as vocabulary (which children learn
menting the reading comprehension profiles of monolingual from hearing their parents talk), and they are quick and easy to
and emerging bilingual language learners (Melby-Lervåg & administer. They are also thought to tap directly into the pro-
Lervåg, 2014) demonstrated negligible differences between cesses that many argue are key for learning language. Impor-
monolingual and bilingual children in phonological aware- tantly, these measures do not appear to disadvantage typically
ness and decoding skills. In contrast, there were large differ- developing ELLs, when compared to monolingual peers (Buac,
ences in both language and reading comprehension, in which Gross, & Kaushanskaya, 2016). Thus, Laing and Kamhi (2003),
bilinguals displayed a large deficit in L2 comprehension and Hwa-Froelich and Matsuo (2005), and Weismer and colleagues
a medium-sized deficit in L2 reading comprehension. Char- (2000) reported that when children perform poorly on
acteristics of the reading comprehension tests, and study ori- processing-dependent measures, there is a high likelihood
gin reliably contributed to the heterogeneity of research they will have some type of language-learning difficulty.
findings. For instance, Canadian studies tended to report The use of processing-dependent measures with CLD
bilingual advantages on tests of decoding, whereas studies populations makes sense, because in theory they are not bi-
originating in the United States tended to report bilingual ased regarding life experience, socialization practices, or lit-
disadvantages. Differences were smaller on reading compre- eracy knowledge. Moreover, many non-word repetition and
hension tests that used sentences and cloze procedures rela- working memory measures are included in currently existing
tive to those that included passage reading and more open- standardized measures, including the Comprehensive Test of
ended questions. This perhaps reflects differences to the Phonological Processing, or in clinical literature, such as the
extent to which these tests are dependent on decoding skills, Non-word Repetition Test (Campbell, Dollaghan, Needle-
language comprehension needed to understand longer, more man, & Janosky, 1997), as just two examples. New measures
complex texts, and expressive language required to generate have been developed and normed with cross-linguistic popu-
responses to open-ended questions. lations in mind, to further minimize potential bias (Chiat &
Furthermore, socioeconomic status (SES) clearly moder- Polišenská, 2016). Nevertheless, some studies have found that
ated the difference between first and second language learn- vocabulary and SES influence performance on processing
ers. In other words, the difference between the two groups tasks, again suggesting that diagnosis based on any one mea-
was much larger in children from economically deprived SES sure is inappropriate (Buac et al., 2016).
backgrounds, whereas in middle or high-SES environments
the difference was attenuated. As we’ve seen, SES is often as- Use of Dynamic Assessment on Emerging Bilinguals
sociated with higher levels of parental education, and thus with Suspected Language Disorder
SES may be a proxy for language input. Parents from higher A second approach to overcoming the limitations of standard-
SES backgrounds may engage in more literacy-based activi- ized tests is the use of dynamic assessment procedures.
ties, decontextualized talk about books and stories, and may We talked about dynamic assessment in Chapter 2. From
be in a better position to support second language learning at there, you will remember that one approach to dynamic
home or at school. assessment is to test, teach, and then retest. This method
Although there is a clear need for more research to track the of dynamic assessment has been shown to differentiate
literacy development of emerging bilinguals from different stronger and weaker language learners in Puerto Rican,
cultural, linguistic, and SES backgrounds, the findings from African-American, and Native American preschool and kin-
this review strongly suggest that children with CLD are at dergarten children (Laing & Kamhi, 2003; Ukrainetz, Harpell,
Walsh, & Coyle, 2000). Another method of dynamic assess- to that specific community. Brice (2002), Goldstein (2000),
ment was examined by Peña, Iglesias, and Lidz (2001). They Kayser (1995), Langdon and Wiig (2009), Roseberry-
used mediated learning experiences (MLEs), designed to teach McKibben (2002a), and Wyatt (2002) have made suggestions
children principles or strategies for learning a task, to deter- for modifying standardized tests to gain information about
mine whether these supports would distinguish language language proficiency in CLD children. They suggest that
difference from language disorder in preschool African- adapting tests should be a group effort, because a monolin-
Americans and Latino American children with low levels of gual SLP making the modifications in isolation might not
language performance. All children received pretest standard make adaptations that are optimal for speakers of a different
language measures. Children were then taught new vocabulary language. The SLP can enlist bilingual EAL teachers, psy-
items; some received MLEs organized around theme-based chologists, special educators, and community members to
play and book-sharing activities, others received no mediation. make the modifications.
All were post-tested on the same tests. Findings revealed that When these modifications are made, of course, the
changes in the post-test scores on knowledge of the new adapted instrument is no longer a standardized test. We are,
vocabulary were associated more closely with the presence of in effect, using the standardized test as a criterion-refer-
mediation than with pretest standard scores. Similar findings enced measure. Although this method will not tell us if a
have been reported (Miller, Gilliam, & Peña, 2001; Peña, child is significantly different from other children, it can tell
Gillam, & Bedore, 2014). us what forms and functions a child uses and understands
Dynamic assessment also allows us to learn, for those chil- in the language being tested. Wyatt (2002) cautioned that
dren who do not improve in quantitative test scores after an when we do adapt standardized tests for use with CLD chil-
intervention, whether their responses are qualitatively im- dren, we need to be especially careful to note the adapta-
proved; for example, whether they provide longer responses, tions in clinical reports on the client. She recommended
or responses closer to the target than they did before. These that any changes made in standardized administration or
changes, too, are indicative of a benefit from the intervention scoring procedures be fully documented in the report. The
and can be used to help distinguish a language difference report also should state whether an interpreter was used
from a disorder. Gutierrez-Clellen and Peña (2001) provide and how the interpreter was trained to administer and score
information on various dynamic assessment techniques, the test. When testing takes place in two languages, the lan-
which are summarized in Table 5.1. ASHA’s multimedia tuto- guages used and the order of use of the languages (English
rial on the use of dynamic assessments with CLD students is first, Spanish second, for example) should be given. Norm-
another useful resource that can be found at: www.asha.org/ referenced scores should be reported only when they are
practice/multicultural/issues/Dynamic-Assessment.htm appropriate for the way the test was administered. If the test
was adapted in any way, norm-referenced scores cannot
Adapting English Language Tests be used without reservations. If published developmental
In communities where there is a critical mass of speakers data are used for comparison to the child’s performance,
of one language but no suitable standardized assessment, it full bibliographical reference to the published data should
may be reasonable to consider adapting a language measure be made.
TABLE 5.1 Five Guiding Principles for Language Assessment of Culturally and Linguistically
Different Children
Principle Considerations in Assessment Process
1. Identify and reduce bias Many types of potential bias including assessment (whether to assess particular groups or
not), test content bias (stimuli or methods inconsistent with experiences), linguistic bias,
interpretation bias (comparison group not relevant to assessed child).
2. Individualize timing of Blanket policies which either prohibit or require language assessment within a specific time
assessment frame are inappropriate. Timing should be determined on case-by-case basis.
3. Consider L1 and L2 abilities and Information gathering should include inventories of language history and current/future
needs, past, present and future patterns of where, when, how, and with whom children use their languages.
4. Look beyond language Knowledge of language dominance does not dictate appropriate comparison data (i.e.,
dominance Spanish dominant does not mean scores on Spanish test should be compared with
monolingual Spanish-speaking norms). Look beyond language to other cognitive skills.
5. Gather data using RIOT (Langdon & Chen, 2002):
multiple measures and Review (information from other professionals)
multiple sources Interview (ethnographic techniques to gather information from family members)
Observe (interactions with peers, in the classroom, using structured tools/checklists)
Test (standardized or criterion referenced, preferably at more than one time point)
Adapted from Kohnert, K. (2013). Language disorders in bilingual children and adults, ed 2. San Diego: Plural Publishing.
Criterion-Referenced Assessment of Culturally in Price and colleagues (2010) using computerized language
and Linguistically Different Children sample analysis is relevant for CLD students as it is for others.
IDEA 2006 specifically permits the use of nonstandard as- The SALT computer program (Miller & Iglesias, 2008) has
sessments for CLD children if they are most appropriate for measures specifically designed for Spanish speakers.
the evaluation of a student. Criterion-referenced assessment When collecting a language sample for these purposes
is used with CLD children in much the same way as for a from a CLD child, it is important to remember that conver-
mainstream child (that is, we use criterion-referenced mea- sational rules are culturally determined. To get a valid sample
sures once standardized testing has established that the child of a CLD child’s language, then, we need to attend to the
is significantly different from peers—in the CLD child’s case, cultural rules that govern conversation for that child. Perhaps
peers from the home culture—in linguistic development). children are not expected to speak extensively to adults in a
The criterion-referenced assessments are then used to estab- certain culture; in this case, a more valid sample might be
lish baseline function, identify goals for intervention, and collected from a peer interaction. Norbury and Sparks (2013)
document progress in the remedial program. Interpreters can emphasized the importance of incorporating culturally ap-
be especially helpful in carrying out criterion-referenced as- propriate materials and topics into the evaluation. These all
sessments, particularly when there is a need to establish base- help to obtain a more representative picture of the child’s
line functioning in both languages. linguistic skills. To monitor the representativeness of a lan-
Since standardization is not an issue for criterion-referenced guage sample collected from a CLD child, we want to learn
assessments, many of the criterion-referenced procedures in the some details of the cultural conversational practices from
following chapters can be translated directly by an interpreter interviews with community members. In addition, we may
into a child’s first language. The only thing we need to be careful want to observe the client in several conversational situations
about is that the forms and procedures used in the assessment and with different conversational partners to select the most
are culturally appropriate. For example, if a child’s home cul- representative one to use as the basis for our sample analysis.
ture’s communication style dictates that you don’t tell people It also is a good idea to check with a parent or familiar adult
something they already know, asking a child to tell what color a to ask whether the sample we plan to analyze sounds like the
picture is may be inappropriate, even if the question is asked in way the child usually talks. Narrative samples can be of use
the native language. Perhaps the situation would have to be for the same types of clients with CLD who function at
modified so that the question concerns a picture that the exam- school-age levels. Kit-Sum To and colleagues (2010) and Ro-
iner cannot see, to make the question pragmatically appropriate jas and Iglesias (2009) provide guidance for collecting narra-
for the CLD client. Here, too, consulting ahead of time with the tive samples from children with Spanish (see also Swasey
interpreter about culturally appropriate procedures can help Washington & Iglesias, 2015) and Cantonese (Wong, Klee,
prevent problems. Stokes, Fletcher, & Leonard, 2010) backgrounds.
We talked in Chapter 2 about the importance of structural Language samples can be collected in the home language
analysis of spontaneous speech samples as one aspect of from children who are not English dominant. In this case,
criterion-referenced assessment and about some guidelines the child may interact with a parent or another fluent
for collecting language samples that truly represent a child’s speaker of the language. The sample can be audio recorded
productive language skills, and Ebert and Pham (2017) and transcribed by an interpreter. Again, the interpreter will
discuss the use of language samples for assessment pur- need to be carefully trained by the clinician so that the tran-
poses in the CLD population. When language sample scription accurately represents the child’s pronunciation,
analysis is part of the assessment of communication in the use of grammatical morphemes, word order, and any other
CLD child, certain cautions need to be kept in mind. Stock- aspects of speech that the clinician wants to examine. With-
man (1996) points out a central concern to us: Language out training, the interpreter may be tempted to “normalize”
sampling is not used to identify a disorder in mainstream the child’s speech, correcting the child’s errors in the tran-
children. Instead, it is used when a disorder has been identi- scription and removing an important source of information
fied with standardized testing and we want to investigate about the child’s linguistic patterns. A translation of the
baseline function and target expressive language goals for sample will need to retain some indication of these errors
intervention. Because language sampling procedures do not to be analyzed by the clinician in collaboration with the
meet psychometric standards of reliability, validity, sensitiv- interpreter.
ity, and specificity, they cannot properly be used to decide The language sample from the home language will be es-
that a child is significantly different from other children. We pecially useful for determining whether the child is progress-
can use language sampling with CLD children just as we use ing as expected in the first language. Norms for Spanish ac-
it for children from mainstream backgrounds: to describe quisition are available (see Fabiano-Smith & Goldstein, 2010;
current functioning in the dominant language and in Eng- Haynes & Shulman, 1998b; Uccelli & Paez, 2007), and a
lish, to identify goals for intervention by establishing the Spanish-speaking child’s spontaneous speech can be com-
next steps in the normal sequence of acquisition of either pared with these normative data. Goldstein (2001) and
language, and to target these goals in an intervention pro- Gutiérrez-Clellen & Simon-Cereijido, (2009) discuss rules for
gram. Rojas and Iglesias (2010) illustrate how SLPs can use computing mean length of utterance in morphemes in Span-
language sampling with ELLs to track progress. Information ish. For languages for which normative data are not available,
the interpreter and the clinician can consult with the parent a picture of current communicative skills. Figure 2.14 gives an
and other bilingual individuals in the community. example of a form that we might use to look at communicative
Collecting a sample of the child’s speech in English also can competence, and this form is appropriate for CLD, as well as
be helpful. Here we would compare the child’s errors in English for mainstream clients (Erickson, 1987). Clinicians can devise
to those made in the home language to look for similar difficul- other forms to look at behaviors of interest as well.
ties in the two languages. The child might be substituting a /t/ for Cheng (2002a), Westby (1990), and Kohnert (2013) have
a /s/ in both languages, for example, or leaving plural mor- argued for the importance of ethnographic assessment with
phemes out of both, even where they are required in the home CLD children. Ethnographic assessment differs from other
language. These kinds of similarities could indicate that the child forms of naturalistic behavioral observation in that we may
is having trouble acquiring language in general, not just in using not know ahead of time exactly what categories and attri-
English. Second, this comparison can identify structures that the butes of behavior we wish to examine. We are using the eth-
child uses correctly in the home language but makes errors on in nographic method because of our unfamiliarity with the
English. These errors can be examined to determine whether cultural norms of the child being observed and will use the
they arise from interference from the home language. If so, they observation itself to discover the relevant parameters.
are likely to resolve on their own as the child develops English Ethnographic assessment may include participant obser-
proficiency, if no other language disorders are present. vation, audio and video recorded data, and open-ended in-
Stockman (1996; 2008) has made an additional suggestion terviews. Participant observation is described as “hanging
for the use of spontaneous speech data as a way to establish around and taking notes.” The clinician watches and may
whether, in fact, a child is demonstrating a language differ- participate in a natural interaction, taking brief notes to be
ence or disorder. The Minimal Competence Core (MCC: e.g., expanded later, to get a rounded and unencumbered view of
Stockman, Newkirk-Turner, Swartzlander, & Morris, 2016) is a set of events. Although participant observation is usually
a criterion-referenced measure that represents the least easier to accomplish than, say, videoing a child in a classroom
amount of linguistic knowledge needed to be judged normal or on the playground, notes of the participant observation
at a given age within a speech community. Although most are usually less inclusive than transcripts of a recording. The
speakers will know more than this core, the MCC is designed relative advantages of each method need to be weighed before
to identify the linguistic features that the least competent deciding what method to use in observing a particular child.
normal child could demonstrate. Because this core includes
common obligatory features, it is less affected by contextual
and vocabulary differences among situations and speakers.
SUMMARY
The use of this metric requires, of course, a detailed and well- In summary, this section on assessment has focused on the
researched set of MCC features for each age and dialect. multiple methods and informants that the SLP needs to piece
together to make an appropriate diagnosis in emerging bilin-
Using Behavioral Observation with the Culturally gual children. This may be best conceptualized by Lewis and
and Linguistically Different Child colleagues (2010), who proposed an approach that they call
In Chapter 2, we talked about using behavioral observation to “Assessment 360” for ELLs. They recommend a comprehen-
describe aspects of a child’s communication when our concern sive approach that takes advantage of a range of assessment
is not to compare the child to some standard but simply to get methods. This approach is summarized in Table 5.2. Further
TABLE 5.2 A Model for Comprehensive Assessment of English Language Learners

Type of Assessment Information Provided Source
Developmental history History of language acquisition Parents
Age of first word, word combination
Like/unlike siblings
Like other children in the community
Medical history that could affect speech and language development
Hospitalizations
Ear infections
PE tubes
Feeding problems
School history History of schooling Parents, teachers, school
US/non-US academic settings records
Stable or interrupted
Instruction in English or home language
History of supports for second language acquisition
Supportive/non-supportive environment
Academic progress similar/not similar to ELL peers
Continued
TABLE 5.2 A Model for Comprehensive Assessment of English Language Learners—cont’d

Type of Assessment Information Provided Source
Language use history Use of primary and secondary language at home with parents, sib- Parents, student
lings, extended family, and friends
Language preferences in different settings or for different activities
Dynamic assessment Ability of child to learn new tasks in structured teaching environment Test, teach, test proce-
Assists in differentiating a child who has not had the opportunity to dure with student
learn a language skill from one who has difficulty learning new skills
Language sampling Child’s connected speech in less structured, social/interactive tasks, Story telling or retelling
including: Conversation
Mean length of utterance
Narrative structure
Pragmatic language skills
Behavioral observation Connected speech in social (low structure) vs. academic settings Classroom conversations
(high structure) to compare BICS vs. CALP and cooperative
Pragmatic language patterns learning with peers
Language preferences
Norm referenced Quantitative comparison of the child’s language skills to typically Individually administered
assessment developing peers tests
BICS, Basic interpersonal communication skills; CALP, Cognitive academic language proficiency; ELL, English language learner; PE, pressure equalizer.
Adapted from Lewis, N., Castilleja, N., Moore, B. J., & Rodriguez, B. (2010). Assessment 360: A panoramic framework for assessing English
language learners. Perspectives on Communication Disorders and Sciences in Culturally and Linguistically Diverse Populations, 17(2), 37-56.
practical guides to assessment may be found in Kohnert opportunities, children with language disorders who speak a
(2013), the CHESL Center (Paradis et al., 2011) (https:// language or dialect other than English should, at some point,
www.ualberta.ca/linguistics/cheslcentre), and the Leaders be given the opportunity to learn to communicate in Stan-
Project (http://www.leadersproject.org/disability-evaluation/ dard English. However, a large body of research (Cobo-Lewis,
school-age-language-assessment-measures-slam/). Eilers, Pearson, & Umbel, 2002; Lopez & Greenfield, 2004;
Perozzi, 1985; Perozzi & Chavez-Sanchez, 1992; Peña, 2016;
LANGUAGE INTERVENTION WITH THE see also Kohnert, 2013, for review) suggests that instruction
CULTURALLY AND LINGUISTICALLY in a client’s native language can facilitate the development of
both languages, although high-quality intervention studies are
DIFFERENT CHILD lacking (Durán, Hartzheim, Lund, Simonsmeier, & Kohlmeier,
Once a language disorder has been identified and baseline 2016). For example, Restrepo, Morgan, and Thompson (2013)
function in both languages has been established, intervention taught preschool ELLs with language disorder either bilingual
for the CLD child generally follows the guidelines we dis- vocabulary or English only (there were also control conditions
cussed in Chapter 3. We need to address a few problems focused on mathematics) in a 12-week small-group interven-
particular to CLD children when we plan their intervention tion that focused on dialogic reading and hands-on vocabulary
programs, though. The first type of problem arises when we instruction of 45 words. Both groups made significant gains in
find that a CLD child has a language disorder. If an SLP who vocabulary relative to the comparison groups, and there were
is fluent in the child’s dominant language or dialect is not no differences between the bilingual and English-only condi-
available, how should intervention be managed? A second tions with regard to the number of new English words ac-
problem concerns the child who is progressing adequately in quired. The real advantage of the bilingual condition was that
the dominant language or dialect but has limited proficiency these children learned significantly more new words in their
in English or uses a nonstandard dialect. What is the SLP’s L1 relative to all other groups! In a smaller scale study,
role with this client? Third, we have a challenge in making Lugo-Neris, Bedore, and Peña (2015) demonstrated that sys-
our intervention culturally appropriate. How can we be sure tematic use of both languages in a short-term intervention
of not creating just another setting in which cultural differ- program yielded overall gains in vocabulary and narrative
ences get in the way of communication and learning? Let’s skills. This study did not employ a no-treatment or alternative
take these questions one at a time. treatment group, but both studies demonstrate that instruction
in both languages can yield positive gains in both languages and
certainly does not hinder development of L2.
The Monolingual Speech-Language Pathologist When a clinician fluent in a client’s native language is
and the Client Dominant in a Different Language available, this approach is preferable. Too often, however, in a
or Dialect diverse society such as ours, clinicians who speak the lan-
Because English language proficiency is so important for guage or dialect of every client on the caseload are not to be
access to mainstream American culture and its economic had. Take Lilly’s case, for example.
CASE STUDY and Restrepo (2005) demonstrated that children with intel-
lectual disability growing up in bilingual home environments
Ms. Engle was an experienced SLP who had worked for learned two languages at the same level as did children with
10 years in a pediatric hospital. But she had never been con-
similar disabilities learning just one. Even children with sig-
fronted with a problem such as the one she faced when Lilly
nificant developmental disorders were able to acquire two
found her way onto her caseload. Lilly’s family had recently
immigrated to the United States from China, and no one in languages with no greater delays than their monolingual
the family, including Lilly, spoke much English. Lilly had re- counterparts (Kay-Raining Bird, Genesee, & Verhoeven,
cently, at age 4, suffered a series of seizures, and her lan- 2016; Uljarevićaigu, Katsos, Hudry, & Gibson, 2016). The key
guage use in her native dialect of Mandarin Chinese appeared to development is the opportunity to hear and use both lan-
to be deteriorating. Distraught, her parents brought her to see guages in familiar, interactive environments. This, of course,
doctors at the hospital, using friends in the neighborhood as may not be the case for many CLD children who hear the
interpreters. Ms. Engle used parent interviews, a speech minority language exclusively at home and do not encounter
sample carefully translated in collaboration with the neighbor- the dominant language until they get to school. Still, a child
hood interpreters, and some developmental scales and modi- exposed to two languages simultaneously will learn both with
fications of standardized tests to establish that Lilly’s lan-
no trouble. A normally developing child exposed to one lan-
guage had been normal when she was younger but had
guage at home and another at school will go through a period
indeed gotten worse since the seizures. Lilly appeared to be
communicating at a telegraphic level, to have difficulty under- of limited English proficiency but will communicate nor-
standing anything beyond simple one-step commands, and to mally in the home language and will eventually master the
rarely initiate communication. In addition to medication to dominant language, given adequate opportunity. Most typi-
control the seizures, the diagnostic team at the hospital rec- cally developing bilingual children learn enough English to
ommended language intervention. Since Mandarin Chinese engage in ordinary social interactions in 2 to 3 years, al-
was Lilly’s first and, at this point, only language, Ms. Engle though, as we’ve seen, acquisition of formal academic English
believed it was important to deliver the intervention in that may take more time. So if a child is having trouble in L1,
language. Ms. Engle, however, did not speak this dialect. exposure to L2 is not what caused it.
2. Must CLD parents speak to their children only in English?
Again the answer is a resounding no. Parents should never
There are a number of ways in which Ms. Engle can sup- feel guilty about using the native language in the home. They
port Lilly’s language development in both languages. Gold- should not feel obliged to speak to the CLD child with a lan-
stein and Iglesias (2006) highlight important services the guage disorder in English, if English is not their own first
monolingual SLP can provide, including in-service training, language. It is the quality of the language input that makes a
consultation, and paraprofessional training. Chabon, Brown, difference in development, not the particular language spo-
and Gildersleeve-Neumann (2010) provide an ethical per- ken (Paradis, 2016). Parents should be encouraged to engage
spective on this issue. in many kinds of communicative interactions with their chil-
dren, including reading books to them, telling them stories,
In-Service Training of Other Professionals engaging in pretend play, and hearing and telling personal
The SLP can provide in-service training for ELL and classroom experiences. The language in these interactions should be the
teachers who work closely with these clients, although there is one in which the parent is most comfortable and fluent. In
a pressing need for intervention studies to determine the im- this way, the child can receive an optimal model of language
pact of this training on child language outcomes (Murphy, structure and function that serves as a strong foundation for
2015). Training can focus on topics such as normal language development in both languages.
acquisition processes, the relation of communication to lan- 3. Can a language disorder exist in one language and not the
guage development, the importance of interaction in language other?
acquisition, appropriate and inappropriate uses of standard- Once more, the answer is no (Cummins, 1981; Juarez,
ized tests, informal and criterion-referenced assessment proce- 1983; Kay-Raining Bird, 2006; Kohnert, 2013). If a child has
dures, techniques for eliciting and evaluating language sam- a deficit in the first language, that deficit will affect the ac-
ples, methods of designing language intervention programs, quisition of English as well. If a child is developing normally
and the differences between “home” and “school” talk (van in the first language, on the other hand, but has limited
Kleeck, 2007). The SLP also can provide answers to some of the English, the problem is most likely to be lack of adequate
most commonly asked questions about CLD children with opportunity to develop English language skills. This lack of
language disorders. These questions include the following: opportunity may be a result of recent arrival in an English
1. Did the child’s bilingual background cause the language speaking country, in which case time and understanding
disorder? teachers may be all that are needed to solve the problem.
The answer to this question is a definitive no. Paradis The lack of opportunity could also stem from social isola-
(2016) and Kohnert (2013) review a broad range of literature tion, though. A CLD child may be exposed to English only
on this topic that conclusively demonstrates that typically in limited, formal contexts in school and interact exclusively
developing bilingual children can acquire two languages, with people who speak the minority language at all other
with no deficits in either language. Kay-Raining Bird (2006) times. The monolingual SLP can make this clear by observing
the child in school. The SLP can document who the CLD BOX 5.5 American Speech-Language-
child spends informal time with during recess and lunch Hearing Association Guidelines for
and what language is spoken. Monolingual Speech-Language Pathologists
If it turns out that the CLD child is socially isolated Working with Clients Who Speak Another
from English speakers, the SLP can use the in-service Language
training setting to encourage teachers to foster some social
Monolingual SLPs may do the following:
interaction. This might include helping teachers to ar-
• Test in English
range an English-speaking “buddy” to pair off with the • Perform oral-peripheral exams
child during some informal parts of the day; organizing • Conduct hearing screening
sports, craft activities, or games between mixed groups of • Complete nonverbal assessments
CLD children and English-speaking classmates during re- • Conduct family interviews with appropriate support personnel
cesses; or developing a lunchtime club with invited mem- • Research client’s language and culture
bers from both linguistic groups who get to eat in a special • Advocate and refer
place (such as the teachers’ room) and talk together in Monolingual SLPs should seek help with CLD clients by doing
English. For normally developing children with limited the following:
English skills, such social interactive opportunities go a • Establishing contacts and hiring bilingual SLP consultants
• Establishing cooperative groups among several school
long way toward building English proficiency.
systems to hire bilingual SLPs
Damico and Damico (1993) discussed the process of ac-
• Establish networks and links between universities and
culturation in students from linguistically and culturally dif- clinical setting to recruit and train bilingual SLPs
ferent backgrounds. They emphasized that a crucial factor in • Establish Clinical Fellowship Year and graduate student
acculturation is the degree to which a person feels affiliated practicum sites for bilingual SLPs training
with the mainstream culture. An attitude of acceptance and • Establish interdisciplinary teams in which monolingual
respect on the part of mainstream professionals is certainly SLPs collaborate with and cross-train bilingual profession-
an important factor in creating this feeling of affiliation. In als from other fields
addition, however, teachers and clinicians who work with • Recruit and train support personnel from the community to
children from culturally different backgrounds would per- serve as bilingual aides and paraprofessionals
form a service by setting up opportunities for playground or • Follow ASHA guidelines for supervising bilingual support
personnel
extracurricular interactions with monolingual peers. These
interactions will go a long way toward developing feelings of ASHA, American Speech-Language-Hearing Association; CLD, cul-
solidarity with the dominant culture that provides ELL chil- turally and linguistically different; SLP, speech-language pathologist.
dren the motivation to improve their English language skills. Adapted from American Speech-Language and Hearing Association.
(1998). Provision of English as a second language instruction by
Consultation speech-language pathologists in school settings; position statement
and technical report. ASHA Supplement, 18; American Speech-
In addition to training teachers in general techniques for de- Language-Hearing Association. (2004c). Preferred practice patterns
veloping language skills in children, monolingual SLPs can for the profession of speech-language pathology. Retrieved from:
consult on the interventions for particular CLD children with http://www.asha.org/members/deskref-journal/deskref/default
language disorders. Clinicians can work with teachers to in-
crease their use of culturally sensitive teaching strategies, such
as those discussed in the “Multicultural Teaching Techniques”
section. We also can encourage the use of script-based inter-
ventions, literature-based scripts, and many of the other inter-
vention strategies we discussed in Chapter 3. Clinicians can
demonstrate in English how to use such approaches, so the
bilingual staff can adapt them to the minority language. Salas-
Provance and Oprandy (2006) provide additional ideas, and
ASHA suggests guidelines for educational modifications for
ELLs, which appear in Box 5.5. A wealth of other resources can
be found at: www.asha.org/practice/multicultural.
SLPs also can, in collaboration with other staff, develop
child-centered or curriculum-based language activities that
can be translated by the bilingual staff. These would involve
consulting with bilingual staff about the language status and
goals for particular clients and about the current classroom
themes and curriculum. The SLP can then design a set of
activities to address these goals in the context of classroom
themes and can consult with staff about translating this pro-
gram into the child’s first language. Bilingual SLPs can deliver services in clients’ first language.
SLPs consulting to classroom programs with CLD chil- highlight vocabulary and language forms and functions that
dren also are important in helping decide when to introduce the child needs to develop. Focused stimulation and clinician-
or focus more sharply on instruction in English. Because directed activities also can be designed by the clinician and
CLD children with language disorders should have the op- translated in collaboration with the paraprofessional.
portunity to develop English-language skills, the monolin- When working with a paraprofessional, of course, the SLP
gual SLP needs to observe their progress to determine when maintains the responsibility to monitor progress in the inter-
some intensive intervention in English is warranted. This in- vention program, by reviewing assessment data gathered by the
volves careful monitoring of both English and first language paraprofessional in the course of the program. The SLP will be
skills. Using the techniques for assessment in both languages the one to decide when to introduce new goals, when to modify
that we talked about earlier, the clinician can use both stan- procedures, when to terminate intervention, and when to
dardized and informal procedures to track growth in each switch to English language instruction or to pair intervention in
language. Criteria we might use to make the decision to in- the two languages. ASHA (http://www.asha.org/Practice-
troduce English-language intervention include the following: Portal/Professional-Issues/Bilingual-Service-Delivery/) has
• The client’s English skills have progressed to about the provided guidelines for monolingual SLPs working with clients
same level as first language skills. English-language inter- who speak another language. These are summarized in Box 5.6.
vention can “shadow” forms and functions being acquired
in the first language.
• The client has reached a plateau in first language learning BOX 5.6 English Language Learners
and is not making rapid progress. English skills commen- in Schools Checklist for Educational
surate with those in the first language can be targeted. Modifications
Miller (1984) suggested that language intervention in Classroom Routine
English should begin with features the child already knows Establish a daily routine.
in the first language. Provide optimal seating so that the student can easily see the
• The client has been in a bilingual program for a considerable materials and hear the instructor.
time. English intervention can be introduced to begin the Review and summarize prior lessons.
transition to more participation in the mainstream program. Set up “partners” in order to team a student who is an
English language learner (ELL) with another student.
Training Paraprofessionals to Deliver Services Teach book format (e.g., table of contents, glossary, direction-
in the First Language ality of text).
When professional staff such as ELL teachers or bilingual clini- Lesson Planning
cians fluent in a client’s language are not available, we may be Consider background of students when planning appointments,
able to draw on bilingual paraprofessionals, aides, or commu- community outings, holiday celebrations, meals and snacks
nity volunteers to deliver first-language services (Kohnert, Yim, (e.g., not all children may celebrate the same winter holiday).
Nett, Kan, & Duran, 2005). SLPs may sometimes need to re- Consider the cultural and linguistic background of students
cruit such people to assist with their programs for CLD chil- when selecting materials (e.g., pictures, books/workbooks,
dren with language disorders. Community agencies, houses of flashcards, videos, music, food, and so on).
Plan for small group activities to allow children to rehearse
worship, and local colleges and community colleges can be
speaking skills.
contacted to locate bilinguals willing to work as aides or volun- Present frequent review and repetition.
teers to teach language skills to children in their cultural group. Provide a blank outline, chart, or web to fill in during class.
The monolingual SLP has the responsibility to plan out the Use a consistent format for worksheets with minimal graphic
client’s program and train the paraprofessional to deliver it. distractions.
Again, the SLP needs to complete the diagnostic process and ar-
rive at goals for first language learning. Commercially available Daily Instruction
materials in the first language can be selected and assembled to Allow multiple methods of sharing experiences and commu-
address some of the goals. The SLP can carefully review the pro- nication (e.g., use of storytelling and props that support the
oral tradition).
cedures for use of these materials with the paraprofessional.
Allow extra time.
The SLP can train the paraprofessional to use the child- Ask specific questions.
centered language approaches we talked about in Chapter 3 Learn and appropriately use key words in other language(s)
when working with clients in early stages of first language (e.g., hello, please, thank you, and so on).
acquisition. These include, you’ll remember, indirect language Present information in short, sequential steps.
stimulation or facilitative play. The clinician can train the Provide hands-on instructional materials.
paraprofessional to engage in child-centered activities and Use multisensory cues for instruction.
provide enriched input in the form of self-talk, parallel talk, Use visual aids, gestures, and physical prompts.
recasts, expansions, and extensions in the client’s first lan- Write instructional key words on the board.
guage. Literature-based script activities also can be taught to From American Speech-Language-Hearing Association. (2017). Mul-
the paraprofessional, with an emphasis on clear and repetitive ticultural affairs and resources. Retrieved from: www.asha.org/
input paired with engaging activities and materials selected to practice/multicultural
The Worst-Case Scenario CASE STUDY

Suppose you have a certain CLD child with a language dis-
Ms. Salford was a new SLP in an inner city school with about
order on your caseload. You don’t speak her language and
90% African-American and Hispanic-American students.
neither does anyone else in your facility; there is no EAL When she arrived, she noticed that the students rarely talked
program in your area; the client’s parents do not speak to adults unless they were directly asked a question. On the
English; and you’ve been unable, after some effort, to re- playground students did lots of talking, yelling, and arguing,
cruit a community member to work with her. What can but inside they were mostly sullenly silent. Teachers com-
you do? Kohnert and colleagues (2005) suggest one alter- plained that the students had “poor verbal skills” and were
native: recruiting typical peers from the same language “language delayed” and wanted large numbers of students
group to provide peer mediation. Peers from the client’s included on Ms. Salford’s caseload for language intervention.
language community can be taught simple strategies, like Ms. Salford sat in on a few classroom sessions to learn more
those used in “Buddy Time” (English et al., 1997), in which about the students’ communication skills. She noticed that
buddy pairs are assigned for a period of the school day and the teachers frequently corrected their students, insisting that
they use “proper” English when they talked. Students were
the buddy’s job is stay with and talk to the client for the
often told that the teacher couldn’t understand them, that
entire period in order for both to earn some reward. Such their speech was “sloppy.” Yet in her playground observations,
simple strategies can provide the client with intensified Ms. Salford heard sophisticated verbal negotiations and a lot
opportunities to practice the home language. of creative use of language for ritualized, playful put-downs.
At the same time, the clinician can deliver appropriate She even heard students getting together in small groups in
intervention in English. We would want to assess, as well as corners of the playground to add verses and make up new
we can, where the child is functioning in the first language to lyrics to their favorite raps. She began to suspect that there
get some sense of baseline function. Then we would begin was a serious discrepancy between what she heard on the
using indirect language stimulation with age-appropriate playground and what the teachers were reporting about the
materials. When the child has begun to use English in this children’s language skills.
setting, some script-based or focused stimulation activities
can be introduced. We would proceed essentially as we
would with a child in the emerging language stage (see
Chapter 7). Vocabulary and themes can be related to class- the child is indeed developing normally in the first one and
room work if the client is in school. The combination of peer is limited only in English. For these children, direct services
mediation in the home language and clinician-delivered in- by the SLP are usually not indicated. Still, as Fitts (2001)
tervention in English can help to shore up both forms reminded us, even though limited English proficiency or
of communication (Restrepo, 2005). ASHA (2008), Peña use of nonstandard dialect may not be a disorder, it can
and Fiestas (2009), and Pederson and Vining (2008) provide constitute a social and educational handicap. For instance,
guidelines for SLPs working with CLD preschool children Whiteside and colleagues (2016) reported that ELLs with
and toddlers. low levels of English language proficiency at school entry
continued to demonstrate both poor English language
attainment 3 years later and were less likely to meet curricu-
The Speech-Language Pathologist and Normally
lum targets 2 years after they started school, relative to
Developing Children with Limited Proficiency ELLs with relatively good English at the start of school.
in Standard English Although some of these children will have language disor-
Several court cases (Lau v. Nichols, 1974; Martin Luther der, many did not, but their limited English was a barrier to
King Junior Elementary School Children et al. v. Ann Arbor academic and social success and over the longer term may
Michigan School District Board, 1979) have ruled that it is impede wider opportunities for economic advancement
unconstitutional for schools to fail to take into account the and security. In light of the importance of using and under-
languages with which children come to the classroom. standing mainstream English to “make it” in the main-
These decisions do not mean that students’ home lan- stream, a legitimate aspect of our scope of practice can be to
guages must be the language of instruction. They do mean, offer our expertise to professionals who deal with normally
however, that public institutions have the obligation to developing ELLs, even when we don’t provide services to
educate teachers about students’ native languages or dia- these children directly. ASHA (2002) provides guidelines
lects and to attempt to eliminate negative attitudes and for these kinds of services, and considers them elective,
diminished expectations on the part of teachers based on rather than required. The main roles we will generally play
their perceptions of their students’ language differences. in this enterprise will be in terms of in-service training and
Ms. Salford’s story, in the next case study, shows how such consultation.
attitudes can affect adults’ perceptions of CLD children. In in-service presentations to other professionals and in
When a normally developing CLD child has low levels of consultation activities, we will want to emphasize the impor-
English language proficiency, the SLP needs to decide, based tance of creating social opportunities for ELLs to interact
on thorough assessment in both languages or dialects, that with native English speakers.
students. Here, students are encouraged to write about their

own experiences in their own dialect. Brief mini-lessons are
presented to address writing mechanics and text structures.
Students get feedback on their work through dialogue jour-
nals, in which teachers comment not only on content, but on
dialect features of the writing and make suggestions to en-
hance academic English forms. Students then share their writ-
ing with the class, and discuss when/how/why they did or did
not choose to use dialect features within their compositions.
Later, instruction would remind children what they have
learned about the different communicative demands of different
contexts and the implications for English language use. Role-
playing would be used for less-constrained production activities
to allow students to practice emerging English skills. Situations
SLPs working with children with LEP can provide social appropriate for this level might include asking a teacher about a
opportunities to interact with SAE speakers.
homework assignment, giving a formal talk on bike safety to a
group of younger students, or telling the student’s life story to a
Another aspect of our responsibility for educating other reporter writing an article for the school newspaper.
professionals about CLD concerns the need to convey the im- Brice and Roseberry-McKibbin (2001) and Roseberry-
portance of language skills for success in the classroom. We McKibbin (2014) made further suggestions for working with
need to help our colleagues see how language skills pervade the children who come from non2English-speaking back-
curriculum at all levels, from preschool through secondary grounds. They emphasized the importance of using the L1 as
grades. Some of the suggestions for in-service training given in a medium for improving students’ communication in L2, and
Chapter 12 can be used to make this point. To take it one step outlined a series of strategies for implementing this sugges-
further for the CLD child, Adler (1990) emphasized that we tion in the bilingual or monolingual classroom. These strate-
need to make colleagues aware of how negative attitudes about gies are summarized in Table 5.3 and can serve as helpful
language differences can affect children’s performance. We also consultation suggestions for SLPs working with classroom
need to help minimize the handicap conferred by a language teachers of children learning English as a second language.
difference by increasing colleagues’ awareness of the problem. Any of the programs we’ve been discussing, or ideas from
Blake and van Sickle (2001) stressed that improving Eng- them, are appropriate information to share with classroom and
lish language proficiency does not mean eliminating the ELL teachers in our consulting role. For SLPs who work in
nonstandard dialect or use of the minority language. On the schools with large numbers of CLD children, these also are ideal
contrary, programs aimed at improving English in culturally opportunities to do some collaborative teaching, coming into
different children should have the aim of helping children the classroom of a CLD child who does have a disorder and do-
become bilingual or bidialectical code-switchers (that is, ing activities such as the ones we just discussed to help the whole
speakers able to move back and forth between language class improve their proficiency in SAE. When we offer these ac-
styles, choosing the one most appropriate for the situation), tivities as consultative suggestions, however, we’ll need to re-
in order to benefit from the social and potential cognitive member that it won’t be enough just to do the activities, if the
benefits that bilingualism confers. For example, Lugo-Neris, teacher doesn’t convey a genuine sense of acceptance of language
Jackson, and Goldstein (2010) showed that reading Spanish- difference. Using the collaborative teaching situation may be one
speaking preschoolers books in English, and providing expla- of the best ways for us to provide a model of this kind of attitude
nations of unfamiliar English words in Spanish produced to teachers who work in classroom settings with CLD children.
greater gains in the children’s use of expressive definitions Finally, it is good to bear in mind that many of the tech-
than English-only instruction. Connor and Craig (2006) niques advocated by writers for children with CLD are the same
showed that AAE-speaking preschoolers were already capable approaches recommended for working with children with lan-
of code-switching, and suggest this ability may serve as a guage-learning difficulties from mainstream backgrounds.
foundation for metalinguistic skill development. Additional Methods such as creating preparatory sets, teaching compensa-
ways to develop bilingual and bidialectical abilities include tory strategies, allowing extra time for processing, bringing
providing instruction not only in SAE forms, but also engag- children’s personal experiences to bear on classroom topics, us-
ing children in discussion of the functions of a variety of ing simplified, repetitive language in instruction, scaffolding,
communicative styles. As a metalinguistic approach, this sort using focused stimulation to correct grammatical errors, teach-
of intervention is ideally adapted to classroom situations. ing phonological awareness and alphabet knowledge explicitly
Talking about language use is a metalinguistic activity that to promote early literacy, using carefully structured questions to
will benefit all students, not just those who are CLD. facilitate language production, explicit teaching of curricular
One example of putting this into practice is the Blake and vocabulary, and using text structures to facilitate expository
van Sickle (2001) Writers’ Workshop approach for older comprehension are advocated by Bejos (2009), Lugo-Neris
TABLE 5.3 Consulting Suggestions for Teachers Working with Bilingual Children
in Classroom Settings
Strategy: Encourage
Teachers to Description Example
Reiterate Repeat what the other speaker said for Student: He take it?
emphasis and clarification. Teacher: Did he take it? I think he did.
Check and expand Checks vocabulary understanding and use. Student: I need a . . . .
vocabulary Introduce new words in English, talk about Teacher: You need an eraser? You need to erase your
Spanish equivalents, and discuss vocabulary answer, to change it? You need an eraser, then. We
items explicitly. use an eraser to erase, or get rid of what we want
to change. How do you say that in Spanish?
Maintain flexible Allow students multiple forms of participation The teacher may occasionally respond to a student
language in classroom discourse, including flexible with “si” rather than “yes,” or prompt with “y que
environment turn-taking, increasing wait time for re- mas” sometimes, instead of “and what else.”
sponses, accepting answers in either
language, rewards for participation.
Value native languages Convey acceptance and appreciation of Teacher reads students a Mexican folktale in English,
multiple languages by recognizing appropri- then asks students, “What’s the word for this bowl
ate uses of each language, asking students in Spanish? How would you ask the girl in the
how to say things in their native languages, story’s name in Spanish?”
including material from native languages
within the curriculum.
Encourage Allow code-switching in student contributions Encourage students to help others master class-
code-switching to encourage spontaneous language use. room concepts by presenting what the teacher
said in English to peers in Spanish.
Ask questions Encourage bilingual students to answer Teacher: There’s a grandmother in this story. What
teacher questions, in the native language if do you call your grandmother?
necessary, to increase class participation Student: Abuelita.
and provide opportunities to hear English Teacher: Abuelita, that’s what you call your grand-
versions of their Spanish responses. mother? I call mine Gran. Abuelita, Gran, two
names for grandmother.
Allow use of home After hearing/reading a story, ask ELLs to After reading allow children to break into groups by
language as a bridge summarize the story in the home language home language. Let ELLs work together to sum-
to English first, then in English (Smyk, Restrepo, Gray, & marize the story in the home language. Then have
Morgan, 2008). groups take turns providing a summary in English.
Provide clear, repeti- Simplified input does not need to replace Ask teachers to paraphrase instructions and impor-
tive, simplified input, more advanced language, but it can tant content, after their normal presentation. For
along with more accompany it. example, “This week we’ll be studying the conver-
advanced forms sion of light to energy by means of photosynthe-
sis. Photosynthesis is the way plants make food.
They turn sunlight into food energy by photosyn-
thesis. Photosynthesis gives plants their energy
to grow.”
ELL, English language learner.

Adapted from Brice, A., & Roseberry-McKibben, C. (2001). Choice of language in instruction: One language or two. Teaching Exceptional Children,
33, 10-16; Roseberry-McKibbin, C. (2008). Multicultural students with special language needs. Oceanside, CA: Academic Communication Associ-
ates; Restrepo, M. A., & Towle-Harmon, M. (September 23, 2008). Addressing emergent literacy in English-language learners. The ASHA Leader.
et al., (2010), Mathes et al. (2007), Roseberry-McKibbin (2014), Multicultural Teaching Techniques
Restrepo and Towle-Harmon (2008), and Thordardottir (2005), How can we make intervention more culturally appropriate
just as they are by those working with mainstream children with and therefore more accessible to CLD children, both with and
language problems (see Chapters 12 and 14). For clinicians, this without language disorders? Tharp (1989) showed that when
means that working with CLD clients and their teachers does similarities between the school and home culture are in-
not involve re-inventing the wheel. Many tried and true creased, the performance of CLD children improved. In both
techniques are helpful for these clients, as they are for others. our consulting role with teachers and in our own direct inter-
The additional piece of the puzzle for clients with CLD is to actions with CLD children, we can incorporate some proce-
encourage these students to continue to learn and use their dures and activities that will help reduce cultural conflicts.
home language, and to employ it as a scaffold to competency in Remember, however, that different cultures may have differ-
English (Kohnert, Yim, Nett, Kan, & Duran, 2005). ent expectations. For instance, some Asian-Americans may
expect teachers to talk and children to listen, speaking only (2008), as well as Schwanenflugel and colleagues (2005) and
when spoken to first. Native Americans, on the other hand, Smyk and colleagues (2008), also support this approach.
may not find speaking in a teacher-directed group a familiar Terry (2008) adds that developing metalinguistic awareness,
or comfortable experience. The suggestions we’ll talk about talking about language and dialect differences as part of the
here may be helpful for some children from some cultural literacy program, reading literature that uses different lan-
groups, but no one suggestion will be appropriate for every- guage styles, and role-play that contrasts language use in dif-
one. We’ll always need to use judgment and rely on advice ferent contexts is appropriate for children with CLD even in
from community members about what techniques will work the preschool and primary years.
best for particular children and cultural groups. Westby and Rouse (1985) stressed the importance of
One issue that faces us when we work with children with teaching executive skills such as planning and metacognition
CLD concerns their view of themselves and their potential. to CLD children, because many high-context communicative
Smyer and Westby (2005) recount what happened when they styles do not place strong emphasis on planning future ac-
invited students in a low-income, all-minority school to enter tivities. They suggested that book reports, particularly reports
an essay contest for scholarships to a summer science camp. developed by a group rather than an individual, offer an es-
They were surprised when, after a long silence, one of the stu- pecially helpful context for developing these skills. Harris
dents replied, “That’s for smart white kids, not us” (p. 23). (1995) emphasized the importance of allowing CLD children
Smyer and Westby conjecture that the persistent achievement to read or hear the whole story before asking any questions,
gap between CLD children and mainstream students has roots because this holistic approach more closely mirrors a high-
in this feeling that only “smart white kids” succeed in school context communicative style.
and academic pursuits. They argue that an important aspect of Having a group of children develop an oral or written
multicultural teaching includes an explicit refusal to accept this book report on a book they have read or listened to is valu-
assumption, and a concerted attempt to convince the children able for several reasons. First, the book sets the topic and can
themselves of their potential as learners. Danzak and Silliman be used by the teacher to get a child back on topic if an as-
(2005) echo this notion, and argue that becoming a competent sociative remark is made. Having the group negotiate the best
English-language speaker involves building a new aspect of way to retell or interpret the story provides valuable experi-
identity; that of a “smart kid” who communicates in English at ence in applying metacognitive and metalinguistic processing
least some of the time. To accomplish this end, Smyer and to a text, such as a remembered story, for which there is little
Westby describe a literature-based program in which they en- contextual support. Looking for characters’ strategies, mo-
couraged students to read (or listen to) and discuss stories of tives, and attempts to carry out intentions, and then evaluat-
individuals, particularly those from nontraditional back- ing the results of characters’ attempts, all help focus attention
grounds, who had overcome obstacles, defied others’ expecta- on the planning aspect of human behavior. Westby and
tions, and used courage and determination to achieve great Rouse (1985) emphasized that the purpose of all these activi-
things. Smyer and Westby also report that, following this litera- ties is to help CLD children learn how to learn in a low-
ture program, several of their students successfully applied for context culture such as the classroom and to allow them to
the summer scholarships. In our consultant and collaborative use the high-context learning styles with which they came to
roles, we can encourage teachers to adopt similar approaches school to acquire that knowledge.
to raising students’ expectations of themselves. Roseberry-McKibbin (2014) suggested using a multicul-
One important aspect of multicultural teaching concerns tural calendar. Here the clinician or teacher would use the
the role of literacy for the CLD child. Connor (2008) empha- typical classroom theme of holidays and special days to
sizes the important connection between oral language and incorporate the experience of the CLD child. Each month,
literacy development, and the impact of this connection on
children with linguistic differences. Because literacy is built
on the base of oral language, a mismatch between the lan-
guage or dialect a child is learning to read and the one he or
she speaks will inevitably lead to difficulties. Kayser (2004)
reported that the International Reading Association advo-
cates encouraging CLD students to become biliterate, as well
as bilingual, and suggests beginning literacy instruction in
the child’s first language. Although this may not be possible
for children from smaller language groups, many programs
working with Spanish first-language users do adopt this ap-
proach. Even if first-language literacy instruction is not pos-
sible, however, Kayser suggests SLPs work with teachers of
CLD children to improve their literacy development by pro-
viding parents with books to read to their children in their
native language, and building bridges between home literacy Working with culturally different clients may involve teaching
and school. As we’ve seen, Restrepo and Towle-Harmon SAE as a second dialect.
mainstream holidays and holidays from the cultures of the the native language, having them translated, and having the
CLD children would be marked on the calendar. Weekly or CLD child retell the story to the class. Collective stories, in
monthly themes for language activities would revolve around which each member of a group retells a part of a story, also
these special days. For example, Thanksgiving might be a can be used. These group stories can be “published” in class
theme for November. Here, activities around the traditional books, with the mainstream and CLD child’s version side by
American celebration would be combined with discussion of side. Discussions of similarities and differences can follow.
harvest festivals of other cultures. CLD children could be Related activities might have groups generate yet another ver-
asked to find out how the harvest is celebrated in their cul- sion of the same story to write, illustrate, and publish. Hyter
ture; to share artifacts, pictures, songs, or dances with the and Westby (1996) also encouraged the use of stories as a way
class; and to compare how these holidays are observed. De- to help children learn to take multiple perspectives. For both
pending on the developmental level of the class, projects mainstream and CLD students, these activities help us to
might include making group picture books with labels for learn to try to “walk a mile in another’s moccasins,” or see
objects used in American Thanksgiving and other harvest how things might look from another’s point of view.
festival celebrations; making greeting cards to send to family Cheng (2002a) also suggested the use of cultural “cap-
members with pictures, ideas, and phrases typically associ- sules” or “clusters.” These are elements, activities, and events
ated with the mainstream and other holidays; writing recipes that are unique to a culture. They might include the African-
and cooking foods associated with each festival; writing de- American Kwanza celebration or the Mexican-American use
scriptions of how to celebrate each holiday; and so on. of piñatas. Items related to cultural clusters or capsules can be
Cheng (2002a) pointed out that map study provides an- displayed and discussed, used for vocabulary development,
other opportunity for incorporating the experience of CLD and incorporated into role-playing activities in which chil-
children in the classroom. Maps can be studied to identify the dren use language forms appropriate for the objects and
place of birth of each class member or to follow routes of trips events. Scripts can be developed ahead of time and rehearsed
that class members have taken (for CLD children, this can so that students can demonstrate their cultural capsules to an
include the route to their country of origin). Students can audience, such as parents or another group of students. Such
work in groups to make maps of various places associated scripts also will support the students’ development of com-
with their personal experience, such as their house, home municative competence about their own culture.
town or village, or home country. Life stories can be written Mainstream culture capsules also can be included in the
and illustrated with maps relevant to each student’s story. intervention program. Here objects and events that may be
Hyter and Westby (1996) suggested the comparative study unfamiliar to the CLD child (such as, erasers, rulers, or “lining
of folktales as another method to bring the CLD child’s experi- up”) can be introduced and studied as other culture capsules
ence into school. Here, again depending on the developmental are. This approach brings home the point that there’s nothing
level of the group, age-appropriate folktales from mainstream more “right” or “natural” about the school culture than the
culture can be read. CLD children can be asked whether they home culture. What is important is to know the language and
know any similar stories. The clinician or teacher may consult behavior that is expected in each. Again, role-playing and
in advance with a librarian about parallel stories from different previously developed scripts can be useful to help CLD stu-
cultures and obtain books that tell parallel tales. “Little Red dents interact with the culturally specific materials. Teacher-
Riding Hood” and its Chinese version, “Lon Po Po” (Young, student, storekeeper-customer, doctor-patient, and other fa-
1989), for example, may be read and compared. miliar roles can be played out to give CLD students additional
Comparative folklore studies have many advantages. They experience with the language and organization of commonly
not only bring students’ experience into the classroom, but occurring activities in the mainstream culture.
they also allow metalinguistic focus on different ways of tell- Cheng (1989) also suggested using the “personal weather
ing stories and support narrative development. Cheng sug- report” (Fig. 5.2) to help develop vocabulary for emotional
gested doing activities, such as having parents tell stories in expression. Because this is an area in which traditional
Anxious Confident Determined Jealous Lonely Mischievous
Disgusted Frustrated Hurt Pained Sad Satisfied

FIGURE 5.2 Personal weather report. (Reprinted with permission from Cheng, L. [1989]. Inter-
vention strategies: A multicultural approach. Topics in Language Disorders, 9[3], 91.)
identify their emotional state on a chart such as the one in

Fig. 5.2. The label for the chosen emotion can be given,
and discussion of the various emotions expressed can be
used to compare and contrast the various words and the
feelings they represent. Later, figurative uses of words such
as “cold” and “warm” to discuss feelings can be added
to the activity. Other figurative uses of such words (“That’s
a hot car!”) also might come up. (These activities will
also be very helpful for students with autism spectrum
disorders.)
Scott and Rogers (1996) discussed ways of helping the
older CLD student improve writing abilities in the class-
room. They emphasized that the writings of CLD students
often sacrifice self-expression for the sake of using SAE fea-
Clinicians can provide a range of opportunities for students
tures. They suggest that students be encouraged to write first
to give “personal weather reports.”
for voice and meaning by giving a verbatim transcription of
the way the student would convey the message in speech.
Through successive editing passes, each attending to only
cultures often differ from our American style of “letting it all one feature of SAE at a time, the students bridge the gap
hang out,” CLD students may need extra help developing a between their oral speech style and an SAE version. Addi-
precise and differentiated lexicon of feelings, beyond happy, tional suggestions for SLPs to use in consultation or collabo-
sad, and mad. Clinicians can start each session by giving ration with teachers in classrooms with CLD children are
their own personal weather report and asking the students to summarized in Box 5.7.
BOX 5.7 Suggestions for Multicultural Teaching Methods to Support All English Language
Learners in Classrooms
Adapt classroom materials, using culturally familiar names, Use dialogue journals in which teacher/clinician responds to,
objects, and events. rather than corrects, student writing.
Bridge vocabulary development by providing some information Use language experience stories, in which the teacher writes
and expansion on new English words in the home language. down students’ oral narratives.
Build on prior knowledge. Use scripts.
Develop cooperative learning groups; allow groups to work first Use semantic webs.
in home language, then move to English. Use social and pragmatic activities.
Employ peer tutoring and mediation. Use visual and contextual supports by presenting information in
Employ role-playing. spoken, written, and graphic modes.
Focus on communication in reading and writing. Use “What I know” charts.
Integrate culturally-based stories. Develop a bicultural approach.
Provide context and background information. Talk about differences between “home talk” and “school
Provide word maps. talk.”
Provide written materials in both English and the first language. Encourage extracurricular activities that come from the home
Read aloud to students throughout the elementary grades. culture and that expose children to mainstream culture
Use a variety of narrative styles (recounts, event casts, and activities.
so on). Encourage high levels of interaction between CLD and main-
Use a variety of social organizations for classroom activities; stream students, or students with different CLD backgrounds.
pairs, continuing groups, reshuffling groups. Include a strong parental and community involvement
Incorporate culturally appropriate materials to new curricular component.
topics and themes.
CLD, Culturally and linguistically different.

Adapted from Faircloth, S. C., & Pfeffer, R. (2008). Collaborating with tribal communities and families to improve the social, emotional, and lin-
guistic competence of young indigenous children. Perspectives on Communication Disorders and Sciences in Culturally and Linguistically
Diverse Populations, 15(1), 19-26; Goldstein, B. (2000). Cultural and linguistic diversity resource guide for speech-language pathology. San Diego:
Singular Publishing Group; Inglebret, E., Jones, C., & Pavel, D. M. (2008). Integrating American Indian/Alaska native culture into shared
storybook intervention. Language, Speech, and Hearing Services in Schools, 39(4), 521-527; Lugo-Neris, M. J., Jackson, C. W., & Goldstein, H.
(2010). Facilitating vocabulary acquisition of young English language learners. Language, Speech, and Hearing Services in Schools, 41(3),
314-327; Roseberry-McKibbin, C. (2008). Multicultural students with special language needs. Oceanside, CA: Academic Communication
Associates; Thordardottir, E. (2005). Language intervention from a bilingual mindset. Perspectives on Communication Disorders and Sciences
in Culturally and Linguistically Diverse Populations, 12(2), 17-22; van Kleeck, A. (September 25, 2007). Home talk and school talk: Helping
teachers recognize cultural mismatch. ASHA Leader.
who have been excluded from the mainstream to find their

CONCLUSIONS place in the bubbling multicultural mixture that is the
We started our discussion of multicultural issues in child Western world, we might do well to remember the pluses and
language disorders with the reminder that, despite our differ- minuses of this historical pattern. We certainly want to help
ences, we all share a common cultural identity, be it American, and encourage CLD children and their families to develop
European, Australian, Kiwi, or South African. Most of us who proficiency in Standard English, which will give them the
are American SLPs now have ancestors who, at some point, broadest opportunities for scholastic and economic success.
were newcomers to this country and spoke little English, too. But at the same time, we might recall the advantages that be-
Most of us have lost the languages with which our families ing bilingual or bicultural can confer. In working with CLD
came to these shores. That has some advantages, like the fact clients, our challenge is to strike a delicate balance. We must
that we can all talk to each other in a rich common tongue provide the tools of Standard English communication that
that has borrowed elements from many of the languages our will allow participation in the mainstream culture, but we
families brought here. But the loss of the old languages is sad, must do so without confiscating the tools of communication
too. So many of us are now monolingual, which limits our that make the life of the individual rich and integrated and
communication in some ways in this ever-smaller world. As the mosaic of our country increasingly vibrant as new ele-
we think about our role in helping new arrivals and those ments continue to be added to its texture.
STUDY GUIDE
I. An Introduction to Cultural Diversity be used to differentiate limited English proficiency
A. Define bicultural education. from a language disorder?
B. Distinguish a language difference from a language F. How can dynamic assessment be used with CLD
disorder. children?
C. Define dialect. G. What are the uses of behavioral observation with the
D. Discuss the meaning and importance of code-switching. CLD child?
E. What is meant by limited English language proficiency? H. What is ethnographic assessment, and how can it be
II. Assessing Culturally and Linguistically Different Chil- used in the evaluation of a CLD child?
dren III. Language Intervention and the Culturally and Linguisti-
A. How can language dominance be established? Why is cally Different Child
it important to establish it? A. What are the service delivery options for a CLD child
B. How can interview data be obtained from families of whose dominant language is not English when the
culturally and linguistically different (CLD) children clinician is monolingual in English?
if the clinician does not speak their language? B. What is the speech-language pathologist’s (SLP’s)
C. Discuss the appropriate uses of standardized tests role with the typically developing child who has low
with CLD children. English language proficiency or a nonstandard dia-
D. When is it appropriate to make modifications to lect of English?
standardized tests? What are appropriate modifica- C. Describe a general approach to improving English
tions? How can the results of these modifications of language proficiency for children with nonstandard
tests be interpreted properly? dialects. Give several specific examples of activities
E. Discuss the use of speech sample analysis with the that might be used in such a program.
CLD child. How can it be done if the clinician does D. Describe several approaches and activities for making
not speak the child’s dominant language? How can it instruction culturally appropriate for CLD children.
APPENDIX 5.1
IDEA Issue Brief
CULTURALLY AND LINGUISTICALLY to children in the LEA, “particularly, but not exclusively” to
DIVERSE STUDENTS those in groups that were significantly over-identified. The
LEA also will be required to publicly report on the revision
What the 2006 Individuals with Disabilities of policies, practices, and procedures. These regulations
Education Act Part B Final Regulations Say clearly define steps that states must take to address the
The 2006 Individuals with Disabilities Education Act (IDEA) problem of disproportionality in special education. In par-
regulations continue to support appropriate service delivery ticular, mandating that funds under §613(f) are to be used
to culturally and linguistically different (CLD) populations. for early intervening services is an excellent strategy for
Areas of practice that remain the same include the following: states with this problem. Research has shown that early in-
• Assessment and other evaluation materials should not be tervening strategies assist in reducing the number of inap-
racially or culturally discriminatory. propriate referrals to special education. Long-term effects
• Assessment and other evaluation materials are to be pro- of reducing disproportionality using early intervening
vided in the child’s native language or other mode of com- services include reduced paperwork, as well as a reduced
munication unless it is clearly not feasible to do so. caseload for special education personnel.
• A child must not be determined to be a child with a dis-
ability if the determinant factor is lack of appropriate Implications for American Speech-Language-
instruction in reading or math, or limited English Hearing Association Members
proficiency. The statute, IDEA 2004, continues to emphasize the need for
• Parents are entitled to an interpreter at the Individualized appropriate evaluation procedures for CLD students. The
Education Program (IEP) meeting if needed to ensure 2006 regulations emphasize the allowance of variance from
that the parents understand the proceedings. standard testing procedures when necessary to appropriately
• When developing an IEP, in the case of a child with limited evaluate a student. Use of nonstandardized testing proce-
English proficiency, the language needs of the child as they dures, such as portfolio assessments or spontaneous language
relate to their IEP must be considered. samples, can provide valuable qualitative information on the
An addition to the 2006 regulations on evaluation proce- child’s communication skills. When evaluating English lan-
dures (§300.304) requires that assessment and other evalua- guage learner (ELL) students, it is important for speech-
tion materials are administered “in the form most likely to language pathologists (SLPs) to carefully review the child’s
yield accurate information on what the child knows and can language history to determine the language of assessment. If
do academically, developmentally, and functionally.” For it is determined that the child should be evaluated in a lan-
CLD students, the “form” in which evaluation procedures are guage other than English, the SLP must use all available
administered vary. The addition of this new language empha- resources, including interpreters when necessary, to appro-
sizes the allowance of variance from standard testing proce- priately evaluate the child. In addition, states are facing more
dures, when necessary, in order to appropriately evaluate a stringent repercussions if their school districts are found to
student. have a disproportionate number of CLD students in special
Additionally, the 2006 IDEA regulations made significant education. SLPs will need to ensure that their assessment
steps toward addressing problems with inappropriate iden- strategies for these students in particular are appropriate and
tification and disproportionate representation by race and that they yield the most reliable results.
ethnicity of children as children with disabilities. A provi-
sion was added requiring states to review ethnicity data in What American Speech-Language-Hearing
addition to race data to determine the presence of dispro- Association Members Can Do
portionality (§300.646). In the event that significant dispro- American Speech-Language-Hearing Association (ASHA)
portionality is determined, the state will not only be re- members must ensure that their assessments for all students,
quired to review and revise policies, procedures, and especially CLD students, are appropriate and yield valid re-
practices, but also will require the local education agency sults. SLPs and audiologists must advocate at the state and
(LEA) to reserve the maximum amount of funds under local levels for identification, assessment, and eligibility poli-
§613(f) of the statute to provide early intervening services cies and procedures for CLD students to assist in eliminating
175
the issues of disproportionality. ASHA members must knowledge and skills needed to provide culturally and lin-
also advocate for inclusion in the development and provi- guistically appropriate services, as well as advocate for re-
sion of early intervening services. Research has shown sources in order to provide effective services. ASHA has a
that early intervening strategies assist in reducing the number of resources on its website at http://www.asha.org/
number of inappropriate referrals to special education. practice/multicultural/ that focus on service delivery to CLD
Long-term effects of reducing disproportionality using early populations. There are also a number of continuing educa-
intervening services include reduced paperwork, as well tion programs that provide information on best practice for
as a reduced caseload for special education personnel. working with ELL students, bilingual populations, and other
ASHA members are encouraged to continue developing the CLD students.
Reprinted with permission from ASHA Ideas Issue Brief (http://www.asha.org/Advocacy/federal/idea/IDEA-Part-B-Issue-Brief-Culturally-

and-Linguistically-Diverse-Students/).
APPENDIX 5.2
A Sample of Multicultural Tests
and Assessment Materials
Name Description
Assessment Instrument for Multicultural A criterion-referenced instrument for examining a broad range of 22 communication
Clients (Adler, 1991) behaviors in children with LEP.
Alberta Language Development Ques- Interview protocol for gathering information regarding child development, family lan-
tionnaire (ALDeQ; Paradis, Emmerzael, guage or learning difficulties, use of languages in the home, and child behavior and
&Sorenson, 2010) interest. For use in conjunction with measures of language proficiency.
Bilingual Classroom Communication Ages 4-11. Observational screening tool to help classroom teachers distinguish
Profile (Roseberry-McKibbin, 1993) communication differences from communication disorders.
Bilingual Language Proficiency Ages 3 and up. Parent interview questionnaire regarding bilingual children’s development
Questionnaire (Mattes & Santiago, and use of speech and language. Items listed in both English and Spanish. Vietnamese
1985) edition available upon request.
The Bilingual Verbal Ability Tests- Assesses the following in people 5 years old to adult: Cognitive Ability; Picture Vocabulary,
Normative Update (BVAT-NU; Muñoz- Oral Vocabulary, and Verbal Analogies. Comprised of three subtests from the Woodcock-
Sandoval, Cummins, Alvarado, & Ruef, Johnson−Revised Tests of Cognitive Ability; Picture Vocabulary, Oral Vocabulary, and
2005) Verbal Analogies. These three subtests have been translated from English into eighteen
languages. The languages available in BVAT are Arabic; Chinese, Simplified; Chinese,
Traditional; French; German; Haitian-Creole; Hindi; Hmong; Italian; Japanese; Korean;
Navajo; Polish; Portuguese; Russian; Spanish; Turkish; Vietnamese.
Bilingual Vocabulary Assessment Ages 3 to adult. Initial screening for expressive vocabulary. Available in Spanish,
Measure (Mattes, 1995) French, Italian, Chinese, Vietnamese
Boehm Test of Basic Concepts—3 Grades K-2. Designed to measure children’s mastery of basic concept vocabulary. The
(Boehm, 2001) test manual and instruments are available in Spanish.
Bracken Basic Concept Scale—Third Ages 3-7. Assess 258 basic concepts including color, quantity, shapes. Child points to
Edition: Receptive (BBCS-3:R; items. Available in Spanish for criterion-referenced use only.
Bracken, 2006)
Bracken School Readiness Assessment- Ages 3-7. Assesses concept knowledge including; colors, letters, numbers/counting,
Third Edition (BSRA-3; Bracken, 2007) sizes/comparisons, and shapes. National norms are provided for English only, but
Spanish norms can be developed for local Spanish-speaking population. Includes
information on how to develop local norms.
Brigance Diagnostic Assessment of Grades PreK-9. Designed to establish language dominance and distinguish between
Basic Skills—Revised, Spanish Edition language difference and learning difficulty. Constructed using the comprehensive
(Brigance ABS-R, Spanish; Brigance, Inventory of Basic Skills (not a direct translation).
2007)
Clinical Evaluation of Language Ages 5-22. CELF–4 Spanish has been enhanced to better address the needs of clinicians
Fundamentals—Fourth Edition, who serve Spanish-speaking children and young adults. CELF–4 Spanish was developed
Spanish (CELF–4 Spanish; Wiig, specifically for Spanish speakers living in the U.S. as a parallel test to the English edition
Semel, & Secord, 2006) of CELF–4. It is not a translation of the English edition of CELF–4. Test items incorporate
grammatical forms appropriate for Spanish speakers and themes familiar to Spanish
speaking students.
Clinical Evaluation of Language Ages 3-7. Comprehensively evaluates the language of monolingual and bilingual
Fundamentals—Preschool 2, Spanish Spanish-speaking children. Offers four levels of assessment to detect disorder, deter-
(CELF–Preschool-2 Spanish; Wiig, mine nature of disorder, pinpoint skills underlying disorder, and evaluate how disorder
Secord, & Semel, 2006) affects classroom performance.
Comprehensive Assessment of Spoken Ages 3-21. Used to assess broad oral language skills or specific categories of interest.
Language-2 (CASL-2; Carrow-Woolfolk, Does not require reading or writing. Includes alternative scoring for African American
2017) dialect.
Continued
177
Name Description
Comprehensive Test of Phonological Ages 4-25. Assessment of reading-related phonological awareness skills. Yields com-
Processing—Second Edition (CTOPP-2; posite scores for Phonological Awareness, Phonological Memory, Rapid Symbolic
Wagner, Torgesen, Rashotte,& Pearson, Naming, Rapid Non-Symbolic Naming, and an Alternate Phonological Awareness
2013) Composite Score for older test takers.
The Critical Questions Interview Protocol for interviewing parents and teachers of a bilingual child with a suspected
(Crowley, 2014) language disorder. Parent interview for use before evaluator sees the student,
teacher interview for after evaluation. Available online.
Diagnostic Evaluation of Language A diagnostic instrument to assess the status of four language domains (i.e., Phonological,
Variation – Norm-Referenced (DELV— Syntactic, Semantic, and Pragmatic) in children ages 4:0–9:11 with assessment that is
Norm-Referenced; Seymour, Roeper, & unbiased for AAE speakers.
de Villiers, 2005)
Developmental Indicators for the Ages 2;6-6. Available in Spanish. Screens development in motor, concept, language,
Assessment of Learning, Fourth Edition self-help, and social function areas.
(DIAL-4; Mardell & Goldenberg, 2011)
Dynamic Assessment of Diverse Compares and contrasts different models of Dynamic Assessment. Outlines a protocol
Children: A Tutorial (Gutieerrez-Clellan aimed at distinguishing language difference from disorder by assessing language-
& Pena, 2001) learning potential.
Expressive and Receptive One-Word Ages 2-adult. Offers an assessment of receptive and expressive vocabularies of
Picture Vocabulary Tests, Fourth individuals who are bilingual in Spanish and English. By permitting examinees to
Edition—Spanish-Bilingual Edition respond in both languages, this test assesses total acquired vocabulary.
(EOWPVT-4 and ROWPVT-4;
Brownell, 2012)
The tests are co-normed on a national sample of Spanish-bilingual individuals. Record
forms include acceptable responses and stimulus words in both languages.
Get Ready to Read! Revised (GRTR- Ages 3-6. A screening tool to evaluate readiness for learning to read and write. Specifically
R;Whitehurst & Lonigan, 2008) developed for preschoolers, the test has been evaluated for its reliability, factor structure,
relationship with other literacy assessments, and consistency across children from low-
and middle income backgrounds. Backed by the National Center for Learning Disabilities,
the instrument has been field-tested in early childhood programs. In Spanish.
Language Experience and Proficiency Designed to assess bilingual individuals’ linguistic profiles. It is used to assess bilingual
Questionnaire (LEAP-Q; Blumenfeld, & experience and proficiency profiles in first and second languages and is a self-report
Kaushanskaya, 2007) questionnaire. It can be used with adolescent and adult bilinguals and multilinguals.
Lindamood Auditory Conceptualization Criterion-referenced test that measures phonological awareness and segmentation
Test—Third Edition, Spanish Version skills. Examiner’s cue sheet for testing Spanish-speaking subjects.
(LAC 3; Lindamood & Lindamood, 2004)
Logramos Tercera Edicion (Riverside Grades K-8. Assesses reading, language, and math. Standardized test designed to
Publishing, 2014) measure the academic progress of Spanish-speaking students. Depending on grade
level, can require up to 8 subtests to be administered.
MacArthur Inventarios del Desarrollo de Ages 3-30mo. Assesses expressive and receptive vocabulary sizes and early grammati-
Habilidades Comunicativas (Jackson- cal production in infants 8-30 mo. Parent-report instrument. Reports good validity
Maldonado, Thal, Fenson, Marchmann, when compared with direct observation measures. The CDIs (English version of
Newton, Conboy, & Bates, 2003) instrument) were normed on approximately 1800 children in three locations, and the
Inventarios were normed on more than 2000 children.
CDIs are also available in more than 60 languages. Contact individual authors for details.
Non-word Repetition Task (NRT; Dollaghan A list of 16 non-word stimuli containing one, two, three, and four syllable words (four
& Campbell, 1998) each). Phonemes are restricted to early developing sounds and only tense vowels are
used.
OnlineIPT Language Proficiency Tests Grades PreK–12. Web-based language proficiency tests available in English and Spanish.
(Ballard and Tighe Publishers, 2017) Assesses oral, reading, and writing proficiency.
The Oral Language Acquisition Inventory, Provides information about the most common language structures children use expres-
Second Edition (OLAI-2; Gentile, 2011) sively and shows clinicians to how elicit meaningful conversation and develop prompts
that expand and refine language with English-language learners and children who could
benefit from language instruction.
Phonological Awareness Literacy Grades K-3. Identifies Spanish-speaking children who perform below grade level expec-
Screening Espanol (PALS Espanol; tation in literacy.
Ford & Invernizzi, 2014)
Preschool Language Scales, Fifth Ages 2;6 to 3 years. Diagnostic measure of receptive and expressive language. Sub-
Edition Spanish (PLS-5 Spanish; tests measure grammar, vocabulary, memory, attention span, temporal and spatial
Zimmerman, Steiner, & Pond, 2012) relations, and self-image. Record forms are available in English and Spanish.
Name Description
The Rosetti Infant-Toddler Language Ages 0-4 yr. Available in Spanish. Identifies early communicative behaviors and verbal
Scale (Rossetti, 2006) language developments in young children.
Scales of Independent Behavior— Available in Spanish. Assesses four adaptive behavior clusters: motor skills, social and
Revised (SIB-R; Buininks, Woodcock, communication skills, personal living skills, and community living skills. Ages birth to
Weatherman, & Hill, 1996) adult.
School-Age Language Assessment Ages PreK-Elementary. Sets of illustrated cards and accompanying questions designed
Measures Cards (SLAM; Crowley, to elicit language samples and narratives from young and school-age children.
Baigorri, & Yeung, 2014)
Spanish Articulation Measures—Revised Ages 3 to adult. A criterion-referenced measure using spontaneous and elicited tasks
Edition (Mettes, 1995) to assess speech sound production and use of phonological processes.
Spanish Language Assessment Ages 3-9. Criterion-referenced measures for assessing vocabulary development,
Procedures: A Communication Skills speech sound production, sentence structure, listening, pragmatics, and other
Inventory—Third Edition (L. Mattes) aspects of a child’s communication.
Spanish Test for Assessing Morphologic Ages 5-11. Assesses production of plurals, verb endings, and other structures as children
Production (STAMP; Nugent, Shipley, complete sentences related to the action in pictures.
& Provencio, 1991)
Structured Photographic Expressive Ages 4-10. Test of expressive language for Standard English or African-American
Language Test—Third Edition (SPELT-3; English speakers. Available for preschoolers or elementary age children. Spanish
Dawson, Stout & Eyer, 2003) version also available.
Test de Vocabulario en Imagenes Ages 2;6-18. Contains items from PPVT-R, selected for universality and appropriateness
Peabody (L. Dunn, D. Lugo, E. Padilla, is Spanish.
and L. Dunn)
Test of Auditory Processing Skills—3 Ages 5-19. Designed to assess auditory skills and particular auditory processes includ-
Spanish Bilingual Edition (TAPS-3:SBE; ing auditory attention, basic phonological skills, auditory memory, and auditory cohe-
Martin, 2009) sion. The test was normed on Spanish-bilingual children from 5 years through 18 years
of age. TAPS-3: SBE is intended to be used as part of a battery of tests to determine
how children use and understand what they hear.
Test of Early Language Development— Ages 2-8. Based on a translation and adaptation of the Test of Early Language
Third Edition: Spanish Version (TELD-3:S; Development—Third Edition (TELD-3; Hresko, Reid, & Hammill, 1999). It evaluates
Ramos, Ramos, Hresko, Reid, & Hammill, the early language development of Spanish-speaking young children (i.e.,
2007) monolingual or Spanish-dominant) between the ages of 2 yr and 7:11 yr.
Test of Phonological Awareness in Ages 4-11. Measures phonological awareness skills in Spanish-speaking children.
Spanish (TPAS; Riccio, Imhoff, Normed on over 1000 Spanish-speaking children. Internal consistency reliabilities
Hasbrouck, & Davis, 2004) from 0.87 to 0.98, test-retest reliability for composite scores are above 0.80.
Vineland Adaptive Behavior Scales— Ages 0-90. Available in Spanish. Assesses performance of daily activities required for
Third Edition (Sparrow, Cicchetti, & personal and social self-sufficiency.
Saulnier, 2016)
Woodcock-Munoz Language Survey III Age 3-19. Available in Spanish. Measures cognitive, academic, and language
(WMLS III; Alvarado, Ruef, & Schrank proficiency. Assesses picture vocabulary, verbal analogies, letter-word identification,
2017) and dictation as measures of oral language, reading, and writing domains.

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5

Developmental Language Disorders

INTRODUCTION serve. Therefore, we need to consider general approaches

Language Difference or Language Disorder? 3. Language impairment, adequate background

Assessment of Different English structure or unit of language is differentially represented, used,

considering how long it might take for Jose to become fully

BOX 5.2 Strategies for Developing

BOX 5.3 Langdon’s Briefing, Interaction,

children (NALDIC, https://naldic.org.uk/the-eal-learner/ performance on different aspects of language for typically

TABLE 5.2 A Model for Comprehensive Assessment of English Language Learners

TABLE 5.2 A Model for Comprehensive Assessment of English Language Learners—cont’d

The Worst-Case Scenario CASE STUDY

students. Here, students are encouraged to write about their

ELL, English language learner.

Anxious Confident Determined Jealous Lonely Mischievous

Disgusted Frustrated Hurt Pained Sad Satisfied

identify their emotional state on a chart such as the one in

CLD, Culturally and linguistically different.

who have been excluded from the mainstream to find their

Reprinted with permission from ASHA Ideas Issue Brief (http://www.asha.org/Advocacy/federal/idea/IDEA-Part-B-Issue-Brief-Culturally-

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