Study Notes on Speech-Language Pathologists' Practices for Multilingual Children with Speech Sound Disorders

Journal of Communication Disorders, Volume 46, Issue 4, July–August 2013

  • Article: International aspirations for speech-language pathologists’ practice with multilingual children with speech sound disorders: Development of a position paper

  • Authors: Sharynne McLeod, Sarah Verdon, Caroline Bowen, the International Expert Panel on Multilingual Children's Speech

  • DOI: https://doi.org/10.1016/j.jcomdis.2013.04.003

Highlights

  • An international expert panel developed a position paper for addressing the needs of multilingual children with speech sound disorders.

  • Panel Composition: 57 international collaborators from 33 countries with proficiency in 26 languages.

  • Key areas addressed include:

    • Referral

    • Assessment

    • Intervention

    • Cultural competence

    • Collaboration with families and professionals

  • The position paper applies the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY).

Abstract

  • A significant challenge in speech-language pathology is the disparity between the linguistic uniformity of the profession and the heterogeneity of its clients' languages (Caesar & Kohler, 2007).

  • The paper outlines the creation of the Position Paper on Multilingual Children with Speech Sound Disorders that assists speech-language pathologists (SLPs) in facilitating multilingual communication.

  • Panel Structure:

    • 14 experts convened for a one-day workshop to explore essential content, followed by contributions from 42 members online.

  • Data sources included:

    • The in-person workshop transcript (133 pages)

    • Online discussion artifacts (104 pages)

  • Identified Themes:

    • Definitions

    • Scope

    • Framework

    • Evidence

    • Challenges

    • Practices

    • Consideration of multilinguality

  • Recommendations are structured using the ICF-CY and focus on the following groups:

    • Children and families

    • SLPs’ assessment and intervention strategies

    • Professional practices of SLPs

    • Collaboration between SLPs and other professionals

Learning Outcomes

  • Recognition: Understand that multilingual children with speech sound disorders possess unique needs both distinct from and similar to monolingual children.

  • Description of Challenges: Articulate the difficulties faced by SLPs working with multilingual children.

  • Cultural Competence: Acknowledge the significance of cultural sensitivity among SLPs.

  • Collaboration Methods: Identify strategies for international cooperation and consultation among SLPs.

  • Community Engagement Importance: Emphasize the need for working with families and local communities to support multilingual children effectively.

Introduction

  • Many children achieve communication proficiency, regardless of the number of languages spoken (Hambly et al., 2013).

  • Some children struggle to communicate effectively in all spoken languages.

  • Speech-language pathology interventions are particularly beneficial for children experiencing speech sound disorders (Law et al., 2010).

    • Intervention may help mitigate risks related to educational, social, and employment outcomes from untreated speech and language difficulties (Johnson et al., 2010).

  • Workforce Diversity Issues:

    • Monolingual SLP workforce contrasts with the multilingual status of clients, especially in various nations with multiple official languages (e.g., Belgium, Canada, South Africa).

    • In the U.S., over 55.4 million people (19.7%) aged 5 and older speak languages other than English (Shin & Kominski, 2010).

    • In Australia, non-English speaking households rose from 21.5% in 2006 to 23.2% in 2011 (Australian Bureau of Statistics, 2012).

  • Core Question: How can we bridge the linguistic divide between a largely monolingual profession and a linguistically diverse client base?

  • The position paper aims to provide guidelines to SLPs to aid multilingual children with speech sound disorders in improving communication outcomes.

  • Speech sound disorders are prevalent among young children and can affect:

    • Speech perception

    • Articulation

    • Phonological representation

  • Can be categorized by known origins (e.g., cleft lip, Down syndrome) or unknown causes.

  • Childhood speech sound disorders correlate with negative long-term developmental impacts, particularly in literacy (Felsenfeld et al., 1994; Lewis et al., 2000; McCormack et al., 2009; Ruben, 2000).

  • Importance of Timely Intervention:

    • Critical for effective treatment before age 5 to 6 years (Bishop & Adams, 1990; Nathan et al., 2004).

    • Early intervention can lead to successful outcomes for speech sound disorders (Law et al., 2010).

  • Noteworthy that more research has focused on multilingual children with language disorders than those with speech sound disorders (Kohnert, 2008; McLeod & Goldstein, 2012).

  • Multilingual children's speech acquisition can vary significantly from monolingual children’s due to factors including language exposure and acquisition order (Hambly et al., 2013; Kohnert, 2008; McLeod & Goldstein, 2012).

  • SLPs’ Role: Identify and distinguish typical multilingual speech patterns from actual speech sound disorders.

Challenges in SLPs’ Practice with Multilingual Children

  • Referral Concerns:

    • Individuals responsible for child referrals (parents, teachers, healthcare practitioners) lack essential knowledge for accurately identifying speech sound disorders in multilingual children (Stow & Dodd, 2005).

    • No correlation has been established between multilingualism and the incidence of speech or language disorders.

    • Differences in representation were noted in studies (UK example):

      • Multilingual children with speech sound disorders: 25.7%

      • Monolingual children with speech sound disorders: 58.4%.

  • Assessment Challenges:

    • Three primary issues identified by SLPs:

      • Cultural appropriateness of assessment tools

      • Normative data scarcity for multilingual acquisition

      • Confidence levels in distinguishing speech differences from speech sound disorders.

    • Limited availability of reliable, valid assessment tools for multilingual children (e.g., reliance on informal measures) (Guiberson & Atkins, 2012; Jordaan, 2008).

    • Some available resources outside English include monolingual and multilingual assessment tools in languages like Arabic, Cantonese, German, and Spanish.

  • Normative Data Gaps:

    • A review identified a lack of sufficient research on normative data related to multilingual children's speech acquisition despite existing papers on the subject (Hambly et al., 2013).

  • SLP Confidence Issues:

    • Lack of confidence reported by 42% of SLPs regarding assessment effectiveness for culturally diverse children (Guiberson et al., 1998).

    • Resulting issues can include late identification or inappropriate representation of multilingual children in SLP services (Winter, 2001).

  • Intervention Challenges:

    • Culturally appropriate resources are scarce (Guiberson & Atkins, 2012).

    • Parental expectations significantly influence intervention language choices (Lee & Ballard, 2011; Cruz-Ferreira & Ng, 2010).

    • Intervention often conducted in SLP's native language rather than the child's languages due to training deficits and available resources.

  • Training Gaps:

    • Pre-service training often insufficient for effectively managing culturally diverse populations (Guiberson & Atkins, 2012).

    • Ongoing training and resources required are crucial, specifically training for working with multilingual children (Kritikos, 2003; Skahan et al., 2007).

  • Interpreter Collaboration Issues:

    • Interpreters and translators are essential for effective service provision but face challenges:

      • Access limitations

      • Inadequate training for collaborative practices between SLPs and interpreters (Guiberson & Atkins, 2012).

  • Cultural Competence:

    • Definition: "Acknowledges and incorporates the importance of culture across service levels, assesses cross-cultural relations, and aims to adapt services to meet unique cultural needs" (Betancourt et al., 2003).

  • Service Delivery Challenges:

    • Limited access to services for multilingual children, particularly noted when referrals rely on parental initiative (Winter, 2001).

    • The need for increased time and resources for appropriate assessment and intervention related to multilingual children and their families.

Position Paper Development

  • The International Expert Panel was formed to:

    1. Define best practices for multilingual children with speech sound disorders.

    2. Identify practical steps to enhance international practices in this domain.

  • The paper serves as an aspirational reference driven by empirical evidence and expert opinion to facilitate best practices for multilingual children facing speech sound disorders.

Acknowledgments

  • Development supported by an Australian Research Council Fellowship (FT0990588) awarded to Sharynne McLeod.

  • Contributors:

    • Sharynne McLeod (chair) (Charles Sturt University, Australia)

    • Sarah Verdon (Charles Sturt University, Australia)

References

  • Comprehensive references supporting the findings and assertions made within the article, including studies and literature exploring multilingual children's speech sound disorders and SLP practices.

Conclusions

  • The Position Paper represents the collective vision of the International Expert Panel for delivering effective services to multilingual children diagnosed with speech sound disorders, structured using the ICF-CY from the WHO.