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Washington KN, Crowe K, McLeod S, Margetson K, Bazzocchi NBM, Kokotek LE, van der Straten Waillet P, Másdóttir T, Volhardt MDS. Methods of Diagnosing Speech Sound Disorders in Multilingual Children. Lang Speech Hear Serv Sch 2025:1-19. [PMID: 40408157 DOI: 10.1044/2025_lshss-24-00099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2025] Open
Abstract
PURPOSE Identification of speech sound disorder (SSD) in children who are multilingual is challenging for many speech-language pathologists (SLPs). This may be due to a lack of clinical resources to accurately identify SSD in multilingual children as easily as for monolingual children. The purpose of this article is to describe features of multilingual speech acquisition, identify evidence-based resources for the differential diagnosis of SSD in speakers of understudied language paradigms, and demonstrate how culturally responsive practices can be achieved in different linguistic contexts. METHOD Examples of different approaches used to inform accurate diagnosis of SSD in 2- to 8-year-old multilingual children are described. The approaches used included (a) considering adult speech models, (b) completing validation studies, and (c) streamlining evidence-informed techniques. These methods were applied across four different language paradigms in countries within the Global North and Global South (e.g., Jamaican Creole-English, Jamaica; Vietnamese-English, Australia; French and additional languages, Belgium; Icelandic-Polish, Iceland). The culturally responsive nature of approaches in each cultural/linguistic setting is highlighted as well as the broader applicability of these approaches. RESULTS Findings related to dialect-specific features, successful validation of tools to describe functional speech intelligibility and production accuracy, and the utility of different techniques applied in the diagnosis of SSD are outlined. CONCLUSIONS Culturally responsive methods offer a useful framework for guiding SLPs' diagnostic practices. However, successful application of these practices is best operationalized at a local level in response to the linguistic, cultural, and geographic context. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.29090000.
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Affiliation(s)
- Karla N Washington
- Department of Speech-Language Pathology, University of Toronto, Ontario, Canada
- Department of Communication Sciences and Disorders, University of Cincinnati, OH
- The Institute for Education Research, Toronto, Ontario, Canada
| | - Kathryn Crowe
- Department of Speech-Language Pathology, University of Toronto, Ontario, Canada
- School of Health Sciences, University of Iceland, Reykjavík
- Children's Voices Centre, Charles Sturt University, Bathurst, New South Wales, Australia
| | - Sharynne McLeod
- Children's Voices Centre, Charles Sturt University, Bathurst, New South Wales, Australia
| | - Kate Margetson
- Children's Voices Centre, Charles Sturt University, Bathurst, New South Wales, Australia
| | | | - Leslie E Kokotek
- Department of Communication Sciences and Disorders, University of Cincinnati, OH
| | - Pauline van der Straten Waillet
- Faculty of Psychology, Educational Sciences, and Speech-Language Pathology, Université Libre de Bruxelles, Brussels, Belgium
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NoorAli S, De Anda S, Cycyk LM, Starlin S. Barriers and Facilitators to Assessment Practices in Linguistically Diverse Children: A Preliminary Application of Theoretical Domains Framework. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2025; 34:1154-1175. [PMID: 40112027 DOI: 10.1044/2024_ajslp-24-00256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/22/2025]
Abstract
PURPOSE Linguistically diverse children face health disparities in special education services in part due to limited linguistic responsivity in communication assessment practices. This study uses the first application of the Theoretical Domains Framework (TDF) to reveal the various factors that affect the implementation of linguistically responsive practices and their respective barriers and facilitators. METHOD Two focus groups were conducted in Oregon with a total of nine speech-language pathologists, most of whom were multilingual. A deductive and inductive analytical approach in a two-stage process was employed, whereby barriers and facilitators were deductively coded using TDF domains (content analysis) and analyzed for subthemes within each domain as well as barriers and facilitators for each domain. Barriers and facilitators were summarized across overarching themes. RESULTS A total of 33 themes were extracted from all the domains. The most commonly coded TDF domains in the focus group transcript were knowledge (69%), beliefs about consequences (48%), and environmental context and resources (33%). The overarching themes identified across domains were related to the role of family, flexibility and adaptability, limitations of assessment tools, need for help through experts, research and training, and approach to language differences. CONCLUSIONS The findings from this study offer a precise initial characterization of the barriers and facilitators to linguistically responsive communication assessment of children from birth to age 5 years. Future research should focus on supporting facilitators while eliminating barriers to ensure equitable service provision for all children. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.28516196.
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Affiliation(s)
- Sabreen NoorAli
- Department of Special Education and Clinical Sciences, University of Oregon, Eugene
| | - Stephanie De Anda
- Department of Special Education and Clinical Sciences, University of Oregon, Eugene
| | - Lauren M Cycyk
- Department of Special Education and Clinical Sciences, University of Oregon, Eugene
| | - Sara Starlin
- Center on Human Development, University of Oregon, Eugene
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Mira AS, Wilkens ME, Washington KN, McKenna VS. Phonemic and pitch variability in bilingual preschoolers: A comparison of Jamaican Creole and English. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2025; 27:113-128. [PMID: 38375802 DOI: 10.1080/17549507.2023.2287426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/21/2024]
Abstract
PURPOSE The purpose of this study was to investigate the cross-linguistic influences of Jamaican Creole (JC) and English on phonemic and vocal development in bilingual JC-English-speaking preschoolers. METHOD Sixteen typically developing children (12 females, M = 4 years; 4 months) completed the Diagnostic Evaluation of Articulation in Phonology Word Inconsistency Assessment subtest in JC and in English. Acoustic measures of voice onset time (VOT), VOT variability (VOT SD), mean fundamental frequency (fo), and fo variability (fo SD) were extracted from each target word. Prevoicing was noted. Mixed models and regression models were analysed to understand the patterns of acoustic measures in each language, and the relationship between phonemic and vocal variability, respectively. RESULT Analyses showed a significant effect of language on fo SD, wherein SD was greater in English than JC. JC spoken (percentage) was a significant positive predictor of VOT SD for voiced (short lag) productions. There was no relationship between phonemic and vocal variability measures. CONCLUSION Greater fo SD in English may be due to linguistic fo differences and speaking environment. Variability for voiced VOT is likely due to the continued maturation of vocal and articulatory control when children are developing adult-like productions, though longitudinal studies are needed.
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Affiliation(s)
- Amna Samir Mira
- Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, OH, USA
- College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Mary Elizabeth Wilkens
- Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, OH, USA
| | - Karla Nadine Washington
- Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, OH, USA
- Department of Speech-Language Pathology, University of Toronto, Toronto, Canada
- Department of Communicative Sciences and Disorders, New York University, New York, NY, USA
| | - Victoria Sue McKenna
- Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, OH, USA
- Department of Otolaryngology-Head & Neck Surgery, University of Cincinnati, Cincinnati, OH, USA
- Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH, USA
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Kokotek LE, Washington KN, Bazzocchi N. Using language sample analyses across English dialects: A case-based approach for preschoolers. CLINICAL LINGUISTICS & PHONETICS 2024:1-18. [PMID: 38965827 DOI: 10.1080/02699206.2024.2374917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 06/26/2024] [Indexed: 07/06/2024]
Abstract
This study compared language samples from typically developing 4-year-olds who spoke African American English (AAE), Jamaican English (JE), or Mainstream American English (MAE) to assess the value of using language sample analysis (LSA) measures for characterising language use across dialects of English. Specific LSA metrics included mean length of utterance (MLU) in morphemes and in words, the Index of Productive Syntax (IPSyn), Developmental Sentence Scoring (DSS) and measures of lexical diversity. Children demonstrated diverse linguistic patterns across dialects, but a Kruskal-Wallis H test did not reveal significant differences in scores obtained through LSA measures. Notably, the IPSyn captured morphosyntactic structures in each category across dialects where prior research has highlighted limitations. This preliminary study uses a case-based approach to illustrate the applicability of LSAs in describing linguistic variations across children who speak different dialects of English. Moreover, the findings from this study underscore the potential use of LSAs in describing linguistic patterns to support the characterisation of communication profiles for culturally and linguistically diverse children.
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Affiliation(s)
- Leslie E Kokotek
- Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, Ohio, USA
| | - Karla N Washington
- Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, Ohio, USA
- Department of Speech-Language Pathology, University of Toronto, Toronto, Ontario, Canada
| | - Nicole Bazzocchi
- Department of Speech-Language Pathology, University of Toronto, Toronto, Ontario, Canada
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Kokotek LE, Washington KN, Cunningham BJ, Acquavita SP. Speech-Language Outcomes in the COVID-19 Milieu for Multilingual Jamaican Preschoolers and Considerations for Telepractice Assessments. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:1698-1717. [PMID: 38573244 PMCID: PMC11253648 DOI: 10.1044/2024_ajslp-23-00164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/26/2023] [Accepted: 02/08/2024] [Indexed: 04/05/2024]
Abstract
PURPOSE The purpose of this study was to characterize the communicative participation and functional speech intelligibility (i.e., how children use communication and how well they are understood across everyday life) of typically developing (TD) bilingual Jamaican preschoolers and those with functionally defined speech sound disorders (fSSDs) in the COVID-19 milieu. Findings were also compared to an existing corpus of baseline data to document and explore differences in children's speech-language outcomes secondary to pandemic-related social restrictions. METHOD Thirty bilingual Jamaican preschoolers, 21 TD and nine with fSSDs, were assessed during the pandemic via telepractice. Association and univariate mean testing were completed to characterize children's communicative participation and functional speech intelligibility. Data were then compared to an existing corpus of baseline data (collected in person between 2013 and 2019), which included direct child assessment and parent reports and consisted of TD (n = 226) Jamaican Creole-English-speaking preschoolers and those with fSSDs (n = 39) to compare performance profiles across data sets. All participants attended schools in Kingston, Jamaica. RESULTS Measures of communicative participation remained stable in the context of the COVID-19 milieu for children in the TD and fSSD groups, but functional speech intelligibility outcomes for children with fSSDs deviated between in-person findings collected from children pre-pandemic. Between-groups differences were also found on measures of speech production accuracy but were no longer significant when considering telepractice as a covariate. CONCLUSIONS Findings from this investigation serve to characterize the communicative participation and functional speech intelligibility of TD bilingual Jamaican preschoolers and those with fSSDs in the COVID-19 milieu. By extension, the results comparing data from preschoolers collected during the pandemic to an existing corpus of baseline data from a different group of preschoolers provide critical insights about multilingual children's speech-language outcomes in the context of acutely changing environmental circumstances. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.25461505.
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Affiliation(s)
- Leslie E. Kokotek
- Department of Communication Sciences and Disorders, University of Cincinnati, OH
| | - Karla N. Washington
- Department of Communication Sciences and Disorders, University of Cincinnati, OH
- Department of Speech-Language Pathology, University of Toronto, Ontario, Canada
- Department of Communicative Sciences and Disorders, New York University, NY
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Fabiano L. Introduction to the Research Symposium on Bilingualism Forum. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:4673-4677. [PMID: 38052066 DOI: 10.1044/2023_jslhr-23-00661] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
PURPOSE The purpose of this introduction is to provide an overview of the articles contained within this research forum of the Journal of Speech, Language, and Hearing Research. Each of these articles is based upon presentations from the 2022 ASHA Research Symposium.
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Affiliation(s)
- Leah Fabiano
- Department of Communication Science and Disorders, School of Health and Rehabilitation Sciences, University of Pittsburgh
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