Clinical Methods Chapter 10
To provide bilingual clinical services in the child's language, bilingual SLP should:
-be able to describe typical speech and language development using contemporary data and theory -possess knowledge of dialects in child's home language -use least biased evaluation tools to gauge speech and language skills -administer and interpret formal and informal evaluation tools -apply intervention strategies in child's language -recognize cultural factors that affect assessment and intervention -be able to aid parents and other professionals in understanding diagnosis, assessment, results, and intervention options
What issues should be taken into account when administering formal assessments to clients?
-examine each item before administering test to determine whether client had prior access to info and if failure should be considered indicative of disorder -determine whether modification of specific test items can reduce bias -consider first administering child's test to adult in order to get info on appropriateness of test items -have families complete case history info, permission forms, release of info documents in person -make an effort to identify IN THE NORMATIVE SAMPLE those measures that include individuals from culturally and linguistically diverse populations
What are some assessment tool factors?
-observe code switching and language interference, or one language on another -report all modifications of standardized administration procedures -report norms only if valid for population being assessed -select test that examines those aspects of language that need to be assessed -use variety of elicitation procedures
What are sociolinguistic factors that might influence a clinician's interaction with a client?
1. child socialization practices and children's play characteristics 2. family characteristics (country of birth, degree of acculturation, religious beliefs, family structure) 3. individual differences in clients from culturally and linguistically diverse populations
What are some considerations for intervention when providing intervention to individuals from culturally and linguistically diverse populations?
1. complete reevaluations of individual's intervention needs periodically 2. set up opportunities for language to be used in natural interactions 3. consider a holistic approach by encouraging clients to 1. explain new information in their own words 2. abstract information 3. generalize information and 4. analyze new information 4. allow clients to think, discuss options, make decisions, establish accountability, and show knowledge verbally and nonverbally 5. use a variety of social organizations 6. incorporate the client's home language and/or dialect into the intervention process 7. employ a family centered approach to intervention
What are testing guidelines to decrease the possibility of misdiagnosis?
1. do not use norm referenced tests only 2. do not use only a language sample to qualify someone for services 3. do not use multiple assessments in order to get low scores so someone will be qualified for services 4. do not use translation of tests 5. do not use only one elicitation technique 6. do not use tests administered in English only 7. do not assume features of a second language or a dialect of English are characteristics of a disorder 8. do not assume that support personnel are automatically trained to aid in the diagnostic process
What might monolingual SLPs want to consider?
1. establishing contacts and hiring bilingual SLPs as consultants or diagnosticians to provide clinical services 2. establishing cooperative groups in which school districts or programs might hire an itinerant bilingual SLP 3. establishing networks such as forging links between university setting and work settings to help recruit bilingual speakers into work force 4. establishing clinical fellowship year and graduate student practica sites 5. establishing interdisciplinary teams in which monolingual SLPs are teamed with bilingual professionals from other fields 6. training support personnel such as bilingual aides, students, family members, or members of the community
What are the most commonly reported issues facing SLPs working with ELLs?
1. inability to speak language of child 2. lack of least-biased assessments 3. lack of support personnel who speak child's language 4. lack of information on developmental norms in student's home language
What will communication assessment of bilinguals include?
1. studying bilinguals as a whole without comparison to monolinguals 2. examining both of bilingual's languages 3. investigating how bilinguals organize and use both languages
What percentage of children on SLP caseloads were ELL's?
11.3%
What is an idiodialect?
A person's own unique way of speaking
What is code switching?
Alterations between languages at the word, phrase, or sentence levels
What needs to be used in addition to formal assessments to make a proper differential diagnosis?
Alternative methods of assessment
To provide bilingual clinical services in the child's language, the bilingual SLP should:
Be able to describe typical speech and language development using contemporary data and theory, possess knowledge of dialects in the child's home language, use least biased evaluation tools to gauge speech and language skills, administer and interpret formal and informal evaluation tools, apply intervention strategies in child's language, recognize cultural factors that affect assessment and intervention, be able to aid parents and other professionals in u der standing the diagnosis, assessment results, and intervention options and approaches
When might under diagnosis occur?
Because the examiner assumes all "errors" produced are due to dialect or second-language acquisition
How can local norms be developed?
By administering the test to individuals without language disorders in the community in which you are working, note the scores they receive and the quality of their responses and use their test results as the standard to which the client's test scores can be compared
What are 3 sociolinguistic factors that might influence your interaction with a client and their family?
Child socialization practices and children's play characteristics, family characteristics (country of birth, degree of acculturation into American society, knowledge of U.S. education system, family attitude toward English and English speakers, religious beliefs, social status, socioeconomic status), individual differences
What 3 factors is modifiability composed of?
Client responsiveness (how client responds to and uses new information), examiner effort (quantity and quality of effort needed to make a change), transfer (generalization of new skills)
What is portfolio assessment?
Collecting samples of clients work over time representing a variety of tasks and assignments
What responsibilities can support personnel do?
Conduct speech language screenings, follow intervention plans or protocols, document client progress, assist during assessment
What might alternative test formats include?
Criterion-referenced tests, dynamic assessment, portfolio assessment, ethnographic assessment, probe techniques
What are some suggestions to provide alternative methods of assessment?
Developing new tests, standardizing existing tests on individuals from culturally and linguistically diverse backgrounds, administering standardized tests in nonstandardized ways
What are problems with using translations of tests?
Differences in structure and content in each language; mistakenly implies children acquiring English proficiency and English-speaking children receive similar socialization, life experiences, language input, etc.; Differences in frequency of target words very between languages; grammatical forms may not be equivalent; translated tests don't tap individual's ability to acquire language
What are some testing guidelines that should be followed to decrease the possibility of misdiagnosis?
Do not use norm referenced tests only, do not use only a language sample to qualify someone for services, do not use multiple assessments in order to get low scores so someone will be qualified, do not use translations of tests, do not use only one elicitation technique, do not use tests administered in English only if individual bilingual, do not assume features of second language or dialect of English are characteristics of disorder, do not assume support personnel automatically trained to aid in diagnostic process
What is not a true statement regarding ELLs?
ELLs are expected to increase over the next decade
Where does most normative information about speech and language development and disorders come from?
English speaking, European American, middle class individuals
Who is considered culturally and linguistically diverse?
Everyone who doesn't fall into the morning category (white, European American middle class)
What issues should be taken into account when administering formal assessments?
Examine each item before administering test to determine whether client had prior access to info, determine whether modification of specific test items can reduce bias, consider first administering child's test to adult in order to get info on appropriateness of test items and likely responses from a child, report all modifications of standardized administration procedures, report norms only if valid for population being assessed, use variety of elicitation procedures, etc.
What 4 domains should language assessment take place in?
Functions and activities (interviews, language samples, dynamic assessment), participation (portfolios with homework, class assignments, tests, writing samples), contextual areas (curriculum measures, reading miscues), decontextual Settings (standardized tests)
What are some factors that influence degree of bilingualism?
Generational level, age, occupation, opportunity for contact with speakers of English, exposure to English media, nature of interactions with members of their community
What can a clinician learn through dynamic assessment?
How a client learns, what is needed for client to learn, and how a client generalizes a task to new situations
What are the most commonly reported issues SLPs face in working with ELLs?
Inability to speak the language of the child, lack of least biased assessments, lack of support personnel who speak the child's language, and lack of information on developmental norms in the student's home language
What will SLPs need to use to complete valid and reliable assessments?
Information on communication and culture, bilingualism, and dialects
What is the degree of bilingualism achieved by a person dependent on?
Linguistic, social, emotional, political, demographic, and cultural factors
What is ethnographic assessment?
Observe client in many contexts with many conversational partners, ask family about culture, attitudes, host culture, and communication in home
What is at chance of occurring if alternative methods of assessment aren't used?
Overdiagnosis or underdiagnosis
What is dynamic assessment?
Performance is gauged by examining client modifiability-change through mediation or teaching
What are clinician factors to respond optimally to patients served?
Positive attitude toward the families values and beliefs even if they're different, understanding of typical and atypical language development
What is intervention?
Process by which clinician deliberately sets out to systematically change course of an ongoing behavior
What will the communication assessment of bilingual children and adults necessitate?
Studying bilinguals as a whole without comparison to monolinguals, examining both the bilingual's languages, investigating how bilinguals organize and use both languages
What are Probe techniques?
Technique assessing small amount of information over a short period of time to gauge rate and amount of learning
According to ASHA, what responsibilities are monolingual SLPs able to perform?
Test in English, perform oral peripheral exam, conduct hearing screenings, complete nonverbal assessments, conduct family interview in English
What are criterion referenced tests?
Tests that specify linguistic behaviors to be tested, establish criteria for acceptable responses, and do not compare the client's responses against some other standard
What is language interference?
The influence of one language on another
What is the definition of culture?
The totality of socially transmitted behavior patterns, arts, beliefs, institutions, and all other products of human work and thought
What is the goal of an assessment with an individual from a culturally and linguistically diverse population?
To conduct a least biased assessment and determine if there is a language difference or disorder
Why is it necessary to gather cultural and linguistic information?
To provide appropriate services to individuals who come from cultures other than your own or speak languages other than yours
What are some ways in which you can increase the likelihood of an appropriate diagnosis?
Use an assessment framework, administer several formal and informal assessments, assess skills in all languages or dialects, recognize that different modes of communication may be in effect and that performance may vary because of those factors rather than the client's abilities
What are registers?
Varieties of a language that depend on the context and conversational participants
When might Overdiagnosis occur?
When an individual is labeled with a communication disorder because their abilities were assessed using a test standardized based on a sample from which the client doesn't come
Should a language disorder exist in all languages or dialects?
Yes
What is the definition of dialect?
a rule governed variety of a language characterized by social, ethnic, and geographical differences
What is a dialect?
a rule-governed variety of a language characterized by social, ethnic, and geographical differences in speakers
What are sequential learners?
acquired one language after another
What does the degree of bilingualism depend on?
age, occupation, nature of interactions with members of the community
What areas may dialects differ across?
all areas of language-phonology, syntax, morphology, lexicon, and pragmatics
What does the term code switching refer to?
alterations between languages?
What are probe techniques?
assess small amounts of information over a short period of time to gauge rate of learning
What sociolinguistic factors should be considered when providing services to individuals from diverse backgrounds?
child socialization practices, family characteristics, individual differences, children's play characteristics
What does IDEA 2004 mandate in regards to completing the most appropriate assessment?
child's native language must be used in all direct contact with the child (SLP must find means to conduct assessment employing language the child uses in home or learning environment)
What is portfolio assessment?
collect client's work over time representing a variety of tasks and assignments
What might alternative testing formats include?
criterion referenced tests, dynamic assessment, portfolio assessment, ethnographic assessment, probe techniques
What does the framework for least biased assessment include?
decontextual settings, contextual areas, participation, functions and activities
An SLP communication assessment of bilinguals requires what?
determining how they use both languages, evaluating both of the bilingual's languages, comparing bilinguals to each other rather than monolinguals
What is the goal of least biased assessments?
differentiate language differences and language disorders
What is an idiodialect?
every person's own unique way of speaking
Who falls into the category of culturally and linguistically diverse?
everyone except those that fall in the category of white, middle class, European americans
What is bilingualism?
individuals who speak more than one language (individuals who speak a dialect of English)
What will SLPs need to use to complete reliable and valid assessments?
information on communication and culture, bilingualism, and dialect
What is ethnographic assessment?
observe the client in many contexts with many conversational partners
What is dynamic assessment?
performance is gauged by examining modifiability (change through mediation or teaching)
What are the 2 categories of bilinguals?
simultaneous learners and sequential learners
What are simultaneous learners?
speak both languages from birth
What are criterion referenced tests?
tests that specify linguistic behavior to be tested, establish criteria for acceptable responses, and do not compare client's responses against other standard
What does accent refer to?
the pronunciation of a language variety
What is the result of a least-biased assessment?
to differentiate individuals developing typically who may have a language difference from those with a language disorder
What should clinicians do to assess their cultural and linguistic competence?
understand what constitutes a disorder across different groups and have a positive attitude toward the families' values and beliefs
What are registers?
varieties of language that depend on the context and conversational participants
Historically, clinicians have tended to base diagnostic and intervention approaches on what?
white, middle class, European americans