Bilingualism London Clinical Excellence Network
Assessing a Bilingual/Multilingual child
WHY DO WE NEED A THOROUGH ASSESSMENT?
To diagnose between a language acquisition problem affecting all language learning and a problem affecting the acquisition of an Additional Language (AL). A child who has limited AL proficiency should not be considered to have a speech or language disorder if the communication pattern reflects the child’s limited exposure in using the AL.
To help decide whether speech and language therapy intervention is required and/or a referral is needed to other agencies.
To investigate the child’s communication abilities and needs in one or more specified areas of language across both/all the languages the child is exposed to, i.e. attention/listening, play, comprehension, expression, speech, social skills.
To describe the child’s speech and language skills in terms of their linguistic ability taking into consideration any medical, cognitive, psychological factors and socio-economic status, providing clear aims and objectives for appropriate management.
If Speech Language Therapy is appropriate, to provide a baseline for therapy.
HOW DO WE ASSESS?
The assessment needs of a bilingual child are essentially the same as those of a monolingual child, regardless of the languages spoken by the child. The aim of an assessment of communication abilities and needs remain the same.
Top 5 questions before you start the assessment process.
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Do you need an interpreter?
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How are you going to make sure that the parents understand what you are explaining?
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Do parents understand your job, you role, how the system works?
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Are you using the correct name/pronunciation of the child's name? Check what name the child is usually called at home.
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Is the child known to your local Ethnic Minority Service team or any other health or educational services
The different principles and resources below are helpful when planning assessments:
RIOT
Review, Interview, Observe and Test
‘Based on the assumption that every individual is an inseparable part of a social system and that one’s behaviour cannot be understood without considering its context’ (McCormick 1997, from Martin D. 2009, Language Disabilities in Cultural and Linguistic Diversity)
Assess/Plan/Do/Review
From the Code of Practice (DFES 2014). The SEN support should be delivered as a four part cycle, also called the Graduated Approach. The Assess/Plan/Do/Review cycle ensures that children's Special Educational Needs (SEN) are regularly reviewed and the provision is adapted accordingly.
Assess both/all languages
The bilingual child’s language proficiency is not like that of a monolingual speaker – as both languages integrate to some extent. We are therefore not looking at 2 individual languages – we are looking at the skills across both languages. As much as possible gain a baseline and ascertain language levels in both/all languages. The therapist needs to look at all areas – attention, listening, play, social skills, comprehension, expression and speech including functional communication skills. Try to get as many samples of natural communication as possible (home, school) in order to accurately establish the child’s level of expressive language.
Ensure you spend time interviewing the parent/carer
Try and observe the child in multiple environments interacting with different people.
Look at the development of the child holistically
Consider cognitive, psychological, social, emotional, environmental, educational, medical, physical aspects of child’s development. Review all pertinent documents from other professionals that are involved.
Differential diagnosis
Apply your theoretical knowledge and consider the features of second language acquisition. Think about the following aspects:
Additional Language Development vs Developmental Language Disorder
Selective mutism vs. silent period
non specific vocabulary vs. word finding difficulties
Co-occurring disorders
Is there another organisation better suited to meet this child’s needs? Is SLT a priority concern for this child and his/her family?
Dynamic Assessment
Dynamic Assessment (DA) incorporates a range of methods for exploring learning potential using prompts, cues and mediation, based on different models (testing the limits, graduated prompting and test-teach-retest) (Pena et al., 2001). It enables a deep understanding of cognitive processes i.e. tactics, strategies, habits, modes of thinking; and approaching and solving problems (Haywood and Lidz, 2007). The main focus is on determining the ‘zone of proximal development’ (Vygotsky, 1978), that lies between the level of performance the child can reach unassisted and the level attained with adult assistance (Gutierrez-Clellen & Pena, 2001).
Performance on dynamic assessments, and observations of children’s responses to mediation, provide a strong indication for their modifiability and aid in determining appropriate strategies for further management (Hasson & Dodd, 2014; Gutierrez-Clellen & Pena, 2001). In contrast to static tests that aim to determine a measure of performance at a point in time, DA offers a systematic hierarchy of learning opportunities that could reveal underlying language abilities (Alony and Kozulin, 2007), explore learning potential, predict therapy outcomes, inform classification and aid in further management of speech, language and communication needs in children from culturally and linguistically diverse backgrounds.
Non Word Repetition Tasks
Chiat (2015) suggests that non-word repetition tasks could have an advantage over other assessments in diagnosing bilingual children with DLD. In a non-word repetition test, children are asked to repeat test items that they have neither learned nor heard before. However, this test is affected by language-specific knowledge i.e. language exposure and experience. As current research findings are mixed due to variations in linguistic factors i.e. how the tests were constructed as well as social, economic and cultural factors, Chiat (2015) highlights reasons for caution in the use of non-word repetition tests in culturally and linguistically diverse populations. Consequently, the COST IS0804 non-word repetition framework (http://www.bi-sli.org) was developed to address the challenges in diagnosis and treatment of bilingual children with DLD.
Formal Assessments
Formal assessments used by Speech and Language Therapists, Educational Psychologists and Teachers are standardised on monolingual L1 speaking children (e.g.English in the UK) and should not be used in the prescribed way for assessing bi/multilingual children learning the majority language as an AL.
Standardising a language developmental test on first language L1 speakers (e.g. English in the UK) means that the norms for language development cannot extend AL speakers/learners.
It may be useful to use the subtests or parts of the assessments to obtain qualitative information. It is not appropriate to use quantitative data such as standard scores or percentiles. Describing the child’s performance in a qualitative manner gives useful information and constitutes a baseline which can also be used for clinical decision making.
Raw scores may be also be useful to obtain a baseline and to describe the child's levels of competency in specific areas.
It is also not appropriate to translate assessment materials in the child's home language.
Translating formal English assessments into other languages can be inaccurate because the linguistic term in English may translate into a different linguistic form in the other language. This may emerge developmentally at a different stage in that language. This creates linguistic mismatches which do not provide the assessor with valid information regarding a child's language development.
Culture Mismatches may also occur. For instance the cultural references of the English tests may reflect a social experience for a specific socio economic strata. For instance in the UK asking a child to “put the spoon in the cup”. This can an obvious association for a child from the ‘white majority culture but a more obscure association for a child from a different culture background. However, take care not to make assumptions and stereotype e.g. do not assume that just because the eating of pork is forbidden in Islamic culture, that you may not use pigs in the language assessment of a Muslim child. Ask first!
Children may not be used to testing situations and will vary in their familiarity with a test situation. This could influence their performance.
Informal Assessments
The most representative language samples are obtained from a variety of natural settings, e.g. at home, playgroup and with different “communicative partners”, e.g. parents/carers, nursery key workers, siblings.
Use informal/natural communication.
Use picture books/toys.
Observe parent-child interaction.
The Communication Trust Progression Tools
The tools are a useful screening tools which can be used by SLTs and education professionals. They are not standardised but will give a baseline of the child's speech, language and communication skills in all the areas you need to assess.
These are available to buy at: www.thecommunicationtrust.org.uk
FLAC - Black Sheep Press
FLAC stands for Functional Language Across Countries. The resources were developed by speech and language therapists with Black Sheep Press to provide informal assessment tools to use with bilingualism
children. They can be used to sample the early language skills of bilingual and non-English-speaking children
These are available to buy at: www.blacksheeppress.co.uk/product-category/speech-and-language-therapy/multilingual-resources/bilingual-assessments-multilingual-resources/
Case History and Language Map
You can use the case history form from our downloadable resources. If you use this form and/or need to adapt it in any way please make sure you reference the original source. This is an important part of the information gathering and will feed in the language map.
You will be able to discuss and establish etiological factors. You can obtain information about the constraints of variables, e.g. a family can speak a different language but cannot read it. This will help you to make sure the support you provide is accessible to the child and his/her family.
You may be able to obtain this information in collaborative working with the local Ethnic Minority Service if they are working with the child/family.
A language map is a document which needs to be created at the beginning of the assessment process with the child and his /her family members. It is not a static document and may need to be updated during your time working with the child and their family. The language map will need to have the following information:
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who speaks what language with whom,
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when
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in what context
Speech Assessments
Be aware that the sounds in the English sound system may differ from the child’s home language. If possible try to determine whether speech sound errors in English are in fact normal in the home language, for example in Arabic [p] does not exist. This sound is therefore realised as a [b].
The DEAP assessment is normed on bilingual children.
Remember that the differential diagnosis process may take longer. As for monolinguals you need to establish if the child has an articulation difficulty vs a phonological disorder.
Articulation problems affect the motor aspects of speech production and can be present in both languages so problems and therefore therapy in one language can impact on the other language, if the sounds targeted are present in both languages.
Phonological disorders affect the child’s speech sounds system at a linguistic level and will differ for each language – so problems in one language will not necessarily be present in the other language and therapy targeting a process in one language may not necessarily rectify or impact an affected process in the other language.
Little Bee Speech produces a number of Apps for SLTs and parents to screen and support speech development. A spanish version is available.
Fluency
The process is the same as for monolingual children, taking into account family history and risk factors.
Voice
The process is the same as for monolingual children, a thorough assessment of breathing, phonation, voice quality and possible contributing factors
Some practical limitations you may encounter
Lack of available developmental norms for some languages.
Uniqueness of each child’s “bilingual” language ability
Uniqueness of each child's linguistic environment and exposure to language, i.e. sibling groups.
Lack of information and/or SLT knowledge about target language/speech sound system
Lack of standardised assessments in the home languages
Insufficient cultural information on family relationships, attitudes to ‘disability’, attitudes towards discourse, language functions and literacy.
Lack of culturally appropriate material and resources (e.g. observation checklists, resources)
Differences between practitioner and child/family (expectations regarding provision e.g. medical model- knowledge, culture, religion,language; gender)
Different dialects of interpreter/support staff
Lack of trained bilingual support staff
Financial and time limitations e.g. interpreting services can be costly
Lack of access to and knowledge of available support services
Generalisation of language/skills from school to home setting and vice versa
Difficulties for parents/carers understanding written correspondence
Terminology interpretations
Standardised Assessments for bilingual children
Dodd, B., Hua, Z., Crosbie, S., Holm, A. and Ozanne, A., (2002) DEAP Diagnostic Evaluation of
Articulation and Phonology, Pearson
Dunn, L.M., Dunn, L.M., Whetton C. and Burley, J., (2009) The British Picture Vocabulary Scale,
3rd edition, Winslow
Apps (please see website page)