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Bilingual vs. Monolingual Therapy Approach: Effectiveness for Bilingual Children with Language Disorders
Lynda McIntosh, B.S. & Abbie Olszewski, Ph.D., CCC-SLP University of Nevada, Reno
• The popula*on of non-‐English speaking families is increasing in the United States (Shin & Kominski, 2007)
• Children of these families are oCen bilingual, speaking the home language and English.
• Some bilingual children, like their monolingual counterparts, are iden*fied with language disorders and/or delays, which impacts their academic performance.
• In the field of educa*on, bilingual educa*on and monolingual educa*on have been used to improve overall educa*onal performance.
• For these bilingual children aMending school, research supports bilingual educa*on programs as an alterna*ve to English-‐only immersion programs.
• These same language of instruc*on approaches have also been used in the field of speech language pathology to increase recep*ve and expressive language skills in bilingual children with iden*fied language disorders.
Search terms: bilingual, language impairment, therapy, mul1lingual, systema1c review, meta-‐analysis, and dual-‐language learner Electronic databases: Pubmed.org, Google Scholar, asha.org, and ScienceDirect Appraisal: • Ten ar*cles were appraised using
a 15-‐point CATE form and a 8-‐point CASM form.
• Minimum of 93% inter-‐rater reliability was achieved on all ar*cles.
• Five ar*cles directly-‐related to PICO ques*on selected for review.
Summary: • Bilingual language interven*on showed gains in English language measures, including vocabulary, TNV, NDW, preposi*ons and pronouns • English-‐only treatment showed gains in English only, but not in Spanish. • Bilingual language interven*on showed to not be detrimental to learning the L2 and may avoid aMri*on of home language, which has socio-‐linguis*c and
family-‐dynamic effects.
Final Decision: Based on external evidence presented in this review and my client’s family input, I will select a bilingual approach to language interven*on for my client. The results suggest that not only bilingual instruc*on facilitate comparable growth in the second language as compared to monolingual delivery of the second language, it also provides support for the home language. These results indicate that there may be other posi*ve factors to maintaining the home language such as con*nuing communica*on with parents and extended family without impeding on growth in the second language.
Select References: Ebert, K. D., Kohnert, K., Pham, G., Disher, J. D., Payesteh, B. (2014). Three Treatments for Bilingual Children With Primary Language Impairment: Examining Cross-‐Linguis*c and Cross-‐Domain Effects. Journal of Speech, Language, and Hearing Research, 57(1), 172-‐186. doi: 10.1044/1092-‐4388 (2013/12-‐0388) Perozzi, J. A., & Sanchez, M. L. C. (1992). The Effect of Instruc*on in L1 on Recep*ve Acquisi*on of L2 for Bilingual Children with Language Delay. Language Speech and Hearing Services in Schools, 23, 348-‐352. doi: 10.1044/0161-‐1461.2304.348 Restrepo, M. A., Morgan, G. P., & Thompson, M. S. (2013). The Efficacy of a Vocabulary Interven*on for Dual-‐Language Learners With Language Impairment. Journal of Speech, Language, and Hearing Research, 56(2), 748-‐765. doi: 10.1044/1092-‐4388(2012/11-‐0173) Shin, H. B., Kominski, R.A. (2010). Language Use in the United States: 2007, American Community Survey Reports, ACS-‐12, U.S. Census Bureau, Washington, DC. Simon-‐Cereijido, G., & Gu*errez-‐Clellen, V. F. (2014). Bilingual Educa*on for All: La*no Dual Language Learners with Language Disabili*es. Interna1onal Journal of Bilingual Educa1on and Bilingualism, 17 (2), 235-‐254. doi: 10.1080/13670050.2013.866630 Thordardolr, E. T., Weismer, S. E., & Smith, M. E. (1997). Vocabulary Learning in Bilingual and Monolingual Clinical Interven*on. Child Language Teaching and Therapy, 13(3), 215-‐227. doi: 10.1177/026565909701300301
PICO Question
• I am a first-‐year graduate speech pathology student beginning my first semester of client therapy. My client is a 5 ½ year old Spanish/English bilingual male child with significant language deficits in English and Spanish. I want to determine which language approach of interven*on to use, both languages or English-‐only.
• Spanish is the predominant language spoken at home with his parents and English with siblings and at school. His mother has expressed a desire to increase her child’s conversa*on skills and is very interested in a bilingual language therapy approach.
• In recent coursework in my graduate program, I have been exposed to research inves*ga*ng which language of interven*on is more beneficial for bilingual children with language impairments. However, research in this area for language therapy interven*on is limited.
• In an effort towards evidence based prac*ce and in order to provide the most effec*ve treatment to my client and possible future work with bilingual popula*ons, I am exploring and reviewing research research regarding the efficacy of bilingual language therapy.
In school-‐age bilingual children with language disorders (P), does bilingual language therapy (I) yield greater change versus
monolingual language therapy (C) in the child’s second language as measures of expressive language (expressive vocabulary, MLU,
pronoun use) (O)?
Study Participants & Diagnosis
Purpose
Dependent Variable
Results
Ebert, Kohnert, Pham, Disher, & Payesteh, 2014
Random Control Trial
N = 59 • Children 5;6 – 11;2 • Receiving special educa*on for
language disorder • Spanish-‐English bilingual • Reported PLI
To inves*gate influence of language instruc*on on overall language skills and non-‐linguis*c processing (cross-‐linguis*c and cross-‐domain transfer).
TONI, ROW-‐E, EOW-‐E, CELF-‐E, NWR-‐E, ROW-‐S, EOW-‐S, CELF-‐S, NWR-‐S, CVD, SSA, ASM
Bilingual group • Showed medium gains in English NWR and overall language skills, • Small-‐to-‐medium gains in expressive vocabulary for English and Spanish • Small gains in Spanish skills (nine comparisons reached significance) English-‐only group • Large improvements for English vocabulary • Medium improvement for overall English skills and non-‐linguis*c cogni*ve processing skills
Restrepo, Morgan, & Thompson, 2013 Random Control Trial
N = 202 • Preschoolers 4;0 – 5;4 • Spanish-‐English dual-‐language
learners (DLLs) • Language impairment
To inves*gate if language of instruc*on affected vocabulary growth rate.
Vocabulary growth rate: • English • Spanish • Conceptual vocabulary
Bilingual vocabulary group • Gains in English comparable to English-‐only interven*on • Recep*ve and expressive Spanish vocabulary gains • Conceptual vocabulary gains English-‐only • Differed significantly from mathema*cs and no-‐interven*on group, but not from bilingual vocabulary group. • Had gains in English, none in Spanish
Perozzi & Sanchez, 1992 Random Control Trial
N = 38 • 1st grades students enrolled in
bilingual classroom • Spanish-‐English bilingual • Standard score of 85 or less on
WLPB-‐Spanish oral language cluster
To inves*gate influence of language of instruc*on on preposi*on and pronoun acquisi*on.
Preposi*on and pronoun acquisi*on: • English • Spanish
Bilingual • Learned preposi*ons and pronouns in fewer trials (twice as rapidly) than English-‐only
Simon-‐Cereijido & Gu*érrez-‐Clellen, 2013 Quasi-‐Experimental
N = 52 • Headstart preschoolers • Primary language Spanish, liMle
or no English • Language impairment
To inves*gate if dual language curriculum designed for Spanish-‐English La*no speakers with language impairments, Vocabulary, Oral Language and Academic Readiness (VOLAR),
• Number different words (NDW) • Total number verbs (TNV)
• Mean length uMerance in words (MLUw)
Bilingual • VOLAR group greater gains in NDW • VOLAR program increased diversity of Spanish and English vocabulary and Spanish and English verbs in spontaneous speech • VOLAR group significantly larger TNV • VOLAR group was not significantly different on MLUw
Thordardolr, Weismer, & Smith, 1997
Single-‐subject alterna1ng treatment
N = 1 • 2;6 male child • Icelandic-‐English bilingual • Significant delay in both
languages
To inves*gate influence of language of instruc*on on vocabulary acquisi*on.
English target word acquisi*on: • Home words • School words
Bilingual • Non-‐overlapping curves had slight advantage over monolingual treatment in home word acquisi*on and not for school words
Bilingual and English-‐only • No clear difference in total # of words between treatments
Introduction
Case Scenario Methods
Discussion