Preschool Language Interventions for Latino Dual Language Learners with Language Disorders: What, in What Language, and How

ABSTRACT

About a quarter of young children in the United States are dual language learners. The large majority are Latino children who are exposed to Spanish in their homes. The language needs of Latino dual language preschoolers are different from the needs of monolingual English-speaking children. As a group, they are likely to live in environments that put them at risk of delays in language development. This situation is direr for dual language preschoolers with language impairment. Recent findings from studies on interventions for Spanish– English preschoolers with language impairment suggest that a bilingual approach does not delay English vocabulary and oral language learning and promotes Spanish maintenance. Targets and strategies for different language domains are described. The effects of pullout versus push-in interventions for this population are preliminarily explored. KEYWORDS: Dual language learners, language disorders,

intervention

Learning Outcomes: As a result of this activity, the reader will be able to (1) discuss evidence supporting a bilingual approach for the intervention of Latino preschoolers with language disorders; (2) select appropriate targets of intervention for Latino dual language learners with language disorders; and (3) implement an individualized education program for a Latino preschooler with language disorders that is based on language needs of dual language learners and the child’s classroom and family environment.

1

College of Health and Human Services, Communication Disorders Department, California State University, Los Angeles, California. Address for correspondence: Gabriela Simon-Cereijido, Ph.D., CCC-SLP, California State University, 5151 State University Drive, Los Angeles, CA 90032 (e-mail: [email protected]).

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Language Impairment in Bilingual Children: From Theory to Practice; Guest Editor, Aquiles Iglesias, Ph.D. Semin Speech Lang 2015;36:154–164. Copyright # 2015 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel: +1(212) 5844662. DOI: http://dx.doi.org/10.1055/s-0035-1549110. ISSN 0734-0478.

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Gabriela Simon-Cereijido, Ph.D., CCC-SLP1

A

bout a quarter of young children in the United States and a third of the children enrolled in Head Start are dual language learners (DLLs).1,2 The large majority of these DLLs are Latino children who are exposed to different varieties of Spanish. Most of the 20 largest U.S. public school districts have a very diverse student body and some school districts, such as Los Angeles Unified School District, Dade County School District, Houston Independent School District, and Dallas Independent School District, predominantly enroll Latino students.3 The language needs of Latino DLLs are different from the needs of monolingual English-speaking children. As a group, Latino children are likely to live in environments that put them at risk of delayed vocabulary and language development. More than a third of Latino children live in poverty based on 2010 census data and are at a high risk of literacy delays.4–6 Many Latino children are immigrants or children of at least one non-English-speaking immigrant parent.7,8 In addition, in 2007, 40% of Latino children had mothers or fathers whose highest level of education was less than high school completion.3 These young children may not be exposed to rich literacy experiences at home and, as a result, are likely to have limited vocabulary skills when they start preschool, putting at risk their future academic achievement.9 This is a dire situation for many Latino children with language disorders who, by definition, face increased challenges to learn language(s). In addition to vocabulary needs in both languages, DLLs with language impairment need to acquire phonology, morphology, and syntax skills in Spanish and English and they need to learn the social communication rules of the classroom. Furthermore, young Latino children not only have low preschool attendance, but, if they do attend, they are likely to reside in neighborhoods with a low percentage of credentialed teachers.3 Many classrooms serving DLLs have been found to dedicate minimal instructional time to vocabulary and academic language.10 Across the country, the number of speechlanguage pathologists (SLPs) working with DLLs is growing11; only 64% of SLPs,

however, feel qualified and very qualified to work with multicultural populations,12 and more than half of them provide services exclusively in English without home language support.12 In sum, home and educational contexts may not support the language needs of DLLs with language disorders. Preschool may be considered the gateway for the future education of many Latino DLLs. When preschoolers have language disorders, SLPs are in a powerful position to scaffold children’s language development and assist both parents and teachers in designing appropriate educational plans for these children. Clinicians frequently ponder over what intervention targets to select and what language of instruction to use with these children. They also ask for guidance regarding service delivery models. In the next sections, a summary of findings from studies on interventions for Spanish–English DLLs with language disorders will be presented.

WHAT AND IN WHAT LANGUAGE? INTERVENTION TARGETS AND LANGUAGE OF INSTRUCTION Support for a bilingual approach to intervention has been growing over recent years. Multiple studies with Latino preschoolers with and without language impairment have shown that (1) interventions with home language support do not delay English learning,13–25 and (2) home language support (but not English-only interventions) promotes home language maintenance.16,23–28 That is, a bilingual approach facilitates English social and academic learning and maintains Spanish communication in the home and community. Bilingual intervention does not imply that the clinician is responsible for the delivery of intervention in the two languages. A monolingual English SLP can also design and plan a bilingual intervention by choosing the appropriate targets of intervention and collaborating with families and bilingual teachers and staff. Intervention goals and objectives need to address the child as a whole and consider the roles played by the two languages in DLLs.29 Variability is inevitably observed in the language of DLLs.30 A Latino DLL may

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show deficits in every language domain, or in specific skills. These skills may be at a similar level across the two languages or relatively stronger in one language versus the other. Intervention targets should be selected based on the individual profile of the child’s linguistic abilities. The lexical skills of DLLs are distributed across English and Spanish,31,32 and, as mentioned previously, many Latino DLLs have vocabulary gaps in both languages. Thus, lexical growth should be an explicit focus of intervention in most cases.33,34 Limited vocabulary skills are associated with difficulties with phonological awareness, word recognition, reading comprehension, and academic delays during the school years.35–37 Several studies have demonstrated positive effects of vocabulary intervention for Latino preschoolers with and without language impairment when programs incorporate evidencebased practice strategies. These strategies include explicit teaching of vocabulary characterized by a careful selection of target words in the two languages,34 emphasis on both vocabulary breadth and depth,38–41 and instruction in meaningful contexts such as during shared book reading.41–43 It is imperative to target different types of words (e.g., verbs, adjectives), not just nouns, because children with language impairment have specific difficulties with verb and adjective acquisition.44–46 Cognates have been shown to facilitate English word learning in Latino DLLs.47,48 Latino DLLs have demonstrated positive growth when provided with bilingual direct vocabulary instruction in several studies.22,49 In these studies, words were taught using the previously mentioned strategies with the support of Spanish. Spanish was introduced in the interventions in different ways. For example, Lugo-Neris, Jackson, and Goldstein found that Spanish definitions provided during English shared book reading facilitated English word learning in 29 Latino children ages 4;7 to 6;10.49 Other programs included explicit vocabulary teaching in the two languages. One such program is the Vocabulary, Oral Language, and Academic Readiness (VOLAR) intervention.50 The VOLAR lessons are designed to teach different types of new words

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that the child is not likely to learn by incidental exposure. Target words have moderate, rather than high, frequency in oral language and include different parts of speech and a few cognates.51,52 The VOLAR program was evaluated with preschool DLLs with primary language impairment (PLI). The program and the control condition (e.g., preschool math lessons) were delivered in small groups using a pullout model. Participating children were randomly assigned to the VOLAR program (n ¼ 97) or the control intervention (n ¼ 105). In the bilingual VOLAR lessons, new vocabulary was always introduced in Spanish first, the children’s stronger language. The VOLAR children comprehended and produced significantly more Spanish and English words than the control intervention children.23 Faster rates of growth for receptive and expressive curriculum-based vocabulary were observed in the preschoolers who received the bilingual Spanish–English VOLAR program compared with the children who received English only VOLAR lessons. In another study, 4-year-old Spanish-speaking DLLs with and without PLI were assigned to the bilingual VOLAR group (n ¼ 74) or to the “business-as-usual” condition (n ¼ 83). The VOLAR program was implemented by Head Start teachers using a “team-teaching” push-in model: teachers were mentored by a VOLAR clinician and taught the VOLAR lessons to children with and without PLI in their classroom. The VOLAR condition differed from the “business-as-usual” condition in that children in both conditions were exposed to the center-selected Head Start curriculum, such as Creative Curriculum53 or HighScope,54,55 but only the children in the VOLAR condition received the VOLAR lessons in addition to the regular curriculum. The VOLAR intervention had a positive effect on the rate of growth of Spanish and English curriculum-based vocabulary measures. These gains appeared to generalize to spontaneous language. The number of different words used in Spanish and English spontaneous language samples increased significantly more in the children who received the VOLAR program than in the control group.24 Therefore, vocabulary interventions that incorporate evidence-based strategies and

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directly teach middle- to low-frequency words in the two languages, or with support of Spanish, appear to have positive effects on the English lexical growth of Latino DLLs with language impairment. Spanish vocabulary makes increased gains when Spanish words are targeted in the intervention. See Table 1 for a list of vocabulary intervention targets and strategies. The profiles of morphology and syntax abilities of DLLs with language disorders are also likely to be heterogeneous.56 These children may show different skill levels in each language. For example, one child may use simple sentences with subjects and predicates in Spanish (e.g., “la rana se metio´” [“the frog got in”]) but mainly noun phrases in English (e.g., the frog). Another child may use correct morphology in Spanish (e.g., “comio´ mucho” [“she/he ate a lot”]) but not in English (e.g., “he eat” for “he eats”). To address this variability, SLPs need to thoroughly assess the grammatical skills of the child in each language and select language-specific targets. If a child has stronger oral language skills in Spanish than English, lesson activities may address complex language comprehension and production in Spanish, whereas the English oral language lessons may focus on the generation and use of simple English phrases, rather than complex sentences. Length of utterance, in this case, is a focus of intervention in English and Spanish;

however, the language-specific target utterances may be of different length and quality. Moreover, language impairment has different manifestations across languages. It is possible that a Spanish language sample from a preschool DLL with PLI would show article and clitic pronoun omissions (e.g., “rana brinco´” instead of “la rana brinco´” [“the frog jumped”]; “dijo a mı´” instead of “me dijo a mı´” [“s/he said to me”]) and few verb errors, whereas the same child’s English sample would present verb morphology omissions (e.g., “the boy look at the frog” for “the boy looked at the frog”) but no article omissions. Bilingual clinicians should take into account these differences when they model language, plan activities and games, and choose storybooks to facilitate oral language. Monolingual English SLPs should also consider these cross-linguistic differences when they collaborate with bilingual teachers and SLP assistants and when they recommend activities to parents. Traditional oral language facilitation strategies are recommended for both English and Spanish (see Table 1).57 Modeling of utterances slightly longer than the child’s utterances in play contexts, wait time, focused stimulation, and expansions are strategies shown to be effective in both Spanish and English outcomes in studies that have evaluated the VOLAR program. The VOLAR program encourages children to use longer sentences such as sentences

Table 1 Recommended Targets and Strategies for Interventions with Latino Preschoolers with Language Disorders Who Are Dual Language Learners Language Domain

Targets

Strategies

Vocabulary

Middle- and high-frequency words in the two languages

Focused vocabulary instruction Vocabulary breadth and depth

Verbs, adjectives, nouns

Shared book reading

Cognates Specific targets according to the

Wait time

linguistic profile of the child across the

Focused stimulation

two languages English verb morphology

Recast sentences and expansions Modeling and prompting

Spanish article, clitic pronouns, and later-

Practice in small groups

developing verb forms such as subjunctive

Do not penalize code-switching

Morphosyntax

Pragmatics

Classroom discourse

Practice in the classroom Encourage conversations

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with two or three arguments, ask questions, and interact with peers. Preschoolers with PLI who received the bilingual intervention using a pullout model improved at a greater rate than the children in the English-only condition for both mean length of utterance in words and mean length of utterance in morphemes.19 In Spanish, the children who received the bilingual program had a faster rate of growth for a sentence repetition task.27 In the push-in VOLAR study in Head Start centers, the children in the VOLAR program exhibited greater gains than children in the control group in the number of verbs produced in their spontaneous English and Spanish language.24 Code-switching, that is switching between English and Spanish within or across utterances, should not be discouraged. Many Latino DLLs negotiate their new language skills and may not stick to the language of the lesson. Acknowledging the meaning of what they have said encourages children to maintain conversations. It is likely that the child’s comment or question in the nonassigned language is relevant and related to the activities. For DLLs who are in the beginning stages of English learning, it is recommended that targets such as English verb morphemes (e.g., present third person singular [–s] and past tense [-ed]) be included. These tend to emerge late in the second language learners.58,59 However, following the principle of facilitating oral language elaboration, rather than correctness in the context of naturalistic and meaningful interactions in play and narratives,57 clinicians should emphasize modeling, focused stimulation, and expansions, rather than discrete practice, during the preschool years. Pragmatics skills may also need to be targets of the intervention (see Table 1). Some preschoolers with language disorders have limited social skills and are less receptive to pragmatic and linguistic input.60 There are some reports of co-occurrence of behavioral disorders, such as internalizing behaviors and shyness, and language delays in Latino children.61 Learning and “working” in a new language may be anxiety provoking,62 and some preschool DLLs with language disorders may refrain from participating in conversations. An accepting and supporting atmosphere that

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allows children to use their home language and that acknowledges the content of what they say encourages children to take risks in English and try saying words that initially may be difficult. Classroom conversations with clinicians, peers, and teachers will help develop the pragmatic skills of DLLs with language disorders.

HOW? SERVICE DELIVERY MODELS Taking into account the needs of DLLs, the preschool classroom is probably the best setting for intervention. The preschool classroom is a rich environment where children with language impairment can encounter plenty of opportunities to interact with adults and peers and learn new words and ideas. These interactions help them acquire language skills. The richer these interactions, the better the learning of language, including vocabulary, sentence length and complexity, and preliteracy skills.63,64 However, we must be cognizant of the fact that opportunities for communication vary across classrooms and Latino DLLs are likely to attend classrooms in which there are few conversations between teachers and children.65,66 Two of the most frequent service delivery models are the push-in and pullout interventions.57 Interventions may be provided in the classroom (e.g., push-in model) or in a separate room, outside the classroom (e.g., pullout model). A collaborative or push-in model may induce higher expressive vocabulary gains in children with PLI than the traditional pullout model according to meta-analysis studies.67,68 Naturalistic routines (e.g., circle time, small groups) and participation of peers as conversational models and partners are frequent in the classroom.69,70 Longer conversations among peers are observed when adults encourage preschoolers to communicate with other children in the classroom.71 There is limited information about differences between push-in and pullout effects in interventions for DLLs with PLI. As a first approach to answer this question, results from DLLs with PLI who received the bilingual VOLAR program using a pullout model were compared with the results from the DLLs with PLI who received the bilingual VOLAR

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program delivered by the Head Start teachers following a push-in model. Participants who had a complete data set for Spanish and English receptive vocabulary and mean length of utterance in words based on their spontaneous language were included in this preliminary analysis. For receptive vocabulary, children had to identify 24 target words in an array of four colored pictures by pointing to the correct picture. This task was administered at baseline, posttreatment, and 3 and 5 months after the end of the intervention (e.g., follow-up 1 and 2). Table 2 includes the means and standard deviations of the two groups. Mean length of utterance in words was based on language samples collected at baseline, posttreatment, and 5 months later (e.g., follow-up 2). Of note, a small group of participants had complete data (i.e., the three time points) for English mean length of utterance (see Table 2). Effect size estimates were calculated using the pooled baseline standard deviation.72 For Spanish receptive vocabulary, the effect size estimate at posttreatment was moderate to large, favoring the push-in model (d ¼ 0.79) and at the last follow-up the same trend was observed (d ¼ 1.09). For English receptive vocabulary, the effect size estimates were mild (d ¼  0.33

at posttreatment and d ¼  0.34 at the last follow-up). However, these estimates favored the pullout intervention. In the case of Spanish mean length of utterance, the effect size estimate was moderate (d ¼ 0.53) favoring the push-in model at posttreatment; but by the last follow-up testing, the effect size was minimal or nonexistent (d ¼ 0.13). In English, mean length of utterance results showed moderate effect size estimates after the intervention (d ¼  0.84) and at the last follow-up (d ¼  0.74), favoring the pullout model. That is, both Spanish measures appeared to show more gains when DLLs with PLI received the bilingual intervention in the classroom. In contrast, children appeared to benefit more in the pullout condition when considering the English measures. These preliminary results should be taken with caution. First, this is an analysis of convenience and conducted a posteriori. The original studies were not designed to answer the question of service delivery and there are multiple differences across the pullout and push-in studies that may confound these results. Some of these include different types of teachers (e.g., VOLAR interventionists versus Head Start teachers), different small group participants (e.g., only children with PLI versus mixed

Table 2 Spanish and English Receptive Vocabulary and MLUw in Children Who Received the Bilingual VOLAR Program in a Pullout Setting and in a Push-In Setting Baseline n

Mean

SD

Posttreatment Mean SD

Follow-up 1

Follow-up 2

Mean

SD

Mean

SD

Pullout

18

5.06

2.23

10.00

3.51

10.33

4.47

10.83

4.23

Push-in English receptive vocabulary

34

4.24

1.56

10.65

4.26

10.88

4.12

12.03

5.08

Pullout

18

3.5

2.71

8.67

3.97

9.33

5.60

10.28

5.90

Push-in Spanish MLUw

34

5.59

2.84

9.82

4.65

9.71

4.72

11.41

4.63

Pullout

17

3.88

1.21

3.96

1.29





5.22

1.50

Push-in English MLUw

31

4.39

1.90

5.38

1.46





5.51

1.47

Pullout

7

3.02

1.29

4.36

1.70





5.93

2.13

Push-in

10

4.20

1.52

4.26

1.33





5.98

1.67

Spanish receptive vocabulary

Abbreviations: MLUw, mean length of utterance in words; SD, standard deviation; VOLAR, Vocabulary, Oral Language, and Academic Readiness. Note: MLUw was not collected at the first follow-up. Follow-up 1 was 3 months after intervention ended. Follow-up 2 was 5 months after intervention ended.

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groups of children with and without PLI), and different lengths of the intervention (e.g., 12 weeks versus 9 weeks). In addition, it should be noted that in both studies the participating children had stronger skills in Spanish than in English and attended preschools with a high concentration of Latino children. Preschool instruction was mainly delivered in English but many teachers and aides were bilingual. That is, these children had some Spanish support in the classrooms. These two factors may explain the superiority of the push-in approach for Spanish outcomes. In contrast, learning the weakest language, English, may be easier in a pullout environment, in which children with language disorders have less distractions.

CONCLUSIONS Intervention research with Latino preschoolers with and without language disorders has grown and evidence is mounting in favor of a bilingual approach. The main advantages of the bilingual approach are reflected in the studies’ suggestion that English learning is not slowed down by the use of the home language and that Spanish support helps children maintain their home language skills. Many specifics are still unknown: the differential effects of Spanish quantity, timing, context (such as models with or without code-switching), and providers (e.g., SLPs, teachers, parents) are still undetermined. However, at least for some vocabulary and grammatical outcomes, Spanish support has been shown to be beneficial in most studies with Latino preschoolers with language impairment. Both bilingual and monolingual clinicians working in preschools with DLLs should consider the following steps: (1) ascertain a detailed linguistic profile of the child, family, and classroom, (2) include a vocabulary objective in both languages, (3) identify language-specific goals for oral Spanish and English taking into account cross-linguistic differences and the child’s linguistic profile, (4) model English morphology that is typically late developing in children learning English as a second language, (5) acknowledge children’s responses in every language, and (6) support pragmatic language

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development in the classroom. It is not clear whether a push-in model is superior to a pullout model for every language outcome. Preliminary analyses suggest that the weakest language, in most cases English, may profit from interventions provided in a pullout setting. When Latino preschool DLLs attend schools with some Spanish support (from teachers, staff, or peers), Spanish outcomes may grow faster when intervention is provided using a push-in model. In actual practice, close monitoring of language growth is necessary to determine what model is the most beneficial for a specific child.

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LATINO DUAL LANGUAGE LEARNERS WITH LANGUAGE DISORDERS/SIMON-CEREIJIDO

Preschool language interventions for latino dual language learners with language disorders: what, in what language, and how.

About a quarter of young children in the United States are dual language learners. The large majority are Latino children who are exposed to Spanish i...
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