Speech audiometry and Spanish-English bilinguals: challenges in clinical practice.

AJA

Tutorial

Speech Audiometry and Spanish–English Bilinguals: Challenges in Clinical Practice Lu-Feng Shia

Purpose: The Spanish–English bilingual population has been on a steady rise in the United States and is projected to continue to grow. Speech audiometry, a key component of hearing care, must be customized for this linguistically unique and diverse population. Method: The tutorial summarizes recent findings concerning Spanish–English bilinguals’ performance on English and Spanish speech audiometric tests in the context of the psychometric properties of the tests and the language and dialect profile of the individual (language status, history, stability, competency, and use). The tutorial also provides arguments for evaluating bilingual clients in Spanish, in English, or in both languages, which may serve as rationales

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here is a great demand in the field of clinical audiology for research related to culturally and linguistically diverse populations. In particular, much work needs to be done on how to assess hearing and speech perception in bilingual individuals whose first language is Spanish. These demands and needs are urgent because the Latino population has been on the rise in the United States in recent years. From 2000 to 2010, more than half of the growth in the domestic population was Latino (15.2 of 27.3 million; U.S. Census Bureau, 2010). The same census data also indicated that the growth of the Latino population (43%) was four times that of the general population (10%), and that more than 16% of the U.S. population identified themselves as Latino (U.S. Census Bureau, 2010). Clinicians must be prepared to service this large, growing community, especially in terms of speech audiometry, a key component of audiological evaluation. Speech audiometric testing is typically provided in English in the United States, whereas a large number of Latinos are brought up to speak in Spanish at home. The number of individuals who use Spanish at home has in fact increased

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Long Island University, Brooklyn, NY Correspondence to Lu-Feng Shi: [email protected] Editor: Larry Humes Associate Editor: N/A Received April 11, 2014 Revision received June 26, 2014 Accepted July 7, 2014 DOI: 10.1044/2014_AJA-14-0022

in support of varied bilingual clinical practices. Last, the tutorial provides information regarding Spanish speech audiometry, including available tests, issues that clinicians may encounter when administering them, and dialectal consideration. Conclusions: It is a challenge as well as an opportunity for clinicians to expand service to the Spanish–English bilingual community. Understanding the characteristics of the individual and the test is essential for ensuring quality services to the bilingual client. Key Words: Spanish–English bilingual, speech audiometry, linguistic background, dialect

by 210.8% from 1980 to 2007 (U.S. Census Bureau, 2007). The substantial household use of Spanish led to the recent census data that most (25 of 34 million) Latinos reported speaking both Spanish and English at least “well” (U.S. Census Bureau, 2010). It is thus inappropriate for clinicians to provide audiological services exclusively in English to an essentially bilingual community. The audiological field has been slow in responding to the ever-changing cultural and linguistic composition of the general population (American Speech-Language-Hearing Association [ASHA], 2009). Although roughly 37% of audiologists reported that they worked with non-Englishspeaking clients to some degree (Martin & Sides, 1985), only 8% of the 157 respondents indicated that they were fluent in Spanish on a survey conducted a decade later across five states with the highest percentages of Latino residents (Flores, Martin, & Champlin, 1996). The mismatch between the demand for service and the number of service providers has hardly improved in recent years. The latest ASHA membership profile (2012) indicated that merely 186 certified audiologists in the nation reported themselves to be bilingual in English and Spanish. Clearly, the vast and diverse Spanishspeaking community remains seriously underserved. Not only are few bilingual audiologists currently available for bilingual clients, but the issue of properly and accurately evaluating bilinguals’ speech perception has traditionally not been a priority on audiologists’ research Disclosure: The author has declared that no competing interests existed at the time of publication.

American Journal of Audiology • Vol. 23 • 243–259 • September 2014 • © American Speech-Language-Hearing Association

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agendas (e.g., Martin, Champlin, & Chambers, 1998; Rudmin, 1987). At present, there is no specific guideline on how to properly and optimally evaluate a Spanish–English (S-E) bilingual’s speech perception. Those of us who work in areas with large numbers of S-E bilingual residents have encountered many questions in our everyday practice. Here I propose eight questions (Table 1) to reflect common situations facing clinicians who work with S-E bilingual clients. The sequence of these questions reflects a conceptual progression of our understanding of the matter. As clinicians, we first wonder why we cannot treat bilinguals simply like monolinguals (Questions 1 and 2) and, after understanding why, we wonder in what language(s) we should render our services (Question 3). How we render service is determined by bilinguals’ language background; therefore, we need to understand how to describe bilinguals and how to predict and interpret their performance on a test (Questions 4 and 5). The last three questions (Questions 6–8) deal specifically with testing S-E bilinguals. Because most of us are not familiar with Spanish speech audiometric materials, common Spanish tests are provided first. Then we discuss dialectal and scoring issues when administering tests in Spanish for S-E bilingual clients. These questions not only come from clinical observations, but also correspond to von Hapsburg and Peña’s (2002) call for clinical research more than a decade ago. In 2002, the authors published a tutorial on how to incorporate bilingualism in speech audiometry. The tutorial defined bilingualism in the confines of audiological practice and identified areas for researchers and clinicians to consider when conducting experiments or clinical work involving bilingual individuals. von Hapsburg and Peña’s expert opinions informed our practice over the past decade, but since 2002, new evidence regarding bilingualism and clinical work— especially that concerning S-E bilingual individuals—has emerged. It is time for us to examine the findings of these research efforts so that we can move the field toward a culturally and linguistically diverse future. The goal of the current tutorial is to summarize new evidence pertaining to bilingual speech audiometry and to discuss how we better understand and service our S-E bilingual clients. Bilingual is a very difficult term to define, because it can be used to refer to individuals with a variety

of skills in two (or more) languages. An excellent detailed discussion on different levels of bilingualism (simultaneous vs. sequential, early vs. late, etc.) is available in Bialystok (1988). In the current tutorial, a bilingual is an individual who uses two languages, Spanish and English, and considers both languages to be significant to her/his life (Grosjean, 2013; Mackey, 2000). This definition does not require a native status or a specific proficiency level for either language and captures the diversity of the present S-E bilingual community. A thorough review of various aspects of bilingual speech perception, such as influence of first language, linguistic profile, and acoustic and linguistic manipulation of speech inputs, is not the goal of the current tutorial, but can be found in other scholarly essays such as Flege (1988), Bohn (2000), and García Lecumberri, Cooke, and Cutler (2010). These essays, however, do not explicitly address clinical practice; hence, the current tutorial is unique in that it places its focus on bilingual studies that recruited a clinical population, employed a clinical test, or were conducted in a clinical setting. Specifically, the current tutorial discusses the eight questions proposed in Table 1 that come from everyday practice in the context of S-E bilingual listeners and tasks. Where evidence is not readily available for the S-E population or listening tasks, findings from studies that examined bilinguals of other language backgrounds or employed tasks in a different language are provided.

Review 1. Is It Appropriate to Test S-E Bilinguals in the Same Way as English Monolingual Listeners? Authors of studies on S-E bilinguals thus far have agreed reasonably well that it is not adequate to test these listeners in English only. One main reason is that S-E bilinguals do not perform as well as English monolinguals on a given English speech recognition task, whether at the phoneme (García Lecumberri & Cooke, 2006), word (Cooke, García Lecumberri, & Barker, 2008; Rogers, Lister, Febo, Besing, & Abrams, 2006), or sentence (Mayo, Florentine, & Buus, 1997; von Hapsburg, Champlin, & Shetty, 2004)

Table 1. Eight questions related to speech audiometry for Spanish–English (S-E) bilingual clients. No. 1 2 3 4 5 6 7 8

Question Is it appropriate to test S-E bilinguals in the same way as English monolinguals? Can’t we test bilinguals in English and speculate the outcome? If not in English, how should we test S-E bilinguals: in Spanish, in the “better” language, or in both Spanish and English? What makes up the language profile of a given S-E bilingual individual? What are the language variables most crucial in determining an S-E bilingual’s speech perception? What Spanish audiometric tests are available for clinical use? Should audiologists worry about dialectal differences among our S-E bilingual clients? Should we service S-E bilinguals even if we do not have extensive knowledge of the Spanish language and Spanish audiometric test materials?

Note. The review section is organized to address these questions in order.

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level. García Lecumberri and Cooke (2006) showed that Spanish-dominant bilinguals’ recognition of intervocalic consonants was nearly 10% lower than English monolinguals’ average. Words and sentences contain more cues than phonemes and are more realistic for evaluation purposes. Although these higher-level cues (lexical, semantic, and syntactic) benefit English monolingual listeners, they are difficult for bilinguals (Nakamura & Gordon-Salant, 2011; Shi & Farooq, 2012). For example, Shi and Farooq (2012) compared English monolingual and bilingual listeners’ recognition of English discourse and found that, in quiet, even bilinguals who considered English to be their “better” language significantly underperformed their monolingual peers. Therefore, all bilinguals’ performance should not be compared to the monolingual norm (Shi, 2011, 2013). Some experimenters have proposed the use of alternative tests that have a minimal linguistic load, such as the English digit-pair speech reception threshold (SRT) test (Ramkissoon, Proctor, Lansing, & Bilger, 2002; Rudmin, 1987). Digits are used every day and are familiar to most bilinguals. Ramkissoon et al. (2002) showed that the SRTs obtained on this test were more equivalent to the pure-tone average (PTA) than those obtained via English spondee words for S-E bilinguals. However, the highly limited pool of digits makes them inappropriate for a suprathreshold word recognition test (Dillon, 1983). In addition to digits, color words have also been attempted for testing bilinguals, but some S-E bilinguals still significantly underperformed their monolingual peers (Cooke et al., 2008). Therefore, using “simple” English words to evaluate S-E bilingual listeners could also lead to faulty clinical impressions. For many S-E bilinguals, the challenge they face in English speech perception is greater in noise than in quiet (Cooke et al., 2008; Crandell & Smaldino, 1996; García Lecumberri & Cooke, 2006; Rogers et al., 2006; von Hapsburg et al., 2004). As the level of noise increases (i.e., the signal-to-noise ratio [SNR] lowers), S-E bilinguals’ performance decreases significantly (Cooke et al., 2008; Crandell & Smaldino, 1996). The decrement due to increasing noise is more substantial in S-E bilingual than in monolingual listeners (Crandell & Smaldino, 1996; García Lecumberri & Cooke, 2006). Furthermore, S-E bilingual listeners are subject to the informational masking effect to a greater degree than are monolingual listeners (Cooke et al., 2008; García Lecumberri & Cooke, 2006). That is, in these studies, these listeners’ speech recognition was more compromised in the presence of dynamic noise (e.g., speech babble) than steady-state noise (e.g., speech-spectrum noise). Although monolingual performance is subject to the same effect, García Lecumberri and Cooke (2006) found the difference between the two groups of listeners to increase from roughly 15% with steady-state noise to 25% with babble. Rogers et al. (2006) further demonstrated that deterioration in performance is not limited to noise. In that study, a group of S-E bilinguals proficient in both languages had poorer English word recognition scores in noise alone and noise plus reverberation, as compared to English monolinguals. Therefore, a variety of

acoustic degradations can pose challenges to S-E bilinguals’ recognition of English speech.

2. Can’t We Just Test Bilinguals in English and Speculate the Outcome? Some of us do not view evaluation of bilinguals to be a difficult issue because “we know they are bilinguals, so their results may be a bit worse.” This view is not consistent with evidence-based practice. Use working with the elderly as an analogy—we certainly cannot say, “Older folks may be a bit off” on a speech audiometric test, and call it a day. The main goal of speech audiometry is to address hearing and processing disorders that may interfere with one’s everyday communication. For a normal-hearing bilingual individual, a performance level lower than expected may be recognized and attributed to language background, barring concurrent cognitive deficits. The situation becomes much trickier when a bilingual individual presents with some degree of hearing impairment. For example, for a 50-year-old bilingual with a PTA of 40 dB HL, should an English word recognition score of 80% in quiet be of concern? Does the age or presence of hearing loss justify the score? How much of the error on the English test is due to language background and how much due to hearing loss? In this case, it takes more than speculation to properly understand a simple score. It is imperative that the source of the difficulty and the decline in performance (due to hearing loss or language background) be differentiated for the purpose of accurate diagnosis and intervention. In the example, unfortunately, it is impossible to partition compromised word recognition between auditory and linguistic causes without knowing the baseline for bilinguals of a similar language profile (see later sections for detailed discussions). If a bilingual individual with significant hearing loss decides to pursue amplification or assistive listening devices, what will be considered a “realistic” expectation? How much improvement in speech perception should the individual be able to make to justify the cost of the device? On what should we base our counseling, audiological, or linguistic variables? If compromised performance is largely due to language background, then audiological services may not be needed. These issues are highly relevant not only to audiologists, but also to speech-language pathologists, special education teachers, hearing prosthetic manufacturers, and third-party payers. These reasons motivated ASHA to issue mission statements as early as 1985 in reference to culturally and linguistically diverse populations. In that document, ASHA (1985) presented litigation involving servicing such populations and cited federal mandates to further strengthen the argument that bilingualism is an important aspect of our practice. These missions were renewed and expanded in a 2004 document authored by ASHA’s Multicultural Issues Board. “Speech recognition tests in quiet and noise” was particularly mentioned in the document (Section 11.0) to be an area that requires us to demonstrate knowledge and skills so that “culturally Shi: Bilingual Speech Audiometry

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and linguistically appropriate services” can be rendered (ASHA, 2004).

3. If Not in English, How Should We Test S-E Bilinguals: In Spanish, in the “Better” Language, or in Both Spanish and English? If not all bilinguals can be reliably tested in English, can they all be tested in Spanish? First, we know that not all S-E bilinguals are dominant in Spanish. Some bilinguals may have learned and are using their native language in a limited context (e.g., with parents or spouse; Valdes, 2000). The interplay between the first and second language is intricate and the amount of mutual influence between the languages remains a topic of ongoing debate in bilingual language acquisition (e.g., Bahrick, Hall, Goggin, Bahrick, & Berger, 1994; Flege, MacKay, & Piske, 2002). There has been evidence that as exposure to English increases, a bilingual’s skills in Spanish may decrease due to attrition (Bahrick et al., 1994; Weiss & Dempsey, 2008). For example, Weiss and Dempsey (2008) compared S-E bilinguals’ performance on an English versus Spanish sentence recognition test. In quiet, early bilinguals (average age of acquisition = 4 years old) performed significantly better in English than Spanish, whereas late bilinguals (average age of acquisition = 16 years old) performed significantly better in Spanish than in English. Based on these findings, Spanish should not be the default language of tests even when it is an individual’s native language. Due to early English acquisition, their “better” language could have shifted from the first to the second language (e.g., Bahrick et al., 1994, suggested 12 years of residence in the United States as the point of the shift). Testing bilinguals on Spanish tests only and comparing their results to Spanish monolingual norms is as hazardous a practice as is comparing their results on an English test to English monolinguals. Because no one language is universally appropriate for all S-E bilinguals, we may consider evaluating them in either their “better” language or both languages. Proponents of testing in the better language base their argument on the lack of existing evidence that testing in one or both language(s) leads to different clinical decisions (Table 2, left column). It would be more cost-effective to test in only one language than in both if diagnosis and recommendations were to be the same based on either approach. Moreover, clinical assessment is mainly concerned with estimating one’s best communication capability. This objective may be accomplished by evaluating bilinguals in their better or dominant language. Even for a balanced bilingual, one language may be used instead of two for assessment when situations call for it (e.g., an individual who uses English at work and has hearing difficulty at work may wish to be evaluated in English only). The primary argument for testing in two languages (Table 2, right column) stems from the census data that most S-E bilinguals use both languages in everyday life (U.S. Census Bureau, 2010). Because the purpose of a hearing evaluation is to assess how effectively an individual

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communicates in daily life, testing in both languages yields results of a high face value. Furthermore, English and Spanish have different phonetic and phonological characteristics that affect listening and comprehension. For example, Spanish words are typically multisyllabic (Harris, 1995). Multisyllabic words have fewer phonetic neighborhood competitors and have faster-growing psychometric functions than monosyllabic words (Flores & Aoyama, 2008). In addition, complex consonant clusters occur commonly in English but not in Spanish (Delattre, 1965; Horiguti, 1962). As such, bilinguals may miss more English than Spanish phonemes and words in everyday conversation. Simply testing them in Spanish may underestimate the difficulty in communication experienced by these individuals. Indeed, Shi and Sánchez (2010) obtained word recognition scores in both English and Spanish for a group of S-E bilinguals and showed that English and Spanish scores were not positively or negatively correlated. This finding suggests that we cannot simply infer bilinguals’ performance in one language from performance in the other, supporting the practice of testing in both languages. Moreover, given the innate linguistic differences between English and Spanish, it is possible that the negative impact of sensory loss may differ in magnitude between two languages in different listening scenarios. Further investigation is needed for us to understand whether testing in the “better” language is adequately representative of overall communication skills. At the present time, we may consider testing bilinguals in two languages if both languages are used on a daily basis, or in the “better” language if a bilingual individual is clearly dominant in that language or heavily relies on that language to carry out everyday activities. In either approach, we should note that bilinguals’ performance may not compare with monolingual norms (Shi, 2010, 2011, 2013), even when the “better” language is used. If the individual has hearing loss, then speech audiometric tests should be conducted in both languages before evidence becomes available to address whether the effect of hearing loss overrides the effect of language background. These clinical decisions are important for clinical practice. As we have seen through the above discussion, clinicians must make these decisions with the individual S-E bilingual’s language profile in mind.

4. What Makes Up the Language Profile of a Given S-E Bilingual Individual? The meaning of being bilingual varies on individual understanding. Some researchers (e.g., Valdes & Figueroa, 1994; von Hapsburg & Peña, 2002) suggested five areas of bilingualism to be considered by researchers and audiologists in the field of communication sciences and disorders: language status, history, stability, competency, and use, all of which contribute to bilingual speech perception. Table 3 presents sample questions related to each of these five areas. In short, language status and stability indicate if one is bilingual and, if so, the kind of bilingual. Language history and use describe exposure, learning, and usage of each language


Table 2. Arguments in support of evaluating bilinguals in their “better” language versus in both languages. Why test in the “better” language?

Why test in both languages?

Some bilinguals use only one language to communicate at present. Some bilinguals may be proficient enough to be reliably tested in only one language. Clinical assessments should focus on one’s best performance. Hearing loss may have parallel effects on communication in two languages. Testing in both languages may increase test time and cause undue fatigue. There is no evidence of cost-effectiveness for testing in both languages. It is difficult to find audiologists who are competent bilingual service providers.

in the past and present. Bilinguals are often the most diverse in these two areas because they differ in the onset, duration, consistency, quality, and intensity of language exposure, learning, and usage. Diversity in language history and use leads to variability in language competency, which consists of language dominance, preference, and proficiency (Marian, Blumenfeld, & Kaushanskaya, 2007). These factors are important in quantifying bilingualism. For example, S-E bilinguals who received their education in an English-speaking country may be required to perfect English to a higher degree than those primarily educated in a country where English is not commonly used. On the other hand, many S-E bilinguals were born in the United States but raised in Spanish-dominant communities where daily activities are conducted in Spanish. These bilinguals may have well retained Spanish. Thus, bilingual individuals can differ widely in many aspects of their language profile. Some may contend that language profile is not of great concern for bilinguals who acquired both English and Spanish from infancy (i.e., simultaneous bilinguals). Because these bilinguals are native to both languages, they must be proficient enough to be evaluated in both languages, for clinical speech recognition tests are “simple.” Some researchers indeed found comparable performance between simultaneous bilinguals

A majority of bilinguals use two languages every day. Clinical assessments should reflect everyday communication. Performance in one language does not correlate to that in the other language. Hearing loss may have different effects on communication in two languages.

and monolinguals (Calandruccio & Zhou, 2014), but evidence from many other studies suggested otherwise. Crandell and Smaldino (1996) studied a group of school-age children who acquired English and Spanish from the age of 2 years. Their recognition of English words was comparable in quiet to that of monolingual children of a similar age; however, when noise was introduced, their performance was significantly lower than that of their monolingual peers. Similar results were reported in studies of bilingual adults by Mayo et al. (1997) and Shi (2010), both of which employed a sentence-in-noise test and demonstrated a lower performance level in bilinguals who had acquired English from infancy than in English monolinguals (Shi, 2010, was not limited to S-E bilinguals). These studies strongly indicate that a native status does not equate to “native” proficiency. Bilinguals may have been using one language more often in everyday life than the other, or they may have been using one language more consistently in some domains (e.g., listening and speaking) but the other language in other domains (e.g., reading and writing). In our practice, we need to consider language variables crucial to how an S-E bilingual individual perceives speech and their relative weight on a speech audiometric test.

Table 3. Five key areas of bilingualism as proposed by von Hapsburg and Peña (2002), along with sample questions related to each area. Key areas of bilingualism Language status Language history Language stability Language competency Language use

Sample related questions Are you bilingual? Are you native to both languages? When did you acquire each language? How did you learn each language? Did you receive formal education in each language? Did you use both languages growing up? Have you moved away from one language due to life events, such as immigration or marriage? Can you listen, speak, read, and write in both languages? Are you equally good in both languages or dominant in one of them? Are you currently using both languages in everyday life? Do you use one language only at work due to job requirements and the other only at home due to family needs?

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5. What Are the Language Variables Most Crucial in Determining an S-E Bilingual’s Speech Perception? First of all, first-language phonetics/phonology imposes a profound influence over one’s learning and perception of speech in the second language (e.g., Best, 1995; Flege, 1995; Kuhl & Iverson, 1995). In regard to Spanish, García Lecumberri and Cooke (2006) analyzed the confusion matrix of English consonants in English-learning college students in Spain. The experimenters found that errors made by these elective bilinguals were related to the phonetic differences between the Spanish and English languages (e.g., listeners made many /b-v/ and /s-z/ confusions). A similar first-language effect was also reported on an English clinical test for Russian–English bilinguals (Shi & Morozova, 2012). English monosyllabic words were scored phonemically and the error pattern was analyzed for the initial consonant, vowel, and final consonant separately. A strong Russian influence was ascertained in the replacement of /i/ by /I/ (the latter is closer than the former to the Russian [ɨ] following a non-palatalized consonant) and in the interchange between /f/ and /v/ (the two phonemes undergo assimilation in Russian at the word ending). We may expect some common patterns of errors on a similar English word recognition test among S-E bilinguals due to the influence of the phonetic/phonological system of the Spanish language, but a same first language does not make all bilinguals the same. Individual language history, use, and competency significantly affect how one recognizes English and Spanish speech. The Appendix summarizes a selection of these variables that have been examined in studies using a clinical test. Only studies published in the past two decades are included in the Appendix. These studies are not limited to S-E bilinguals, but focus is placed on adult listeners because the effects of some variables (e.g., length of immersion) may not have been fully realized in children. Of all the variables, age of acquisition is one of the strongest predictors of performance (e.g., Danhauer, Crawford, & Edgerton, 1984; Lopez, Martin, & Thibodeau, 1997; Mayo et al., 1997; Shi & Sánchez, 2010; von Hapsburg et al., 2004; Weiss & Dempsey, 2008). For example, in Mayo et al. (1997), in addition to the simultaneous bilingual group discussed in an earlier section, the experimenters also presented sentences in multitalker babble to two other groups of bilingual listeners who were proficient in English but differed in age of English acquisition. Data showed that simultaneous bilinguals outperformed the prepuberty group (age of English acquisition < 6 years old), which in turn outperformed the postpuberty group (>12 years old). In another sentence recognition experiment, better performance was also found in early (age of English acquisition < 7 years old) as opposed to late (>11 years old) S-E bilingual listeners (Weiss & Dempsey, 2008). Likewise, bilinguals who acquired English late performed better on a Spanish than English word (Shi & Sánchez, 2010) or sentence (von Hapsburg et al., 2004; Weiss & Dempsey, 2008) test. Other than age of acquisition, commonly investigated variables of importance to speech recognition include

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duration of English learning, length of residence in an English-speaking country or community, language dominance and proficiency, accent in speaking English, intensity of first-language use, among others (e.g., Bahrick et al., 1994; Flege & Fletcher, 1992; Flege, MacKay, & Meador, 1999; Flege et al., 2002; Gat & Keith, 1978; Jia, Strange, Wu, Collado, & Guan, 2006; MacKay, Meador, & Flege, 2001; Nakamura & Gordon-Salant, 2011; Rimikis, Smiljanić, & Calandruccio, 2013; Shi, 2011, 2013; von Hapsburg & Bahng, 2006, 2009). Duration of learning and length of residency, both measures of language immersion, are often tied to the phenomenon of language attrition, as mentioned earlier. That is, as skills in one language improve, skills in the other language may be compromised (e.g., Silva-Corvalan, 1991; von Hapsburg & Bahng, 2006, 2009; Weiss & Dempsey, 2008; Yeni-Komshian, Flege, & Liu, 2000). Von Hapsburg and Bahng (2006, 2009) reported that native Koreans who acquired English late in life performed differently on a Korean and an English sentence test. Those with moderate English proficiency tended to correctly recognize more English sentences than those with poor English proficiency; however, the former group of listeners recognized fewer Korean sentences than the latter group. By contrast, Nakamura and Gordon-Salant (2011) found their Japanese–English bilingual listeners (length of residence in the United States > 4 years) to perform comparably to Japanese monolinguals on the Japanese sentence test, but significantly underperform English monolinguals on the English sentence test, in quiet or in noise. This study demonstrates a first-language retention rather than attrition effect. The above findings indicate that bilingualism is not static. It is likely that a bilingual individual will perform quite differently on the same test at different stages of life as a result of changing language status. We may need to perform tests in different languages to optimally evaluate bilinguals’ performance at different points in their lives. To reflect this view, Weiss and Dempsey (2008) devised a variable, “bilingual age,” by incorporating age of acquisition and length of learning or exposure. We can compute this variable by dividing the length of one’s being bilingual by biological age. Weiss and Dempsey (2008) found their S-E bilingual listeners’ recognition of Spanish Hearing in Noise Test (HINT; Soli, Vermiglio, Wen, & Filesari, 2002) sentences to decrease as their bilingual age increased. Most clinical studies focused on the effects of one language variable, but Shi and Sánchez (2010) included a few language background variables. S-E bilinguals in that study were presented with English and Spanish words in quiet and in speech-spectrum noise (+6 and 0 dB SNR). Because all listeners had acquired Spanish since birth but varied in their history of English learning, age of English acquisition naturally became a significant predictor of the relative success on the English versus Spanish test. To perform comparably well across the two languages in quiet, one would have to have acquired English by approximately 10 years old. In noise conditions, the age for equal performance decreased to around 7.5 years, indicating that


degraded acoustics made it so challenging that one had to have considerable experience with the language to do well on the test. In addition to age of English acquisition, language dominance was also found to be a significant predictor of the outcome. This variable carried an odds ratio of 10.83–13.20 for favorable listening conditions (in quiet and at +6 dB SNR) and the odds increased to 42 for 0 dB SNR, suggesting that bilingual individuals are 42 times more likely to do relatively better in English (or Spanish) if their dominant language is English (or Spanish). These models were later validated in a follow-up study (Shi, 2014) with a larger sample and can be directly applied in everyday clinical work. It should be noted that many of these language variables are mutually correlated. In a large study involving 801 Cuban and Mexican immigrants who had lived in the United States over 50 years, Bahrick et al. (1994) showed that age of English acquisition was no longer critical to a collection of linguistic measures, including oral comprehension, once English education and use of English were taken into account. Although task specific, language dominance shifted from Spanish to English beyond 12 years of residence in the United States. This study illustrates the complex interplay of the language variables. These variables can interact and contribute, either separately or as a whole, to a given bilingual individual’s speech perception. Several interesting recent findings, although not specific to S-E bilinguals, are also worthy of note here. Shi (2012) provided evidence of bilinguals’ experience and proficiency in reading as strong indicators of their performance on English sentence recognition involving contextual processing. This relationship may appear odd at first glance because reading and listening represent two different processes. However, reading experience and proficiency can be regarded as a sort of “language sophistication index” because to achieve reading, one must develop literacy skills, which typically result from substantial learning and use of the language. The importance of reading variables was later corroborated in word recognition studies in quiet (Shi, 2011, 2013) and in noise (Shi, 2014). Shi (2013, 2014) went on to demonstrate that proficiency ratings across domains of language skills (listening, speaking, and reading) and across languages (English and Spanish) better predicted bilingual performance than domain- or language-specific ratings. Because a detailed language profile is of great importance, how can we obtain it in a busy audiological clinic? Researchers have developed many questionnaires for bilingual individuals. Of these, the Language Experience and Proficiency Questionnaire (LEAP-Q; Marian et al., 2007) has been validated in a series of clinical bilingual studies (Shi, 2011, 2012, 2013; Shi & Farooq, 2012; Shi & Morozova, 2012; Shi & Sánchez, 2010) and may be preferable for clinical use. The LEAP-Q addresses all five areas raised by von Hapsburg and Peña (2002) and includes major language variables such as age of acquisition, length of residence, proficiency and dominance, accent severity, and so forth. It also solicits information regarding cultural and educational background, which mediates bilingual development

(Cummins, 1979; Pika, Nicoladis, & Marentette, 2006). The LEAP-Q is available in Spanish (adapted by Marilyn Hall at Northwestern University, free download at http://comm. soc.northwestern.edu/bilingualism-psycholinguistics/files/ Spanish-LEAP-Q-Pencil-and-Paper.pdf). The questionnaire takes roughly 10–15 min for a typical bilingual individual to complete. Thus, a client can easily fill it out at home or while waiting in the clinic.

6. What Spanish Audiometric Tests Are Available for Clinical Use? Most clinical speech audiometric materials are recorded in English, making it a challenge for us to effectively and accurately assess S-E bilinguals should there be indications for testing in Spanish. A number of Spanish speech audiometric tests have nonetheless been developed for clinical use. Table 4 summarizes some commonly used tests in the United States as well as those yet to be made commercially available. Psychometric properties have not been clearly established for many of these materials due to the dearth of validating studies. One exception is the bisyllabic word recognition test produced by Auditec (St. Louis, Missouri), which has appeared in a series of works across laboratories over the past two decades (e.g., Cokely & Yager, 1993; Flores & Aoyama, 2008; McCullough & Wilson, 2001; Shi, 2014; Shi & Canizales, 2013; Shi & Sánchez, 2010, 2011; Weisleder & Hodgson, 1989). Similar to commonly used English monosyllabic word recognition tests, the Auditec recording includes four lists of 50 bisyllabic Spanish words, spoken by a Mexican male speaker. Weisleder and Hodgson (1989) were the first researchers to establish the psychometric function for this test in quiet. The experimenters assessed a group of S-E bilingual college students in the United States. The words were presented at four levels (8–32 dB HL). Psychometric functions were not directly computed, but the slope of the function was estimated for each of the four word lists. Results indicated all but one list (List C) to be statistically equivalent. The slopes across lists were nonetheless judged to be comparable to those of the functions for English monosyllabic words. In addition, words were rankordered per list according to their difficulty. Flores and Aoyama (2008) compared List A of the Auditec recording with three other word tests (Berruecos & Rodriguez, 1967; Roeser, 1996; Zubick et al., 1983). All words were presented in quiet over the range of 20–40 dB SPL. Of the four Spanish tests, the Auditec recording and the Zubick et al. (1983) recording produced psychometric functions most comparable to that of an English monosyllabic word recognition test. The function for Roeser’s (1996) monosyllabic words had the slowest growth over the test range, suggesting that Roeser’s Spanish monosyllabic word test is more difficult than both the English monosyllabic word test and the Auditec test. Whereas the above studies assessed their bilingual listeners in quiet only, three studies by Shi and colleagues included both quiet and noise conditions. Shi and Sánchez


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Table 4. Spanish audiometric materials that have been developed for clinical use. Test

Study

Child speech reception Spanish Spondee Threshold (SST) test Adult speech reception Spanish speech reception threshold test Spanish matrix sentence test Child word recognition Children’s Spanish word discrimination test Pediatric Spanish–English speech perception task Adult word recognition Spanish nonsense syllable test Berruecos & Rodriguez words Spanish Multiple Choice Rhyme Test (SMRT) Boston College Auditory test Auditec word recognition test Spanish Picture-Identification Task Comm Tech test Sentence recognition Spanish Synthetic Sentence Identification (SSI) test Spanish Hearing in Noise Test (HINT) Spanish Speech Perception in Noise (SPIN) test Auditory processing Spanish Staggered Spondaic Word (SSW) test Spanish adult auditory processing battery

Note.

Target

Martin & Hart (1978); Schneider (1992)a

Bisyllabic words with pictures

Spitzer (1980)b

Bisyllabic words

Hochmuth et al. (2012)

Five-word sentences with a fixed syntactic structure (name + verb + numeral + object + adjective)

Comstock & Martin (1984)

Bisyllabic words with pictures

Calandruccio, Gomez, Buss, & Leibold (2014)

Bisyllabic words with pictures shared by corresponding English words; specifically developed for bilingual children

Ferrer (1960)

Nonsense monosyllables (detailed characteristics not available) Bisyllabic words

Berger (1977); Berruecos & Rodriguez (1967) Tosi (1969); Cooper & Langleyc (1978) Zubick et al. (1983) Shi & Canizales (2013)d; Weisleder & Hodgson (1989) McCullough & Wilson (2001); McCullough, Wilson, Birck, & Anderson (1994)e Roeser (1996)

Two-talker babble and speech-spectrum noise

Bisyllabic words with pictures, presented in an open- and closed-set format Monosyllabic words Nonsense sentences with minimum semantic and syntactic cues

Huarte (2008); Soli et al. (2002)f

Sentences with limited contextual cues Sentences with rich vs. minimal contextual cues, generating two scores

Ramos, Windham, & Katz (1992); Soto & Windham (1992)g Fuente & McPherson (2006)h

Speech-spectrum noise

Words (detailed characteristics not available), presented in an auditory or audiovisual mode Bisyllabic words Bisyllabic words

Benitez & Speaks (1968); Lopez et al. (1997)

Cervera & González-Alvarez (2010)

Noise

Single-talker passage presented ipsilaterally or contralaterally to the target Speech-spectrum noise 12-talker babble

Spondee words presented dichotically in an overlapping manner Monosyllabic words for the speechin-noise, binaural fusion, and filtered speech subtests; digits for the dichotic digits subtest

White noise for the speechin-noise subtest

Tests without a formal name are referred to using the term in the published study.

a

Schneider (1992) applied the test to children speaking the Castilian, Caribbean, and Mexican dialects. bSpitzer’s material (1980) was also normed for children. cCooper and Langley (1978) applied the test in both audio and audiovisual modes. dShi and Canizales (2013) applied the test to adults speaking the Caribbean and South American Highland dialects. eIn their response to a letter to the editor that discussed the selection of some of the test words, the authors pointed out that the test was designed for evaluating adults more than children. fHuarte (2008) is a Castilian Spanish version of the HINT; Soli et al. (2002) is an American Spanish version. g This test has been incorporated into the Spanish adult auditory processing battery by Fuente and McPherson (2006). Fuente and McPherson (2006) referenced the manual of the test released by the manufacturer (Soto & Windham, 1992). h This test also includes non-speech subtests such as pitch pattern sequence, duration pattern sequence, masking level difference, and random gap detection.

(2010) and Shi and Canizales (2013) were both focused on the effects of listener characteristics (dominant languages in Shi & Sánchez, 2010; dominant languages and dialects in Shi & Canizales, 2013), whereas Shi and Sánchez (2011)

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was a rare combination of both listener and test characteristics. In that study, bilinguals listened to and rated the familiarity of 150 Auditec words (excluding List C). As expected, English-dominant bilinguals gave lower overall


ratings of word familiarity than Spanish-dominant bilinguals. Moreover, although both groups’ Spanish word recognition, averaged across quiet and noise conditions, was significantly correlated to word familiarity, correlation was higher for English-dominant than Spanish-dominant listeners. These findings collectively suggest that the Auditec words are lexically heterogeneous enough to create differences in listener performance and that even bilinguals who consider Spanish their “better” language may be subject to the familiarity effect. Of interest, removing words least familiar to bilinguals reduced the correlation between word familiarity and listener performance, suggesting that current clinical tests may require modifications to be appropriate for S-E bilinguals of different language profiles.

English-dominant bilinguals), but the dialect effect was also significant (Highland bilinguals outperformed Caribbean/ Coastal bilinguals). Differences between the Highland and Caribbean/Coastal group were most robust in favorable listening conditions (e.g., in quiet). The latter finding is particularly noteworthy, because these are the conditions typically employed in the clinic. Of most interest, both English- and Spanish-dominant groups demonstrated a dialectal difference on the test, suggesting that dialects affect bilinguals regardless of their skills in the Spanish language.

7. Should Audiologists Worry About Dialectical Differences in Their S-E Bilingual Clients?

If we decline to service S-E bilinguals due to their uniqueness and diversity, some of these individuals may be unable to receive any service. We cannot relegate all the clinical work involving bilingual clients to the handful of bilingual practitioners; rather, all of us should do our best to include this vast population in our practice. Cokely and Yager (1993) showed that audiologists’ experience and proficiency in Spanish did not affect their capability of scoring the Auditec Spanish words. A few other studies also advocated for audiologists who had little knowledge of or received minimal training in Spanish to evaluate bilingual listeners on Spanish speech audiometric tests (e.g., Comstock & Martin, 1984; Schneider, 1992). Findings from these studies are encouraging to those of us who are willing to reach out to the bilingual community but have limited cultural and linguistic experience and competency to do so. On the other hand, we must be careful of potential pitfalls while evaluating S-E bilinguals and interpreting their test outcome. Cokely and Yager’s conclusion (1993), for instance, came from a small sample of nine participants, not to mention the statistically (albeit not clinically) significant difference in scoring oral responses between experienced and inexperienced audiologists. Because it is well known that listeners with an accent may be difficult to understand (e.g., Flege & Fletcher, 1992; Flege et al., 1999), written responses should be solicited in addition to oral responses. However, the written form is not free of accent, dialect, or language influences, and it could be difficult for us to interpret the responses orthographically. For example, both phonological and typological features unique to Caribbean/Coastal Spanish have been noted (Caballero, Moreno, & Nogueiras, 2009; Shi & Canizales, 2013). Some listeners of Dominican descent tend to interchange “r” and “l” (e.g., calta for carta). Such phonemic substitutions typically are not tolerated on an English word recognition test, but may be accepted as correct based on Caribbean Spanish phonology (Canfield, 1981; Dalbor, 1997). Similarly, some listeners interchange “s” and “z” (e.g., meza for mesa), replace “ll” with “y” (e.g., caye for calle), or do not spell out “h” (e.g., ilo for hilo) in writing. Similar incidences could occur if these bilinguals were asked to spell on an English word test, particularly between “s” and “z.” Some bilinguals also mix Spanish and English graphemes that correspond

English listeners’ performance has been found to be subject to dialectal influence in word recognition (American vs. South African English: Wilson & Moodley, 2000) and auditory processing (American vs. British English: Dawes & Bishop, 2007; Marriage, King, Briggs, & Lutman, 2001). Given the wide dialectal variety of the Spanish language, dialectal effects on speech audiometric tests are to be expected. In the United States, most Spanish speakers are of Latin American origin (U.S. Census Bureau, 2007). Although the dialectal complexity of American Spanish is well recognized (Canfield, 1981; Dalbor, 1997), many experimenters (e.g., Cokely & Yager, 1993; Mayo et al., 1997; Rogers et al., 2006; Weisleder & Hodgson, 1989; Weiss & Dempsey, 2008) mainly recruited bilingual college students to be the participants, most of whom were reported to be of Mexican descent, therefore limiting the generalizability of their findings. A full description of the phonetic/phonological differences across these dialects is beyond this article, but one can be located in Canfield (1981) and Dalbor (1997). A common view, however, includes five major dialects in the American Spanish dialectal system (Canfield, 1981; Dalbor, 1997): Mexican, Central American, Caribbean/Coastal South American, South American Highland, and Argentinian. Weisleder and Hodgson (1989) noticed an apparent dialectal effect on the Auditec word recognition test between nine S-E bilinguals of Mexican origin and the remaining seven bilinguals of various origins (Central American, Venezuelan, Colombian, and Castilian). The Mexican bilinguals were better performers than other bilinguals, possibly because the speaker of the words was Mexican. No S-E bilingual speech audiometric studies since Weisleder and Hodgson (1989) touched upon dialects until Shi and Canizales (2013) investigated the interaction between dialect and dominant language in 40 S-E bilinguals. In this study, 40 listeners were grouped according to their region of dialect (Caribbean/Coastal or South American Highland) and their dominant language (Spanish or English). The same Auditec words were presented to each listener in quiet and in noise. A highly significant dominant language effect was ascertained (Spanish-dominant bilinguals outperformed

8. Should We Service S-E Bilinguals Even If We Do Not Have Extensive Knowledge of the Spanish Language and Spanish Audiometric Test Materials?


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to the same phoneme (e.g., hugo for jugo). These written responses may be acceptable based on the characteristics of S-E bilinguals.

2.

We need to determine how hearing loss may differentially affect an S-E bilingual individual’s perception of speech in Spanish and in English. That is, does hearing loss affect speech perception in the two languages to a comparable extent? Does the severity of hearing loss have any impact on the relative reduction in speech perception between the two languages?

3.

We need to obtain the psychometric properties of common clinical tests for S-E bilingual individuals. Ideally, materials specific to the region and reflective of the local dialectal and cultural characteristics should be used whenever available, but the task of developing region- and dialect-specific materials may be prohibitive due to research cost. To maximally utilize existing tests, the norm on these generic tests should be obtained specific to a given bilingual group sharing a similar language profile.

4.

We need to conduct bilingual research specific for clinical purposes. A large portion of what we know of bilingual speech perception comes from research in psychology, linguistics, and education that employs techniques such as intergroup comparisons. This type of evidence is informative, but clinically we are less concerned with difference of any size than with difference large enough to resemble disorder. Hence, methods such as Thornton and Raffin’s binomial model (1978) that generate norms may prove particularly valuable for clinical endeavors (Shi, 2011, 2013).

5.

We need to direct more attention to S-E bilingual children, because effort to understand this critical population has been sparse over past decades (Calandruccio, Gomez, Buss, & Leibold, 2014; Comstock & Martin, 1984; Crandell and Smaldino; 1996; Garstecki & Wilkin, 1976; Schneider, 1992). Bilingual children develop their speech and language in a unique way, and hearing plays an essential part in this process. Timely and accurate assessment of bilingual children’s speech perception skills may have bearings on their academic achievement and social development.

Conclusions Discussions of the above eight questions demonstrate how in a sociolinguistically complex clinical setting, audiologists must be cognizant of the language and dialect backgrounds of S-E bilingual clients, their communicative needs, and the psychometric properties of the test material. Specifically, consider the following recommendations: 1.

It is probably not optimal to evaluate an S-E bilingual individual in one language only, especially when the individual uses both languages in everyday communication. This argument, however, does not preclude a bilingual individual from being evaluated in one language when evaluation in both languages is not readily available.

2.

It is inappropriate to compare an S-E bilingual individual’s performance to norms derived from either English or Spanish monolinguals. Specific norms should be established for bilinguals sharing a similar language profile.

3.

It is imperative to consider the characteristics of the S-E bilingual individual before the evaluation. These characteristics include language status, history, stability, competency, and use (von Hapsburg & Peña, 2002). Dialect should also be considered when the individual is evaluated in Spanish. A thorough language and dialect profile should be obtained through established questionnaires in addition to case history.

4.

It is important to consider the psychometric property of the test and test condition during the evaluation of an S-E bilingual individual. Bilinguals’ performance in quiet does not necessarily correlate to that in noise or reverberation. Similarly, their performance on the Spanish test does not necessarily correlate to that on the English test.

5.

It is helpful to obtain and compare oral and written responses from an S-E bilingual individual during evaluation. Accent may be a challenge with oral responses, whereas literacy and spelling issues may complicate the interpretation of written responses.

A number of areas merit future work: 1.

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We need to determine what kind of S-E bilinguals would be best tested in Spanish, in English, or in both. We need to determine if testing in both languages yields more information than testing in one language. If additional information can be garnered by including both languages, does it change our clinical decision? If additional information is not helpful for diagnostic purposes, is it helpful for making treatment plans (e.g., measuring hearing aid benefit)? Ultimately, we need to develop a model of practice for working with S-E bilinguals.

It is to our advantage to expand service to include the growing bilingual community. Such an outreach will widen our client base, allow us to access a vast underserved population, comply with broader legislation (U.S. Department of Health and Human Services, Office of Minority Health, 2013), and prepare the profession for a culturally and linguistically diverse society in the near future. Through a summary of recent findings, the current tutorial provides some guidance to clinicians working with S-E bilingual clients and identifies the areas in bilingual clinical work that should be targeted in the coming years so as to move the field forward.

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255

256


Study

Two groups of Spanish– English bilinguals (English dominant and Spanish dominant)

Shi (2014); Shi & Sánchez (2010)

NU-6 words and Auditec Spanish bisyllabic words in quiet and in speech-spectrum noise

Reverberant SPIN sentences in English 12-talker babble

English W-22 and NU-6 words in quiet and in noise (Speechspectrum noise, English multitalker babble, and music played forward and backward)

English monolinguals vs. three groups of bilinguals (simultaneous, early, and late)

English monolinguals vs. four groups of bilinguals (simultaneous, early, late, and very late)

English W-22/SIG-Ra words in quiet, in speech-spectrum noise, and in noise with reverberation.

Group comparison

English and Spanish SSI sentences in English and Spanish singletalker competing speech English and Spanish SSI sentences in English and Spanish singletalker competing speech with or without “filler” white noise English SPIN sentences in English 12-talker babble

Group comparison, correlation, and regression

Group comparison and regression


Group comparison

Group comparison

Group comparison

Group comparison

Analysis

English and Greek BEL sentences in English three-talker babble

Stimuli

Study design and finding

English monolinguals vs. simultaneous/early bilinguals

English monolinguals vs. simultaneous Greek– English bilinguals Two groups of bilinguals (Spanish–English and English–Spanish) English and Spanish monolinguals vs. early Spanish–English bilinguals English monolinguals vs. three groups of bilinguals (simultaneous, early, and late)

Listeners

Shi (2010, 2012)

Rogers, Lister, Febo, Besing, & Abrams (2006) Shi (2009)

Mayo, Florentine, & Buus (1997)

Lopez, Martin, & Thibodeau (1997)

Lew & Jerger (1991)

Language history AOA Calandruccio & Zhou (2014)

Language variable

(appendix continues)

(a) Performance decreased as age of acquisition increased; (b) simultaneous bilinguals’ performance was comparable to monolinguals’ performance; (c) bilinguals’ psychometric functions grew more slowly than monolinguals’ functions, regardless of AOA. Simultaneous/early bilinguals performed on par with monolinguals in quiet, but more poorly than monolinguals’ performance in noise with and without reverberation. (a) Simultaneous bilinguals performed on par with monolinguals but better than other bilinguals; (b) early bilinguals performed better than late bilinguals in dynamic maskers but not speech-spectrum noise; (c) AOA accounted for bilinguals’ performance in quiet, multitalker babble, and music. (a) Performance decreased as age of acquisition increased; (b) simultaneous bilinguals’ performance was worse than monolinguals’ performance in a moderate but not mild or severe amount of noise and reverberation; (c) AOA in listening/ speaking and AOA in reading were both correlated to bilinguals’ performance across test conditions. AOA predicted outcome (better relative performance in English or in Spanish).

Bilinguals performed on par with Spanish monolinguals in Spanish but more poorly than English monolinguals in English.

Bilinguals performed comparably, regardless of first language.

Simultaneous bilinguals performed on par with monolinguals.

Finding

Main language variables investigated in clinical assessment of speech perception, along with main findings from selected studies since 1991 that investigated effects of variables on adult bilinguals’ performance on speech audiometric tests.

Appendix


257

Group comparison

Correlation and regression Group comparison and regression

English and Japanese HINT sentences in quiet and in speech-spectrum noise

English BEL sentences in speechspectrum noise English W-22 and NU-6 words in quiet and in noise (speechspectrum noise, English multitalker babble, and music played forward and backward) Reverberant SPIN sentences in English 12-talker babble

English monolinguals vs. Japanese–English bilinguals who had lived in the United States for more than four years (also compared to Japanese monolingual norms) Bilinguals (compared to English monolingual norms) English monolinguals vs. three groups of bilinguals (simultaneous, early, and late)

Shi (2012)f

Rimikis, Smiljanić, & Calandruccio (2013)d Shi (2009)e

Nakamura & Gordon-Salant (2011)c

Shi & Farooq (2012)

English monolinguals vs. two groups of bilinguals (English dominant and non-English dominant)

Two groups of Spanish– English bilinguals (English dominant and Spanish dominant)


Two groups of Spanish– English bilinguals (early and late)

Group comparison, correlation, and regression

Group comparison

NU-6 words and Auditec Spanish bisyllabic words in quiet and in speech-spectrum noise

CST passages at normal, slow, and fast speaking rates in quiet and in English six-talker babble



Group comparison

English HINT sentences in quiet and in speech-spectrum noise delivered at different azimuths English and Spanish HINT sentences in quiet and in speech-spectrum noise

English monolinguals vs. late bilinguals


Analysis

von Hapsburg, Champlin, & Shetty (2004) Weiss & Dempsey (2008)b

English and Mandarin HINT sentences in quiet and in continuous and interrupted noise

Stimuli

English monolinguals vs. late Mandarin–English bilinguals

Listeners


Stuart, Zhang, & Swink (2010)

Study

Language competency Dominance Shi (2014); Shi & Sánchez (2010)

Length of immersion

Language variable

Appendix (Continued).


(a) Bilinguals performed better when tested in their dominant language; (b) bilinguals’ performance was not correlated between the two languages; (c) dominance predicted outcome (better relative performance in English or in Spanish). (a) Bilinguals of both groups underperformed monolinguals; (b) performance was comparable between bilingual groups for a given test condition.

Length of immersion in the United States and at English-speaking school/work were both correlated to bilinguals’ performance across test conditions.

Age of immigration and length of residence in the United States were both correlated to bilinguals’ performance. Length of learning accounted for bilinguals’ performance in speech-spectrum noise and music masker played forward.

(a) Both bilingual groups performed better in Spanish than in English in quiet and in noise; (b) late bilinguals performed better than early bilinguals in Spanish, whereas early bilinguals performed better than late bilinguals in English in noise only; (c) bilingual age accounted for Spanish performance in quiet and in noise. Bilinguals’ psychometric functions grew more slowly than English monolinguals’ functions but were comparable to Japanese monolinguals’ functions.

Late bilinguals’ performance was poorer than monolinguals’ performance.

(a) Bilinguals underperformed monolinguals in English; (b) bilinguals performed better in Mandarin than in English.

Finding

258


Proficiency

Preference

Language variable

English monolinguals vs. four groups of bilinguals (English- and Arabicdominant Arabic–English bilinguals and Englishand Spanish-dominant English–Spanish bilinguals) English monolinguals vs. two groups of Spanish– English bilinguals (those preferring English and those “balanced” in their preference) English monolinguals vs. four groups of bilinguals (simultaneous, early, late, and very late) Bilinguals (compared to English monolingual norms)

Shi & Zaki (2014)

English monolinguals vs. bilinguals of various background


Shi (2011, 2013)

Shi (2012)

Rimikis et al. (2013)

Shi (2012)

Flores & Aoyama (2008)

Listeners English monolinguals vs. two groups of Russian– English bilinguals (English dominant and Russian dominant)

Study

Shi & Morozova (2012)


Stimuli


NU-6 words in quiet

English BEL sentences in speech-spectrum noise


W-22 words, Auditec Spanish bisyllabic words, Berruecos & Rodriguez words, Boston College Auditory Test words, and Comm Tech words in quiet

NU-6 words in speechspectrum noise

NU-6 words in quiet


Binomial model, sensitivity/specificity, and receiver operating curve

Correlation and regression


Group comparison

Group comparison

Group comparison

Analysis

Study design and finding Finding


Preference of speaking and preference of reading in English were both correlated to bilinguals’ performance across test conditions. English speaking proficiency as measured on the Versant English Test (Pearson Education, 2010) was correlated to bilinguals’ performance. (a) Many bilinguals self-rated to be “proficient” in English performed below the monolingual norm; (b) proficiency rating across domains (listening, speaking, and reading) predicted outcome (at or below the monolingual norm) better than domain-specific rating; (c) proficiency rating across languages (English and the other language) predicted outcome better than languagespecific rating; (d) AOA and dominance when combined with proficiency rating could improve outcome prediction. Self-rated proficiency in listening, speaking, and reading in English were all correlated to bilinguals’ performance across test conditions.

Balanced bilinguals’ psychometric functions grew more slowly than English-preferring bilinguals’ functions.

(a) English-dominant bilinguals, regardless of first language, yielded psychometric functions comparable to monolinguals; (b) Arabic- and Spanish-dominant bilinguals’ functions grew more slowly than monolinguals’ and English-dominant bilinguals’ functions.

(a) English-dominant bilinguals made more errors than monolinguals but the two groups shared similar phoneme error patterns; (b) Russian-dominant bilinguals made more errors than the other two groups and had a unique phoneme error pattern.


259

Shi (2012)

von Hapsburg & Bahng (2006)g

Study

English monolinguals vs. bilinguals of various background

English monolinguals vs. two groups of Korean– English bilinguals (moderate- and low-proficiency)

Listeners Group comparison

Binomial model, sensitivity/specificity, and receiver operating curve

NU-6 words in quiet

Analysis

English and Korean SPIN sentences in English and Korean 12-talker babble, respectively

Stimuli


Self-rated accent severity and nonnativeness were both correlated to bilinguals’ performance across test conditions.

(a) Monolinguals performed better than moderate-proficiency bilinguals and moderate-proficiency bilinguals performed better than low-proficiency bilinguals in English; (b) both groups of bilinguals performed comparably in Korean.

Finding

a

W-22 words were used in the SIG-R test. b The study also incorporated “bilingual age” as a language variable. Bilingual age was computed as the difference between the individual’s age of English acquisition and chronological age. c The study used length of residence in the United States as a measure of length of immersion. d The study used age of immigration and length of residence in the United States as measures of length of immersion. e The study used length of English learning as a measure of length of immersion. f The study used three measures of length of immersion: in the United States, in an English-speaking family, and at English-speaking school/work. g The study also obtained acceptable noise level in English and Spanish, which is not discussed here.

Note. Studies define their bilingual listeners differently. Here, loose descriptors are used not to most accurately describe age of acquisition but to make cross-study comparisons easier. Simultaneous refers to acquisition of two languages since birth but no later than 2 years of age; early refers to acquisition of the second language by 5–6 years of age; late refers to acquisition of the second language around puberty; and very late refers to acquisition of the second language postpuberty, including in adulthood. AOA = age of acquisition; BEL = Basic English Lexicon test (English: Calandruccio & Smiljanić, 2012; Greek: Rimikis, Smiljanić, & Calandruccio, 2013); HINT = Hearing in Noise Test (English: Nilsson, Soli, & Sullivan, 1994; Japanese: Shiroma, Iwaki, Kubo, & Soli, 2008; Mandarin: Wong, Soli, Liu, Han, & Huang, 2007; Spanish: Soli, Vermiglio, Wen, & Filesari, 2002); NU-6 = Northwestern University Auditory Test No. 6 (Tillman & Carhart, 1966); SIG-R = Speech Intelligibility Gain—Reverberant Test (Koehnke & Besing, 1996); SPIN = Speech Perception in Noise test (Bilger, Nuetzel, Rabinowitz, & Rzeczkowski, 1984; Kalikow, Stevens, & Elliott, 1977); SSI = Synthetic Sentence Identification test (English: Speaks & Jerger, 1965; Spanish: Benitez & Speaks, 1968); W-22: Central Institute for the Deaf W-22 test (Hirsh et al., 1952); CST = Connected Speech Test (Cox, Alexander, & Gilmore, 1987).

Accent severity

Language variable


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