Description
Fall 2008, SODBP, Newsletter, Issue
ASHA CONNECTIONS:
Bilingual Language Learners, Early Hearing Assessment
By Pam Mason, MEd, CCC-A and Amy Hasselkus, MA, CCC-SLP
American Speech-Language-Hearing Association (ASHA)
Bilingual Language Learners
Health care professionals often work with children and families who speak more than 1 language at home. Children typically are able to learn languages without much difficulty. Some learn both languages at the same time (simultaneous language learners) while others may learn 1 language first and then add the second (sequential language learners). Screening children who speak English as a second language or who speak more than 1 language presents the pediatrician or other health care provider with unique challenges. Ideally, children will be screened in their native language, if that is most appropriate.
Simultaneous language learners follow the same pattern of speech and language development as monolingual language learners. Their first words are usually at about 1 year old. Children will begin to string 2 words together at approximately 2 years of age. It is important to consider the receptive and expressive language development in both languages and not compare them to a monolingual English learner.
Sequential language learners are typically exposed to the second language at 2-3 years old or older. Receptive language in the second language typically develops before expressive language.
Opinions on how to teach children to become bilingual vary; however, many researchers agree that consistent exposure to 2 languages at an early age is best. When developing their language skills, there may be a period of time when the child mixes the 2 languages or goes through a “silent period”. This is normal and should gradually disappear as their language skills develop.
For a child to have a true language disorder, it must exist across all languages. If a parent has concerns about the child learning English as a second language, but has no concerns about the home language, it may be more a matter of exposure to English than a true language delay. A speech-language pathologist (SLP) with experience working with bilingual language learners is able to determine the nature and extent of any disorder. The American Speech-Language-Hearing Association (ASHA) has established policies about providing appropriate intervention to children who speak more than 1 language or for whom English is a second language. In the document, Clinical Management of Communicatively Handicapped Minority Language Populations (available at http://www.asha.org/docs/html/PS1985-00219.html), published by ASHA, it states that the most appropriate language for intervention will be determined by the assessment. Treatment must be provided in the most appropriate language for the client.
To locate a bilingual ASHA-certified SLP, visit ASHA’s Find a Professional (available at http://www.asha.org/proserv/).
Additional resources for physicians and families:
• Acquiring English as Second Language: What’s “Normal”, What’s Not Available at http://www.asha.org/public/
speech/development/esl.htm
• Learning Two Languages Available at http://www.asha.org/public/speech/development/BilingualChildren.htm
• How Does Your Child Hear and Talk? Brochures, posters, and other formats available in English, Spanish, and Chinese. Available at http://www.asha.org/eweb/OLSDynamicPage.aspx?kwrd=how+does+your+child+hear+and+talk&webcode=
olsresults&x=17&y=12
• Childhood Bilingualism: Current Status and Future Directions [PDF] Summary of 2004 workshop sponsored by the Office of English Language Acquisition, the Office of Special Education and Rehabilitation Services, and the National Institute of Child Health and Human Development, National Institutes of Health, with support from the American Federation of Teachers, the International Reading Association, and the American Speech-Language-Hearing Association. Available at http://www.asha.org/NR/rdonlyres/398FE4B0-279A-4904-A732-9194E10CCC71/0/ChildhoodBilingualism05.pdf
Pediatric Hearing Assessments for Infants and Young Children
Hearing plays a vital role in the acquisition of speech and language, as well as other developmental milestones in young children. Everyday in the US 33 babies are born with permanent hearing loss. Approximately 1 in 1,000 newborns are born profoundly deaf with another 2-3 out of 1,000 babies born with a partial hearing loss, making hearing loss the number one birth defect in America. Universal newborn hearing screening programs have been successful in the US with more than 90% of all newborns screened for hearing loss before leaving the birthing hospital.
To improve outcomes for infants identified through the screening process and suspected to have hearing loss, the medical evaluation and appropriate audiologic evaluations must proceed prior to 3 months of age (JCIH, 2000).
The goal of the initial audiologic assessment of newborns and infants is to confirm or rule-out the presence of hearing loss, to estimate the degree and configuration of the loss, and to better understand the integrity of the auditory system. The information gathered in the audiologic assessment can serve as the baseline for initiating early intervention decisions such as selection and fitting of amplification and other assistive devices. Ongoing assessments should be part of the management process for the child. One single audiologic assessment will not adequately address fluctuating, late onset and/or progressive hearing loss.
There are specific procedural recommendations that are critical in the comprehensive audiologic assessment and are supported by research evidence and cumulative clinical experience. A test battery approach in audiology clinical practice is recommended based on the complex nature of the auditory mechanism. Any single test assessment alone is not appropriate. The battery should include behavioral, physiologic and developmental measures that are outcome based and cost effective. Corroboration of test results with case history, parent/care-giver report and observations of behavior is vital to assessing the functional use of hearing.
Once a child reaches the age of 6 months, more formalized behavioral test techniques should be used and no further physiologic assessments will be necessary in most cases. Periodic hearing monitoring; at a minimum every 3 months through 2 years of age is recommended to determine stability of the hearing loss and for evaluating the functioning of amplification systems (JCIH 2000).
To locate appropriate pediatric audiologic facilities and professional services, contact the Early Hearing Detection and Invervention (EHDI) Coordinator in your state. A listing of EHDI coordinators is available at http://www.asha.org/about/legislation-advocacy/state/issues/infant_state_directory.htm. To locate an ASHA-certified audiologist, visit ASHA’s Find a Professional (at http://www.asha.org/proserv).
Additional resources:
• Effects of Hearing Loss on Development
http://www.asha.org/NR/rdonlyres/9E6076F7-0D8C-45FF-800D-694334552BFB/0/InfoSeriesHearingLossEffects.pdf
• Audiologic Assessment of Children from Birth to 5 Years of Age (2004)
http://www.asha.org/NR/rdonlyres/0BB7C840-27D2-4DC6-861B-1709ADD78BAF/0/v2GLAudAssessChild.pdf
• Centers for Disease Control and Prevention Early Hearing Detection and Intervention Program http://www.cdc.gov/NCBDDD/EHDI
• JCIH Year 2000 Position Statement: Principles and Guidelines for Early Hearing Detection and Intervention Programs (2000)
http://www.asha.org/NR/rdonlyres/EAF34BE9-3EE3-4BAA-8D54-2F86B6C33C37/0/18832_1.pdf
• ASHA Patient Education Materials
ASHA has a unique 40 minute DVD full of helpful tips for encouraging speech and language development. It is a great way to educate and inform parents. We have priced the DVD to encourage professionals to give it to families (10 or more copies = $5.50 each). Brochures are also available on hearing loss and speech, language, and hearing development. http://www.asha.org/eweb/OLSDynamicPage.aspx?Webcode=olsresults&cat=Consumer%20Education:%20Brochures,%20 Posters,%20and%20more
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Publication date: Sep 16, 2009
Revise date: Sep 16, 2009
TextID: 712
