Greetings ¡Adelante! readers! After a bit of a hiatus, Bilingual Therapies is proud to bring back our monthly blog. We will publish the list of our upcoming articles in the next few weeks. We invite you to let us know if there are any topics or potential authors that you would like to see featured on ¡Adelante!. For this month’s article, we are pleased to let you know a little more about the Bilingual Symposium coming up in July:

Bilingual Therapies 2012 Symposium in Orlando, Florida
We at Bilingual Therapies hope that 2012 finds you in good spirits. The office staff is buzzing with the thoughts of being in the happiest place on earth this summer-Disney World! The 2012 symposium will be held at the World Center Marriot. We are very proud to announce our speakers and topics for the 2012 Symposium.

The Application of Dynamic Assessment to Bilingual Phonological Disorders
-Brian Goldstein, Ph.D., F-CCC-SLP, Temple University, Philadelphia, PA
Description:
In assessing bilingual children speech-language pathologists must differentiate disorders from differences. Dynamic assessment is one alternative assessment practice available to clinicians to make that distinction. That practice, however, is less often used for phonology compared to other domains of language. The purpose of this seminar is to discuss the application of dynamic assessment to bilingual phonology.

Grammatical Development of Spanish/English speakers: Applications to Clinical Practice
-Raquel Anderson, Ph.D., CCC-SLP, Associate Professor, Indiana University, Bloomington, IN
Description:
In this session, information concerning the development of grammatical skills in both English and Spanish of young dual language learners will be discussed. Thus, the focus will be on the 0-5 population, although early school age will also be covered. Strategies for evaluating and assessing grammatical skill in dual language learners in general, and Spanish/English learners in particular, will be presented, with implication for treatment of grammatical deficits. Although the presentation will focus on Spanish, the data/research presented will be broad in nature, thus permitting participants to apply the information to other dual language learners.

Bilingualism and Cognition across the Lifespan
-Maria L. Muñoz, Ph.D., CCC-SLP, Associate Professor, Texas Christian University, Fort Worth, TX
Description:
The purpose of this session is to review recent research on bilingualism and cognition in children and adults and draw implications for the assessment and treatment of language and cognitive impairments across the life span. Differences, advantages, and costs associated with bilingualism have been demonstrated on tasks of language processing, memory, attention, and executive functioning. Topics of interest include the organization of and access to semantic memory, strengths in executive functioning that may be provide some protection against cognitive decline later in life, and increased demands on attentional control.

The Dynamics of Bilingualism in Stuttering
-Edna J. Carlo, M.S., CCC-SLP, Assistant Professor, University of Puerto Rico, San Juan, Puerto Rico
Description:
This session will introduce participants to cultural and linguistic aspects to be considered when assessing and treating bilingual speakers who stutter. Prof. Carlo will discuss theoretical aspects in relation to bilingualism. She will also address frequently asked questions and myths to specifically differentiate between stuttering and lack of language proficiency. Specific examples from Spanish and available clinical resources will be presented.

The Bilingual Practitioner as a Leader, Advocate, and Educator
-Nate Cornish, M.S., CCC-SLP, Co-Clinical Director, Bilingual Therapies, Inc., Skokie, IL
-Melissa White, M.A., CCC-SLP, Co-Clinical Director, Bilingual Therapies, Inc., San Antonio, TX
Description:
As the United States becomes increasingly culturally and linguistically diverse, bilingual speech, language and hearing professionals find themselves taking on leadership and advocacy roles for the communities they serve. This keynote session will highlight ways that practitioners serve their clients- and the larger CLD community- outside of the therapy room. Resources for educating and collaborating with colleagues, families and the public will be discussed.

If you are as excited about this symposium as we are, register at www.bilingualsymposium.com.  Hope to see there!

Dr. Ruth Crutchfield, SLP.D., CCC-SLP
University of Texas-Pan American, Edinburg, TX

Dr. Ruth Crutchfield is a lecturer and clinical supervisor at the University of Texas-Pan American. Dr. Crutchfield graduated with her master’s degree in Communication Disorders Bilingual/Bicultural from UTPA in December of 1997 and has held the Certificate of Clinical Competence from the American Speech and Hearing Association since then. Dr. Crutchfield received her Doctor of Speech Language Pathology in May of 2010. She practiced for seven years in the public school system and for four years as the director of speech-language pathology at a pediatric outpatient rehabilitation center. For the last three years, Dr. Crutchfield has been a clinical instructor and supervisor at the University of Texas-Pan American where she teaches language disorders in children, speech science and clinical report writing. Her experiences range from working as an SLP in the school system, working with the geriatric population in a nursing home and outpatient facility, and working with the pediatric population in all scopes in an outpatient rehabilitative facility. She has attended various workshops (i.e. SI for SLP’s, M.O.R.E., Beckman Oral Motor, Visual Phonics, Therapeutic Listening, Autism, Feeding Strategies, Dysphagia, Apraxia Kids, Fluency Therapy – Efficient Strategies, PROMPT, Carbone’s Verbal Behavior Therapy to name a few) from which knowledge she is able to draw from when forming a prescriptive treatment plan.

Introduction

It is important to acknowledge that music is used in the area of speech therapy largely due to the influence that has been received by the field of music therapy itself.  Music therapy is a profession that is delving on its own to provide proof of its effectiveness in rehabilitation of individuals with various disabilities.  For speech therapy, speech-language pathologists (SLP’s) have been using music to enhance their treatment plan.  At times, music is used to mark the beginning or ending of a session, or to enhance a certain activity that the SLP has prepared where a specific song emphasizes the language concept that the therapist is targeting in a private setting.  SLP’s in the schools work with the special education units where music may be utilized throughout the day.  The effectiveness of its use is evident in the manner in which the students successfully transition, or that morning routine is beginning.  These are all examples of how music is naturally utilized in therapeutic settings.  Molnar-Szakacs and Overy (2006), recently found through functional magnetic resonant imaging evidence suggesting that “music, like language, involves an intimate coupling between the perception and production of hierarchically organized sequential information, the structure of which has the ability to communicate meaning and emotion” (p. 235). Molnar-Szakas and Overy (2006) provide more of a substantial basis for using music in speech therapy. However, the question is posed: Is there evidence to prove that music therapy is effective for the specific purposes of speech and language therapy and what specifically can be done that is effective in promoting treatment outcomes?

Search Strategy

In order to provide evidence to answer these questions, a search was completed in the following databases:  CINAHL (2001-2011), ERIC (2001-2011) and all ASHA journals (2001-2011) with the search terms of music and speech therapy.  As a selection criteria, only randomized controlled clinical studies comparing music and its effect on speech therapy in normal hearing children were selected.  Additionally, attempts were made to find controlled studies that were focused on Spanish-dominant children, but this search provided no results. Two studies were found that met the aforementioned criteria.

Thompson, Schellenburg and Hussein (2004) completed a study where 43 six-year olds were randomly selected to participate in keyboard, drama, vocal or no classes at all. The purpose of the study was to investigate if enhancing a particular musical skill would increase the children’s ability to identify prosodic changes in their speech such as anger or fear.  The findings revealed that the children who participated in the music group (e.g. keyboarding and voice lessons) were able to identify the prosodic changes in speech at an equivalent level to the drama group and outperformed the group of children that received no lessons. The significance in this study was that the drama group was being taught how to act out emotion specifically. However, the music group increased awareness of prosody, naturally, due to the increased exposure to musical concepts.

Lim (2010) completed a study where 50 children with Autism Spectrum Disorder from the ages of 3 to 5 were randomly selected to participate in a study that included a group in music training, a group in speech training and a control group with no intervention.  The music group watched music videos of a story of 9 minutes in length while the speech group watched a video of a story being told over about 5 minutes in length via six training sessions.  Results via pre and post-testing revealed that the children in the music and speech groups presented with increases in verbal production. The higher functioning children in both groups did increase verbal production; however, the lower functioning children in the music group had significantly more verbal productions than the speech group.

What works for bilingual children?

Knowing that there is some evidence of how effective the use of music can be in speech therapy provides SLP’s with the ability to utilize music as a modality with more assurance.  What are the components of music that help children increase in verbalizations, in prosody awareness, and in clarity of speech (Crutchfield, 2010; Lim, 2010; Thompson, Schellenburg& Hussein, 2004)? Key practices noted were the repeated use of music in a structured and consistent manner, the type of music that was selected, the selection of terms for intervention targets, and the use of movement to enhance the musical experience.

Music was used in a structured manner before, during or after the sessions (Crutchfield, 2010; Lim, 2010; Thompson, Schellenburg & Hussein, 2004). It is feasible that if music is going to be used as part of the speech therapy session, a specific structure needs to be implemented.  For example, the session can be opened or closed with music, or a specific part of the therapy room can be allotted the music center where the child will complete the center at the midpoint of the session.  Also, music can be used as a parent/home program. The parent can be given a CD with the music that is being used in therapy to play at home to the child during an optimal learning time. The focus of this would be to provide the child with repeated exposure to the music; therefore, providing repeated exposure to the targets of speech therapy.

The music that was selected contained the therapy targets (Crutchfield, 2010; Lim, 2010); therefore, it is imperative that the music is carefully selected.  For example, the SLP needs to verify that the music being used contains the target vocabulary for the language concept that is being targeted, or the target words for the phonological pattern present, or of the phoneme that the child is producing in error.  There are options for selection in the use of music in Spanish.  The SLP needs to research and locate the music that is available.  Some SLP’s venture forth and write their own music and lyrics in order to assure that the concepts targeted are embedded in the music experience.

Additionally, movement was used throughout the studies found (Crutchfield, 2010; Lim, 2010; Thompson, Schellenburg & Hussein, 2004). In one study, keyboarding allowed the engagement of the hands.  In the same study, singing allowed for the engagement of the whole body.  It is the natural inclination of one to sway, clap, and move when listening to music.  Because of this, it is to the SLP’s benefit to implement kinesthetic or movement cues to enhance the music experience such as clapping, tapping, waving, nodding of the head, and body motion in order to bring the child into the musical experience all together.

Is there efficacy in the use of music as a modality in speech therapy?  The evidence is pointing towards a resounding, “Yes!”

References

Crutchfield, R. (2010).  Music Therapy Efficacy on Increasing Word Length in Spanish

Dominant Phonological Process Disordered Children.  Nova Southeastern University Dissertation Database.

Lim, H.A. (2010). Effect of  “Developmental speech and language training through music” on

speech production in children with autism spectrum disorders. Journal of Music Therapy,

XLVII(1), 2-26.

Molnar-Szakacs, I. &Overy, K. (2006). Music and mirror neurons:  from motion to ‘e’motion.

SCAN,1, 235-241, doi:10.1093/scan/ns1029.

Thompson, W.F., Schellenberg, E.G., & Husain, G. (2004). Decoding speech prosody:  Do

music lessons help? Emotion,4(1), 46-64, doi:  10.1037/1528-3542.4.1.46.

]]> http://blog.bilingualtherapies.com/treatment-resources/music-in-speech-therapy-with-children-who-are-bilingual-what-works/feed/ 6 http://blog.bilingualtherapies.com/treatment-resources/music-in-speech-therapy-with-children-who-are-bilingual-what-works/ http://feedproxy.google.com/~r/BilingualTherapies/~3/L-XjHERJpNc/ http://blog.bilingualtherapies.com/background-knowledge/perspectives-on-being-a-bilingual-speech-language-pathologist-from-clinicians-at-various-points-in-their-careers/#comments Fri, 01 Apr 2011 13:14:08 +0000 Nathan Cornish http://blog.bilingualtherapies.com/?p=309

Greetings! The field of speech-language pathology, and our practice as bilingual clinicians, is always changing. Along with these outside changes, our own experiences make us evolve as individuals. It’s good to assess our own roles and views of the profession periodically, and in doing so it seems valuable to hear the experiences of others. We can be inspired by the energy and earnestness of newer clinicians, and we can benefit from the perspective and experience of more seasoned practitioners.

This month’s ¡Adelante! article is a compilation of reflections about the profession from three clinicians at different points in their careers. Sara Bayona is a recent graduate who is busily growing as a CF. Raquel Martínez has participated in a number of working environments in the few years since she completed her CFY. Karen Miranda has broad experience both as a speech-language pathologist and a speech aide. Each of them shares important insights into life as a bilingual clinician in this unique article. Please feel free to share your own in the comment section!

Sara Bayona, M.S., CF-SLP
Houston Independent School District, Houston, TX

Sara works at the elementary school level in Houston Independent School District. She graduated in May 2010 from Texas Tech Health Sciences Center. This is her first year working as a bilingual speech-language pathologist.

I was very honored when Nate Cornish asked me to contribute to the ¡Adelante! blog. I began my professional career as a bilingual speech-language pathologist eight months ago and it has been a non-stop ride ever since.

There are a few things I have learned since the previous stage in my career (graduate school). First, I have learned that confidence in your knowledge and skills is just as valuable as your actual knowledge and skills. You have to come prepared to explain, defend, and support your results from an evaluation or therapy sessions. When you present this information with confidence, your colleagues and your student’s parents will trust your professional opinion. You need to believe that you did learn valuable information in graduate school and be ready to share that with the world! Second, I have learned that one of your greatest tools will be networking with other clinicians in your school district. I suggest branching out and making friends with as many clinicians as you can at your first district meeting. The advice, suggestions, and tips from other professionals going through the same experiences as me has gotten me through this first school year. You will have an endless supply of therapy ideas for every holiday, season, or animal that is the theme of the week, support from someone who understands how it feels to spend 30 minutes with a three year-old that will only say one word, and encouragement when you think you cannot take on one more report. Finally, I have learned you cannot worry about being the perfect clinician your first year out of school. You will make mistakes. It is easier if you accept it from the start. The best advice I received before starting my job was, “control what you can control and for the rest just do the best that you can”.

Before the beginning of the school year, I asked some experienced therapists what to expect. The overall answer was to be prepared to be overwhelmed. They were correct, but if you have your time management skills in check then you will be just fine. I wish I had known the amount of time that would be spent away from the students. I expected to see students from 8 to 3 and then be on my way. There will be an incredible amount of paperwork coming your way, but like I mentioned, time management skills is the key.

In conclusion, I have learned many new things throughout my clinical fellowship year. There are a few things I wish I had known before hand, but it is all part of the learning process. The best part of this stage in my career is the joy you experience from finally putting years of studying theory into practice. The excitement of trying the therapy technique you read about and seeing results that impact a child’s communication and education. You might not be the perfect clinician, but if you find support from other professionals, have confidence in your skills, and manage your time then I promise you will make it through this exciting yet challenging time in your career.

Raquel Martínez, M.A., CCC-SLP
Austin Independent School District, Austin, TX

Raquel received her bachelor’s degree at the University of Texas at Austin, and her Master’s degree at Our Lady of the Lake University in San Antonio. She currently practices as a bilingual speech-language pathologist in Austin through Bilingual Therapies.

I’ve been an official member of the Bilingual Therapies team since August of 2009. Since 2009 so much has happened! I started out in San Antonio as a CFY, and then I moved onto South Padre Island to work in a Pediatric Private Practice setting and am now in Austin working as a school-based clinician.

Being a bilingual clinician has been a blessing— I enjoy the perks of endless traveling opportunities. I’d like to think that one of the best things about this profession is the diversity and the energy! I love, love, LOVE the diversity the profession has to offer. The profession itself is continuously evolving, which beautifully fits my “student for life” mantra. I don’t think we ever stop learning- evolving into better clinicians with every year that comes. In these last two years I’ve found that the key is to remain open. If I could go back, as a CFY I’d tell myself two things: 1) “It’s okay if you don’t get it right the first time, change WILL always be there, it’s a constant.” 2) It’s not about having all the answers; it’s putting theory into practice.

For me, it’s about changing lives one individual at a time!

Karen Miranda, M.S., CCC-SLP
Prince George’s County School District, Maryland

Karen received her M.S. in Disorders of Communication from California State University Northridge and her B.A. in Communicative Disorder from California State University Long Beach. She currently works through Bilingual Therapies as a Diagnostician for the Dual Language Assessment Team in Prince George’s County Public Schools, Maryland.

I began in the field of Speech – Language Pathology as a “Student Evaluation Technician”, which was a fancy title for a speech aide in the school system, at the ripe ol’ age of eighteen. Unaware of what I was getting into, I soon realized I enjoyed helping monolingual SLPs work with their Spanish-speaking students in providing adequate therapy sessions. I decided to major in that area and as a result of working in the field while I went to school, I was privy to a few things my fellow soon-to-be SLP classmates would encounter…in due time! I knew that the job was not glamorous or always fun, as we would be made to work in small hall closets that were once occupied by cleaning supplies. Nonetheless, I learned many good therapy ideas from different SLPs and I applied them once I became a full-fledged SLP.

Now that I am in a different stage of my career, where my focus is on evaluations, I have learned how to write better reports in order to present a clear and thorough representation of my client, in writing. I try to create a kind of verbal hologram, if you will, of my client so that the reader will have a clear representation of what occurred during testing. I have learned that you cannot rely solely on standardized data because communication skills are far more intricate than just being able to produce grammatically and syntactically correct sentences on command. And I have learned to keep up on current guidelines as they are ever-changing.

But perhaps one of the most important lessons I have learned throughout my years of experience, is that we do not just improve clients’ communication skills, but rather wear many hats in order to help improve clients’ lives. Being that we are bilingual SLPs and speak the same language as the families we work with, they look to us for assistance and guidance. We act as counselors (mostly, I just listen), as interpreters, as advocates, as liaisons between parents and school staff and as discipline coaches. Frankly, I enjoy it! So, I must admit that I find myself watching some Super Nanny episodes in order to learn tips I can pass along to parents on how to make discipline work for them.

All in all, if I had to do it over again, I would not hesitate to choose Speech – Language Pathology as my career path. I meet great people, from parents, to children, to educators and colleagues that teach me something new everyday. And, in light of the economic changes our nation is going through right now, the best thing about our profession, as I see it, is that it appears to be “recession proof.” As I am sure it is the case with everyone else, my caseload continues to grow and I am busier now than I ever was in the past, (at least it seems like it)! We have so many options available to us…we can choose to work in almost any part of the world, we can be creative in our practice, we can work with people of all ages and we can concentrate on different areas to work in… the opportunities are endless! That is really exciting to me and I can’t think of any other profession that has so many options!

Melissa D. White, M.A., CCC-SLP
University of Texas-Austin, Austin, TX

Melissa is a bilingual speech-language pathologist who has worked with culturally and linguistically diverse school age children with various communication disorders in Texas and Illinois. Previously, Melissa served as a clinical faculty supervisor for the University of Texas- Austin Speech and Hearing Center (UTSHC). There, Melissa primarily supervised graduate students during their bilingual Spanish rotations and worked as a clinical mentor on the Implementing Treatment Practices (ITP) Project, which is a training grant through the Office of Special Education, U.S. Department of Education. Melissa currently works through Bilingual Therapies at the Northside ISD in San Antonio, TX and is a Team Leader for the Mountain West region.

I’ve supervised many graduate students over the years and know that the weeks before spring break can be very stressful.  Most of you started graduate school with the goal of finishing the program and being a bilingual SLP.  What you might not have known was the roller coaster ride it was going to be.  Here are some tips to help you stay on track.

1.  “Know who you will be”

If you are interested in becoming a bilingual SLP, you probably already know that it isn’t just about speaking a second language.  ASHA has defined skills that a bilingual speech and language pathologists should have (http://www.asha.org/docs/html/RP1989-00205.html).  Reviewing this document will help you understand what the expectations are for being a bilingual service provider.  You can also access other position statements on ASHA’s website that relate to multicultural issues (http://www.asha.org/practice/multicultural/readings/position.htm).

2.  “Know your Program”

While there are more university programs in communication disorders that offer a bilingual program for graduate students, the number is still limited.  Many graduate students who are interested in being a bilingual SLP end up having to “MacGyver” their monolingual program and supplement it. Find out what your academic and clinical faculty areas of specialty are.  While you may not be at a program with a bilingual emphasis, you may have individuals who are researching or have experience working with culturally and linguistically diverse populations.  It is important to discuss knowledge and skills needed in assessment and intervention of culturally and linguistically diverse populations and develop a plan for acquiring those skills.  If you feel that you don’t have this type of support, find a mentor.  ASHA has a mentoring program for graduate students that is excellent.  You can find information about signing up for a mentor at http://www.asha.org/students/gatheringplace/.

3. “Know your University”

Start researching other programs within your university.  The college of education may have bilingual education programs, as well as bilingual special education programs.  These types of programs may have courses on bilingualism and working with diverse populations.  Many colleges and universities have programs that focus on child development, family studies and multicultural studies.  You may also be able to find courses that focus on Spanish linguistics and phonetics.

4.  “Know your skills”

As a graduate student, doing therapy in English can be daunting.  Many graduate students are trying to figure out how to talk to kids for the first time.  Now imagine doing all the assessment and intervention tasks in your second language for all disorders and age groups.  If you aren’t sure about your bilingual language skills then you need to find out quickly.  Knowing conversational Spanish or academic Spanish can only get you half of the way.  If you want to get better at communicating in your second language, you have to use it.  Take courses in conversational Spanish, join Spanish speaking groups on campus, watch T.V. shows and movies in Spanish, take a Spanish medical terminology course etc.  The point is, you have to find ways to improve your second language skills.

You also need to know what your biases are.  We all have had a variety of experiences that have shaped our perceptions.  Recognizing that we have biases allows us to examine them and to determine whether they will positively or negatively impact our assessment and intervention.   ASHA has helpful self-assessments at http://www.asha.org/practice/multicultural/self.htm .

5. “Know you are not alone”

The number of bilingual SLP’s is growing every year. Don’t get discouraged and keep working at it.  Being a bilingual speech and language pathologist is a rewarding profession and in high demand.  If you are passionate about working with culturally and linguistically diverse students stay on the course, it’s worth the ride.

Anny P. Castilla, Ph.D., Assistant Professor in CSD, State University of New York – Fredonia, Fredonia, NY

Dr. Anny Castilla completed her clinical degree as a speech-language pathologist in La Universidad del Valle, in Cali, Colombia. In 2008, she obtained her doctorate degree at The University of Toronto. Currently, Dr. Castilla is an Assistant Professor in the Department of Communication Disorders and Sciences at SUNY Fredonia in New York.

It is my pleasure to share my experience and knowledge on the use of narratives as a language assessment tool in Spanish-speaking (SS) children. I have worked with narratives since I began my doctoral work in 2003. In my own research, I have used narratives to examine typical and atypical language in preschool SS. In other work with my colleagues, I have also used narratives to examine the influence of Spanish-language skills on the acquisition of English and the effect of a Spanish supplemental program on Spanish language development.

Why SLPs should incorporate narrative assessment into their evaluations?

The use of narratives as a tool to assess productive language skills in children is highly encouraged because of their high ecological validity – children are often exposed to and asked to produce narratives – and their association with academic skills (Hughes, McGillivray & Schmidek, 1997). Narrative production is a task with high language demands allowing the assessment of productive language skills such as vocabulary, morphosyntax, language complexity and story grammar (Klecan-Aker & Hedrick, 1985; Paul & Smith, 1993; Scott, 1988). In addition, narrative tasks are culturally appropriate activities to assess language skills in SS preschool children (Castilla, 2008; Restrepo & Castilla, 2007). My own research indicates that measures of productive language derived from narratives are sensitive to developmental changes in SS children during the preschool years.

How to elicit a narrative and what language measures can be calculated from it?

My preferred method for narrative elicitation is story retelling. Children tend to be more productive if they do not have to create their own story.  I read the story while I am changing the pages of a book, and, once I am finished, I ask the child to repeat the story back to me. If the child is slow to repeat the story, I ask him/her to identify the main characters on the first page and then ask again to tell me the story. I say “y entonce que pasó?’ or “Y qué mas?” to encourage language production. I find that this methodology works very well with preschool children.

I record the child retelling me the story and later I transcribe and code. As previously mentioned, narratives can provide one with information on language complexity, vocabulary, grammatical development and story grammar. The following measures can be calculated from a narrative:

a)     Number of T-units and Mean Length of T-units. A Terminable Unit (T-Unit) is a main clause plus its subordinated clauses (Hunt, 1965). Subjectless sentences where the verb is conjugated are considered T-units. (Gutierrez-Clellen and Hofstetter, 1994). Count the number of T-units produced and the average length in words.

b)    Subordination Index. Subordination Index is the number of dependent and independent clauses divided by the total number of T-units. A SUB-I score of one indicates that children used only simple sentences in their story retellings. A higher subordination index score indicates that the child can produce complex sentences.

c)     Number of Grammatical Errors per T-unit. Calculate the sum of all grammatical errors divided by the total number of T-units. This will give you a grammaticality index (Restrepo, 1998).

d)     Number of different words produced in the sample.

e)     Story grammar. I use the Index of Narrative Complexity (Petersen, Gillam & Gillam, 2008) to code for story grammar. This tool works very well with narratives produced by SS children (Castilla & Hammer, 2010; Castilla, Hammer, Petersen & Spencer, in preparation).

My research suggests that all these previous measures, with the exception of number of grammatical errors per T-unit, increase with age during the preschool years in SS children.

How effective are narrative assessments as diagnostic tools for Spanish-speaking children?

One recommendation regarding language assessment for SS children is to use language measures obtained through the analysis of spontaneous language samples (Gutiérrez-Clellen, Restrepo, Bedore, Peña & Anderson, 2000; Restrepo & Gutierrez-Clellen, 2004). In fact, researchers have made significant advances in the identification of SS children with language disorders using spontaneous language samples (Bedore & Leonard, 2005; Restrepo, 1998; Gutierrez-Clellen and Simon-Cereijido, 2007). For example, researchers have determined that measures of sentence length (Bedore & Leonard, 2005; Simon-Cereijido & Gutierrez-Clellen, 2007; Restrepo, 1998) and indices of grammaticality (Simon-Cereijido & Gutierrez-Clellen, 2007; Restrepo, 1998) can discriminate SS children with language disorders from typically developing children. Narratives are considered samples of spontaneous language.

Preliminary data from a current research project carried out in my laboratory indicates that measures of language productivity, vocabulary and story grammar derived from a story-retelling task differentiate typically developing children from children with language disorders.  Currently, I am collecting data in both monolingual and bilingual populations to further advance our knowledge in this area.

References and Recommended Readings

Bedore, L., & Leonard, L. (2001). Grammatical morphology deficits in Spanish-speaking children with specific language impairment. Journal of Speech, Language, and Hearing Research, 44, 905-924.

Bedore, L., & Leonard, L. (2005). Verb inflections and noun phrase morphology in the spontaneous speech of Spanish-speaking children with specific language impairment. Applied Linguistics, 26, 195-225.

Castilla, A. P. & Hammer, K. (2010) Assessment of Narrative Development in Preschool Monolingual Spanish-Speaking Children. Presentation at the Symposium on Research in Child Language Disorders, Madison, WI.

Castilla, A. P. (2009). Morphosyntactic Acquisition in monolingual 3-, 4-, and 5-year-old Spanish-speaking children. In V. Marrero & I. Pinera (Eds.) Linguistics: The Challenge of Clinical Application. Proceedings of the II International Conference on Clinical Linguistics. Euphonia Ediciones: Madrid, Spain.

Castilla, A.P., Restrepo, M.A. & Pérez-Leroux, A.T. (2009). Individual differences and language interdependence in Spanish-English bilingual children. International Journal of Bilingualism.

Gazella, J., & Stockman, I. J. (2003). Children’s story retelling under different modality and task conditions: Implications for standardizing language sampling procedures. American Journal of Speech-Language Pathology, 12, 61-72.

Gutierrez-Clellen, V. F., & Hofstetter, R. (1994). Syntactic complexity in Spanish narratives: A developmental study. Journal of Speech and Hearing Research, 37, 645-654.

Gutierrez-Clellen, V. F., Restrepo, M. A., Bedore, L., Peña, L., & Anderson, R. (2000). Language sample analysis: Methodological considerations. Language, Speech, and Hearing Services in the Schools, 31, 88-98.

Hunt, K. (1965). Grammatical structures written at three grade levels. Champaign, IL: National Council of Teachers of English.

Hughes, D., McGillivray, L. & Schmidek, M. (1997). Guide to narrative language: Procedures for assessment. Austin, TX: PRO-ED Inc.

Klecan-Aker, J.S. & Hedrick, D.L. (1985). A study of the syntactic language skills of normal school-age children.  Language, Speech, and Hearing Services in Schools, 16, 187-198.

Loban, W. (1976). Language development: Kindergarden through grade twelve. Research Report No. 18. Champaign, IL: National Council of Teachers of English.

Miller, J. F., & Chapman, R. S. (1996). SALT: A Computer program for the systematic analysis of language transcripts. Madison, WI: Language Analysis Lab, Waisman Center.

Peterson, D.B., Laing Gillam, S., Gillam, R.B. (2008) Emerging procedures in narrative assessment: The index of narrative complexity. Topics in Language Disorders, 28 (2), 115-130.

Restrepo, M. A. (1998). Identifiers of predominantly Spanish-speaking children with language impairment. Journal of Speech, Language, and Hearing Research, 41, 1398-1411.

Restrepo, M.A., Castilla, A.P. Schwanenflugel, P., Pritchett, S., Hamilton, C. & Arboleda, A. (2010) Sentence length, complexity and growth in Spanish-speaking children attending English-only and bilingual preschool programs. Language, Speech and Hearing Services in Schools.

Restrepo, M.A., & Castilla, A. (2007). Language sample elicitation and analysis as a research and clinical tool for Latino children. In. J.G. Centeno, K.L. Obler, & R. Anderson (Eds.), Communication disorders in Spanish speakers: Theoretical, research and clinical aspects. Clevedon: Multilingual Matters.

Restrepo, M. A., & Gutierrez-Clellen, V. F. (2004). Grammatical impairments in Spanish/English-speaking children. In B. Goldstein (Ed.), Bilingual language development and disorders in Spanish-English speakers (pp.213-134). Baltimore, Maryland: Paul H. Brookes.

Restrepo, M.A., Castilla, A.P., Schwanenflugel, P., Neuharth-Pritchett, S.,  Hamilton, C. & Arboleda, A. (in press). Effects of a supplemental Spanish oral language program on sentence length, complexity, and grammaticality in Spanish-speaking children attending English-only Preschools. Language, Speech, and Hearing Services in the Schools.

Simon-Cereijido, G., & Gutierrez-Clellen, V. (2007) Spontaneous language markers of Spanish language impairment. Applied Psycholinguistics, 28, 317-339.

Nate Cornish, M.S., CCC-SLP, Director of Clinical Services, Bilingual Therapies, Inc.

Nate Cornish, M.S., CCC-SLP is a bilingual speech-language pathologist, clinical director of Bilingual Therapies, and moderator of the ¡Adelante! blog. Previously, Nate provided bilingual speech-language services to secondary students and served on a city-wide bilingual assessment team in the Washington, DC Public Schools. Nate is the current president of The Hispanic Caucus, a related professional organization of ASHA.

Greetings ¡Adelante! readers!  I’m exercising some “moderator liberty” (or perhaps using the “blog bully pulpit”) in submitting this article.  However, I’m very excited about this topic because it describes my own experience as well as that of many of the professionals I work with at Bilingual Therapies.

As a bit of background, during my undergraduate years I looked forward to the prospect of attending a bilingual graduate program.  I did my homework, visited campuses, spoke with professors, and then applied to the schools that I thought would be a good fit.  There were a number of wonderful options in front of me after the acceptance letters came in, including a few bilingual programs.  However, at the end of the day I chose to attend the University of Nebraska, a program that does not offer formal curriculum or clinical experience in bilingualism.  Although I think I would have had a different and equally great experience at another school, I have never regretted my choice!

There are many reasons for making decisions about our academic careers, and not everyone who wants to work with bilinguals ends up attending a specialized bilingual program or studying with someone who is doing research in bilingualism.  So how does this group of future professionals obtain the knowledge and skills needed to provide competent services to bilingual clients?  In this article I will talk through:

• The knowledge and skills that ASHA has identified for those who represent themselves as a “Bilingual SLP”
• Legal regulations of bilingual SLPs
• Possible benefits of studying in a specialized bilingual program
• Possible benefits of attending programs that do not specialize in bilingualism
• Some tips for learning what you need to know from the literature
• Some tips for getting the clinical experience you need

What Are the Knowledge and Skills that ASHA Has Identified For Those Who Represent Themselves as a “Bilingual SLP?”

ASHA does not currently have a specific “certification” for those who would represent themselves as bilingual.  There are a number of possible reasons for this, not the least of which is the difference in resources that we have for various languages.  For example, we can verify a clinician’s language proficiency in Spanish rather easily, but how would we do that for a speaker of Ndebele?  We can verify someone’s knowledge of typical language development in French better than we can for Quiché.  It would simply be difficult to apply certification standards equally to all clinicians who may be qualified to provide bilingual services.

Instead, ASHA has provided a “definition” for those who may represent themselves as bilingual service-providers.  For the most part, this definition works on the honor system.  Clinicians have the ethical responsibility to meet the ASHA-specified criteria before telling current clients, future clients, employers, other professionals, etc. that they are a “Bilingual SLP.”  While it seems like the professions may run the risk of having less-than-qualified individuals providing services, clinicians are answerable to ASHA under a number of points within the association’s “Code of Ethics,” such as:

• Principle IA: Individuals shall provide all services competently.
• Principle IIB: Individuals shall engage in only those aspects of the professions that are within the scope of their professional practice and competence, considering their level of education, training, and experience.
• Principle IIIA: Individuals shall not misrepresent their credentials, competence, education, training, experience, or scholarly or research contributions.

So how does ASHA define a competent bilingual SLP?  You can view the entire document that details this information on the ASHA web site.  However, here are the key points:

• The clinician must speak or sign two or more languages with native or near-native proficiency in the areas of lexicon, semantics, phonology, morphology/syntax and pragmatics.
• The clinician must understand language acquisition processes for both monolingual and bilingual speakers of those languages.
• The clinician must be able to administer formal and informal tests in the languages and distinguish between a difference and a disorder.
• The clinician must be able to provide appropriate intervention strategies in the client’s language.
• The clinician must recognize cultural factors that would impact services.

Is There Any Legal Regulation of Bilingual SLPs?

The answer to this is actually pretty brief, but I think some background is important to mention.  Part of my professional responsibilities includes helping bilingual clinicians across the United States obtain the appropriate licensure to practice in school districts.  Every state is a little different (well, sometimes very different).  I’ve had the unusual experience of becoming familiar with the requirements of a number of them.  However, it’s impossible to be an expert on professional legal requirements, including the regulation of bilingual clinicians, in every jurisdiction in the country.  (In other words, I think what I’m about to say is based on a good idea of what is happening in most places around the country, but I’m willing to bet that there are some exceptions that I don’t know about.)  The best thing you can do is find out what is happening in the state and city where you plan to practice.  A good place to start is on ASHA’s “State-by-State” web page.

So, all that said, to my knowledge there are only two states that have some form of regulation for bilingual SLPs.  These states are Illinois and New York and the regulation for both is specific to clinicians who work with school-age clients, (i.e., it does not apply to SLPs working in hospitals, rehab centers, etc.).  New York’s regulation appears a little more complicated; however, because I am more familiar with the process in Illinois I will use it as an example of what this regulation can look like: Illinois school-based clinicians must submit an application, take a language proficiency test that is administered by the Illinois State Board of Education, and show proof of having taken university-level coursework on testing bilingual children.  Provisional approvals may be granted to clinicians who have taken the language test and are in the process of obtaining the required coursework.

In short, for most SLPs there is not a bilingual-specific credential required.  Where it is required, the SLP will probably have to do things like pass a language proficiency test and demonstrate completion of specific coursework.  Even though it’s not likely that you will need a special license to practice as a bilingual, it’s important to verify that when you are learning about the other credentialing requirements in your jurisdiction.

What Are the Benefits of Studying in a Specialized Bilingual Program?

Of course, the more information and experience you can get during graduate school, the better.  As you will have noticed in ASHA’s definition, speaking a second language is only one piece of what makes someone a competent bilingual clinician.  Having access to coursework, clinical experience and knowledgeable individuals will make acquiring the skills you need a process that is definitely rich, and probably simpler than in a non-bilingual program.

It’s also important to understand that not all bilingual programs offer the same type or amount of support and resources.  There may be very formal programs that offer a specialized curriculum, clinical experience, research opportunities and may even culminate in a “bilingual certificate.’  Other programs may not have a specialized curriculum, but do offer bilingual clinical practicum with experienced bilingual clinicians.  Still others may simply have someone on faculty who does research in the area of bilingualism and may be available to provide guidance.  Each of these will give you access to resources that students in non-bilingual programs may have to work a little harder to obtain.

As I mentioned previously, ASHA does not currently have bilingual certification, and very few legal jurisdictions do, either.  Thus obtaining a graduate school’s “bilingual certificate” is ultimately not always going to give you an advantage in getting the credentials you need to practice.  However, if either ASHA or your state eventually does adopt regulations for bilingual clinicians, the coursework you have in a bilingual program could potentially help you out.  For right now, attending a bilingual program may also give you a leg-up with potential employers who might see your academic history as proof that you have the skills you need to work with their bilingual clients.

Are There Benefits of Attending Programs That Do Not Specialize in Bilingualism?

I just mentioned that students in non-bilingual programs may have to work harder- so what advantage could there be with that going on?  For starters, you may have the opportunity to develop other interests that your bilingual program counterparts don’t get.  Every accredited graduate school needs to present certain material (more accurately, a LOT of material), which can make for a busy couple of years!  If your program specializes in bilingualism, you may be using any elective credits on that specialization.  Going to a non-bilingual program could give you a chance for a broader educational program where you can spend your electives on other courses.

Because the bilingual niche of our profession is relatively new, a lot of what we know comes from coupling our understanding of the dynamics of bilingualism with our understanding of other areas.  Attending a program that is strong in another clinical subset of the profession, (like fluency, adult neurogenics, or AAC), may give you a deeper understanding of that subject area than you might get in a bilingual program.  As long as you are also getting the information you need on how bilingualism works, your experience can actually give you some unique tools for addressing these issues in bilingual populations.

Tips for Learning What You Need to Know from the Literature

You’re either already well aware, or soon will be well aware, of how much information is jam-packed into a graduate program.  There’s barely any time for your required reading, let alone elective reading about bilingualism!  A solution that worked for me in grad school was to work with my professors to do some academic multi-tasking.  For example, if you’re doing a project in your aphasia class, see if you can do it on language recovery patterns in bilingual aphasic patients.  If you have to report on some journal articles about phonological treatment, ask if you can read-up on bilingual phonological treatment.  If you’re writing your thesis on traumatic brain injury, ask if you can study and write on the dynamics of cultural and linguistic plurality in TBI patients.  It’s been my experience that many professors are more than willing to work with you on this and may even appreciate the unique perspective you bring to these assignments.

Where do you find information on bilingualism in the literature?  Here are a few of my favorite tricks:

• The ASHA Journals: You get free access if you’re an ASHA member.  If not, your university media center probably has access.  Simple keyword search for things like “bilingual, Spanish, CLD” have gone a long way for me.  (You can also find a list of ASHA-recommended readings here.)
• The Perspectives Journal of ASHA’s Division 14 (CLD Populations).  You must be a member to access online, but it’s $35 you won’t regret spending.  (You can check out a free sample issue here.)
• Journals from other professions (e.g., bilingual education, psychology, neurolinguistics, etc.):
  • Bilingual Research Journal
  • International Journal of Bilingual Education and Bilingualism
  • Bilingual topics from multiple journals can be found by doing a keyword search through Google Scholar
• Handouts from Workshops and Conferences.  There are some that are archived and able to be downloaded by the public.  Here are a couple:
  • ASHA Annual Convention (handouts are available back to 2006)
  • Texas Speech-Language-Hearing Association (handouts available back to 2007)
• The ASHA Leader.  This isn’t peer-reviewed, but there are some useful articles in their archives.
• Newsletters from CLD organizations in the profession.  These are also not peer-reviewed, but often have useful and accessible info:
  • The Hispanic Caucus
  • The California Speech-Language-Hearing Association’s Diversity Committee
• Books and other publications.  The Hispanic Caucus keeps a pretty comprehensive list of books on bilingual and Hispanic issues in communication sciences and disorders.

Tips for Getting the Clinical Experience You Need

I mentioned some ways of getting the information you need in a non-bilingual specific curriculum.  The one area that I can’t find any substitute for is clinical experience.  In my own and observed experiences, one of the most valuable things you can do is to partner with a knowledgeable bilingual clinician in working with bilingual clients.  Beyond finding someone who speaks a second language, you want to work with someone who can share their understanding of the dynamics of language in monolingual and bilingual speakers, the strengths and limitations of formal assessment, the purposes and procedures of informal assessment, the science and the art of providing therapy to individuals with bilingual needs, and the legal/ethical ins and outs of working with CLD clients.

Even if you attend graduate school in a part of the country that isn’t stereotypically rich in cultural and linguistic diversity, it’s important to remember that stereotypes can be deceiving and the country doesn’t look like it did even ten years ago.  Areas that generally experienced less diversity are now the places that are seeing the largest per capita growth of culturally and linguistically diverse communities.  In the case of the Hispanic Community in the US, according to the Pew Hispanic Center (2008), the states with the largest percent growth between 2000 and 2006 were:

• Arkansas (69.3%)
• Tennessee (60.9%)
• Georgia (60.1%).

Compare that to growth of the Hispanic Community in states like:

• Texas (26%)
• California (19.8%)
• New York (10%).

Keeping that in mind, graduate schools all over the country will probably be excited to have bilingual students in their program and may be accommodating in helping you find creative solutions to work with bilingual caseloads and access bilingual supervisors.  In my case at the University of Nebraska, the closest available bilingual supervisor lived almost 500 miles away in Colorado.  However, the school arranged for me to perform a 12 – week practicum there, and one of the university clinical supervisors even made the drive from Lincoln, Nebraska to Fort Collins, Colorado a few times to perform site visits with us!

Temporarily moving for a bilingual practicum required some flexibility and mobility on my part as well.  However, it was worth it!  Be open and consider your level of flexibility as you discuss possibilities with the graduate programs that you are considering.  Also, be aware that advances in tele-practice and distance mentoring programs like ASHA’s S.T.E.P. may also open doors for you to learn from experienced bilingual clinicians.

I would also keep in mind that speech pathologists are generally resourceful people!  Just because they don’t speak the client’s language doesn’t mean they don’t find ways of providing meaningful therapy.  This really hit home for me in graduate school when one of my supervisors and I worked with Arabic and Farsi-speaking students (two languages that I don’t speak).  She exemplified how to provide best practice and affect change where there isn’t a lot of research, information, or language support available.  Now that I’m well into my professional life, I’ve sometimes found myself scratching my head with some of the Hispanic individuals I’ve worked with, even though I speak Spanish!  I think the skills I gained working with that supervisor, as well as other monolingual supervisors, has proven useful in these moments.

So in short, there may be more CLD individuals than you think in the area where you attend graduate school.  The language skills you bring with you to the graduate clinical experience will probably be put to good use, and your school may be flexible in finding you the bilingual support you need (as long as you are willing to be flexible, too).  You may also learn more about working with bilinguals from your monolingual supervisors than you think.

Good luck as you weigh the many considerations you have to account for in finding a graduate program that is right for you!  Fortunately, there are a growing number of resources out there to help you have a rich experience and meet your goals of competently working with bilinguals, even if you choose a non-bilingual program.

Sean J. Sweeney, M.S., M.ED., CCC-SLP, Instructional Technology Specialist, Newton, MA

Sean J. Sweeney is a speech-language pathologist and instructional technology specialist working in the public schools and in private practice in Newton, Massachusetts. He has presented on the topic of technology integration in speech and language at ASHA convention and is the author of the blog SpeechTechie: Looking at Technology Through a Language Lens.

I was very pleased to be asked by Nate Cornish to write a post on the Bilingual Therapies blog about the uses of mobile technology in therapy.  Although I have to disclose that I am not a bilingual therapist, I hope that my thoughts on the applications (apps, so to speak!) of technology for intervention will offer some guidance to clinicians in that subsection of our very wide field of practice.

I also admit that I was not necessarily an early adopter of mobile technology in my practice.  I have always been a huge Internet guy, with a strong interest in how interactive websites in particular can serve as a context for therapy activities. Initially I dismissed the iPod Touch as problematic on a number of fronts: it’s an iPhone minus the phone part, Wi-Fi dependent, and small in both screen and, necessarily, keyboard.  Then, Apple and the developers who had vision started doing amazing work in creating apps of every imaginable ilk, including many with educational relevance.  My own purchase of an iPhone, and initial trials of using apps with students, caused me to do a quick turnaround, and eventually I was unable to resist jumping on the iPad bandwagon as well.

The benefits to using mobile technologies are increasing on a daily basis.  First of all, let’s be honest about the fact that the iPod Touch and iPad are way cool.  Kids just light up and become instantly engaged when they get to use these superbly designed, bright, and shiny devices. But the flash is really just a hook to pull them into a learning context, and I often find that their requests to play specific games are few and easily redirectible.  The logistics of using apps on these devices are often extremely simple, from the interfaces of the apps themselves, the ease of directing students, portability and lack of cords, and frequently, connections with web resources so that data and work can be stored. Additionally, new apps are easily obtained, frequently free or very inexpensive. You can browse and quickly download new therapy tools right from the App Store on your device, or use iTunes and sync from your computer.

I am an advocate of thinking broadly about how technology resources can serve as therapy tools, beyond the many great apps designed specifically for speech and language therapy. If clinicians only use that type of app, they risk missing many others that, while created for other purposes, provide a great context for eliciting language.  For bilingual therapists, many apps can present a context for using multiple languages concurrently with the student, either through the app interface itself or through language cueing and scaffolding.  To bring the murky area of app selection into focus, I have suggested a set of criteria that SLPs can use when determining if a tech resource (including apps) would be well-suited for therapy activities: the FIVES criteria, standing for Free, Interactive, Visual, Educationally Relevant, and “Speechie.”  Here’s how it applies to selecting apps.

Free- Is the App free (or nearly free) or at least reasonably priced?  Part of the promise of mobile technology is inexpensive extensions of the technology that are achieved through apps. A great example of a free app for therapy activities is BrainPop Featured Movie, which offers a free short movie every day from the BrainPop site.  These movies are great contexts for building content vocabulary and using information mapping strategies such as graphic organizers.There are definitely exceptions to this rule, especially for specialized apps that are worth paying for such as ArtikPix and Proloquo2Go.

Interactive- Does the App provide a context for interaction between the clinician and student, eliciting language either through its interface or through a scaffolded discussion? We should look for apps that are more than just a link to a web-based presence and that take advantage of touch screens to engage the students in generating language or solving problems.  Interactive apps also allow creation and publication; try PicToon Lite, in which kids can practice language by adding stickers or word/thought bubbles to a photo!

Visual- Does the App make good use of the device’s potential to provide visual supports that scaffold language comprehension and production? Viewing pictures of curriculum and other contexts are a great way to build comprehension and elicit language, and kids are very motivated to inspect images on mobile devices.  Google Earth, for example, really puts the entire world in your hands; try navigating to landmarks and viewing the near limitless supply of geotagged photos in the Panoramio layer.

Educationally Relevant- For school-aged clients, does the App help them access abstract curriculum and provide a context for applying language-based strategies? The realm of education-based apps grows every day, placing complex and out-of-reach topics in students’ hands via interactives on mobile devices.  Slide by Slide is just one example; this app allows you to access shared PowerPoint-style presentations (via the SlideShare website) created by teachers on all sorts of curriculum topics.

“Speechie”- Does the App provide an opportunity to address the client’s or student’s specific speech and language goals?  As I stated, there is a growing collection of mobile apps designed specifically for speech-language assessment and intervention (see Eric Sailers’ great list of apps here and an additional list of special education apps at iPodsibilities). Also, apps such as Popplet, which allows you to make a semantic map on any topic and easily incorporate images from the web, clearly link to language goals around comprehension and expression.

There are also many apps specifically in Spanish, though this is still an evolving area and consists largely of Rosetta-Stone-style “Learn Spanish” apps.  MindSnacks Spanish appears to be a cut above, and a great entry point for use with kids and teens. To find more interactive language websites, try searching Google with the keyword “interactive,” or searching social bookmarking sites such as diigo or delicious for sites tagged as interactive.  Edublogs also has a great directory of blogs of all types, including language blogs, which often provide helpful links and reviews of apps and websites. Happy Hunting!

Irmgard Payne, M.S. CCC-SLP, Bilingual Clinical Supervisor, Texas Christian University, Fort Worth, Texas

Irmgard R. Payne is a clinical supervisor at the Miller Speech and Hearing Clinic on the Texas Christian University campus. She supervises the clinical practicum of undergraduate and graduate students and supervises graduate students in the Emphasis for Bilingual Speech-Language Pathology program. Interests include Speech and Language Disorders in Bilingual Populations, Multicultural Issues and Accent Modification.

When Nate Cornish asked me write an entry for the Bilingual Therapies Blog regarding the clinical experience in a bilingual Speech-Language Pathology program, I took a peek at previous entries to the blog. I was pleased to see that Dr. Raquel Anderson had written the blog for January of this year. Dr. Anderson was my clinical supervisor when I did my clinical practicum at Texas Christian University (TCU). Her blog was titled Bilingual Graduate Programs: What Students Should Know and How They Can Prepare. My blog will basically follow along those recommendations and describe what TCU offers in our Emphasis in Bilingual Speech-Language Pathology within our Master of Science graduate program. All bilingual programs are different depending on their size and resources; however, some of the basic information on bilingual development, disorders, multicultural and linguistic considerations and clinical experiences are essential for effective training. The goal for my blog is to provide information about what we do in our program and for this to provide a model for a bilingual graduate experience.

1. About our program
The Texas Christian University bilingual track, as it was called initially, was the first program to have a federally funded training grant for bilingual Speech Language Pathologists (SLP) and has been in place for over 30 years. The grant was renewed for many years. This is how I was able to get my training as a bilingual SLP. Manuela Juarez and Joe Helmick were involved in making that first grant possible. Over the years, we’ve had notable faculty do research, teach and/or supervise in the areas of bilingualism, second language acquisition, fluency, adult neurogenic disorders, and phonology, including Hortencia Kayser, Belinda Reyes, Raquel Anderson, María L. Muñoz, Lynita Yarbrough, Jennifer Watson and Raúl Prezas. One of the strengths of our program is that those professors who teach and do research also supervise our students at the clinic. This effort emphasizes the application of classroom teaching into the therapy room. Christopher Watts, our department chair, fully supports our current Emphasis in Bilingual Speech-Language Pathology program.

2. Information about the program
Specialized Coursework
As our graduate program consists of 5 semesters over a two year span, I will divide the coursework and clinical experiences into those two years. Along with the regular curriculum in their first year, the bilingual students take Assessment and Treatment of Communication Disorders in Bilingual Children. Also in their first year, they take part in a one hour, once a week lab in which assessment and treatment issues specific to their caseloads are discussed. In their second year, they take Speech, Language and Cognition in Adult Bilinguals. In addition to the bilingual students, all of the graduate students take one of the bilingual classes. In fact, Culturally and Linguistically Diverse (CLD) issues are touched upon in all classes, not only in those geared specifically for the bilingual students. Furthermore, the bilingual students have the opportunity to write a thesis with the research faculty, including María L. Muñoz (bilingual/Spanish aphasia), Raúl Prezas (Spanish phonology) and Jennifer Watson (stuttering in Spanish speakers).

Clinical Experience
Our program requires for the bilingual students to complete 125 clinical hours (out of 400 total) with Spanish and bilingual clients. In the first year, the bilingual students have in the past screened and assessed speech and language development, and treated Spanish-speaking and bilingual children at local Head Start Centers. Beginning this Fall 2010 semester, the first year bilinguals will be working in a new collaboration with the Fort Worth Independent School District (FWISD). They will be assessing pre-school aged children and treating them in a program that includes individual therapy and an early childhood classroom model. In addition to the FWISD clinical experience, the bilinguals treat young bilingual clients at the Miller Speech and Hearing Clinic (MSHC) on the TCU campus. Clients at FWISD and MSHC may have speech/language disorders, artic/phonology disorders, fluency and voice disorders as well. Supervision is carried out with bilingually trained supervisors, including myself and Raúl Prezas. In addition, TCU alumna Lynita Yarbrough, is the liaison between FWISD and our TCU program. Dr. Prezas also takes and supervises students to Grand Prairie ISD to assess and treat Spanish-speaking and bilingual school-aged children.

In the summer and fall semesters, the bilingual students begin their externships with Early Childhood Intervention (ECI), school districts, and/or medical facilities. One of the benefits of TCU residing in Fort Worth, Texas, is the large Spanish-speaking and bilingual population. These externships offer great opportunities to interact with this population at these sites. Again, bilingually trained SLPs are selected to supervise the bilingual students at the externships. Some students have gone to externships in other parts of the state and other states. These externships were selected because of the need and/or interest of the student. Funding for these out of state externships are the responsibility of the student. During the second year at the MSHC, the bilinguals work with CLD adult clients with disorders such as Aphasia and Traumatic Brain Injury supervised by María Muñoz. Other bilingual adult clients seen are Aural Rehab (Theresa Gonzalez, Habilitation for the Deaf supervisor) and Voice patients (Raúl Prezas, supervisor).

Pre-requisites for Admission to the Program
An undergraduate degree in Communication Sciences and Disorders (Speech-Language Pathology) (or equivalent for leveling students) is required for the bilingual program. A Grade Point Average (GPA) of at least 3.0 on 4.0 scale with GRE scores in the 1000 range is preferred. In addition, we ask that our bilingual students have a near native proficiency in verbal and written Spanish. This is required because as soon as the clinical practice begins, the students are expected to interact with Spanish-speaking families and clients, write letters and reports in Spanish, and easily switch from Spanish to English during assessment, treatment and conferences. Our TCU program is small, so we admit only 12 new graduate students each year and four of those are bilingual. Our bilingual students have come from varied backgrounds including Latino, Asian Caucasian and African-American.

Funding opportunities
Qualified applicants may receive one of several forms of financial assistance. These awards offer tuition remission and require up to eight hours per week of service to the program. Some awards include a small monthly stipend.

3. Apply to the programs
It has been noted that in recent years the interest in bilingual programs has increased tremendously with over 30 applicants on average for our program. During the application process, all requirements are assessed including GPA, GRE scores, Spanish proficiency, essay, and letters of recommendation. Our candidates for the bilingual program are also interviewed over the phone or face-to-face to assess their language proficiency.

It is important to note that even though the clinical experience at TCU is in Spanish because of the large Hispanic population in our area of Fort Worth and North Texas, information and skills acquired in the courses and clinical work are applicable to working with individuals whose primary language is other than English and Spanish. Evaluations and treatment at the clinic have included clients who speak Vietnamese, Mandarin and Cantonese at home, while utilizing resources outlined by the American Speech-Language-Hearing Association (ASHA) and interpreters from the community.

In addition to the above coursework and clinical experience, all students in our program complete the PRAXIS, written and oral comprehensive exams in their last semester. Most of our students have job interviews and have been hired even before their graduation. Our program has changed over the years and we are now pleased with the bilingual experience the students are able to get. We are able to offer a clinical experience across the life span which we weren’t able to offer previously. Our research capabilities in the CLD area have also increased and expanded including some research done in Chile and Puerto Rico.

I’ve presented our model for our bilingual program at TCU. As mentioned before, other programs will vary depending on their size, location, faculty and resources. Students can take this information and use it as an example for what to look for in other programs. As a bilingual student, you have so much potential and so many opportunities and, therefore, you are well sought after. It is important that you choose a program that gives you the preparation necessary to be able to effectively and appropriately serve the bilingual population.

Carla Wood Jackson, Ph.D. CCC-SLP, Assistant Professor, School of Communication Science & Disorders at Florida State University, Tallahassee, Florida

Carla Wood Jackson, Ph.D. CCC-SLP is an assistant professor in the School of Communication Science & Disorders at Florida State University. Dr. Jackson’s teaching and research focuses on child language development and disorders. She has been a certified speech-language pathologist for over 16 years including service in public elementary schools. Dr. Jackson developed a multicultural/multilingual clinical program at Florida State University which provides outreach services to ELLs in surrounding communities. Her research has focused on facilitating early language and literacy skills of English language learners. She has presented on the topic at national conferences and published in professional journals such as Language Speech and Hearing Services in the Schools, Communication Disorders Quarterly, and Early Childhood Services: An Interdisciplinary Journal of Effectiveness. Jackson is in her fourth year as the principle investigator on a 4-year training grant focusing on serving culturally and linguistically diverse populations.

Dr. Carla Wood Jackson’s research lab, BLOOM, has focused on developing and examining language learning supports for young English language learners (ELLs). A series of language learning intervention studies have been conducted with the assistance of colleagues and graduate students in partnership with the Panhandle Area Educational Consortium on Migrant Education. Speech-language pathologists, teachers, and special educators continue to report challenges and obstacles in providing high quality intervention and instructional support for ELLs (Jackson, Leacox, & Callender, 2010). In response, the primary aim of BLOOM (Bridging for Language Outcomes in the Classroom) is to develop language and literacy interventions for young English language learners and refine and test implementation in authentic classrooms.

The use of native language expansions, referred to as “Spanish bridging”, during shared reading serves as a catalyst of English word learning by providing engaging, comprehensible input utilizing children’s stronger language. Spanish bridging shows promise as a transitional venue for facilitating English language learning, particularly in rich shared reading instruction. The use of children’s native language as instructional support during acquisition of English is controversial; however, burgeoning research supports the benefits of Spanish bridging for early English language and literacy development in some ELLs. The use of Spanish bridging demonstrated promising outcomes in the master’s thesis of Mirza Lugo-Neris (Lugo-Neris, Jackson, & Goldstein, 2010).

This project investigated word learning of ELLs in response to repeated shared reading with embedded instruction of word definitions in either Spanish or English. Children demonstrated growth in their word labeling in English, receptive understanding of targeted words, and expressive definitions in both English and Spanish intervention conditions; however, additional benefits were observed when the word definitions were provided in Spanish. Subsequent studies have examined supplemental Tier 2 and Tier 3 level supports for vocabulary learning including bridging with accompanying manipulatives (Jackson, Bancayan & Quiles, in preparation), voice-output pre-recorded definitions for preview and review, and bridging implemented through computer-mediated e-book instruction (Leacox & Jackson, in preparation).

Currently, doctoral student Lindsey Leacox and Jackson are extending the BLOOM project for broader implementation in preschool – 1st grade classrooms. Children practice and rehearse targeted English word labels by selecting the electronic links to hear a model of the English label and embedded expansion of the word definition provided in Spanish. Preliminary results support the use of Spanish-bridging during computer mediated instruction to facilitate English word learning. On-going longitudinal study of ELL’s vocabulary skill acquisition in English and Spanish is underway in the BLOOM lab at Florida State University.

François Grosjean, Ph.D., Professor Emeritus, Université de Neuchâtel, Switzerland.

François Grosjean is Emeritus Professor of Psycholinguistics, Neuchâtel University, Switzerland. His specialty is psycholinguistics and his domains of interest are the perception, comprehension and production of language, be it speech or sign language, in monolinguals and bilinguals. He also has interests in biculturalism, applied linguistics, aphasia, sign language, and natural language processing. He is better known for his work on bilingualism in which he has investigated the holistic view of bilingualism, language mode, the complementarity principle, the processing of code-switching and borrowing, as well as the bilingualism of the Deaf. He is the author of numerous articles and of five books, the latest of which is Bilingual: Life and Reality (Harvard University Press, 2010).  Dr. Grosjean currently maintains a blog entitled, “Life as a Bilingual.”

Greetings! My name is Nate Cornish. I am a bilingual speech-language pathologist, the clinical director for Bilingual Therapies and moderator of the ¡Adelante! blog. It is my pleasure to introduce as well as to participate in this month’s article, which will be presented in a different format than we are accustomed to. I had the opportunity to engage our contributor, renowned psycholinguist Dr. François Grosjean, in an interview on biculturalism. Our discussion was based on a chapter of his book, “Studying Bilinguals” (Oxford University Press, 2008). Chapter Twelve, titled, “The Bicultural Person: A Short Introduction,” raises some interesting points that are pertinent to our work with culturally and linguistically diverse individuals. Clearly, language and culture are closely linked. However, we as communication professionals may not always consider the dynamic of biculturalism as readily as we consider bilingualism, even though its impact on our clients’ participation in academics and life may be just as profound.

In Dr. Grosjean’s book, he acknowledges that most people are simultaneous members of multiple cultural groups. The “minor” cultures that a person may identify with (occupation, family, hobbies, etc.) are often complementary and coexist within a “major” culture (national, linguistic, social, religious, etc.). While an individual may belong to a number of minor cultures, aspects of major cultures are frequently mutually-exclusive. Thus, navigating, and identifying with, more than one major culture may require some effort.

While the bicultural person may be characterized by a number of traits, there are three in particular that Grosjean focuses on:

1. Bicultural individuals take part, to varying degrees, in the life of two or more cultures
2. They adapt, at least in part, their attitudes, behaviors, values, language, etc., to these cultures.
3. They combine and blend aspects of their cultures.

These traits bear some similarities to the characteristic cross-linguistic skills and needs of bilinguals with at least one important difference: Grosjean states that “Bilinguals can usually deactivate one language and use the other in particular situations… whereas biculturals cannot always deactivate certain traits of their other culture in a monocultural environment.” In other words, there appear to be some aspects of culture that are “adaptable and controllable” while other features are more “static,” meaning that they are “always present and cannot be easily adapted.”

One of the significant points Dr. Grosjean makes is in regards to identity and biculturalism. Grosjean observes that the bicultural individual may experience conflict unless she accepts her identity as a bicultural person with an experience that is distinct to that of monocultural persons. Particularly problematic are external and internal perceptions that an individual cannot successfully be a member of multiple cultures. For example: an individual may be judged to belong to only one culture despite a clear need to navigate two. This is particularly problematic if members of Culture A perceive that the individual belongs exclusively to Culture B, while members of Culture B perceive that the individual belongs solely to Culture A. In such circumstances, Grosjean posits that the bicultural person may make one of the following decisions regarding their identity:

1. They may identify solely with Culture A
2. They may identify solely with Culture B
3. They may reject both cultures
4. They may accept themselves as a bicultural individual with the need to operate in two or more constituent cultures.

Dr. Grosjean states that the process of finding one’s identity as a bicultural person may be long and even arduous. Continued conflict may exist when identifying exclusively with only one culture, or rejecting both cultures. Those who choose these solutions may feel “uprooted, marginalized, or ambivalent.” However, those who can “come to terms with their biculturalism”, and recognize that they do indeed belong to two cultures, have a stronger likelihood of navigating their two cultures with ease.

With that summary, I would like to share the content of my enlightening (and enjoyable) conversation with Dr. Grosjean:

In an article that you wrote on the topic of bilingualism, (Grosjean, 1989) you state that a bilingual is not the sum of two complete or incomplete monolinguals, but rather a distinct and competent communicator. How would you liken (or differentiate) that view to the bicultural individual?

I believe this view also applies to the bicultural person, perhaps even more so. As already mentioned, biculturals take part, to varying degrees, in the life of two or more cultures; they adapt, at least in part, their attitudes, behavior, values, and languages to their cultures; and they combine and blend aspects of the cultures involved. The first two characteristics are similar to those that describe bilinguals. As we all know, bilinguals live within two of more language communities and they adapt their language to each group. This said, bilinguals are not two monolinguals in one person, and similarly, biculturals are not two monoculturals in one person. This is particularly clear when one examines the third trait that characterizes biculturals – combining and blending aspects of the cultures involved.

But don’t bilinguals also “mix” their languages?

True, bilinguals also combine their languages in the form of code-switches and borrowings (when in a bilingual language mode) but they do not normally blend their languages the way biculturals blend their cultures. Not all behaviors, beliefs, and attitudes can be modified according to the cultural situation the bicultural person is in. A bicultural who has roots in both the French culture and the American culture, for example, blends aspects of each culture and may find that she cannot be 100 percent French in France and 100 percent American in the United States, however hard she tries.

This form of static cultural interference is a differentiating factor between bilingualism and biculturalism: bilinguals can usually deactivate one language and only use the other in particular situations (at least to a very great extent), whereas biculturals cannot always deactivate certain traits of their other culture when in a monocultural environment.

How does a speech-language practitioner determine these cross-cultural traits (or blends)? What questions should they ask?

It is only by getting to know the client very well that these cultural blends will become apparent. Biculturals themselves often cannot identity them for others unless they have undertaken quite an extensive introspection. Cultural blends can be found in greeting and leaving behaviors, hand gestures and facial expressions, the amount of space that is left between oneself and others, etc. but also in less visible domains such as what you talk about, your attitudes, your beliefs and so on.

Can you say something about biculturals and the monocultural – bicultural continuum they operate along?

Biculturals may find themselves at various points along a situational continuum that requires different types of behavior depending on the situation they are in. At one end they are in a monocultural mode, since they are with monoculturals or with biculturals with whom they share only one culture. In this situation they must deactivate as best they can their other cultures. They attempt to apply the motto, “When in Rome, do as the Romans do.” If their knowledge of the culture in question is sufficient, and they manage to deactivate, at least to a large degree, their other cultures, then they can behave appropriately. However, because of the blending component in biculturalism, certain behaviors, attitudes, and feelings may not be totally adapted to a situation and may instead be a mixture of the person’s two (or more) cultures.

At the other end of the continuum they are with other biculturals who share their cultures. With them, they will use a base culture to interact in (the behaviors, attitudes, beliefs of one culture) and bring in the other culture, in the form of cultural switches and borrowings, when they choose to.

In what ways does biculturalism affect language use and need?

As is now well established, bilinguals usually acquire and use their languages for different purposes, in different domains of life, with different people. Different aspects of life often require different languages. I have called this the complementarity principle and I discuss it extensively in my recent book, Bilingual: Life and Reality. The cultures that characterize biculturals will often impact differently on language need, fluency and use. If a language is spoken in a reduced number of cultural domains and with a limited number of people of a specific culture (these biculturals are dominant in the other culture), then it will not be developed as much as a language used in more domains and with more people. More specifically, if a cultural domain is not covered by a language, bilinguals will simply not possess the domain-specific vocabulary, the stylistic variety, or even sometimes the discursive and pragmatic rules needed for that domain.

I recall a conversation that I had with one of my bicultural colleagues about her experiences as a Mexican-American child growing up in the United States. I was intrigued by a statement that she made while discussing the rules that she had to abide by, which were very different than those of her Anglo-American friends. She said, “Nobody tells you it’s a cultural difference. You’re just frustrated with your parents.” What does the process look like as biculturals become aware of differences and then become aware that the differences are cultural rather than individual?

This is a fascinating issue which has not been studied very much. The best data we have currently can be found in autobiographies of immigrants who have written about how they grew up in a minority family and then discovered and entered the mainstream culture. Writers such as Maxine Hong Kingston, Richard Rodriguez, Eva Hoffman, Olivier Todd and Paul Preston, among many others, evoke their awakening and adaptation to biculturalism.

What can you say about self-identity and biculturalism?

An important aspect of biculturalism relates to the identity bicultural people decide to take on. Their dilemma is that monocultural members of their different cultures want to know if they are members of culture A or culture B, or of a new culture, when biculturals just want to be accepted for who they are: members of two or more cultures. How does the identity process take place? First, biculturals have to take into account the way members of the cultures they belong to categorize them. These members will take into account their kinship, the languages they speak and how well they do so, their physical appearance, their nationality, their education, their attitudes, and so on. The outcome, in each culture they belong to, will often be categorical: biculturals are judged by friends, acquaintances, and others to belong to culture A or to culture B, but rarely to both cultures. An additional problem can be that culture A may categorize them as members of culture B and vice versa, a form of double, contradictory, categorization.

Faced with such sometimes contradictory perceptions, biculturals then have to reach a decision regarding their own cultural identity. They take into account how they are seen by the cultures they belong to, as well as such other factors as their personal history, their identity needs, their knowledge of the languages and cultures involved, the country they live in, the groups they belong to. The outcome, after a long and sometimes trying process, is to identify solely with culture A, solely with culture B, with neither culture A nor culture B, or with both culture A and culture B.

Many of us have observed biculturals struggling with this process.

Yes, and that is because the first three solutions—that is, only A, only B, neither A nor B—are often unsatisfactory in the long run, even if they might be temporary answers. They do not truly reflect the bicultural person who has roots in two cultures, and they may have negative consequences later on. Those who choose to identify with just one culture (whether freely or when pushed to do so) are basically turning away from one of their two cultures, and they may later become dissatisfied with their decision. As for those who reject both cultures, they often feel marginalized or ambivalent about their life.

As for the fourth route, and being able to say, “I am bicultural, a member of culture A and of culture B”, it may require a lot of energy and time. And yet, this is the optimal solution since biculturals live their lives within two cultures, combining and blending aspects of each one, even when one culture is dominant. Some biculturals are helped by the existence of new cultural groups, such as the immigrant groups in North America. Identifying with Cuban Americans, or Haitian Americans, for example, and being able to use those labels, is a fine way of telling others that you are of dual heritage, Cuban and American or Haitian and American, and that you wish to be recognized as a bicultural individual.

Why is it important for professionals to be mindful of the cross-cultural dynamics of their speech and language-impaired clients?

Even though professionals are concentrating on the speech, language and communication of their clients, it is important that they view them holistically as bilingual bicultural people. Most bilinguals in the United States are also bicultural (recall that in other countries, the two do not always go together) and hence they must be mindful of both aspects. Certain language behaviors such as the reserved, or outgoing, nature of their clients, the amount of speech that is produced, the subjects that are talked about (or not talked about), even their voice amplitude, may find their roots in the specific cultures present in these people.

What role can a speech-language professional or other concerned parties play to help the bicultural individual establish a healthy cultural self-identity?

A first step is to obtain a clear understanding of what it means to be bicultural. In addition, recognizing the assets of being bicultural is needed. Bicultural people are invaluable in today’s world—they are bridges between the cultures they belong to, useful go-betweens who can explain one culture to members of the other and act as intermediaries between the two. Professionals can also accompany, and sometimes help bilingual and bicultural children and adolescents on their journey which will lead, hopefully, to their acceptance of their dual identity.

I end my recent book in the following way, “Caring and informed adults must accompany them – many already do – and ease their passage from one stage to the next. I dream of the moment when these young people and, later, adults will all be proud of their languages and cultures, and be accepted for who they are—bilingual and bicultural individuals, quite simply.”

Thank you Dr. Grosjean, for your important work in the area of biculturalism and for sharing this information with our readers!

Further readings by François Grosjean:

- Grosjean, François.  “What Bilingualism is Not.”  Weblog.  Harvard University Press Publicity. 29 July 2010.  Harvard University Press.  4 August, 2010.  http://harvardpress.typepad.com/hup_publicity/2010/07/what-bilingualism-is-not-.html

- Bilingual: Life and Reality (most notably Chapter 10, “Bilinguals who are also bicultural”).
Cambridge, MA: Harvard University Press, 2010.

- “The bicultural person: A short introduction”. Chapter 12 of Studying Bilinguals. Oxford: Oxford University Press, 2008.

- “The bilingualism and biculturalism of the Deaf”. Chapter 13 of Studying Bilinguals. Oxford: Oxford University Press, 2008.

- Grosjean, F. (1989) Neurolinguists, beware!  The bilingual is not two monolinguals in one person.  Brain and Language 36, 3-15.

François Grosjean’s website: www.francoisgrosjean.ch