ACQ Vol 11 No 1 2009

MULTICULTURALISM AND DYSPHAGIA

normal communicative behaviours in bilinguals of all levels of language proficiency (Brice, 2000; Brice & Anderson, 1999; Mahon et al., 2003; Oller & Pearson, 2002); however, it can also appear as a consequence of confusion or inadequacy in one language. There are few guidelines in the literature to assist the professional in deciding whether the child is code switching normally or is confused. Brice and Anderson (1999) found that a hierarchy of syntactic elements is common in code mixing, for example nouns in subject and object position were most common, followed by verbs, then verb phrases (p. 21). This hierarchy may be used as a guideline for assessing the appropriateness of code mixing in bilingual children. However, further research is needed to ascertain the appro­ priateness and efficacy of assessing code mixing in this manner. The fact that the bilingual person is likely to use pragmatic, syntactic and morphological elements of another language when communicating in English should also be part of the assessment. An analysis of a language sample in English needs to apply information on language characteristics of the speaker’s first language (such as that found in Swan & Smith, 2001). For example, since Chinese speakers do not formally distinguish parts of speech, we may expect English–Chinese bilingual speakers to use different English word classes such as difficult and difficulty interchangeably, and that this is a feature of bilingualism not a language disorder. Standardised tests for which the normative population is not bilingual should not be used, or at the very least no standard scores should be reported. Paul (2007, p. 182) made a number of suggestions for how standardised tests might be used for this population, and all of them involve treating them as criterion-referenced tests and not using the standard scores as they are meaningless. Unfortunately, a normative sample of bilingual children from the same language background would be difficult to obtain because of the diversity of languages and varied levels of language exposure. There are some psycholinguistic markers (rapid automatic naming and non-word repetition skills) that have come to prominence in recent literature which seem to be relatively language-free and which identify children with language impairments. For example, Wiig, Zureich and Chang (2000) found that monolingual English-speaking children with language disorders had a statistically significant reduction in rapid automated naming for tasks across semantic groups such as colour and shape. Estes, Evans and Else-Quest (2007) conducted a meta-analysis of the differences in non-word repetition skills between children with and without SLI and found children with SLI to exhibit significantly poorer skills in non-word repetition skills compared with children without SLI. However, the apparent promise of such findings may not carry over to other languages as we might have wished. Stokes, Wong, Fletcher and Leonard (2006) found that there was no significant difference in repeating Cantonese non- words between children with SLI and typically developing children of the same age. On the other hand, Kohnert and Windsor (2004) found that monolingual English-speaking children with SLI performed significantly poorer than typically developing bilingual Spanish and English-speaking children on non-linguistic processing tasks such as choice visual detection. This involved determining how accurate the children were in associating a particular colour presented with an associated response button. However, the bilingual and language-impaired monolingual groups of children performed comparably on identifying real and non-words as well as on response time for picture naming tasks (Windsor & Kohnert, 2004). It seems that the nature of psycholinguistic tasks as well as the languages spoken by the children are contributing factors in determining whether these tests can be used reliably to identify children from multilingual back­

grounds with SLI. Certainly, further research in the area with children of diverse language backgrounds may provide clearer recommendations about the appropriateness of certain tests for certain populations. Another issue that concerns assessment of children learning the language of instruction is that of nation-wide or district assessments. Assessing the academic potential of students who are still in the midst of learning English is likely to result in misleading impressions of their potential as well as their academic progress (Cummins, 2000). Cummins highlighted that students who have been learning English for about three years in school perform at about one standard deviation below age-equivalent norms in English academic skills. If such data are not incorporated into the interpretation of test scores, many students learning English as a second language in academic programs can be deemed as language delayed or language impaired. Intervention There are a number of implications for intervention from the material discussed so far. A summary is provided in table 3. Ideally, speech pathologists working with bilingual clients should themselves be bilingual. However, this is not a practical solution – we cannot be competent in all the languages our clients may present with. However, it is our argument that all clinicians have an obligation to work bilingually. They need to use the language skills and knowledge they have, in addition to the skills of interpreters, teachers, parents, language teachers and others. Achieving this may require the acquisition of new skills on the part of the clinician and changes in the way speech pathology students are educated. n A monolingual SLP working in a bilingual “team” – Primary interactant can be an interpreter, family member, or ESL teacher – Conduct of session can be primarily in a non- English language – Conduct of session can be 50% in one language, 50% in another n Teach code switching n Use one language in the teaching of another; explanations in the “better” language n Specifically teach enhanced metalinguistic skills: point out differences and similarities n Teach the clinician the other language, with the client/team as expert. – Uncover those things that are unique to that language – no equivalents in English – Work with those activities/functions only used in the non-English language – cultural activities, family interactions, talking on the phone to community members, etc. An example is the issue of code switching discussed earlier. As we reported, skilled bilinguals exhibit considerable code switching, which enhances their interactions with other bilinguals (Brice & Anderson, 1999; Grosjean, 1989). Logically therefore, competent code switching should be a goal in bilingual intervention. However, it is doubtful that this goal is being used in any speech pathology education program at present and there are no clear protocols for achieving it. Table 3. Some possible “new” intervention skills, goals or methods

S p eech P athology A ustralia

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