Document Type

Dissertation/Thesis

Date Created

8-2-2023

Abstract

Purpose: This study aimed to explore and describe current practices of speech-language pathologists (SLPs) who presently work or have worked with bilingual children with Childhood Apraxia of Speech (CAS) in diverse settings. Exploration of this topic may contribute to the need for more knowledge in the Speech-Language Pathology field regarding evidence-based practices for the target population. The primary aims addressed in this study were: 1) To describe the assessment procedures currently used by speech-language pathologists to diagnose bilingual children with Childhood Apraxia of Speech, 2) To describe the intervention approaches currently used by speech-language pathologists to treat bilingual children with Childhood Apraxia of Speech, 3) to describe diversity training provided to SLPs who treat bilingual children with Speech Sound Disorders (SSDs) across regions. Method: This study followed a qualitative research approach utilizing a descriptive, questionnaire-based survey design. An online survey of speech-language pathologists working with bilingual children with SSDs and CAS was distributed through e-mail and snowball sampling. The survey requested information regarding the clinicians' background and work setting, the composition of caseloads, diversity training, current assessment procedures used in the field, current intervention approaches used in the field, and service delivery challenges. Results: Seven surveys were received and analyzed. Monolingual and bilingual participants from Colorado, Texas, and Virginia participated in the study. Of the total participants, six reported providing services to bilingual children with SSDs, and only four participants indicated currently providing services to bilingual children with Childhood Apraxia of Speech. Between 10-25% of the participants' total caseload comprised bilingual children with SSDs between ages 4-12, and less than 10% of children in their total caseload were identified as bilinguals with CAS between the ages 5-12. All participants reported being competent and comfortable at assessing and treating individuals from a cultural or racial background other than their own, even though 57.1% of SLPs reported that service bilingual children do not speak a second language. In addition, all participants indicated that they do not utilize the services of interpreters/translators when assessing and treating bilingual children aligning with the lack of coursework received on working with an interpreter throughout their carrier and the ongoing challenge faced by these participants on the lack of interpreters who speak the necessary languages to provide services. Speech-language pathologists employ a combination of formal and informal methods to assess bilingual children with Childhood Apraxia of Speech. These methods are modifications of monolingual English assessment and treatment approaches as they have not yet been explored and are not supported by evidence to be employed with the target group. Conclusions: Results confirm the ongoing growth diversity of the population in our country and the lack and limited resources to provide best-practice to bilingual children with SSDs and Childhood Apraxia of Speech. Clinicians are trying to closely follow the American Speech-Language-Hearing Association's (ASHA) recommended guidelines when providing services to bilingual children. However, despite the increase and improvement of training opportunities, a large proportion of SLP professionals still lack confidence in serving the bilingual Hispanic population due to insufficient training in this area. Currently, SLPs rely on various modifications of monolingual English assessment and treatment approaches, which may yield uneven or erroneous outcomes as they may not consider cultural and linguistic variables. Hence, the need for specialized skills and the ability to recognize individual differences, given the child's linguistic background and the nuances of bilingual language development, is highly necessary when serving bilingual children with Childhood Apraxia of Speech. The urgent need for more study in this field has been established, particularly on the best effective evaluation technique and treatment method to utilize with this population. Continued descriptions of developmental norms in culturally and linguistically diverse groups, evidence-based screening and assessment techniques, and research-based intervention methods should be included in future studies. Hence, based on these findings, recommendations are to conduct further studies that contribute to developing evidence-based practice guidelines and ensure the best quality of services to culturally and linguistically diverse children with Childhood Apraxia of Speech.

Keywords

bilingualism; bilingual children; CAS; Childhood Apraxia of Speech; SLP; SLPs; Speech-Language Pathology; Speech-Language Pathologists; current practice; assessment; intervention; dynamic assessment; dynamic system theory; survey; Speech Sound Disorder

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