Last week, I had the opportunity to attend a workshop on bilingual speech-language pathology.  As the United States becomes more diverse, more and more SLPs and other professionals are facing caseloads with clients who are not native English speakers.  In the past, the “rule of thumb” was often English-only, and parents were told that speaking their native language at home could cause or contribute to language delays, would confuse children, or was otherwise harmful.  With new knowledge and research, so much has changed!  We now know that oral bilingualism* is within reach for many children with speech and language delays, including those with hearing loss.  We now know that adding a second oral language doesn’t make you language impaired.  You can learn a second oral langauge to the extent you can learn a language.

Here are some of my favorite resources on bilingual oral language learning for therapists and parents, as well as some new ones that I learned about during today’s presentation:

• Bilingual Therapies offers printable parent information sheets in English and Spanish
• The Hanen Program, which I have written about before HERE, is also available in Spanish, Dutch, French, an adaptation for Native American parents, and more
• The John Tracy Clinic offers its parent correspondence course (which is FREE) in Spanish, and has Spanish-speaking staff available to assist parents, as well as many articles in Spanish on its Clinica John Tracy site
• JTC also offers an international summer session for families from around the world and one session specifically in Spanish 
• HERE is a link to some of JTC’s material’s translated into Arabic
• Hearing Families is a site in both Hebrew and English maintained by Dr. Efrat Schorr, a developmental psychologist who is also the mother of a child with hearing loss
• 2 Languages, 2 Worlds is a fascinating blog maintained by a group of researchers who investigate bilingualism throughout the lifespan, and frequently update the site with the latest research in a vareity of domains
• T-oigo.com is a website from Spain with many Spanish-English resources related to hearing loss, including a section on oral bilingualism

Assessing children who speak two languages, or who are monolingual speakers of a language other than English but entering an English-speaking school system, presents many challenges.  For many of our standardized speech-language assessments, bilingual norms do not exist.  For others, norms my exist for Spanish but not for the hundreds of other languages students may arrive at our door using.  One assessment discussed during today’s seminar was the Routines Based Assessment developed by R. A. McWilliams.  This assessment walks a family through their daily routine, and seeks to identify the language used and any communication challenges during each part of the day.  From that information, professionals work with parents to assess the child’s overall functioning in his environment and create a plan for intervention.

A growing number of professionals in the field are multilingual and multicultural, but the vast majority of TODs, SLPs, and AVTs do not reflect the life experiences and backgrounds of the clients they serve.  Even if you do speak multiple languages, it would be virtually impossible to know the language of every family served in a major metropolitan area.  What can a monolingual therapist, or a bilingual therapist who is not bilingual in a client’s language, do to help her bilingual clients?

• The use of interpreters is crucial to protect the legal rights and liability of both the clients and the professional.  More than an interpreter, though, therapists should seek out and make use of cultural brokers, people who have both fluency in the language as well as knowledge of the culture and are able to mediate the social aspects of the situation, not just the linguistic ones.
• Learn about the culture of the families you serve.
• ASK — families are often more than willing to provide you with the information you need (is it okay to talk about this holiday?  what kinds of foods do you eat in your home?  what word do you use for this?) if you just speak up and request assistance.  Families have a lot to offer in the therapy process — include them as the experts on their culture and their family.
• Learn about the basic language structures in the child’s native language.  See how you might be hearing those structures translated into what seem like “errors” in English but are really the influence of L1 on L2 (first language on second language).
• Understand the typical process of language development from L1 to L2 (the silent period, code switching, differentiation between languages, etc.)

Speech-Language Pathologists and other professionals are often in a position to educate others on the child’s team about bilingual oral language learning.  Just as many general education teachers are not informed about typical speech and language development in children, they are even more uninformed about the development of bilingual oral language learners.  One workshop participant noted that we must inform general education teachers about the process of how trial and error actual help second language learning, and remind them that, “Language learning is not an errorless process.”  Helping general education teachers know what to expect from second language learners, and how SLPs can support them in the classroom, gives the child a more cohesive and well-informed team.

*So what about children with hearing loss?  You’ll see at the beginning of this article that I emphasized that the content of this presentation focused on bilingual oral language learning.  Bimodal bilinguals, people who speak and use a signed language, like ASL, are a completely different subset in the research, and the conclusions presented above often do not apply to this experience.  While oral bilingualism makes use of the same part of the brain, and fluency in one oral language often provides correlates (e.g. most languages use rising intonation for a question, words in different languages can be cognates or etymologically related to each other) that facilitate learning of other languages.  For children with hearing loss, the auditory discrimination skills necessary to hear and understand one language translate to the comprehension of phonemes in words of other languages.  Bimodal language learning (spoken and signed language) uses different parts of the brain, and has been shown to have deleterious effects on the oral language learning of children with hearing loss, especially when we consider that access to fluent language models is KEY for the learning of any language, and hearing parents who begin learning sign when their child is identified are at a distinct disadvantage in this arena.

The overwhelming majority of parents of children with hearing loss are choosing a listening and spoken language outcome.  Some of these families reflect the demographics of our increasingly diverse and bilingual society, for whom bilingualism is a daily reality, not a choice.  Other families choose oral bilingualism for their children because they value second language learning or have a cultural connection to another language.  Is it possible for a child with hearing loss to learn two (or more!) oral languages?  YES!  For more information, view this informative presentation from Amy McConkey Robbins, MS CCC-SLP.  You can also find many stories of bilingual CI users on the Cochlear Implant Online website, like Rachel Chaikof, Vivie, Christian, Rachel D., and Kunal.

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