Helen Grech
1, Barbara Dodd
2, Sue Franklin
31 Faculty of Health Sciences, University of Malta, 2 School of Community and Health Sciences, City University London, 3 School of Health Sciences, University of Limerick
Abstract. Speech language pathologists working with Maltese-English bilingual children often assess and diagnose speech disorders using assessment protocols standardised on monolingual, English-speaking populations. Such tests are considered inappropriate for the Maltese bilingual children since they are not linguistically or culturally oriented. An innovative speech assessment protocol which is bilingual in nature, was developed and standardised. Children were tested in Maltese and/or English depending on their language (or language mix) exposure. A novel feature of this assessment battery was that for all of the items, children were able to respond in either language, reflecting the reality of language mixing in a bilingual population. Trends of speech development for monolingual and bilingual children aged between 2;0-6;0 years are reported, differentiating between the emergence of the ability to produce speech sounds (articulation) and typical developmental error patterns (phonology). This assessment gives clinicians a more objective view of the discrepancy between typical development, delay and deviancy for children acquiring speech in Malta. The research findings are novel and have both theoretical and clinical implications.
Keywords: bilingual assessment, Maltese bilingual assessment, bilingual speech test, Maltese- English speech test
Introduction
Research related to children’s speech and language development comes mainly from studies of monolingual English-speaking children (Hua & Dodd, 2006). However, there has been increased interest in children acquiring other languages (e.g., Fox, 2000 for German; Ballard & Farao, 2008 for Samoan). Research suggests that children acquiring different languages have some language specific developmental error patterns indicating that findings for one language are not applicable to other languages (e.g., So & Dodd, 1994 for Cantonese; Amayreh & Dyson, 1998 for Arabic; Grech, 1998 for Maltese; Zhu & Dodd, 2000 for Putonghua; Macleod, Sutton, Trudeau, & Thordardottir, 2010 for Québécois French). During the past decade, research on bilingual acquisition has become of more interest.
Studies on bilingual acquisition include those of Lleó, Kuchenbrandt, Kehoe, and Trujillo (2003):
German-Spanish; Salameh, Nettlebladt, and Norlin (2003): Arabic-Swedish; Fabiano and Goldstein (2005): Spanish-English; Munro, Ball, Müller, Duckworth, and Lyddy (2005): Welsh-English; De Houwer, Bornstein, and De Coster (2006): Dutch-French; Holm and Dodd (2006): Cantonese- English; Sundara, Polka, and Genesee (2006): French-English. There are indications that children exposed to early sequential bilingualism show different patterns of phonological acquisition to those of monolingual children of the respective languages (e.g., Holm & Dodd, 1999; Grech & Dodd, 2008). Further, sequential bilinguals may exhibit differences in type and amount of errors from simultaneous bilinguals (De Houwer, 2009). When Wright and Gildersleeve (2005) compared 11 monolingual English-speaking children with five Russian-English bilinguals (two of whom learned Russian and English simultaneously and three who acquired English once their Russian was established), they found that the sequential bilinguals made more consonant errors than the simultaneous bilinguals and that overall the bilingual children made more errors than monolingual subjects.
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The finding that bilingual children’s phonological acquisition differs from that of monolinguals of either of the languages spoken indicates that having two phonologies affects the course of acquisition.
This is in line with the Interactional Dual Systems Model for the mental organization of more than one language. The model asserts that bilingual children have two separate phonological systems, but that those two systems can influence one another. Paradis (2001) reported such cross-linguistic features in the productions of bilingual children. The model fits with data from other studies of bilingual children (e.g., Johnson & Lancaster, 1998 (Norwegian-English); Holm & Dodd 1999a, b, c (Cantonese-English, Italian-English and Punjabi-English, respectively); Keshavarz & Ingram, 2002 (Farsi-English); Salameh, Nettlebladt, & Norlin, 2003 (Swedish-Arabic)). On the other hand, Navarro, Pearson, Cobo-Lewis, and Oller (1995) found no atypical phonological error patterns in the speech of 11 successive bilingual Hispanic-English pre-school children in the US.
Hua and Dodd (2006) reviewed the varying reports concerned with the phonological development of bilinguals. Some studies (Burling, 1959/1978; Leopold, 1939-1949; Schnitzer & Krasinski, 1994, 1996; and Johnson & Lancaster, 1998) claim initial periods of a single phonological system for simultaneous bilinguals. Other studies (Wode, 1980; Fantini, 1985; Watson, 1991) report that successive bilinguals tend to superimpose an unknown system on the more stable one, using one system as a base, and differentiating the second system by altering or adding to the first system. Hua and Dodd concluded that apparently conflicting findings may reflect differences between the different language pairs learned, or the comparative length of exposure to a child’s two languages.
Research describing bilingual language acquisition is limited in terms of the language pairs studied and the language learning contexts investigated. Data are often reported from studies where the children’s first language is that of their immigrant parents in a country where the dominant language is English (e.g., Goldstein & Washington, 2001 for Hispanic children in the US, Stow & Dodd, 2003 for Pakistani Heritage languages in the UK). They are in a community where one language is spoken apart from the home language. The child becomes bilingual as a result of the shift of linguistic environment. However, there also exist simultaneous bilinguals where acquisition of two or more languages occurs very early in their lives. De Houwer (2009) refers to two sub-groups of such children, i.e. those who have bilingual first language acquisition (BFLA) when there is no existing chronological difference in the exposure of both languages; and those children who are early second language learners (ESLLs) where they are exposed to a second language on a regular basis between 18 and 48 months of age. De Houwer also refers to formal second language acquisition, whereby children are introduced to a second language and literacy at about 5 years of age. Second language acquisition (SLA), and English language learners (ELLs), or equivalent terms used in non-English contexts, are other terms used often referring to learning the second language at school. Sequential acquisition can also refer to learning subsequent languages at any time during life.
Another important limitation of the available data on bilingual children’s acquisition of language is that, very often, the two languages studied come from the same language family that share similar phonological characteristics. There is evidence that research findings from two Indo-European languages (e.g., English-French; Spanish-English) differ from those for other language pairs (Hua &
Dodd, 2006) where English is learned in addition to Cantonese (Yip & Matthews, 2007) or Maltese, which is Semitic in origin. Further, the number of children involved in these studies has been extremely small (many are case studies) with the consequence that there are no normative data for many language-pairs, thus limiting the assessment and diagnosis of speech and language disorders.
Studies in English-speaking countries have established and standardized assessments to identify children with speech and language difficulties but no such protocols are available for the Maltese population. The authors attempted to address this gap in the knowledge base concerned with speech and language acquisition in the Maltese context by developing a bilingual speech assessment, and administering it on a large sample of Maltese children. Data were analysed for trends of acquisition for children reported to be ‘monolingual’ by their parents, and those exposed to Maltese and English at home.
The phonologies of Maltese and English have their origins in two different language groups (Semitic and Indo-European). The consonant phonetic inventory of Maltese is similar to that of English (with // and /ts/ being ‘additional’ Maltese phonemes while English //, /ʒ/ and /ð/ are not part of the
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Maltese inventory. However, the two languages differ in their phonotactics. Maltese has a greater range of possible consonantal clusters and consonantal sequences and is characterised by multi- syllabic lexemes (Borg & Azzopardi-Alexander, 1997). A speech test standardised on English- speaking children, such as the Diagnostic Evaluation of Articulation and Phonology (DEAP) (Dodd, Zhu, Crosbie, Holm, & Ozanne, 2002) is therefore not applicable since it does not cater for Maltese phonotactics and should not be used to assess Maltese-speaking children. The use of English-only standardized tests, when clinicians evaluate non-native English speakers has often been reported (e.g., Skahan & Lof, 2007) and should be avoided as it may lead to misdiagnosis of a speech disorder.
Clinicians need language specific tools to identify children with speech and language difficulties, since it is well known that children with an early history of language impairment may be at risk for continuing communication difficulties particularly related to written language development (Shriberg
& Kwiatkowski, 1994). Educational achievement is also related to early speech and language abilities (Bickford-Smith, Wijayatilake, & Woods, 2005) as well as social, emotional, or behavioral challenges (Rome-Flanders & Cronk, 1998). It was therefore considered crucial to develop a speech and language assessment that can identify children who have speech and language disorder in Malta. The objectives of this study were to construct and standardize a speech assessment battery appropriate for children acquiring language in the bilingual language learning context of Malta. Traditionally assessments for children in bilingual contexts have consisted of two separate tests, one for each language. This does not reflect the reality of the way that bilingual children use language in terms of language mixing and word borrowing. Indeed to respond appropriately in the required language may require an added degree of metalinguistic control. Uniquely in this speech and language assessment battery, children are able to use Maltese or English in response to each stimulus item. Scoring and analysis also cater for language mixing (for details see Manual in Grech, Franklin, & Dodd, 2011).
The Maltese socio-linguistic context
The Maltese Islands have a complex language learning context. There are two official languages (Maltese and English), most children are bilingual in that they have some knowledge of both languages but one of the languages may be dominant. Reports from parents indicate that in some homes one of the languages may be used exclusively while other families use both languages (Grech
& Dodd, 2008) so that the child is exposed to two languages at home soon after birth (simultaneous acquisition). In comparison, some children are exposed to only Maltese or English at home, followed by exposure to their second language in the community, usually by 3 years of age when they start attending pre-school (early sequential acquisition). This context was used in this large scale project to study the effects of language exposure at home on the rate and course of speech and language acquisition. Data from children reported by the carers to be simultaneously bilingual (as referred above) were analysed and reported separately from data of children who were reported to be exposed to Maltese or English at home (referred as monolingual in this study). The term ‘monolingual’ in the Maltese context has to be treated with caution and refers to home exposure. The language learning context of Malta, where most people have some knowledge of two languages reflects emerging patterns of language use in the European Union, due to population shifts, where many people have some knowledge and functional use of at least two languages, although one language may be dominant.
Research questions
The purpose of the study was to develop a bilingual Maltese-English speech and language assessment and to identify trends of acquisition for children reported to be ‘monolingual’ by their parents and those exposed to simultaneous bilingualism at home. This paper reports data related to the speech assessment.
The Maltese-English Speech Assessment (MESA) (Grech, Dodd, & Franklin, 2011) was constructed and evaluated to address the following research questions:
- Does the MESA demonstrate that a single battery can effectively assess monolingual and bilingual children?
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- Do the speech acquisition patterns for these two populations differ?
- Is the MESA a reliable and valid test of speech development?
- Does the MESA distinguish between typically developing children and those with delayed or disordered speech (making the assessment a useful tool for clinicians working with Maltese- speaking children?
Methodology The sample
The public registry of births for the Maltese Islands was accessed to draw a random sample of 1,000 Maltese children aged 2;0 to 6;0 years. All children whose parents consented to participate in the project (a total of 241 children) were assessed on a picture naming task to evaluate phone articulation, phonology and consistency of word production. The children were also assessed for oro-motor skills and the ability to repeat phonotactically complex words. The sample included a total of 134 girls and 107 boys. Twenty-two participants were aged 24-35 months; 35 were 36-41 months; 45 were 42-47 months; 40 were 48-53 months. Information was collected from the carers related to whether the children had an underlying sensory, cognitive or anatomical/physiological condition, family history of communication difficulties, and other factors such as socio-economic status that could reflect on their speech and language acquisition. However, this information did not result in exclusion of children from the study unless the assessment distressed them. The rationale for this decision was to avoid over-diagnosis of impairment, since data identifying typical performance must be based on a representative sample of the total population.
Table 1. Maltese sample by age and gender
Age in months Total no. of age cohort No. of girls No. of boys
24-35 20 9 11
36-41 36 23 13
42-47 45 27 18
48-53 40 19 21
54-59 34 11 23
60-65 37 25 12
66-72 29 20 9
Total
% of sample
241 100%
134 56.6%
107 44.4%
Table 2. Maltese sample by language learning context
Age in months Maltese English Maltese-English Total per cohort
24-35 10 1 11 22
36-41 18 2 15 35
42-47 23 2 20 45
48-53 28 1 11 40
54-59 22 1 11 34
60-65 22 1 14 37
66-72 15 3 10 28
Total
% of sample
138 57.26
11 4.56
92 38.17
241 100
Other information related to the primary language of the child and language/s used at home was collected. The children were allowed to use the language they chose (either Maltese or English).
Ninety-two children (38.17%) were reported by parents to speak both Maltese and English at home, 138 (57.26%) were reported to speak Maltese and 11 (4.56%) only English at home (see Tables 1 & 2 for details of the sample).
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The Assessment Battery (MESA)
The MESA is based on the DEAP (Dodd et al., 2002) and consists of four tests that assess articulation, phonology, consistency of production and oro-motor skills.
The Articulation Assessment is meant to identify perceptually any phonemes that cannot be produced by the child. The assessment includes 42 pictures depicting all consonant and vowel sounds in English and Maltese. If a picture is not named spontaneously by the child the administrator attempts to elicit it through imitation in syllable context or in isolation.
The Phonology Assessment is meant to determine the use of surface speech error patterns (developmental phonological processes) that are produced by the child. These may include the language-specific ones (e.g., compensatory vowel lengthening), universal ones (e.g., fronting) and in some instances atypical patterns. Children are asked to name the same 42 pictures and in the same order as in the articulation sub-test, though these have a different coloured background.
The Inconsistency Assessment allows the administrator to evaluate the consistency of production (stability) of the child’s contrastive phones. When considered part of the test battery, this assessment enables the identification of those children whose speech is inconsistent but who have no oro-motor difficulties. Children are required to name 17 pictures on three separate trials within one session.
The Oro-motor Assessment evaluates the child’s oro-motor function in relation to his/her diadochokinetic (DDK) skills for sequencing and intelligibility. Imitation of isolated and sequenced movements involving speech musculature is also assessed via a separate sub-test. Another sub-test involves the repetition of a list of 11 words some of which are multi-syllabic some include syllable initial consonantal clusters. For this sub-test, the child is asked to repeat the word uttered by the administrator, 3 times consecutively. This word repetition test was included specifically because of the syllabic structure of Maltese and the wide range of multiple combinations of consonantal cluster possibilities as well as multi-syllabic utterances. Examples of words in this sub-test include: /tpɪnʤɪ/
meaning ‘colouring; /hwɛɪɛʧ/ meaning ‘clothes’; /sʊfɐrɪnɒɐ/ meaning ‘match’.
The MESA portfolio includes the Manual, which provides clear instructions for its administration.
The Stimulus book contains pictures that are culturally appropriate, age appropriate and colourful.
This was checked by piloting the test on Maltese children of varying ages. Clinicians were also approached for feedback before confirming the list of pictures to be used. The pictures are visually attractive to children between 2;0-6;0 years of age on whom this test should be administered. The Score sheets are colour-coded for ease of reference and allow for entry of raw scores for each section.
Different sub-tests can carried out on separate sessions (but close in time), particularly if the test is being used for review purposes. The articulation test is easy and quick to score whereby the clinician is only expected to circle any phones that the child does not produce in the adult form. Phonetic transcription according to the International Phonetic Alphabet (IPA) is required for the phonology test. This would allow for the identification of error patterns and idiosyncratic phoneme production.
Quantitative analysis is recommended to calculate percent consonants correct (PCC) and percent vowels correct (PVC) for the different language codes (e.g., Maltese; Maltese-English). PCC and PVC measures are used regularly to index the phonological skills of children. PCC measures are reported to be linguistically and psychometrically valid (Shriberg, Austin, & Lewis, 1997).
The Inconsistency test score is calculated as a percentage of the number of words produced differently in 3 trials in relation to the total number of words produced 3 times. The other sub-tests are easy to score whereby accurate production is given a score and the total score per sub-test is noted. Speech- language pathologists (SLPs) are expected to administer the test, score, analyse the data, and compare them to ‘typical’ data.
Procedure
Most of the children were assessed at home in one or two sessions. During each 1-hour session short breaks were given as often as was considered necessary. A few children were assessed in the
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University Communication Therapy Teaching and Research Clinic following parental request. The children completed the MESA and additional language related tasks that assessed narrative comprehension, expressive language, sentence imitation, and phonological awareness skills. The carers also completed checklists related to the child’s voice quality, fluency, and pragmatic skills.
This paper reports results of the MESA only. Pre-assessment criteria were set in relation to the test- administrators’ language use for instruction. Maltese was used to give assessment instructions unless the child was English-speaking. If unsure, the examiner used the language chosen by the child. When carers reported that the child was bilingual, Maltese was used. A novel feature was that the children had the choice to respond in either language. Ideally, bilingual children should be tested in both languages. For the MESA study this was not done since data collection already involved considerable time commitment due to the administration of the MESA and a language assessment battery, which extended to 2 home visits for most children. This decision was also supported by there being only 3 additional English phonemes which do not exist in Maltese phonology, i.e. /θ, ð, ʒ/. It has been reported (e.g., Grech, 1998) that the Maltese use /t/ and /d/ for /θ, ð/, respectively when speaking English (generalisation of Maltese phonology). Meanwhile, /ʒ/ is the least frequently used phoneme of English (http://www.instructables.com/answers/What-are-the-most-commonly-used-to-least-comonly- u/). The MESA scores sheets allow for code-switching, the data showing that most children produced some words in both languages.
Reliability of the MESA
The accuracy and consistency of the MESA was measured by test-retest reliability and inter-rater reliability. Test-retest reliability was estimated by testing 5% of the sample twice (mean age: 51.6 months). The between test interval was less than 5 weeks. Inter-rater reliability was measured in relation to the degree of consistency between persons scoring, transcribing, and analysing the children’s speech. The audio recordings of 12 children (5 % of Maltese normative sample; mean age:
46.3 months) were transcribed and analysed by 2 independent examiners.
Validity
The content and concurrent validity of the MESA were established in different ways. The data from the typically developing children using MESA were compared with those in Azzopardi (1997) and Grech (1998). These studies presented data from typically developing children. Azzopardi’s (1997) phonological study investigated the development of Maltese consonants and some consonant clusters in 4-year old Maltese-speaking children. A cross-sectional study of 10 children was carried out.
Parents were interviewed and relevant screening measures were applied before including children in the study. A phonological sample was collected at each child’s home using picture elicitation materials designed specifically for this study. The sample was transcribed and analysed using the Phonological Assessment of Child’s Speech (PACS) (Grunwell, 1985). The results indicated that: (a) fricatives and liquids were most likely to be misproduced; (b) only 5 developmental processes (error patterns) were observed, thus indicating that the children had eliminated most developmental phonological processes; and (c) many of the clusters were produced consistently.
Grech’s (1998) exploratory study was related to the phonological development of 21 normally developing Maltese-speaking children. The children were recorded in their natural settings at four different stages between ages 2;0 and 3;6. The data collected were transcribed narrowly and analysed.
Each child’s phonetic/phonological inventory was identified; various developmental phonological processes were also recorded throughout the period of study. A developmental profile was collated for the group, indicating trends of stages of phonological development. This profile was compared cross- linguistically. The data fits in with current theories highlighting universal phonological acquisition particularly in the early years. As predicted some language-specific behaviour was also observed.
The usefulness of the MESA was also validated by data from a clinical population (not part of the larger cohort of the study). It was hypothesized that data from children who had been clinically identified with speech sound disorder would differ from those of the normative sample and from those of children with ‘other’ communication impairments. Differential diagnosis of these children with impairments was made by a clinician using various speech and language assessment tools that are not