Pedagogical Approaches to Cultural and Linguistic Diversity in Communication Sciences and Disorders Programs: A Nationwide Survey.

PURPOSE: This study investigates how instructors in communication sciences and disorders (CSD) programs teach about cultural and linguistic diversity (CLD) in general-content courses as well as those dedicated to CLD content with the goal of identifying ways of improving training of preservice clinicians to provide culturally responsive service delivery. METHOD: A survey was sent to 4,192 instructors in CSD programs at 295 institutions in the United States and Puerto Rico, of which 565 responded. The survey contained choice response questions and open-ended questions. RESULTS: Curricular infusion as the sole strategy of CLD training has decreased since a similar survey was published by Stockman et al. (2008), while the number of programs that offer courses dedicated to CLD or use both strategies has increased. Dedicated CLD courses offer broader training in CLD issues and are considered more effective at preparing students to work with CLD populations. A number of challenges were identified, such as a lack of available resources or time to cover CLD issues. CONCLUSIONS: A combination of curricular infusion and dedicated CLD coursework is recommended to ensure sufficient training in CLD issues. The development of additional resources is needed to better support instructors in both general-content and CLD-dedicated courses. Finally, CLD training should engage students in challenging unjust systems and harmful ideologies and not just celebrate multiculturalism in order to provide culturally responsive service to all clients. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.25587651.

Community responses to persons with aphasia participating in CoActive therapeutic theatre: A pilot study.

BACKGROUND: Persons with aphasia (PWA) experience a number of communicative and social-emotional challenges. Reported experiences of PWA include but are not limited to, being misunderstood, isolated, frustrated, and infantilised. AIMS: The aim of this pilot study, involving a Life Participation Approach to Aphasia (LPAA), conducted over the course of 2 years, was to understand community perceptions of aphasia while PWA engaged in an interprofessional treatment program involving speech and drama therapy. METHODS & PROCEDURES: The interprofessional treatment program involved PWA participating in a therapeutic theatre program using the CoActive Therapeutic Theater (CoATT) while also receiving speech-language therapy. Each year, the PWA performed a different, original therapeutic theatre production for a public audience, at the culmination of their interprofessional treatment program. In this paper, we share data obtained from perspectives of audience members who witnessed the theatre production and aphasia education during the first year of the study and friends and family of PWA who participated in the therapeutic theatre process during the second year of the study. OUTCOMES & RESULTS: Responses from audience members who participated in aphasia education and witnessed the therapeutic theatre performance by the PWA during the first year, indicated an increased knowledge of aphasia. Friends and family members of PWA who witnessed their loved ones engaging in the CoATT process through interprofessional treatment, in the second year, reported that their loved ones benefited from the CoATT process, which was distinct from other therapeutic processes to their knowledge and that they were impacted by watching their loved one perform. CONCLUSIONS & IMPLICATIONS: These initial findings create footing towards understanding impact of therapeutic theatre in combination with speech-language therapy in the lives of PWA. They help us to obtain an initial appreciation of how therapeutic theatre and aphasia education help connect PWA and their community. WHAT THIS PAPER ADDS: What is already known on this subject Caregivers and communities at large play a significant role in and substantially impact the recovery of their loved ones (Dalemans et al., 2010; Grawburget et al., 2013; Kniepmann & Cupler, 2014) with aphasia. However, existing research suggests that persons with aphasia (PWA) are often misunderstood, isolated and infantilised by their communities. What this paper adds to existing knowledge The findings of our study reveal that friends, families and extended communities of PWA gain a positive and deep understanding of challenges experienced by PWA through therapeutic theatre supported by speech language therapy, based in a new CoActive Therapeutic Theatre (CoATT) model. This PWA community also agrees that therapeutic theatre in combination with speech-language therapy provides confidence and camaraderie between PWAs and strengthen connection between all constituencies. These results support the need for interprofessional intervention within the framework of a Life Participation Approach to Aphasia (LPAA). What are the potential or actual clinical implications of this work? Treatment paradigms that bring PWAs in contact with their communities using an LPAA approach can increase confidence and social engagement for PWAs potentially leading to better outcomes for their individual speech-language therapy as well as create means of educating communities about PWA, and their stories.

Automaticity of speech processing in early bilingual adults and children.

We examine whether early acquisition of a second language (L2) leads to native-like neural processing of phonemic contrasts that are absent in the L1. Four groups (adult and child monolingual speakers of English; adult and child early bilingual speakers of English and Spanish, exposed to both languages before 5 years of age) participated in a study comparing the English /I/ - /ε/ contrast. Neural measures of automatic change detection (Mismatch Negativity, MMN) and attention (Processing Negativity, PN and Late Negativity, LN) were measured by varying whether participants tracked the stimulus stream or not. We observed no effect of bilingualism on the MMN, but adult bilinguals differed significantly from adult monolinguals on neural indices of attention. The child bilinguals were indistinguishable from their monolingual peers. This suggest that learning a L2 before five years of age leads to native-like phoneme discrimination, but bilinguals develop increased attentional sensitivity to speech sounds.

Neural Indices of Vowel Discrimination in Monolingual and Bilingual Infants and Children.

OBJECTIVES: To examine maturation of neural discriminative responses to an English vowel contrast from infancy to 4 years of age and to determine how biological factors (age and sex) and an experiential factor (amount of Spanish versus English input) modulate neural discrimination of speech. DESIGN: Event-related potential (ERP) mismatch responses (MMRs) were used as indices of discrimination of the American English vowels [ε] versus [I] in infants and children between 3 months and 47 months of age. A total of 168 longitudinal and cross-sectional data sets were collected from 98 children (Bilingual Spanish-English: 47 male and 31 female sessions; Monolingual English: 48 male and 42 female sessions). Language exposure and other language measures were collected. ERP responses were examined in an early time window (160 to 360 msec, early MMR [eMMR]) and late time window (400 to 600 msec, late MMR). RESULTS: The eMMR became more negative with increasing age. Language experience and sex also influenced the amplitude of the eMMR. Specifically, bilingual children, especially bilingual females, showed more negative eMMR compared with monolingual children and with males. However, the subset of bilingual children with more exposure to English than Spanish compared with those with more exposure to Spanish than English (as reported by caretakers) showed similar amplitude of the eMMR to their monolingual peers. Age was the only factor that influenced the amplitude of the late MMR. More negative late MMR was observed in older children with no difference found between bilingual and monolingual groups. CONCLUSIONS: Consistent with previous studies, our findings revealed that biological factors (age and sex) and language experience modulated the amplitude of the eMMR in young children. The early negative MMR is likely to be the mismatch negativity found in older children and adults. In contrast, the late MMR amplitude was influenced only by age and may be equivalent to the Nc in infants and to the late negativity observed in some auditory passive oddball designs.

Sensitive periods for language and recovery from stroke: conceptual and practical parallels.

In this review, we consider the literature on sensitive periods for language acquisition from the perspective of the stroke recovery literature treated in this Special Issue. Conceptually, the two areas of study are linked in a number of ways. For example, the fact that learning itself can set the stage for future failures to learn (in second language learning) or to remediate (as described in constraint therapy) is an important insight in both areas, as is the increasing awareness that limits on learning can be overcome by creating the appropriate environmental context. Similar practical issues, such as distinguishing native-like language acquisition or recovery of function from compensatory mechanisms, arise in both areas as well.

The Development of English Vowel Perception in Monolingual and Bilingual Infants: Neurophysiological Correlates.

The goal of this paper was to examine intrinsic and extrinsic factors contributing to the development of speech perception in monolingual and bilingual infants and toddlers. A substantial number of behavioral studies have characterized when infants show changes in behavior towards speech sounds in relation to amount of experience with these sounds. However, these studies cannot explain to what extent the developmental timeline is influenced by experience with the language versus constraints imposed by cortical maturation. Studies using electrophysiological measures to examine the development of auditory and speech processing have shown great differences in infant and adult electrophysiological correlates of processing. Many of these differences are a function of immature cortex in the infant. In this paper, we examined the maturation of infant and child event-related-potential (ERP) electrophysiological components in processing an English vowel contrast and explored to what extent these components are influenced by intrinsic (e.g., sex) versus extrinsic factors, such as language experience (monolingual vs. bilingual). Our findings demonstrate differences in the pattern of ERP responses related to age and sex, as well as language experience. These differences make it clear that general maturational factors need to be taken into consideration in examining the effect of language experience on the neurodevelopment of speech perception.

Electrophysiological indices of discrimination of long-duration, phonetically similar vowels in children with typical and atypical language development.

PURPOSE: The authors investigated the neurophysiological bases of vowel perception in children with specific language impairment (SLI) compared with typical language development (TLD) controls using 250-ms phonetically similar vowels. In a previous study, children with SLI showed a poor neurophysiological response (the mismatch negativity [MMN]) to 50-ms versions of these vowels, regardless of whether attention was directed to (attend) or away (passive) from the auditory modality (V. Shafer, M. Morr, H. Datta, D. Kurtzberg, & R. Schwartz, 2005). They hypothesized that longer vowels would allow for improved speech perception. METHOD: Brain responses were elicited to the vowel contrast in 2 conditions: (a) attend and (b) passive. Behavioral discrimination and identification responses were also examined. RESULTS: Both SLI and TLD groups showed evidence of discrimination (MMN) of the vowels in the attend and passive conditions. Only subtle differences in the scalp topography of a late negative (LN) brain component were observed between groups. The SLI compared with the TLD group showed significantly poorer identification of these long vowels, as found previously with the shorter vowels. CONCLUSIONS: Increased vowel duration can improve discrimination in children with SLI. However, poor identification of these longer vowels by some children with SLI suggests a deficit in long-term phonological representations or accessing these representations.

Maturation of speech discrimination in 4- to 7-yr-old children as indexed by event-related potential mismatch responses.

OBJECTIVES: This study examined maturation of mismatch responses (MMRs) to an English vowel contrast (/I/ versus /ε/) in 4- to 7-yr-old children. DESIGN: Event-related potentials were recorded to a standard [ε] and deviant [I] vowel presented in trains of 10 stimuli at a rate of 1/650 msecs and with an intertrain interval of 1.5 secs. Each train contained two deviant vowels. Averaged responses were calculated for the infrequent (deviant) and the frequent (standard) trials for each child and compared across age groups. RESULTS: Significantly greater negativity, consistent with the adult mismatch negativity (MMN), was observed to the deviants between 300 and 400 msecs for both younger (4- and 5-yr-old) and older (6- and 7-yr-old) children. This MMN-like negativity shifted earlier in latency by 25 msecs/yr with increasing age. Most of the children younger than 5.5 yrs and some of the older children also showed a positive MMR (p-MMR) peaking between 100 and 300 msecs. The p-MMR diminished in amplitude with increasing age. CONCLUSIONS: Maturation of speech discrimination, as indexed by MMN, occurs more rapidly between 4 and 7 yrs of age for vowels than for tones. A p-MMR preceding the MMN also reflects discrimination in younger children and declines in amplitude with age.

Native language experience influences the topography of the mismatch negativity to speech.

The ability to learn second language speech sound categories declines during development. We examined this phenomenon by studying the mismatch negativity (MMN) to the /r/ - /l/ distinction in native English speakers and learners of English as a second language who are native speakers of Japanese. Previous studies have suggested that the MMN is remarkably plastic when evaluated as a waveform at a central electrode. We replicated this finding: analyses of the MMN at a typical electrode location (Fz) revealed only small, non-significant differences between groups, despite large behavioral differences in the ability to discriminate these sounds from one another. Topographic analyses, however, revealed reliable differences in lateralization of the MMN, such that native English speakers' responses were left-lateralized relative to native Japanese speakers' responses.

Neurophysiological indices of attention to speech in children with specific language impairment.

OBJECTIVE: The aim was to determine whether children with specific language impairment (SLI) differed from children with typical language development (TLD) in their allocation of attention to speech sounds. METHODS: Event-related potentials were recorded to non-target speech sounds in two tasks (passive-watch a video and attend to target tones among speech sounds) in two experiments, one using 50-ms duration vowels and the second using 250-ms vowels. The difference in ERPs across tasks was examined in the latency range of the early negative difference wave (Nd) found in adults. Analyses of the data using selected superior and inferior sites were compared to those using electrical field power (i.e., global field power or GFP). The topography of the ERP at the maximum GFP was also examined. RESULTS: A negative difference, comparable to the adult Nd, was observed in the attend compared to the passive task for both types of analysis, suggesting allocation of attentional resources to processing the speech stimuli in the attend task. Children with TLD also showed greater negativity than those with SLI in the passive task for the long vowels, suggesting that they allocated more attentional resources to processing the speech in this task than the SLI group. This effect was only significant using the GFP analysis and was seen as smaller GFP for the TLD than SLI group. The SLI group also showed significantly later latency than the TLD group in reaching the maximum GFP. In addition, a significantly greater proportion of children with SLI compared to those with typical language showed left-greater-than-right frontocentral amplitude at the latency determined from each child's maximum GFP peak. CONCLUSIONS: Children generally showed greater attention to speech sounds when attention is directed to the auditory modality compared to the visual modality. However, children with TLD, unlike SLI, also appear to devote some attentional resources to speech even in a task in which they are instructed to attend to visual information and ignore the speech. SIGNIFICANCE: These findings suggest that children with SLI have limited attentional resources, that they are poorer at dividing attention, or that they are less automatic in allocating resources to speech compared to children with typically developing language skills.

Neurophysiological indexes of speech processing deficits in children with specific language impairment.

We used neurophysiological and behavioral measures to examine whether children with specific language impairment (SLI) have deficits in automatic processing of brief, phonetically similar vowels, and whether attention plays a role in such deficits. The neurophysiological measure mismatch negativity (MMN) was used as an index of discrimination in two tasks; one in which children ignored the auditory stimuli and watched a silent video and a second in which they attended to the auditory modality. Children with SLI showed good behavioral discrimination, but significantly poorer behavioral identification of the brief vowels than the children with typical language development (TLD). For the TLD children, two neurophysiological measures (MMN and a later negativity, LN) indexed discrimination of the vowels in both tasks. In contrast, only the LN was elicited in either task for the SLI group. We did not see a direct correspondence between the absence of MMN and poor behavioral performance in the children with SLI. This pattern of findings indicates that children with SLI have speech perception deficiencies, although the underlying cause may vary.

The development of the length of the temporal window of integration for rapidly presented auditory information as indexed by MMN.

OBJECTIVE: The length of the temporal window integrating successive auditory stimuli into unitary percepts has been estimated to be less than 200 ms in adults. The aim of the study was to investigate the development of the integrating window in children to determine whether it is similar to young adults. METHODS: A modified auditory oddball paradigm was presented at a rapid (150-400 ms) onset-to-onset pace during recording of electroencephalogram in two groups of children (aged 5-8 and 9-11 years) and one group of adults. Latencies and amplitudes of the P1, N1, and the mismatch negativity (MMN) components of event-related brain potentials (ERPs) were measured. RESULTS: The length of the temporal window of integration (TWI) was shorter in adults (<200 ms) than older children (<300 ms in 9-11-year-olds) and younger children (<350 ms in the 5-8-year-olds). In addition, age-related changes were found in the latency and amplitude of the ERP components. CONCLUSIONS: The results demonstrate a general maturational development of the auditory evoked potentials and also a specific maturational process for temporal encoding of information in auditory cortex. SIGNIFICANCE: Rapid stimulus presentation rates can be successfully used in school-aged children to study neural mechanisms of auditory processes.