Creating evidence-based guidelines for culturally responsive clinical practices: Supporting accurate diagnosis of speech sound disorder in Icelandic-Polish speaking children
Background: Speech-language pathologists often lack the proper tools and methods to assess speech sound disorders (SSDs) in multilingual children, putting these children at risk of both over- and underdiagnosis. SLPs in Iceland require evidence-based, culturally responsive methods to accurately diagnose SSD in multilingual children.
Aim: To describe the development of a data-driven method of culturally responsive assessment and diagnostic decision-making using a converging evidence approach, to more accurately differentiate typical multilingual speech acquisition from SSD in Icelandic-Polish multilingual speakers.
Method/approach: Speech samples using a single-word speech production test were collected from 19 Polish-speaking adults who had learned Icelandic as an additional language and 36 Icelandic-Polish speaking children aged 4;2 to 5;0. Analysis identified mismatches typically observed in Icelandic-Polish speakers. Children’s samples were analysed using traditional and culturally responsive approaches. Study approval was obtained from Vísindasiðanefnd and Siðanefnd háskólanna um vísindarannsóknir.
Results/findings: A range of phonological processes were identified as part of the typical cross-linguistic interaction between Polish and Icelandic. Measures of the accuracy of children’s speech increased when mismatches influenced by cross-linguistic interactions were not counted as errors. Using multiple sources of evidence changed children’s diagnosis from 20 with SSD using the traditional approach to only five using a converging evidence approach.
Conclusion: It is possible to develop evidence-based guidelines for assessing multilingual children’s speech even for language pairings within small languages, such as Icelandic.
Implications for children and families: You will learn how multilingual children develop speech differently from their monolingual peers and why traditional approaches to assessment and diagnosis are inaccurate.
Implications for practitioners: You will learn how SSD presents differently in monolingual and multilingual children, as well as factors to consider when deciding whether to refer a multilingual child for evaluation by an SLP.
Funding: Menntarannsóknasjóður [219261-051].
Keywords: multilingual, speech production, speech sound disorder, intelligibility, Icelandic, Polish, speech-language pathology
This presentation relates to the following United Nations Sustainable Development Goals: