Culturally Responsive Assessment & Therapy for School Aged Children & Adolescents

Differentiated instruction is an approach to teaching and learning for students with different abilities in the same classroom. The theory behind differentiated instruction is that staff should vary and adapt their approaches to fit the vast diversity of students in the classroom. The staff may tailor the content, activities, and learning environment based on the individual needs of a child.  Differentiated instruction goes hand in hand with culturally responsive speech/language assessment and therapy.  As speech pathologists, it is our duty to provide exceptional evidence-based services using assessment methods and therapeutic intervention that considers multicultural and multilingual needs.

When providing a comprehensive speech/language assessment for a child who speaks a primary home language other than English, it is best practice to provide the evaluation in his or her native language. This is important so that the standard scores that are reported from formal speech/language measures will be valid and a true reflection of a child’s communication and linguistic capabilities. If there is no accessibility in the child’s native language, it is difficult to know how to weigh each language for diagnostic purposes. For the most accurate assessment for bilinguals, consider both languages in assessment and diagnostic decision-making.

Speech language pathologists should utilize interpreters for parent interviews and case history forms in a child’s native language to gather accurate background information about developmental, family, and school history. Do not assume that because a school aged child speaks English that they are not bilingual or multilingual. It is critical to recognize that levels of bilingualism and multilingualism are on a continuum. Each individual will have varying levels of linguistic proficiency with listening, speaking, reading, and writing in his or her primary, secondary, or tertiary language.

Across cultures and languages, gathering data on verbal narrative abilities is a great indicator of a child’s receptive/language skills. Analyzing this information can help identify language difference vs disorder. It will assist the speech/language pathologist in determining if the child’s language skills are commensurate with peers from his or her cultural and linguistic background, or if the child is in fact demonstrating characteristics of a communication or language disorder. The Leader’s Project developed by Columbia University in New York has several language elicitation cards and questions available in the following languages to assist with culturally and linguistically responsive speech/language assessment:

English, Spanish, Arabic, Russian, Hindi, Tamil, Mandarin, Portuguese, Japanese, Jamaican Creole, Punjabi,  and Urdu

Click here for that information.

Additionally, monolingual or bilingual speech/language pathologists who do not speak the same language as a client may utilize wordless picture books during an assessment in English or in a child’s native language with the use of a trained interpreter. This will provide a baseline of a child’s narrative skills in English. Have the child describe what is going on in the story and audio or video record the narrative. Then using methods of Dynamic Assessment, the speech/language pathologist can model a more descriptive verbal narrative with key story grammar markers or story elements. Then have the child repeat telling the story. The clinician can analyze the results to see if the child’s narrative skills improved with a verbal model of the story. You may learn more about accurate implementation of Dynamic Assessment here that involves test, teach, and re-test methodology.

Self-reflection is a necessary component of providing effective speech/language services with diverse children and adolescents.

For the following activity, you can use the following ratings:

1 Things that I always do

2 Things that I sometimes do

3 Things that I rarely do

Here is a checklist provided by ASHA to ensure that you, the speech pathologist, are heightening your awareness towards culturally and linguistically diverse populations:

I consider clients’ and their families’ norms and preferences when planning:

___ Appointments

___ Community outings

___ Holiday celebrations

___ Meals, snacks

___ Services in the home

___ Homework/recommendations for caregivers

I allow for alternative methods of sharing experiences and communication, such as:

___ Story telling

___ Use of props to support the “oral tradition” that is prevalent in some cultures.

I allow for alternatives to written communication, which may be preferred, such as:

___ Communicating verbally

___ Modeling the recommendations

___ Use of video/audio clips

When communicating with clients whose native language is NOT English, I use:

___ Key words or signs in their language

___ Visual aids

___ Gestures/physical prompts

___ Trained Interpreters/translators

Review the ratings that you have given as a two or a three and consider the areas that you need to make modifications in your delivery of services.

To undertake an assessment in another language, SLPs can take the following steps:

 

1.Familiarize themselves with the language and assessment tool or test

 

2.Train a native speaker (interpreter) to help administer the test

 

3. Audio- and video-record the child with high-quality recording equipment and microphones (e.g., .wav; Vogel & Morgan, 2009)

 

4. Transcribe and analyze the child’s speech using knowledge of phonetics and phonology to identify whether a need is present. Make sure

that you do not apply norms or standardized scoring based on monolingual children’s speech

5. Identify whether the child’s speech is significantly different from the comparative measure

6. Develop an intervention plan with the family and interpreter.

In addition, throughout speech/language therapy sessions it is important to develop rapport, connect with clients and families, and learn about their cultural background. Building authentic relationships and providing a welcoming learning environment is key to being culturally responsive with children, adolescents, and families. Then, the clinician may include multicultural therapy items such as children’s books related to one’s cultural identity, literature from other cultures, and activities with diverse graphics and images. SLPs should differentiate therapy activities by using children’s interests and providing choices of children’s literature, interactive games, music, and/or related arts/crafts as much as possible. This will contribute to increased engagement in sessions and mastery of speech/language objectives.

Source: ASHA, https://pubs.asha.org/doi/10.1044/2017_AJSLP-15-0161

 

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