Browsing by Author "Mills, Monique T."
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Item A COMPARISON OF VERBAL MORPHOLOGICAL ERRORS IN SPANISH-SPEAKING ENGLISH LANGUAGE LEARNERS WITH AND WITHOUT DEVELOPMENTAL LANGUAGE DISORDERS(2021-05) Balderas, Clarissa; Castilla-Earls, Anny; Mills, Monique T.; Zhang, JiePurpose: The purpose of this study is to assess morphological markers in Spanish-speaking children, who are English language learners, with and without DLD, to determine the type of verb errors made by each group and the frequency of the verb errors. Methods: The participants in this study included 76 Spanish-English bilingual children between 4;3 and 8;2 with (n=52) and without DLD (n=24). Spontaneous language samples were collected in Spanish and English for each participant and the recordings of the samples were transcribed and then coded. The coding process specifically analyzed errors of verb morphology that were categorized as an omission of an obligatory context, a substitution of a verb, auxiliary, or copula, an overregularization, or marked as a verb error. Results: The proportion of accurate verbs and the number of obligatory contexts was significantly higher in bilingual children with TD in comparison with children with DLD when both languages were taken into account or when the best language was used. Verb errors were more frequent in English than in Spanish. In Spanish, substitution errors were the most frequent type of error, while in English, verb tense errors were most common. Lastly, a large percentage of children with DLD made verb omission errors in both languages. Conclusion: Analysis of verb error type and frequency should be considered in the assessment of Spanish-English bilingual children to gather sufficient information about their language profile and determine accurate DLD diagnoses.Item Assessing for Developmental Language Disorder in the Context of African American English(Pearson Clinical Assessments, 2023) Francois, Isabelle; Lapka, Stefanie; Berstein Ratner, Nan; Mills, Monique T.Structured Abstract. Clinical Question: For young AAE speakers (P), how useful is the Developmental Sentence Scoring (DSS) compared with Index of Productive Syntax (IPSyn) in identifying developmental language disorder (DLD) in the presence of African American English (AAE) ? Method: Structured Review. Study Sources: PsycInfo®, Education Source, Education Resources Information Center (ERIC), Communication & Mass Media Complete (CMMC), PubMed, Scopus, ASHAWire . Search Terms: (1) African American English (including African American Language AND African American Vernacular English AND Black English AND AAE AND AAVE), (2) child, AND (3) language assessment (including language testing AND speech evaluation). Number of Included Studies: 3. Primary Results: DSS and IPSyn appear to be dialect-neutral measures of morphosyntax in young AAE speakers DSS was better able to detect morphosyntactic differences between children with typical language development (TLD) and children with DLD. DSS and its variant, Black English Sentence Scoring (BESS), appear to be clinically useful language sampling analysis tools. Conclusions: Available evidence suggests that DSS is a more useful clinical tool over IPSyn for evaluating DLD within the context of AAE because it provides the opportunity to evaluate mastery and accuracy of grammatical features and not only the presence of structures.Item Code-switching in Bilingual Children With and Without Language Disorders(2021-05) Huels, Emma Eileen; Castilla-Earls, Anny; Gross, Megan C.; Mills, Monique T.Due to increasing linguistic diversity across caseloads in the United States, it is important for speech-language pathologists (SLPs) to understand code-switching as it relates to typically developing children and children with language disorders. When analyzing language samples, SLPs may be unsure of how to analyze samples when code-switching is present. Because children with language disorders demonstrate difficulty with grammar, syntax, and vocabulary, this may impact the patterns of code-switching that we see in their everyday language. Much of the research on bilingualism involves typically developing children. This presents challenges when appropriately assessing bilingual children with language disorders or other communication deficits. This study aims to address code-switching as it relates to bilingual children with and without language disorders, to appropriately address ramifications for assessment and treatment.Item The Effects of Visual Stimuli on the Spoken Narrative Performance of School-Age African American Children, with Erratum(Language, Speech, and Hearing Services in Schools, 2015-10-01) Mills, Monique T.Purpose. This study investigated the fictional narrative performance of school-age African American children across 3 elicitation contexts that differed in the type of visual stimulus presented. Method. A total of 54 children in Grades 2 through 5 produced narratives across 3 different visual conditions: no visual, picture sequence, and single picture. Narratives were examined for visual condition differences in expressive elaboration rate, number of different word roots (NDW) rate, mean length of utterance in words, and dialect density. The relationship between diagnostic risk for language impairment and narrative variables was explored. Results. Expressive elaboration rate and mean length of utterance in words were higher in the no-visual condition than in either the picture-sequence or the single-picture conditions. NDW rate was higher in the no-visual and picture-sequence conditions than in the single-picture condition. Dialect density performance across visual context depended on the child's grade, so that younger children produced a higher rate of African American English in the no-visual condition than did older children. Diagnostic risk was related to NDW rate and dialect density measure. Conclusion. The results suggest the need for narrative elicitation contexts that include verbal as well as visual tasks to fully describe the narrative performance of school-age African American children with typical development. ---Erratum--- In the original article, the text in the Abstract on p. 337 reads, “Dialect density performance across visual context depended on the child's grade, so that younger children produced a higher rate of African American English in the no-visual condition than did older children. Diagnostic risk was related to NDW rate and dialect density measure.” The text should have stated, “African American English production across visual context depended on the child's grade, such that younger children produced a lower rate of AAE in the picture sequence condition than did older children. Diagnostic risk was related with NDW rate but unrelated with dialect density measure.” In addition, on p. 346, the original text reads, “As shown in Table 2, these children produced DDM rates that were similar in the no-visual (M = 0.02, SD = 0.01), picture-sequence (M = 0.03, SD = 0.02), and single-picture (M = 0.03, SD = 0.02) conditions.” For clarity, the text should have stated, “As shown in Table 2, older children produced DDM rates that were similar in the no-visual (M = 0.02, SD = 0.01), picture-sequence (M = 0.03, SD = 0.02), and single-picture (M = 0.03, SD = 0.02) conditions.” We sincerely apologize for this error.Item English Tense/Agreement Measures as Potential Diagnostic Markers in Spanish-English Bilinguals with Developmental Language Disorder(2020-08) Ronderos, Juliana; Hernandez, Arturo E.; Castilla-Earls, Anny; Mills, Monique T.Considerable individual variability is characteristic of bilingual language development, including the development and mastery of morphosyntactic skills (Paradis, 2005; Paradis et al., 2008). To address this variability, best practices for assessment of language disorders in bilingual children recommend evaluating both languages to take into account any cultural and linguistic biases (Bedore & Peña, 2008; Kohnert, 2010). However, bilingual assessment is not always feasible. In the current study, we explored the potential clinical use of an English-only assessment approach using tense/agreement composite measures. Participants included 93 Spanish-English typically developing bilingual children and 62 peers with language disorders. Measures of tense/agreement diversity, productivity, and accuracy (Hadley & Short, 2005; Bedore & Leonard, 1998) were calculated from language samples in English. We created a new measure, morphosyntactic development levels, inspired on the tense/agreement composites while also considering a child’s relative language dominance and length of exposure to English. The morphosyntactic development levels reflected diversity and productivity of tense/agreement morphemes and then evaluated accuracy after sufficient levels of diversity and productivity were reached. All measures were evaluated with regards to their ability to predict group difference and their discriminant accuracy for clinical utility. All measures demonstrated the ability to predict group differences. The morphosyntactic development levels provided the most informative results and classification accuracy values. These results suggest that English-only language measures may have informative value in assessment of bilingual children’s language when used in combination with parental report, language dominance, and exposure information.Item Examination Of Speech Disfluencies In The Story Generation Narratives Of Bidialectal Children(2021-05) Starling, Emily Marie; Johnson, Kia N.; Mills, Monique T.; Daniels, Derek E.As language use in the US continues to expand and diversify, concerns have arisen regarding the use of diagnostic criteria for stuttering that were created based on monolingual English-speaking norms. Specifically, research has already revealed that bilingual Spanish-English speaking children are at an increased risk for misdiagnosis of stuttering. The purpose of this study was to determine if bidialectal children who speak African American English (AAE) and Mainstream American English (MAE) are at that same risk. We hypothesized that bidialectal children would speak with a greater frequency and variety of speech disfluencies in their story generation narratives. The story generation narratives of children who speak with no variation (monodialectal), some variation (bidialectal), and strong variation (monodialectal) from MAE were coded for speech disfluencies and analyzed for statistical significance between the three groups. No statistically significant differences were found between any group in the amount or variety of speech disfluencies. This suggests that bidialectal children are not at an increased risk for misdiagnosis of stuttering, and current diagnostic criteria is appropriate for use with this population.Item Examining the Presentation of Speech Disfluencies in Story Generation Narrative Samples of Bidialectal Children(2020-05) Walker, Chenelle Lee; Johnson, Kia N.; Mills, Monique T.; Daniels, Derek E.Bilingualism affects fluency resulting in increased disfluencies when compared to monolingual speakers (Coalson, Pena, & Byrd, 2013). However, little is known about the impact of speech fluency when speaking two dialects, also referred to as bidialectalism (Lanehart, 2015; Lee-James & Washington, 2018). Johnson and Mills (2019) examined the speech disfluencies of bidialectal children during a story retell paradigm. Findings suggested that unlike bilingual Spanish-English speaking children, bidialectal children who do not stutter (CWNS) did not exceed or meet the criteria used to diagnosis developmental stuttering in children. However, story retell tasks do not necessarily mimic conversational speech which means that this could still be an issue for bidialectal children based on other forms of communication. The purpose of this study was to investigate the characteristics of speech disfluencies exhibited during story generation narrative samples of bidialectal children who are classified as having (1) no variation from Mainstream American English (MAE), (2) some variation from MAE, and (3) strong variation from MAE as determined by the DELV. The subset of 42 African American (AA) participants (male=20, female=22; ages= 88-144 months) from Johnson & Mills (2019) were split into three groups: no variation from MAE (n=15), some variation (n=6), and strong variation (n=21). Findings indicate that all three of the talker groups exceeded 3% of stuttering-like disfluencies (SLDs). Additionally, all groups presented with blocks and prolongations similar to children who stutter (CWS). This suggests that the communication style of AA culture, not dialect may be related to fluency.Item Exploratory examination of speech disfluencies in spoken narrative samples of school-age bidialectal children(American Journal of Speech-Language Pathology, 2022) Johnson, Kia; Mills, Monique T.Purpose: This study examined the relationship between school-age children’s speech disfluencies and the use of and variation of Mainstream American English (MAE) and African American English (AAE). Given that bilingual children may present with notably more speech disfluencies than monolingual children (Byrd, Bedore, et al., 2015), it was hypothesized that bidialectal speaking children (i.e., those that use both MAE and AAE) may exhibit higher speech disfluencies, as compared to children who speak mainly MAE and those who mainly speak AAE. It was also hypothesized that bidialectal speaking children would exhibit a greater variety of speech disfluency types when compared to the other two dialect groups (i.e., MAE and AAE). Method: School-age children (n = 61) with typical development and fluency were classified into three dialect groups: MAE speakers (n = 21), bidialectal MAE-AAE speakers (n = 11), and AAE speakers (n = 29). Tell-retell narrative samples were elicited from each participant using a wordless picture book. Speech disfluencies exhibited during these narrative samples were examined for frequency of stuttering-like and nonstuttering-like speech disfluencies and type of speech disfluency. Results: Findings indicated that bidialectal speaking children do not present with a higher frequency of speech disfluencies when compared to children who speak MAE and children who speak AAE. Additionally, there were no differences in the types of speech disfluencies exhibited by the different dialect groups. Conclusions: Unexpected findings of the current study nullify both hypotheses and suggest that bidialectalism, in comparison to bilingualism, has less of an impact on speech fluency. Findings provide evidence that bidialectal speaking children are not at an increased risk for stuttering or a misdiagnosis of stuttering. Clinically, these preliminary findings provide some scientific validity and specification to the appropriateness of using already established diagnostic criteria commonly used for stuttering with dialect speakers.Item Implementing Strength-Based Dialogue to Reframe Clinical Education and Community Engagement(Perspectives of the ASHA Special Interest Groups, 2023) Mills, Monique T.Purpose: Healthcare professionals want to solve problems. When health disparities are observed, the solution often rests on expanding access to clinical services. But what are the varied paths that persons with communication disorders might take to access speech, language, and hearing care? Where are these paths successful and where does a well-intended initiative have an absent or limited effect in altering disparities? Multiple, complex factors affect access to healthcare in underserved communities. However, current practice tends to frame the goals and metrics of outreach programs in terms of access to healthcare services, which risks privileging the perspective of the providers who want to increase the volume of services accessed over the voices of the community members for whom access to healthcare is only part of the larger course of their lives. Solutions that do not reflect those community strengths outside the service provision framework likely yield minimal impact on quality of life, since the community members are less likely to fully embrace the solution. Method: In this clinical forum, we describe a community-informed strengths-based framework for clinicians and clinical researchers whose work is designed to reach underserved communities by employing mutual trust, empathy, active listening, and patient-centered care planning. Through case scenarios we exemplify key tenets of the framework. Conclusion: The community-informed strengths-based framework detailed in this clinical forum supports a paradigm shift from a biomedically-informed strengths-based framework to a model of healthcare service provision that focuses on individual or community strengths. Eliciting guidance from those receiving care and framing the totality of encounters in terms of the process of responding to community strengths can build a collaborative and sustainable path forward toward achieving health goals. Keywords: strengths-based service delivery, health outcomes, developmental language disorder, cognitive decline, community health workers, clinical educationItem Influence of Examiner Dialect on a Bidialectal Speaker with Aphasia(2021-08) Guess, Kennedy Kehaulani; Maher, Lynn M.; Mills, Monique T.; Oetting, Janna B.This study investigated whether there was an impact of examiner’s dialect on the quantity and quality of narrative discourse in a bidialectal African American with mild aphasia. We hypothesized that there may be a cognitive cost when responding to the examiner by code switching from African American English (AAE) to General American English (GAE) for bidialectal people with aphasia. We elicited story retell and personal narratives on two separate occasions under two conditions: one where the examiner spoke exclusively using GAE and the other where the examiner spoke exclusively in AAE. These narratives were analyzed for differences in the density of nonmainstream forms of AAE, amount of verbal output, local cohesion errors, and information content. There was a higher density of nonmainstream forms of AAE overall in the personal narrative task in both conditions as opposed to the story retell task. In addition to the density of nonmainstream forms of AAE, there was also a difference in the variety and the type of nonmainstream forms of AAE produced. While there were no substantial differences between the two conditions with respect to the amount of information conveyed, there were observable differences in the quality of the narratives, specifically an increase in local cohesion errors in the GAE condition. The results of this study suggest it may be important to consider the impact of task demands and linguistic context on narrative discourse in bidialectal people with aphasia.Item The Effects of Language Variation and Age on Measures of Narrative Microstructure(2021-05) Francois, Isabelle; Mills, Monique T.; Castilla-Earls, Anny; Bernstein Ratner, NanThe aim of this study was to explore the relationship between language variation, age and narrative microstructure in the spoken narratives of African American school-age children. While efforts to identify language-variety fair measures are underway (e.g., Mills et al., 2021; Mills et al., 2017; Mills & Fox, 2016), more work is needed to improve access to accurate language assessments for school-age African American children. Narrative microstructure offers insight into semantic and syntactic production, complexity and accuracy in a way that is culturally-fair in school-age children who speak AAE (Mills, 2015). We evaluated the fictional narratives of 49 African American children with typical language development, from ages 7-11 years. Frog Where Are You? (Mayer, 1969) and three narratives from the Test of Narrative Language (Gillam & Pearson, 2004). The transcripts of oral narratives provided by these participants were collected and analyzed in Systematic Analysis of Language Transcripts (SALT; Miller & Iglesias, 2010), then uploaded to Computerized Language Analysis (CLAN; Ratner et al., 2019) for secondary analysis. A series of multiple regressions were used to analyze the data with age and dialect variation (DVAR) being the dependent variable and Developmental Sentence Scoring (DSS; Lee & Canter, 1971) and Index of Productive Syntax (IPSyn; Scarborough, 1990) being the independent variable. Findings indicated that age predicted DSS scores, as did language variation. Age, and language variation did not predict IPSyn scores. This study suggests that DSS does show promise as a measure that can provide information about development and age-related changes. However, DSS may not be an adequately dialect-neutral assessment. In addition, IPSyn appears to be a dialect neutral assessment but is insensitive to age differences.