Misdiagnosis of Speech Sound Disorders in Latino Children

 描述(申请人提供)：双语儿童经常被误诊为言语障碍，当他们真正表现出正常的发育时。此外，言语语言病理学家(SLP)正在避免对双语儿童进行评估，因为缺乏与这一群体进行最佳实践所需的知识和资源。在这一人群中，语音障碍的误诊会带来长期的情感、经济和教育成本。如果我们获得更多关于双语人群中什么构成正常和紊乱的言语发育的信息，就可以防止对双语儿童言语障碍的误诊。一个允许我们区分言语产生差异(即，由于一种语言对另一种语言的影响，双语儿童说话方式的差异)和言语障碍(即潜在的言语学习障碍)的理论模型将为SLP提供防止误诊所需的知识。这项研究的具体目的是(1)建立一个理论模型，通过测量双语者的两种语言如何以及在多大程度上相互作用，来解释语言之间的互动如何促进或抑制双语者的语音产生；(2)为临床医生制定基于证据的诊断标准，以区分典型发育的双语儿童和患有言语声音障碍的双语儿童。有典型发育障碍的双语儿童将在语音能力方面与说英语的同龄人进行比较。儿童将用单个单词发出声音，他们的声音将被拼音转录。将以英语和西班牙语以及两种语言对儿童作品进行审查，以了解用于单语儿童的常见诊断措施。混合效应回归模型将被用来确定双语语音中的语言间交互作用，而接受者操作特征曲线(ROC)将被用来确定所考察的诊断措施的敏感性和特异性。这些发现将导致双语儿童典型和紊乱的语音发育的特征，并为言语-语言病理学家提供用于鉴别言语差异和言语障碍的诊断指南。这些发现将减少在这一人群中识别语音障碍的诊断错误，减少拉丁裔儿童的健康差距。

 DESCRIPTION (provided by applicant): Bilingual children are often misdiagnosed as having a speech disorder when they truly exhibit normal development. In addition, speech-language pathologists (SLP) are avoiding the assessment of bilingual children due to the lack of knowledge and resources necessary for best practice with this population. Misdiagnosis of speech sound disorders in this population has long-term emotional, financial, and educational costs. Misdiagnosis of speech disorders in bilingual children can be prevented if we acquire more information on what constitutes normal and disordered speech development in the bilingual population. A theoretical model that allows us to differentiate difference in speech production (i.e., a difference in how a bilingual child speaks due to the influence of one language on the other) from speech disorder (i.e., an underlying speech-learning disability) will provide SLPs with the knowledge they need to prevent misdiagnosis. The Specific Aims of the proposed research are to (1) to develop a theoretical model that accounts for how between-language interaction facilitates or inhibits speech sound production in bilinguals by measuring how, and to what extent, the two languages of bilinguals interact and (2) develop evidence based diagnostic criteria for clinicians to differentiate typically- developing bilingual children rom bilingual children with speech sound disorders. Bilingual children with typical and disordered development will be compared to their English-speaking peers on measures of speech sound ability. Children will produce sounds in single words and their productions will be phonetically transcribed. Child productions will be examined, in both English and Spanish and across both languages, on common diagnostic measures used for monolingual children. Mixed effects regression models will be used to identify between- language interaction in bilingual speech and the Receiver Operating Characteristic Curve (ROC) will be used to determine sensitivity and specificity of the diagnostic measures examined. Findings will lead to a characterization of typical and disordered speech sound development in bilingual children and diagnostic guidelines for speech-language pathologists to use in the differential diagnosis of speech difference from speech disorder. These findings will reduce diagnostic error in the identification of speech sound disorders in this population, reducing health disparities for Latino children.