An associate professor at the University of Arizona has received a $2.5 million federal grant for research involving an issue that is critical in Arizona and other states with large Hispanic populations: the diagnosis and misdiagnosis of speech sound disorders in bilingual Latino children.
Latino children make up 25 percent of elementary school students in the U.S., a figure that is expected to rise to 30 percent by 2030, according to the National Center for Education Statistics. Yet when it comes to diagnosing speech sound disorders in bilingual children, 40 percent of speech-language pathologists say they are more likely to avoid diagnosing a communication disorder due to their own lack of knowledge.
It's a problem Leah Fabiano-Smith, an associate professor in the UA Department of Speech, Language and Hearing Sciences hopes to solve by developing evidence-based diagnostic criteria for clinicians to differentiate typically developing bilingual children from bilingual children with speech sound disorders.
"School-based speech-language pathologists, or SLPs, are required to provide culturally competent services to all children, including those who speak both English and Spanish," Fabiano-Smith says. "They face a great clinical challenge: accurate identification of speech sound disorders in children who speak two languages."
While there are many standardized tests that SLPs can use for monolingual children, there is only one for bilingual children. A five-year, $2.5 million grant from the National Institute on Deafness and other Communication Disorders, part of the National Institutes of Health, will allow Fabiano-Smith to continue the research she started in 2015 to reduce health and educational disparities for bilingual children.
Fabiano-Smith is building on her earlier research, which was funded by the National Institute on Child Health and Human Development, to develop tools that SLPs need to accurately diagnose speech sound disorders in Latino children.
Fabiano-Smith and her research team partnered with Tucson's Sunnyside Unified School District, which is approximately 82 percent Latino, and are continuing their work with 3- and 4-year-olds enrolled in preschool programs. The children are recorded while being asked to identify pictures; the recordings are then analyzed to determine where the children are having problems with their speech sound production.
If a bilingual child is not producing English speech sounds exactly like their monolingual peers, they may not have a disorder. They may just need extra help with English language skills, Fabiano-Smith says.
"SLPs have some confidence when assessing bilingual children whose primary language is English, but lack confidence when assessing bilingual children whose primary language is Spanish," Fabiano-Smith says. "What helps is if you look at both the English and Spanish of Latino children together, instead of just looking at one or the other to make a diagnosis. By combining skills in both languages together, you get a much more accurate diagnosis."
The NIH grant will allow Fabiano-Smith to use the data collected in her first study to develop an evidence-based assessment procedure for identifying bilingual children with speech disorders. Her goal is to create a test for bilingual children that is both accurate and efficient.
"We are in danger of misdiagnosing a generation if this problem is not solved now," Fabiano-Smith said.
"As a land-grant institution, the University of Arizona is deeply invested in the education of people of all ages, and in ensuring that all children have the support they need to achieve their dreams," said UA President Robert C. Robbins. "The UA's status as a Hispanic-Serving Institution is driven by our commitment to the academic success of every member of our community, and Dr. Fabiano-Smith's work with bilingual children is a vital contribution to this part of our mission. I am very excited by what this grant will enable."