Guest Perspective: Bi/multilingualism in SLP practice – beyond bane or boon

Prathibha Karanth

The Com DEALL Trust

Bangalore

INDIA

 

 

Bi/multilingualism, long been viewed as being detrimental to overall language mastery (by the largely monolingual western world), is in the recent past increasingly being viewed as possibly contributing to cognitive capabilities/strength. For the practising SLP, the long held notion of the superiority of monolingualism, has resulted in a dictum that individuals with speech-language issues be encouraged to use one and only one language, irrespective of their sociolinguistic or educational background. Despite the difficulties in implementing this policy in multilingual countries like India, we have blindly mouthed this dictum without consideration of whether this is practical or practised at all, when advised (see Karanth, P. 2000). Further, despite the growing scientific evidence for the possibilities of bi/multilingualism possibly enriching cognitive potentials, the spill over of the implications of this changing position, to clinical practise is yet to happen.

 

Neither position, however addresses the practical complexities from the viewpoint of the child/individual with a communication disorder or from the point of SLP practice and needs. A realistic exploration of the complexities of this issue from the point of view of those with communication disorders, their particular language background and the nature of the disorder;  by SLPs, exploring both the positive and negative aspects, is more likely to maximize benefits for our clientele.

 

Let’s for example explore the one language rule advocated for children with developmental language disorders. Who is this constraint really suited for – the hearing impaired whose primary issue is processing language through the auditory/phonological mode and for whom having to learn more than one phonological system might make it particularly difficult or for all children with developmental language disorders irrespective of the nature of the disorder. Additionally where is the evidence either for the feasibility or outcome of implementing this rule,  particularly given the very complex nature of language exposure in the natural surroundings of the children growing up in multilingual societies. For instance it is quite common in India to have couples who converse in English most of the time, but whose ‘mother tongues’ are different (say  Malayalam and Punjabi, which belong to two different language groups) living in a city where a fourth language, often the state language is spoken widely (including domestic help and child care givers), compounded further by the fact that the maternal and paternal grandparents whose primary mode of communication is one of the two ‘mother tongues’ referred to earlier; are the primary caregivers, alternately for extended periods of time. The choice of language when restricted to one, in these instances, often ends up being English, given that in our upwardly mobile society the mastery of English is seen as being a core essential. In the case of adults with communication disorders like aphasia, on the other hand the choice is often restricted to or influenced by the language that is most likely to enable the individual to continue with his work.

 

While the  socio–linguistic factors described above have been the primary factors that have compounded the issue of restriction on the number of languages that the child with a communication disorder is exposed to; the choice of language for therapy is often over ridden by the social aspirations of the family. In contrast the disability or disorder specific factors that also need to be considered in selecting the language/s for therapy have seldom been considered in SLP practise. For instance should the choice of language for a child with SLI be influenced by the fact that the language is not a highly inflected language and would be relatively easier for the child, or a more transparent orthography such as a syllabary be recommended for a dyslexic child with auditory processing difficulties as against a visually simpler alphabetic writing system for a child/adult with visual processing issues (see Karanth, 2003).

 

Finally, should not educational policies concerning how many languages and writing systems a child should  be required to learn in school and when and how these are introduced and taught in school, be influenced by SLPs ?

 

 

Reference:

Karanth P.   2000. “Thou shalt speak one and only one language…” In ASHA KIRAN the newsletter of the Asian-Indian caucus of the American Speech-Language and Hearing Association

Karanth. P. 2003. Cross-Linguistic Study of Acquired Reading Disorders: Implications for Reading Models, Disorders, Acquisition and Teaching. Kluwer Academic: New York.

 

SLTs support Samoa measles outbreak emergency response

In December 2019, a deadly measles outbreak on the Pacific island of Samoa spread rapidly, mainly affecting babies and young children. British doctors, nurses and physiotherapists from the UK Emergency Medical Team (UKEMT), trained by UK-Med and Humanity & Inclusion (HI), travelled to Samoa to work with the Australian Medical Assistance Team (AUSMAT) to support the response.

It became apparent very rapidly that many children with oral, pharyngeal and oesophageal lesions caused by the virus were experiencing difficulties with eating and drinking. After children were stabilised and their emergency non-oral feeding methods removed, many were averse to returning to oral feeding, and babies struggled to return to breastfeeding, due to pain and scarring on their lips and in their mouths. Maintaining an oral hygiene routine with children was also challenging, putting them at further risk of infection.
In response to these challenges, HI sought the advice of SLTs to offer support to the medical team on the ground. Through networks including the RCSLT CEN Communication Therapy International, two therapists with international dysphagia expertise were identified by HI to offer voluntary remote support: Louise Edwards, who provided pre-deployment training; and Helen Barrett who coordinated an advisory group to respond to the challenges on the ground in Samoa. The advisory group consisted of six experts with experience working internationally (including in Samoa) and in humanitarian contexts, and they together produced guidance for the team in Samoa, in response to their priority challenges.
583 patients were cared for by the combined medical teams during the UK deployment and the remote SLT support was very well received. The value of SLT support in outbreak responses such as this has been recognised and the teams are currently reflecting upon the Samoa experience to ensure maximum preparedness for any future outbreak responses resulting in feeding difficulties.
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With thanks to Pete Skelton at HI and the dysphagia advisory group: Helen Barrett (Coordinator: UK/Malaysia); Louise Edwards (UK); Mershen Pillay (South Africa); Georgina Feint (UK); Emma Shah (UK); Hannah Poynter (UK) and for the support of Julie Marshall (Chair, CTI).

This article was first published in RCSLT Bulletin in April 2020 and has been reproduced with the kind permission of RCSLT.

CTI CEN Study Day 2020

Our next study day “Confidently Competent, 6 steps to working well in low and middle income countries” will take place on Saturday February 29th 2020 in Manchester Metropolitan University.

The day is our annual study day and AGM – an opportunity to network with those who have worked or are thinking of working in low & middle income countries. We are basing this year’s study day on the theme of our new competencies framework for working in LMICs.

To book, please follow the link to our eventbrite site.

A number of £20 bursaries are available for students/unwaged as a contribution to registration fee/travel expenses – please email ctimembership@gmail.com with a paragraph to say why you will benefit from a bursary. Applications must be received by Friday 21st February.