Session 3 | Bridging Voices: Multilingual, Multimodal Best Practices

Hello, everyone.

Welcome and thank you for joining us this evening. Bienvenidos y gracias por acompañarnos esta tarde. My name is Karin Hartunian-Koukean, and I will be your moderator this evening. I am a bilingual SLP with a passion for telepractice across the lifespan, as well as a professional development enthusiast. As the current CE content consultant here at Parallel, I'm especially excited to present the 3rd and final session in our spring series in partnership with Hispanic Caucus, Bridging Voices: Building Comunidad in Multilingual Practice. Thank you for spending the next hour with us. At Parallel, we take pride in nurturing our professional community as well as the broader community by offering innovative, high-quality programming for clinicians and educators alike. Rooted in the Hispanic Caucus's mission, this series emphasizes bridging languages, systems, and professional roles to promote equity, foster collaboration, and strengthen comunidad through reflective and equitable practice. Here's a few housekeeping items to highlight before we begin our presentation. This course is being offered for 0.1 ASHA CEUs and 1 NASP approved CPD credit. If you wish to have us report CEUs to ASHA and/or receive a certificate of completion to obtain a record for your NASP CPD, please be sure to do the following: attend the entire live webinar. Your attendance will be tracked through Zoom reports and no partial credit will be given. Be sure to have joined us through the email address attached to your registration. Complete and submit a self-assessment evaluation within 3 business days of today's presentation. That will be Wednesday, May 20th. Please note you will receive this email with the survey and resources by the end of the day tomorrow. If you have not received an email by Monday, please feel free to reach out. For ASHA CEUs, be sure to indicate you want to receive them by by providing your ASHA ID number in addition to your name and email address, and this is all in the post-webinar survey. We love and encourage questions from our participants. If you have any questions at all, please feel free to drop them in the Q&A. Our chat is closed, but you can feel free to comment in the Q&A as well. We expect our educational content to last exactly an hour or so. and would love for you to stay for the Q&A afterwards. All right. And now it is my pleasure to join me in welcoming Leslie Guzmán from Hispanic Caucus, who will speak about their mission, introduce our speakers, and begin our presentation.

Thank you, Corrine, and welcome everyone to session 3 of our learning series presented in partnership with Parallel Learning: Multilingual, Multimodal Best Practices. I'm Leslie Guzmán, here on behalf of the Hispanic Caucus. Before we begin tonight, we want to take a moment to share who we are. We are the Hispanic Caucus for ASHA, a diverse comunidad of professionals, students, and advocates committed to representation, connection, and better support for the multilingual and multicultural communities we serve. Our roots and stories span across Latin America and the Spanish-speaking world, and our mission is to increase resources research, and Spanish-speaking professionals in our field so our communities can feel seen, heard, and supported. Tonight we'll be focusing on how we can better support multilingual, multimodal learners through equitable assessment, family-centered care, and communication supports that honor the full way students access language. Our invitation today is to gently ask yourself: What is one thing I will change tomorrow so my students and clients can access language more fully? That reflection is really at the heart of this conversation. We are so grateful to be in partnership with Parallel Learning for this series and grateful that you are here with us today. If you would like to stay connected, you can scan the QR code on the screen. You can email us, visit our website, or check out our Instagram. Before we continue, just a couple dates that I hope you can save on your calendar for the Hispanic Caucus events. On May 26th at 1:00 PM Eastern time, we'll have our next cafecito where we will discuss everything about working in the hospital setting and pediatric feeding disorders. And on May 28th at 7:00 PM Eastern time, we'll have our first UniCafe for students, a really good place for students to connect, get to know one another, and seek more resources. Now, it is my honor to also be one of your presenters today. Again, I'm Leslie Guzmán, bilingual SLP. I am also a listening and spoken language specialist. My work in pediatric hearing loss, cochlear implant care, and craniofacial practice has really shaped how I think about language access, family partnership, and culturally responsive care. I was raised in the borderland of Ciudad Juárez, Chihuahua, and El Paso, Texas. as an English language learner. Growing up, I had to learn how to navigate between 2 countries, 2 languages, and 2 different cultures. And that lived experience deeply shaped how I see and treat children and their families today, as well as my perception of the systems I work in. Here are my disclosures. And then Cecilia.

Hello, everyone. My name is Cecilia Jimenez. Like Leslie, I am on the board of the Hispanic Caucus as well. I am also a bilingual SLP, although my journey is a little bit different than Leslie's. I was raised in Querétaro, Mexico for all of my elementary school years, and then I moved back to Cincinnati, Ohio where I was born. I am also a pediatric hospital-based SLP. I am a clinical specialist in culturally responsive care, meaning I provide a lot of education not only to our PT, OT, and speech therapists, but as well as the hospital community at large in providing culturally responsive care across our hospital. I also am a specialist in alternative and augmentative communication. I really love working with kids who have more complex communication needs, and I lead our team in those assessments and dynamics. So those culturally responsive care and AAC are my 2 big areas that bring me a lot of joy. And here are my disclosures, and then I will turn it over to Patricia.

Hi, I am Patty Jimenez. I was born and raised in Lima, Peru. I moved to the States in 1979, more than 40 years ago.

I was 13.

English language learner myself. I have a master's in school psychology, working currently for Cincinnati Public Schools as an ESL support specialist, and I work with multidisciplinary teams. Across the district, and you will see my credential disclosures.

All right, so for the learning objectives, I'm going to kind of jump in and do them a little bit more quickly, and we'll talk through the agenda a little bit more. But really what we want to focus in on is that family-centered care, right? How do we apply at least 2 family-centered strategies to affirm and provide culturally responsive care? We became a little bit more specific, but then also looking at our other 2 learning objectives, we're going to identify 3 evidence-based strategies to identify a language difference versus a language disorder. I'm hoping if you're here you have a little bit of an idea of what that difference might be, but we will go into that a little bit more in depth, and we will design— you'll be able to design at least one multimodal or culturally linguistically responsive intervention plan as you are thinking about how you're best going to serve these patients or these students. And so for today's agenda, we're going to talk about multilingual and multimodal communication, again going back to that difference versus disorder conversation, talk about collaborative and culturally responsive assessment and intervention, and in that part of that collaboration, really focus in on those family-centered strategies to help support our students and give them the best outcomes that they can get. Okay, so this is our first, um, poll that we have in the chat. So it says, which statement best reflects your current assessment practice with multilingual/multimodal learners? That should be popping up on your screen soon, and I would ask you to pick one of those choices. So A is, I primarily rely on standardized testing. B, I use standardized testing plus caregiver interview. C, I regularly use language sampling or dynamic assessment. And D, I use fully multimodal team-based culturally responsive approaches. So we'll give you guys a minute to do that. Okay, it looks like a lot of you are already doing a lot of the things that we are going to talk about, which is great. I see about 44% of you are using a fully multimodal team-based approach, and 34% of you are already using language sampling or dynamic assessment, which is amazing. So this is great. Sounds like we have some background here, and we'll get to talk a little bit more in depth about how we can make that practice even better. Okay, I will turn it over to Patty to talk about family-centered interviewing.

Alrighty, so as I said, I work for Cincinnati Public Schools. When we are talking about family-centered interviewing, we always have to put the family, the student, the parents first. They are the ones that know the kid the best. They can share their concerns, their strengths, what they're working on. It is extremely important that we do thorough parent interviews to learn about the language history, their schooling, the communication. When we're talking about school-based, if you're doing an evaluation for a kid, learning about medical history, it is very— health history as well. Milestones, that type of thing. It is important when we're talking to the families that we meet them where they are. It has been my experience with Cincinnati Public Schools, we have a lot of families from Guatemala that the parents never went to school, so we have to make sure that we explain and ask things in the ways that parents are going to understand and find the best way to communicate with the parents. Next. When we're talking doing school psychology assessments, first of all, it is important that if you're going to test a kid for special ed services, we rule out language because we don't want to penalize a kid because he's learning English. So when we do the testing, even though we use reference norm testing, we also have to do comparisons with similar peers. For example, if you're talking a kid that is having issues with language, we're not gonna compare them with only English-speaking students. We're going to compare them with kids with a similar background culturally, same background, they've been in the States for the same amount of time. So that is very important that we're using those metrics because we do not want to punish a kid who's learning English. There are many good psychological norm lessons. One of my favorites is the Woodcock-Munoz Language Service. It is available in Spanish and English, so you can compare the language. The BASC, the Wechsler test, intelligence testing, also, if that is not available to you. It is very important to use a nonverbal IQ test. The Vanderbilt for ADHD, that's available in Spanish. The Adaptive Behavior Scales. Are also available in Spanish. It is crucial that we use these assessments when we're talking about English language learners because, like I always tell a lot of my teachers, if you go to China and I give you an IQ test in Chinese, you're gonna fail that test. So we have to meet our students where they are. As far as working in with interpreters, There's a lot of lingo that we use in education, ETR, IEPs, norms, adaptive skills, you know, expressive language. It is important that even though we have to use all the technical terms, we are able to explain these things in a parent-friendly way. When you're using an interpreter, always talk to the child or the parent, not the interpreter. Having visual supports is extremely helpful. One thing I like to use when we're going over an evaluation is to use the bell curve because it gives a great visual to the families to see where their kids are falling. Before you have the meeting, talk to your interpreters so they know what to expect. They learn the lingo and explain to interpreters. And the main thing for me is being extremely parent-friendly. Next slide. As far as the service provider, we are the frontline. We are the first people that are talking to the parents about the needs, so we have to show a lot of compassion and find the best way to communicate with the family. A lot of times we send written forms, and it's always good to have an interpreter because parents might not be able to read. Also, it is extremely important to tell the parents that always keep the home language, because when the home language gets better, their English is eventually going to follow along. And yes, using similar peers as, as norms as well.

So this is Cecilia jumping back in. It sounds like a lot of us are already talking about providing culturally responsive care, using our dynamic assessment, all of those things, etc. But I also really wanted— one of the things that we at this, as the Hispanic Caucus, focus in a lot is cultural humility, um, and not just cultural responsiveness, right? So cultural humility is the ongoing self-reflection and the lifelong learning, um, that we use When we're providing culturally responsive care. And this is something that we as clinicians should be doing every day. I still do it every day, right? I can be part of what I think is a similar Latinx, Latinx background with a family that I'm working with, but I don't know all the ins and outs of their culture because I might not be from the same country, or I also just don't live in their house, right? There is little— every familial culture is slightly different, right? So that's really important when we're thinking about that. Always keep an open mind and that ongoing self-reflection. To ask what that communication looks like for this family, for this child, for the student across all of their communicative environments in the community, in the school, at home, and always be mindful of your own assumptions. My coworkers will always make fun of me because they always hear me asking. Now they all know the question in Spanish, right? Like, ¿Cómo ustedes cómo dicen blank? How do you all say? And normally the word is like socks. Which, because every Latin American country has its own word for socks, and straw, because very similarly, um, every Latin American country has its own word for straw. And I also want to make sure that I'm using the words that the kids are going to hear at home, right? I might say popote because I grew up in Mexico and that's the word for straw in Mexico, but not all my kids know what that means. So I always ask. And noticing your own assumptions, um, And being able to ask those questions is also really helpful. And when you have those conversations in an open-ended, just honest way with families, it really does go a long way to establish better rapport and reduce kind of those power dynamics. I always kind of make it a joke and I'm like, I'm gonna ask because I never wanna say the wrong thing to your child. How do you say blank? And just the smile I see on parents' faces and the buy-in I get from that simple question is really meaningful.

Thank you, Cecilia. And so the big takeaway that we want everybody to leave here with today and to hopefully pass on to anybody that you meet is that the access to language is really a human right. And so we want to ensure that we learn and we ask how a child makes meaning across different contexts, because When we do that, we're more likely to build the supports that prevent language deprivation rather than unintentionally contributing to it. Language deprivation is a term mostly heard within the deaf and hard of hearing community, and it is a phenomenon where deaf children grow up without quality exposure to any fully accessible language. If you have the time, scan the QR code on the screen and you will watch a 2-minute video that explains this topic in further detail. Another thing that is so important to discuss is that spoken language, it's not a gold standard. Yes, it is an important pathway and one of the main pathways that we all use to communicate. However, it is not the only meaningful outcome, and our job is to not privilege one communication modality from another. So our job is to support the access, participation, Connection and authentic expression. I saw that somebody in the chat just asked what gatekeeping means, and in my perspective, that means that myself as a provider, as a professional in this position, I know what the child may need. However, I may withhold giving them an AAC device or doing an evaluation because it may require additional paperwork or time consumption. And so that's kind of what we mean by we say gatekeeping some of that information or not sharing that to families that spoken language is not the gold standard, and that there are many other ways for the child to communicate that are equally meaningful. And so what counts as language? Language can show up through speech, sign language, AAC, gestures, writing, drawing, and translanguaging. We use all of those modalities on a day-to-day basis, right? We text each other, we send emojis, we make meaning off of different ways to communicate. However, when our children are trying to do the same thing, we want to revert back to that spoken language output. And so this is the, the type of mind shifting that we're trying to build today.

All right, so I'm going to jump back in here a little bit to talk about translanguaging. It is a newer concept that's coming out in the literature within the past couple of years. It's a little bit different than what we think about as code-switching. I think a lot of us are already familiar with the general idea of code-switching where, you know, you mix the 2 languages in one sentence. We're like, yo quiero Coke, I want a Coke, or yo quiero Coca-Cola, right? Cool, easy. 2 languages in the same sentence, code-switching, great. Translanguaging, it's a little different. Um, it's where we look at not the 2 systems, 2 separate systems being combined into one sentence, but it's rather one, a multilingual learner, so an ESL student, a bilingual student, whoever it might be, uses the full linguistic repertoire including all their modalities, if it's a child who is deaf or is a child who is a device user, to functionally communicate and strategically learn new things. So for example, instead of just taking that original sentence of like, I Yo quiero algo. What was it? Yo quiero Coke, right? I want Coke, right? Just as two separate things. We're looking at, oh well, maybe they said Coke because they've heard that context more in school. Or looking at, for example, I'm trying to think of another example of like, I'm hungry, or like tengo hambre, I'm hangry, right? We all know what hangry is because we understand that in English, but there's not really a word like that in Spanish. So they are trying to get that point across, but they don't have that word in Spanish, so they fill it in in English. So like I said, they— translanguaging is a more, um, modern kind of up-and-coming literature topic, which has been very interesting. But like I said, it includes all the modalities visuals, as Leslie had said, even like emojis and GIFs and all of that when we're writing. And if we look at it in that way, we see a lot more linguistic flexibility rather than starting trying to think of, here's language A, here's language B, here's how they're separated, here's how they're combining them. It's about the whole feature and how that child is communicating most effectively rather than trying to separate them out into A and B. All right, Leslie, next slide. So now here's the big one, difference versus disorder. It sounds like a lot of people are already familiar with it, um, which is lovely. What we know, right, as Patti said earlier, we cannot punish a child by only testing them in English. I always really like her example of what if I dropped you in a foreign country that you didn't know and then you had to be tested in the language you've never been exposed to. Right? We would all be, you know, poor— oh, we would all be qualified for services that we don't necessarily need, right? Um, so when we are doing assessments, we should include all of the child's languages and all of their modalities if that applies to them, um, to provide the best picture of the child's full linguistic abilities and communication abilities. Also be aware Uh, Leslie, sorry, if you wouldn't mind going back one slide. Um, anything that is considered non-standard is not necessarily an impairment. There are well-documented patterns of, for example, African American Vernacular English, Spanish-accented English, in both language and speech, um, that we should not penalize students for. And there are plenty of wonderful resources that go through all of those examples as well. All right, next slide.

Thanks, Leslie.

So it's hard, right?

It—

we are pushed and pushed and pushed to do turn-through evaluations, get things done, meet those productivity requirements, all those things, right?

It's a—

it's very easy to fall into that pitfall of, I'm just gonna give the CASLL or the PLS-5 bilingual, that kind of thing, and there we go, we're good. But we also, if we do that we are not reflecting the full bilingual experience. And the— even if we report like, yes, modified— the standardized scores are not being reported because the child is multilingual, um, which is something that we should all be doing if we're using a standardized assessment that is not normed on a child with that language background. So for example, using the GIFTA English on a bilingual child I wouldn't report those standardized scores. Even if we do that, um, it still doesn't give you that full context, right? To keep using the gifted example, maybe they're highly unintelligible in English, but did we look at how intelligible they are in Spanish? If we didn't, we don't have the full picture of their linguistic and communication abilities. Okay, so what do we do? A lot of the things I think we've already been talking about. Reaching out to caregivers and parents and teachers, seeing how they communicate, seeing what those people who are around the child most often are noticing as the barriers to their communication or their access to education. Likewise, you going yourself, if you are able to, into the environments to observe them in the school setting. A lot of times I will ask parents to send me videos to see what they are seeing at home, I'm just like, send me a video of your— of the so-and-so playing with their older sister, right? I just want to see what it looks like. We will go a little bit more into language samples and dynamic assessment, but these are 2 great tools to use with bilingual learners, English language learners, whatever word you want to use, because they help us take off the standardized assessment hat and see how can the child learn and what is the child currently doing. And if I teach them something new in a way that makes sense to them, where can they go, right? Kind of starts guiding your intervention plan a little bit by doing a little bit of intervention during the assessment piece. Like I said earlier, use those standardized assessments with caution. Even if they are normed on bilingual students, some of them are also not always the most accurate. Bear that in mind as you work through your assessments.

Thank you, Cecilia. So now we'll talk a little bit more about dynamic assessments for multilingual learners. Oftentimes when we talk about this topic, it is included within a list of other assessments to use, so, and, but we are not ever really deep diving into this topic. So one thing that I would like for everybody to do is to scan the QR code on the screen. It'll take you to ASHA's dynamic assessment lesson. It is actually divided into 4 different modules, and it is presented by Dr. Elizabeth Peña. Today you will see an overview, and you will receive materials that are going to— that you can apply tomorrow if you need to. But this is just a really good tool so that you can deep dive if you have any further questions. So let's answer the next poll question. When you hear dynamic assessment for multilingual and multimodal learners, Which description best matches your current practice? A, I mostly use static tests. I rarely or never use dynamic assessments. B, I occasionally try mediated learning or test-teach-retest, but without a clear protocol. C, I regularly use structured dynamic assessment with modifiability ratings. Or D, I consistently integrate dynamic assessment and see it as essential for distinguishing Difference versus disorder? As you're answering the question, I want this to be more of a self-reflection and not to really judge what you've been doing. Again, you will receive a lot of tools today that hopefully you can apply as soon as we, we finish today's conversation. All right, let's see the results. Awesome! A little bit less than the initial poll, but still pretty, pretty good. About 38% of you responded to D, and then the next largest one was B, which at 27%. So a lot of you do understand these tools and are using some of them. Thank you for answering that question. So moving beyond the static scores, static scores tells us what happened on one task, one day, and oftentimes with a new person, which is us, right? They've probably never met us before and we're trying to get this information from the child. With dynamic assessment, you have a bigger, much more clinically useful question, which is what happens when we teach, scaffold, and support the student? This matters because standardized tests alone can both over-identify and under-identify multilingual learners, especially when those tools are translated, adapted, or used outside the populations they were designed for. So with dynamic assessment, we can reduce some of that bias because we're thinking about other factors such as modifiability rather than unfamiliar test performance. So now our child— the question is not, did the child get the questions right or wrong? The question becomes, what happens after we have already had the opportunity to teach the child. So let's talk about the test, teach, retest portion of it. So first, we're gonna probe with the skill. That specific skill has to be something you already know the child is having difficulty with. You may get that through an IEP. You could get that through the teacher interview, through the parent interview. You can get that from a previous report from an SLP, or you can get it from the test that you've already done. It is time-consuming, but then you have to have your pretest and a comparable posttest for— in order for you to complete the dynamic assessment. And so when we provide that teaching, that mediated learning experience, we want to then see some change. When students improve with relatively small amounts of support, then that often points us towards a disorder— a difference rather than a disorder. So during the teach phase, we're gonna be extremely intentional. For that intentionality, I might tell the student, okay, so today we're gonna be working on following 3-step commands. I clearly state the goal of what we're doing together. For meaning, I'm gonna explain why this matters. And so we're gonna say something like, this helps you, this is gonna help you complete your classroom assignments. For transcendence, I wanna connect that to real life. So then I could tell the student, you know, if you miss part of that direction, you may not get your work finished on time. And then for the application piece, now this is the opportunity for us to model and practice with the student. And then for competence, we're gonna check whether they can explain what they have learned and then where they can use it next. Just quickly to mention some of this, I recently attended ACPA and they did a study where they talked to students and they asked what the students thought about speech therapy. And a lot of the students say that they couldn't understand the why, because they would go to their lessons and then they would be told what to do, what to say. However, the why portion was oftentimes left out. So with mediated learning, this is already letting you know that you're the why is not just for you, it is for the student to understand fully. We have to keep in mind the prompting hierarchy because it's going to help us not just to document whether the child got it right or wrong, but how much help did they need. And then for the modifiability portion, this is really the child's responsiveness to our teaching efforts. So this is more how does the child respond to Our teaching. So this QR code will take you to Dr. Peña's Module 3 on modifiability. And so she suggests that we take certain behaviors like those in social and emotional, you see on your screen anxiety, motivation, and that correlates to the chart over here. Then you have the opportunity to rate on a scale of 1 to 5 where the child falls into those particular categories. The reason we're trying to do this is we're trying to figure out what are some other external factors that could be in play as a child is doing this mediated learning. Some of the considerations you can take in mind is how comfortable was the child during the experience, how enthusiastic were they about the task, and were they determined to continue participating even though This was a difficult task. And so after today's lesson, you're going to receive these adapted rating scales, both for the social-emotional piece and also for the cognitive portion. And so when we're thinking about the cognitive side of modifiability, now we're looking at asking different questions such as, does a child understand the task? Do they notice when something isn't working? Can they problem solve, or can they shift or start to use the strategies that we just taught them during that mediated learning experience? Again, after this presentation, you will get these charts so you can apply those to your next assessment. And then this is just another list of a lot of examples of what are the things that you could assess dynamically. So from concepts and directions to answering questions, sentence repetitions, formulations, and also narrative macrostructure. I feel very privileged to have had my CF experience with Dr. Carol Westby, and she has paved the path towards us really understanding and using narrative assessments. So I also created a handout where you— there's a list of different narrative assessments that are available to all of us and that we can choose from and then decide side to use that as part of our assessment process. You're also going to receive yet another handout after the presentation that is going to list all of those assessments that we have available that are normed on bilingual or Spanish-speaking students, okay? And then just a reminder to make sure that we pair all of the assessments that we do with dynamic assessment and language sampling, which leads us to our next topic.

All right, yes, language sampling. I feel like when I was in grad school, that was the thing that everyone was like, you're gonna do language sampling all the time because it's so helpful and it tells you so much about the student. And then you get into the real world and you're like, when am I gonna find time to do a language sample, right? So that leads us into the poll of how often do we actually collect and analyze language samples across languages and modalities, if it applies to your students, for an evaluation? So, A, only when required or when tests are inconclusive. B, I occasionally try mediated learning or test-teacher-retest but without a clear protocol. C, for many multilingual or deaf/hard of hearing AAC users but not consistently. Or D, it is a routine part of almost every evaluation I do. I will give you all a minute or so to think about it as well. I know if I'm being honest with myself, um, a full language sample for some of my kids who are a little bit more complex communicators is not something I always do, so it's always something that we can all strive to be better at doing. Um, but I'm interested to hear what you all say.

Nope.

All right, everyone. Okay, so I see 46%, it is a routine part of almost every evaluation I do, and then another 20% for many multilingual or multimodality learners but not consistently, right? It is hard. It is a lot of work. But it is important. So we will move on to our next slide. We know why it matters. We heard about this a lot in grad school, but just to reaffirm the point, it captures the language in its natural context. How is a child communicating? There is no better way to get a picture of how the child is communicating than sitting there and communicating with the child, right? Because sitting there and pointing out vocabulary tests like, oh, which one of these 4 pictures is the dog, right? That might have some— that gives us an idea, but it doesn't show us if they can functionally use that idea to label the dog or talk about a dog or talk about their experiences. The other big part of why we use language sampling is because it can be collected across languages and across modalities, right? You can get a language sample in English, you can get a language sample in Spanish, or whatever other languages being spoken in the home and be able to compare and contrast the two. It also really helps you identify those treatment targets. Yes, the child might have a great vocabulary, but if the child is not able to use that vocabulary functionally to say, I'm hungry, I'm thirsty, I'm upset, I need a break, right? They might be able to identify all those things, but if they're not using them functionally, as we can see from a language sample, that's where you know where to start and start identifying those treatment areas. Um, and like I said, again, just to beat the, uh, hammer home again, it supports more equitable assessment for multilingual learners because it shows the grammar, the vocabulary, the MLU, all those things that we were taught about language sampling. But on a larger level, with the macrostructure, it shows us higher-level skills such as inferencing, story grammar, links, um, theory of mind as well. It helps us again, as I have said probably 4 times already, show us how the child functionally communicates across their contexts and the ways that they need to communicate. And it shows us where we can keep going and where is the breakdown happening and what specifically we can use in our treatment areas to help that breakdown no longer happen in our intervention. All right, Leslie, next slide. So choosing an elicitation task can be hard. I do like this chart a lot. It kind of talks through the recommended language samples by age. In early childhood, preschool, playing with toys is great because that is what they are doing, right? As we start to move into early elementary Pre- and elementary school years, having conversations about what they like to do. Tell me about what you did at recess today, or, oh, what'd you have for lunch? That kind of thing. Starting to also introduce the story reteller, story generation. I really like wordless picture books. Um, I still have my chalk book from when I was in grad school, and I got another one recently, um, just to, you know, I also make it fun, right? Oh my gosh, this book has no words in it. We're gonna tell the story together, right? That will pretty much— any child is like, whoa, a book without words? That's crazy. So it's a good way to do that as well. As we get into our older elementary, middle school, adolescent age, we should really start looking at again those higher level skills, that expository language Can I explain something, or can I persuade someone to, um, on an opinion or whatever they might do, right? Because those are things that they are asked to do in middle school and high school. All right, next slide. So why it matters, we, we already kind of talked through what is all the data that we can collect. We can get the MLU, we can get the number of words, the, um, their general idea of what their vocabulary looks like. We see if there are grammatical or morphosyntactic errors, and then you can kind of compare. If we're seeing morphosyntactic errors in, in English but not in the home language, that tells me, that starts calling me in, maybe they need a little bit more ELL support, right, English language learner support, versus if we're seeing grammatical and syntactic errors in both languages, that tells me, oh yes, there is a true underlying language learning disorder that the child needs support in order to be able to functionally communicate in both of their languages. As we know, we aim for about 50 utterances for broad measures whenever possible. Longer samples may be needed for older students who need to work on more persuasive or narrative-based assessments and those skills, but the task should be comparable in the pre- and the post-test, right? So if I'm doing a wordless picture book, um, for an elementary school child when I'm initially testing them, if I'm going to reevaluate and do a progress summary and see where they are, I would do a similar assessment of, um, another wordless picture book. I don't tend to like to use the same one because then I have kids who remember the book and they're like, Oh yeah, we talked about the dinosaur for however long, but something comparable. SLAM cards, which are available online for free, and we'll put it in our resources, is great because they have a lot of like 6-picture scenes that are word lists that you can kind of use to elicit that narrative-based sample as well. And you can use one in the beginning, one for progress, and one at the end, which is great. And I'll let Leslie talk about the technology because she is much more technologically savvy than I am when it comes to language sample analysis.

Thank you, Cecilia. And yeah, we totally get it. It was so cool to see that about 50% of you are doing language sampling, and that is actually very comparable to what the data shows. The thing is that 50% are not doing language sampling as well, so we have to think about both sides. And One of the main reasons why people choose not to even collect language samples is because it's so time-consuming. Not only are you trying to find, like Cecilia mentioned, you have to find the best way to gather the sample, but guess what? Now I have to transcribe it, then I have to analyze it, then I have to write it up in the report, and then I have to present that report to the family and the teachers and everybody else. However, we now have a lot of tools that can help reduce some of that burden from the time. And so all of those include CLAN, SALT, ELSA, and SUGAR. And so today you will, after today's presentation, you will receive another handout that has all of these tools listed. It'll list what the tool can do for you as a clinician, and then it'll have whether the tool is accessible free or do you have to pay for it, and then a link for each tool. I recently took course where they talked a lot about ELSA, and it seems extremely promising. It can gather, even if the child is using multiple languages within the sample, it'll take that information and it'll decode what was in English, what was in Spanish, and give you the results at the very end. With that in mind, we have to keep in mind that there is no software that can ever replace our clinical reasoning. And so because of that, A, our job is secured, but also it means that we have to make sure that we look at the sample after it's been transcribed and at the results and make sure that everything is correct and it adds up to what we saw in our sessions. You're also going to receive another handout, like Cecilia said, that will have— it's going to be your language sampling toolbox. It's going to have the tools that Cecilia brought up today along with some additional tools that you can use when you're gathering a language sample, whether it's narrative, conversation, or play-based. Another caution that we want you all to consider is that there is no one universal language sampling protocol that works for every child, and the results of that language sample are going to shift depending on the task, the context, and the measures that you choose. So language samples should always sit inside a broader, more comprehensive assessment process. All of these research articles are amazing, and I encourage you to look for them. They're all available through ASHA. In the event that you have a hard time finding them, reach out to us and we will send those directly to you. But what evidence shows is that across different populations, the first one talks about deaf and hard of hearing children, the second one talks about bilingual students, and the third one about AAC users. It all points in the same direction, that language samples often reveal clinically important patterns that formal testing is missing. And so they're especially valuable when we want to understand that real-world language use, competence, and the supports needed by the child so they can continue to thrive. And then we have this chart over here that I hope that it's more practical to you. It lists the different populations, and so of course we have multilingual learners, we have deaf and hard of hearing students, AAC users, and then complex— children with complex speech disorders, including those children with apraxia of speech or any motor speech disorder. I work very closely with children who have velopharyngeal dysfunction, and so whenever we're assessing someone with any of these differences, we want to take a look at what those main concerns can be, but then also what are those additional testing tools that we want to use in our language within our dynamic assessment.

And to piggyback a little bit more specifically from what Leslie was talking about with the AAC users, because they are my favorite people to talk about, we're going to talk very briefly about Supporting bilingual AAC users in both of their languaging, in both of their languages, kind of going back to that, um, translanguaging model. Generally, I think if you're here, you know this already, the student should have access to both of their languages on their device. That is really important so that they can access and say things that they want to say across both of their languages. It's also really fun just to kind of see them work around sentences. Be very mindful, and I would say this about any AAC user when you're using a language sampling method with them, of operational versus linguistic skills, right? I've had eye gaze users who are linguistically very strong and have actually very few linguistic deficits and are demonstrating to me age-appropriate receptive skills, but because they are still learning to navigate, where do I find this button on this device, or I don't know how to use the word finder feature. Those are all those kind of operational skills of how do I operate my AAC device. Being mindful when you're doing that language sample that you're teasing that apart of, yes, I am seen in this other way, that the linguistic skill is there, the child is able to follow directions within their motor capacity, and they are able to identify things, um, without their device in a certain way. They might just still need additional support in that operational feature of like, how do I use the word finder if I can't— if I don't know where the word is? How are these categories in my device— how are these words in my device categorized, right? So it's just something to be aware of. And, um, you can kind of take a look at that, of you kind of see it in their faces, right? If they're frustrated, they know what they want to say, um, but it's just taking them a little bit more time versus if they're frustrated because the communication breakdown is there. A lot of times you can see a slight difference even in just how they're asking for support and where that might go. So jumping back to bilingual AAC specifically, it should focus on linguistic accessibility for highly salient topics. What are the things that the child wants to talk about? This is a complex communicator that already has a harder time than the average— than their average peer talking and communicating. Let's not make it harder by making the things they want to talk about be hidden behind 3 or 4 pages, right? There are certain programs that have better, um, comparable layouts between one language and another. There are some that don't. Right? I would start looking for those features. And, um, there's a great— I will make sure that gets linked, um, it's called a Padlet that has a lot of bilingual AAC resources across languages. It has been a lifesaver for me when I work with, um, children who have different language pairs than my own. That just kind of shows you where all these features are and how you focus in on those salient topics, right? If the child wants to talk about Whatever they want to talk about. I had a child who used a device today, you know, tell me that they want to talk about church. Cool, we'll talk about church. That's fine. Um, and as we know, this bringing it all home, how it's all related, right? Caregiver education and input is really important for every child, but especially important for AAC users because, um, at the end of the day, the child is The family also has to learn a new modality of communication, and that is really daunting for a lot of families. So making sure to provide good caregiver education, um, and involve them as much as possible in the process. I could talk about this forever, but we do not have the time, so we will move on to our next slide. Just general quick tips for bilingual students intervention best practices. I think I said saw a question about this already. The big thing that I always like to start with, and this is what I was, you know, what we're taught, is identifying the overlapping features of the grammar, of the syntax, of the morphology, of the speech sounds, and target those first. Why? Because then you are more likely to see generalization across both languages. I think the easiest example is to talk about speech sounds, and I will just use Spanish and English as the example. I'm not going to target a rolled /r/ to say carro if the child can't say their S's, right? An S is the same sound in English and Spanish. It's made in the exact same way. If the child can't say that, like for me, if I would— I wouldn't be able to say my name, Cecilia, right? If we target those things that are shared across both languages, that generalization— one, you're targeting things that are gonna improve their communication across both languages, and that generalization will then help improve that communication overall across both languages. There are— ASHA used to have a great resource on this. I'm not— I was just checking their website. I'm not sure if it's still around, but one of the— Wikipedia for me is one of the easiest places to check where that shared— those shared features are. If you just search Like, for example, Mongolian language, it gives you the grammatical structure, it gives you the phonemic chart, it gives you all the information that you need, and then you can kind of compare and contrast between that home language and, um, English. I was gonna say Spanish— English. Um, and it just really is a nice way to start looking and thinking, oh, okay, I see these languages both have subject-verb object order. Okay, let's work on that sentence and narrative structure. Great. Kind of, I talked about the top 2. First, identifying what those shared features are, then targeting them first to have that maximum impact. As Patti said earlier, encourage the family to continue speaking the home language. I, my go-to parent-friendly way to explain this is 20 years ago, we thought the 2 languages in our brains were completely different, completely distinct. What we know about bilingual brains now is that we have the underlying concepts. So I hear the word manzana and I hear the word apple, and it helps reinforce that crunchy red fruit that grows on a tree and is delicious, right? And just keeping it in that simple parent-friendly way, explaining that to them, that no, it will not confuse the child. It will only help the child, even if there is a language disorder or a language delay, really helps parents realize that they have a role in their child's communication and overall educational development as well. We talked about this earlier. It must be important if we're saying it again. Collaborate with the team. Talk to the teachers. Talk to the aides. Talk to the parents. What does the student's communication look like across environments? If they're doing really well in one area, like if they're communicating really well at home, great, that probably means their home language is great. If they are not communicating well at school, okay, that's where we kind of start teasing apart. Is it a language difference? Is it a language disorder? Do we need more ELL support? And sometimes I've had cases like this where parents think like Yeah, no, they're communicating fine at home. They're doing really well. Like, I understand everything, right? And then you sit with the child and start talking to them in Spanish, and you're like, oh, oh, your parents are very good at listening and understanding what you're saying, because even though I speak the same language, I have no idea what you're saying, right? So making sure— doing your own due clinical diligence, um, and evaluating them across all their environments, but also keeping in mind that sometimes certain team members might be a little bit more biased, especially our parents who'd be like, yep, I got it, because parents are great at knowing what their kids want, and kids are great at letting their parents just do things for them. So that is what it is, but keep all those things in mind. Okay. And then for learners, just these are kind of the things that we've already said, but we're wrapping it up with a nice little pretty bow. Continue to get— gather that language history and all those developmental milestones, an understanding of what languages and what modalities the child uses. Assess across languages. You should always assess all languages the child is exposed to. Use those interpreters or use those those cultural brokers when needed and use all that converging evidence. Use the dynamic assessment, use the parent interviewing, use the language sampling, um, all of that to get a full picture of where the child is at in terms of their communication and their overall development. And last but not least, avoid the assumption that English-only performance equals disorder. Like I said, that is the clearest way to see difference versus disorder. If a child is showing up, you know, as functionally communicating within normal limits, whatever average range, whatever you want to say, across all your other evidence tracks in the home language, but they are showing up as delayed in English, that to me says the child needs more English language learner support because they have had the ability to learn one language to be able to functionally meet their communication goals and milestones. Um, that shows if they have the ability to learn one language, they have the ability to learn the second. If we're seeing errors, functional breakdowns, um, syntactic breakdowns where in whatever domain of language or speech it might be across both other languages, to me that shows a language learning disorder. And to go back to the difference, right, never— always be mindful, and that's where your resources of looking up the, um, impacts of like what does Spanish-accented English sound like, what does AAVE English, um, sound like, what do those grammatical contexts look like. If they're following the rules of a minority language or a minority dialect, that is a difference, not a disorder, because even those dialects are rule-based and follow linguistic rules, just like what we would call quote-unquote Standard American English does as well. And those are our references. We made it right on time. I am pleasantly surprised. I really thought we were going to go over, um, but I will hand it over to Corinne.

Yeah, oh my goodness, you guys are right on the mark. We so appreciate that. Thank you for such an informative presentation. This concludes the educational portion of our webinar available for ASHA CEUs and NASP CPDs. As a reminder, you will be receiving your survey by email by the end of the day tomorrow. That will include all the resources. I know there were some questions regarding that, so both the slides and the handouts that were referenced with all those resources will be headed into your inbox by the end of the day tomorrow. If you don't receive them by Monday, please reach out. If you have any questions, there have been some excellent questions that have come in, but do put them in the Q&A. We are going To slightly pivot at this moment, we have a few more announcements about Parallel, and then we're gonna have an extended Q&A afterwards. So we hope that you will stay for that. All right, and I need to put something in the chat for everybody. So give me one second as I multitask here. All right, so we have a link here that you can use. So we do have. Sorry, I apologize. Parallel is always looking for talented providers, and if you're interested in exploring Parallel positions, we'd love to meet with you. We are hiring for 2026-27 school year. We're thrilled also to officially launch our Every Student Supported initiative, a commitment from parallel to make sure no student falls through the cracks, even when staffing and resources are stretched thin. Every week we hear from clinicians and educators who are doing heroic work but feeling stretched thin. Caseloads climbing, evaluations piling up, and districts struggling to find the specialists they need. You've probably felt this too. That's exactly the gap this initiative is built to close. Through Every Student Supported, we're committed to 3 things: giving district leaders free tools to pinpoint their support gaps, closing staffing and service gaps with our provider network, and rebuilding family trust by making support consistent and reliable. And the best part? You don't have to solve this alone. The next slide shows how you can help us get these resources into your So Loop Them In. Here's a QR code for you guys. Meet Loop, our way of connecting the dots between providers like you who see the gaps every day and the district leaders who can actually do something about them. Here's how it works. Scan the QR code on your screen, fill out a quick form with your district's contact information, and we'll connect you with a Loop Leader. leader's name and email, and Loop will generate forwardable email you can pass along to your special education director, principal, or district administrator. That email invites them to complete our District Snapshot Tool, a short diagnostic that gives our partnerships team a clear picture of where their biggest needs are so we can come to the conversation ready with a plan for the next school year. Whether your district needs direct services, speech-language pathology assessments, specially designed instruction, or behavioral mental health counseling, or just free professional development like today's session, we want to help. Take 30 seconds right now to scan the code. One referral from you could mean dozens of students getting the support They've been waiting for. All right, I will put one more link in the chat here. Thank you, everybody. And now I'm excited to transition to our Q&A. We've had some excellent questions that have come in. So let me get those queued up.

I was gonna say, I was reading them when I was like, oh, we are ready to get into some deep discussion, which I really appreciate.

Excellent. Yes, I think I'd like to start off with the one, um, that kind of will set the tone for the rest of the conversation. Um, how do you distinguish between a language difference versus a language disorder in multilingual students? I know this is probably a separate Webinar, but maybe like the, the short answer.

Um, I kind of tried to address it there towards the end, but really the big thing that I always like to reinforce for everyone on my team— I work with a lot of SLPs as well— um, difference still follows the rules of language, right? If it's a different dialect, if it is L1 influence on L2, those rules are still there and they are still rule-based and they make sense in that context when you think about why that— that's a rule that they are borrowing from their L1, from their other dialect, whatever it may be. Disorder, I always start looking back at are there functional breakdowns across both of the child's languages and we start thinking about— I always really like to think about disorder in the for multilingual kids, is it that the child has an underlying ability to learn those rules of any language? That is a language disorder versus if the child has been able to learn their L1, whatever that L1 is, um, and follow all those linguistic rules of that L1, and now they're having difficulty learning that L2, that to me shows maybe they do need a little bit more, um, English language learner support, or you need to go back and dig deeper with caregivers who knew the child, have known their child their whole life, right?

If you—

if this is a recent newcomer to the United States, or is a kindergartner who's only been exposed to the home language, and really start digging apart. Even if parents are reporting like No, they, you know, they talked on time, they made all their milestones on time. That's when there is that discrepancy, that's when you really have to go in and dig deep. And well, what, what is— is the home— is the child following the home language's linguistic rules, the grammar, the syntax, the morphology, the phonology, actually?

Or—

and then were those communicative milestones actually on time? To really tease that apart. I think that is kind of one of the trickiest cases that you see is when you have caregivers reporting, yeah, their communication is great, I understand them all, but then you start to see clinically, wait, I'm seeing these learning difficulties across both of their languages, and that's kind of when you have to dig a little bit deeper.

I think another thing too, to make it practical, is understanding that this is the reason why we do dynamic assessment, right? Because if you're able to teach a skill, the child with mediated learning, that experience is so important. If you can explain to the child and then you notice that the child understands the reason why they're being taught a certain skill, and then they understand that they can be applied to different contexts, and then with your post-test you realize, you know what, with just a little bit of support with that mediated learning, I saw that they were able to get that skill, then that right away is telling you that the child does not, is not does not have a disorder. That is more of a difference. And like Cecilia mentioned, you always keep in mind how long they have had exposure to that second language. In order for us to even do dynamic assessment for English, for example, for a child that speaks Spanish and English, they have to have the basic interpersonal communication skills, or BICS, in that L2.

Any other comments before we move on? I think this next question is really also very important and universal. There's a question about the possibility of over-identification. So we have someone who mentioned that they do early intervention assessments, and they often mention that Assessments are only a snapshot in time, and then there are, you know, parameters where the family ends up qualifying for speech therapy, but it does benefit them beyond the speech. They end up getting other services as well. And then I guess the ultimate question is, do you think this benefit outweighs the chance that the child may possibly be overidentified due to this snapshot qualification?

Yeah, no, this is the question that I saw and I was like, oh, we are ready to like get deep into this discussion because I think this is something that we do have to be very mindful of, right? When we identify a child, and I think Patty can speak to this a little bit more, right, that label will go with them for as long as they have their IEP, and that IEP is a legal document. Um, I absolutely get the— well, they're getting resources, they're getting support, that's great. That's absolutely— that's great. And I think this is where we talk about that language delay versus the language disorder. Who is a child who might eventually catch up in that early intervention window, who is considered that quote-unquote late talker, versus that kid who has that true disorder who's going to show those deficits throughout their academic career. That can be really tricky. There— I would have to go back and dig, but there is a formula that you can run for your district, that you can run for your EI population, that helps you identify is your team over-identifying or under-identifying students who are multilingual.

The percentage should be the same across, you know, all, all language learners, all backgrounds and things like that. The formula is not that complicated from what I remember for a speech-language pathologist who hates math, um, but it's a good thing to look at and run that data and see, are we over-identifying? Are we under-identifying? But I think it is a really tricky— I don't think that you can have a blanket statement of the benefits outweigh the chance or the risk of being over-identified. I think that's where having those honest and tough conversations with families is really important, and having that cultural humility, especially if they are looking like a child who, you know, might have— might age out of those supports, right? They catch up, they're Right.

Right, like, yes, I'm identifying this child now, but those supports might not always be in place. Give the parents that heads up, like, hey, we're seeing really great progress, they might not need support. 9 times out of 10, we think that's great, that's a kid off our caseload, that's a family that the child has met all their goals there, we can, you know, discharge them, say they've done a great job. But then families get scared when those supports are lost, right? So having those conversations early and often of like, your child's meeting their goals, that's great. Let's talk about what that transition looks like as well.

I think also, like, if we think about the birth through 3 population, right, which is early intervention, that's why we have an individualized family service plan because it has to be extremely team-based in order for everybody to be in agreement that the child requires those services. One thing that I do is I often Zoom into other early intervention specialist sessions. And what I notice sometimes is that what happens within the session is that the providers come into the home, they work with the child, they talk with the family to get some updates, and then they leave. And where was the next thing? Where was the plan for the next session? Where was the plan for even that week? So I think one thing in order for us to recognize, because families do become become attached to their providers and they become attached to those services at times. And sometimes they're like, we don't want to leave the caseload. But if we have these continued conversations where every week we talk about progress and we talk about where we're headed, it'll make it that much easier to ensure that the child is receiving the right supports because I would much rather have a child in EI than not in EI, right? But at the same time, understanding when that child no longer needs those individualized services.

So it's almost like you're talking out loud your SOAP notes. I kind of like view it that way.

You're kind of talking it out loud. Yes, no, exactly. You talk your SOAP note out loud and then ensuring that the family has that verbal— verbally understands and tells you that they understand what the next step is. Because at the end of the day, if we don't have this constant assessment during every session, then what are we doing? Where are we headed? We have to always ask ourselves, what is the next step in the treatment?

The other only thing that I would add to all of that, in order not to help over-identify, it is important that when we are working with kids, when we are doing dynamic assessment, look at the norms, compare them with similar cultural peers. Like a kid that is from Peru, and they came when they were 13, and they have been in school for so many years, try to find those comms. That way— today I had a student that we didn't qualify for services because even though he was working below grade level, when you were comparing him with other ELs, he was at the same level or a little higher. So we know that that It's not a disability because they are able to learn in home language. Eventually they will catch up.

Thank you. I think it's a good time to switch gears. We had a question come in about how to support colleagues. So how could bilingual professionals support their colleagues? Support in a respectful and appropriate way culturally and linguistically diverse school settings and support in suggesting therapy activities or communication or bridging language or cultural gaps?

That's a great question, but it's a question that I still— I think the 3 of us all still think about every day. Like, I have had examples where yesterday I'm like, Really? Like, you, you just said that?

You really?

And I think the biggest thing that we want— but I always remind myself, I can't speak for everyone, I always remind myself that ignorance is not something that, like, they're doing on purpose, right? Because I think it is so easy to get heated and be like, I can't believe so-and-so said that, that is so wrong, I can't believe they don't know that, right? It comes from a place of this wasn't taught, right? A lot of what I presented on was taught in my, um, bilingual certification courses in grad school. It was not part of the core curriculum to graduate. This is unfortunately in the field still considered a little bit more highly specialized. So remembering that not everyone has this background and has this knowledge and that it is not something that people even think about. And having those conversations and start asking them like, oh, what do you mean by that, right? And start— I always like to come at it with an open-ended question of like, where is— like, if they're like, I'm having a really hard time with this bilingual student, I just can't figure it out, like, what's happening? Like, and how can I support Rather than, you don't know what you're talking about, this is so wrong, right? One of the things that I did when I came to the job I'm currently working at, where I was and still am the only bilingual SLP, um, just having those— asking those questions, and then people started coming to me more with those questions. And I asked the team, like, would you all be interested in a conversation, a presentation about multilingualism? And then they were like, yeah, that'd be great. I think coming at it with that knowledge of they're not doing this intentionally and being willing and able to answer their questions gains you that trust. And then you can start having those conversations of, oh, you know what, this would be a great idea to do with this group of multilingual learners. Right? You could read this book and pulling out those activities that you have found kind of have worked really well, you know, from that cultural responsive lens.

Right.

And that's when we're thinking about cultural humility, right? We can ourselves, even though we know this information, address comments and/or questions in a very— in a way that where we even pose ourselves as lifelong learners. And part of that is continuing with that curiosity. And like you said, Cecilia, using open-ended questions. I wonder how, I wonder why, what if we tried this? And I think one of the biggest pieces is always making it about the child or the individual that you're serving. When you can bring it back to the reason why we're all here as a team and we're all here together, it's not to boost my ego or your ego. It's what can we do as a team to really support this individual so they can thrive? Let's look at what is happening currently, and then as a team, how can we bring our minds together? How can we each bring the knowledge that we have and then collectively support this individual?

Excellent, thank you. We have some specific questions about, um, the resources and whatnot. So first, um, how would repeating utterances be used as a dynamic assessment task is the idea that recall strategies would be taught.

This one, I think there's a couple of things here. I— there is research and literature to support that non-word repetition shows again that kind of underlying language learning.

It does—

the child have that ability to learn rules of language they're non-words, right? So there is literature to support those non-word utterances, show you does a child have that ability to use those rules of the languages that they're exposed to, to ex— to apply those rules to non-words. That has a little bit more evidence base. I don't know if that's specifically what was being asked. I think, um, sorry, I'm going back to read it. Repeating utterances could be recall. Wesley, most of my kids are AAC users. So if you have more to say, go ahead.

Well, you're also thinking about auditory memory and auditory processing as they're repeating, right? And so, no, you brought up such a good point too. And then we also use non-words when we're potentially trying to dynamically assess whether the child can gain new vocabulary that is not tied to a particular language. Dr. Crawley from the LEADERS Project has some wonderful videos on how she does fast mapping with non-words for vocabulary, and so we're happy to also link those.

The other Dr. Ortiz, who we also cited, also has a lot of good papers about non-word repetition tasks, and he's kind of developed some non-word repetitions for Spanish and English, and he's looking at other languages as well.

And I guess to kind of tag along with that, which wordless books do you recommend? And if it's easier for you guys to maybe put it in the resources, I think people would appreciate that.

They are.

So we did provide them.

Oh, excellent. Okay, you guys are so helpful.

Chalk is my favorite one though.

Which one?

Chalk is my favorite. It's about like kids who's— they're playing with chalk and then it— the things that they draw turn into life and Just fun watching kids.

My favorite is Good Dog, Carl because it has a Rottweiler and I love dogs.

Clearly really clinically thought out favorites.

Those are great. Have you heard of the MAIN, M-A-I-N, and what are your thoughts on it?

I actually looked it up as soon as I saw that and I just thought to myself, this is why we are building community. We want to learn about new tools and assessments. And sadly, no, I don't know about it. But now I have it pinned on my desktop and I will, I will definitely look into it. Nice.

How do you recommend transcribing a language sample? Is there a voice-to-text app you recommend? I know there's a lot of AI.

So I do know there are some— I don't know the names of the researchers. I do know there are some researchers that are looking into using AI and speech-to-text transcription. The thing that is hard, that is challenging, children's voices are harder for AI to transcribe. And then if we think about a child who has a language disorder or has a speech sound disorder, I think it's still unfortunately a ways away. I think right now we are still pretty much stuck in the typing and writing what you heard. At least that's what I do. Um, but at least we're not writing it by hand. Um, because the other thing that we do have to be mindful of is if you work in more of a medical setting, which I know was a question further down. I think someone in a prior practice was asking about that HIPAA compliance. I am not aware of any. I know there are certain hospital systems and whatnot have like those HIPAA compliant transcribers, Texas speech to help summarize notes, but that's something that I think on a system level you would have to ask about. I don't personally know of any. I, um, like to say that I work at the equivalent of a Title I hospital, so we don't have access to those things. Um, so unfortunately I don't have the answer for that one, but I'd say that's something to be mindful of.

A couple things that you could do, you could transcribe as you're listening to the sample. That is one thing that, yes, it takes away from the focus of being with the child, but let's be real, we need all the time we can get. And so transcribing, typing as a child is speaking is one thing that you can do while you record with— I like to use video cameras so I can catch anything visually that I maybe have missed or the child uses ASL, for example. And then the other tools that you can use is getting a parent release in order for you to record, of course, is indicated first in order to cover your bases with HIPAA. And then tools like ELSA, like I mentioned, that tool you can upload recordings and then the recording will be transcribed. Yes, it uses an AI model. It is designed by SLPs, however, so I feel a little bit better using that tool because at the end of the day, like I mentioned, you still have to go back, review the recording, and then make sure that even the transcription that has been done by the computer can be— is equivalent to what you noticed.

Yeah, with all the mispronunciations, I would imagine there would be a lot of autocorrect that would throw things off. Um, that's one concern I have about the, the transcription tools. Um, I did want to ask, there was something interesting, a comment here about how AAC doesn't necessarily, um, provide verb tenses.

Mm-hmm.

And any comments on that or ways Yeah, so that is—

I actually saw a great poster at the ASHA convention last year that was looking specifically at Spanish-English bilingual AAC programs, of which there are more than I thought there were, but not as many as I had hoped. Specifically, for example, if we're talking about Spanish and English, Spanish has a lot more tenses. There is a subjunctive. There's also mood, right? So subjunctive mood and things like that, versus kind of thinking about it in English equivalent of like, I will do something versus I should do something, right? That is a distinction in Spanish. And a lot of those apps, I don't think any of them, if I remember from the poster correctly, make that distinction, right? So if we are looking at a child who, like I was talking about the case of this eye gaze user who is cognitively intact and has the ability to understand all those different tenses and all that nuance of higher-level language, but their system doesn't allow for those— that nuance, right? That's where you have to be mindful of that. And at that point, if that child is showing that they understand that nuance, that they can do it, and their app isn't working to show that, I start kind of having that conversation with the families of, you know, and normally at that point they're pretty literate. I start asking like, are we ready to move to kind of more that quote-unquote grown-up AAC where it is more text-based so that they have more access and not looking at the symbol-based AAC that we think about for a lot of our communicators in the kind of early elementary school age?

Thank you. There was a question here about whether there will be handouts that are relevant for school psychologists or professionals other than speech pathologists. Just wanted to double-check that.

Yeah, I would say for— I can share like the comprehensive parent interviews that we do at Cincinnati Public Schools, and you can always go to the National Association of School Psychology resources. In their website, they have a lot of good information.

We also will have the assessment identification metrics for school psychs that'll be included in the resources, and then we have another handout on cultural humility as well.

Sounds great, thank you. I'm going to take maybe one more, and again, thank you. This was extremely enriching and very, very Just insightful in so many ways, and I'm so happy to see so many people still hanging on for the answers to these questions. So let's see, a final question here. How would you address parents or other disciplines who assume that speaking 2 languages causes a delay in learning? I've provided handouts and reference articles, but many people are under that assumption, and I have to say personally in my practice, I go through this constantly. Any comments?

Yes. I mean, most simplest for people to also kind of like take into consideration the importance, I always bring it back to the brain, brain development. And then I, the reason why I do that is I let families know and I even have pictures of like, once we build this pathway like a road for one language, that pathway is already built. It's not going anywhere. And on that same pathway, we can add more languages to it. And then I know that you've provided resources and handouts. That is another thing that I like to do. But I think once we talk about brain development with families, their light perks up. It's like, okay, this is important stuff that we're discussing. And I tend to find that once we do that, once I talk about, even for like, I work really closely with doctors. And so one of the ENTs I was working with was talking about ASL and then spoken language. And so I was saying, you know, as long as the child has one path for language, we can start to map the other ones. After she heard that, for her, even for her, it started to make sense, like, okay, I can't be picking and choosing a language that the family will focus.

I think also for other providers or even parents, you know, who are trusting and have heard the opinion of a provider and that's kind of what they're sticking with, of like, no, one, one is the way to go. I like to give an example. This is a personal example, but I think you could talk about this more generally as well. Of 20 years ago, that was the case, right? We were told, and SLPs were taught, and doctors were taught, um, if the kid has a language delay, only speak to them in one language. You don't want to confuse them, right? But no one really thinks about the long-term social impact of that. So the example that I use is of my younger brother who had speech delays because he had hearing difficulties, and we were told like only speak one language to him, and now he cannot communicate with a lot of our family. And I talk about how isolating that is, and I especially for, I think, people who are a little bit more stuck in the mud. I talk about that, like, would you want, like, your child not to be able to communicate with their grandparent, right? No, you want them to be able to communicate that. And I think having that kind of more salient reminder of you are taking away access to a child's ability to communicate with a huge huge portion of the people who are important in their life is also a really powerful tool.

I think that was so well said. Thank you so much. Um, again, thank you for such an impactful and insightful presentation. Thank you to everybody for staying on for the Q&A. Um, we will, uh, be mindful of any future topics that this has kind of brought to people's minds, and please include that in the survey. But thank you so much, everybody, and thank you, and I hope you have a wonderful evening and stay tuned for our fall series announcements coming up in the next month or so. Thank you.

Thank you, everybody.

Thank you.