UW Researcher Aims to Improve Recognition of Language Disabilities in Spanish

Due to a shortage of bilingual providers and a lack of psychometrically sound screening tools, there is a critical need for telehealth language screening measures to determine whether young Spanish-speaking children are developing language skills appropriately.

A University of Wyoming professor has conducted a study to describe the classification accuracy of telehealth screening measures with Spanish-speaking preschoolers from rural and underserved parts of the country.

“There’s a shortage of bilingual Spanish-speaking pathologists and early childhood practitioners to identify developmental and language disabilities,” says Mark Guiberson, associate professor in the UW College of Health Sciences Division of Communication Disorders.

Guiberson is lead author of a paper, titled “Accuracy of Telehealth-Administered Measures to Screen Language in Spanish-Speaking Preschoolers,” which will be published in the September issue of Telemedicine and e-HEALTH. It is described as the leading international peer-reviewed journal that covers the full spectrum of advances and clinical applications of telemedicine and management of electronic health records. The paper, co-written with Anna Zajacova, associate professor in UW’s Department of Sociology, and University of New Mexico researcher Barbara Rodriguez, already has appeared in the online version of the journal.

The study’s purpose was to determine the relationship between the screening measures and standardized language assessment scores; and to examine the accuracy of individual and combined screening measures presented using a hybrid telehealth approach.

“Children with developmental language disabilities don’t talk as much. They have fewer words, speak in shorter sentences and have a hard time repeating words. These children also frequently have difficulty with symbolic abilities that underlie gesture play and language,” Guiberson says. “This is important because play and language skills are the foundation for all learning.”

To gather data for his study, Guiberson and members of his research team traveled to Head Start and state-funded preschool programs in Cheyenne, Green River, Pine Bluffs and Rock Springs, as well as those in rural Colorado and New Mexico. He and his research team visited with 82 Spanish-speaking children (ages 37 to 69 months) enrolled in developmental preschool programs in those cities.

“At one of the programs in Cheyenne, they did not have a Spanish-speaking professional at all,” Guiberson says. “In Rock Springs and Green River, they have a pretty sizable Spanish-speaking population.”

During his visits, Guiberson collected three measures in Spanish. First, children would watch an e-book of a short story (titled “The Duck is Dirty”) on a tablet, and then were prompted to recount the story in as much detail as possible. The story retells were recorded with a flip-camera, and later transcribed and coded by research assistants.

“I wanted to see how much children retained and the level of complexity of their retells,” he explains. “I also looked at their vocabulary, sentence length and number of grammatical errors.”

Testing methods also included a parent vocabulary checklist and a non-word repetition task in which the children repeated various syllables or nonsense words in Spanish. The latter test occurred through FaceTime or Skype videoconferencing on the tablet.

“A parent vocabulary checklist is a list of words that is used as a measure of a child’s vocabulary,” he says. “There were 100 common or developmentally appropriate Spanish words on the checklist we used.”

The information gathered showed that, for 91.5 percent of the families, their children were exposed to Spanish 90-100 percent of the time in the home. The other 8.5 percent of families indicated their children heard Spanish between 80 percent and 89 percent of the time in the home. In addition, 89 percent of the children were exposed to electronic tablets or smart phones.

“We found that parents are pretty good at identifying when their kids are behind. Our results show that early childhood programs can use the vocabulary checklist for screening purposes,” Guiberson says. “The non-word repetition, or nonsense words, also is pretty good, especially when combined with information from the retelling of the ‘The Duck is Dirty’ story.

“This study shows that telehealth measures are viable ways to screen for developmental language disorders in Spanish-speaking preschoolers,” he says.

Guiberson believes this knowledge can be applied in the field by using a telehealth model to screen for language delays. Spanish-speaking professionals or para-educators can administer these telehealth measures to identify children who need to be assessed by a speech language pathologist.

The study was funded with a National Institutes of Health General Medical Science Grant.