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ACQ Volume 13, Number 3 2011 151
research findings are now available, including work by Hoff
and Place (in press), Pitko et al. (2007), and Paradis, Crago,
Genesee, and Rice (2011) that have investigated the
differences in language processing between bilingual and
monolingual children. For instance, Hoff and Place (in press)
reported on a longitudinal study of bilingual development
based on data from 47 children (25 boys and 22 girls)
exposed to both Spanish and English from birth and 56
children (30 boys and 26 girls) exposed only to English. The
authors concluded that although bilingual children acquired
(composite) vocabulary and syntax within the same range
as monolingual children, the overall time taken to acquire
their two languages was longer than the monolinguals’ one.
This finding appeared strongly related to the relative
amounts of input received in the two languages. Such
findings support the need to look in detail at a child’s
language history and input received during assessment,
countering earlier arguments presented in this column to
“treat all children the same” and “only consider English”. It
is important to note in practice that a slightly different
trajectory to language learning appears to be evident in
bilingual children. Furthermore, the language skills of
bilingual children may not be evenly distributed and special
attention should be paid to the sociolinguistic contributions
made by their different languages during assessment and
intervention planning (Goldstein, 2006).
indicating that children with language difficulties can learn
two languages; 2) there are indications that two languages
may be an advantage in language learning for some
children; 3) participants in these studies represent a range
of presenting conditions, including autism, Down syndrome,
and hearing impairment, and all fail to support the idea that
“it is too hard for these children to manage two languages”;
and finally, 4) interventions can be successfully carried out
using a variety of methods and do not require a bilingual SP
in order to do so.
Related evidence
Given that there are still only a small number of studies
investigating bilingual intervention for children with language
disorders, it is important to consider other lines of
supporting evidence. For example, we can look at what is
known about normal bilingual acquisition, which suggests a
potential advantage in bilingualism. A number of robust
Table 4. Critically appraised article
Article purpose An intervention study looking at whether children with delayed expressive vocabulary given dialogic book-reading intervention
in two languages would gain words in both languages compared to a control group of similar children. They also wanted to
measure if parents found this a satisfactory and appropriate intervention. The method had already been shown to be effective
for monolingual children using similar presenting conditions and targets.
Citation Tsybina, I. & Eriks-Brophy, A. (2010). Bilingual dialogic book-reading intervention for preschoolers with slow expressive
vocabulary development. Journal of Communication Disorders, 43(6), 538–556.
Design Randomly assigned to experimental and control groups. Control group had no intervention, but regular measures, during the
intervention for the initial treatment group. The control group then had the treatment also.
Level of evidence Level II-1 (Justice & Fey, 2004); NHMRC level – III-1.
Participants 12 children, 22–42 months of age.
The intervention Thirty x 15-minute sessions using dialogic book-reading strategies were provided in each language in the children’s homes,
in English by the primary investigator and in Spanish by the children’s mothers, who were trained in the techniques of dialogic
book-reading. The intervention took place over a 6-week period.
Results The children in the intervention group learned significantly more target words in each language than the children in the
control group. Effect sizes were large. The intervention children learned an average of 6.7 targets in English (range 5–9), and
an average of 3.2 targets in Spanish (range 0–6). The control children learned an average of 0.8 targets in English (range
of 0–1), and an average of 0.5 targets in Spanish (range 0–2). A post-test 6 weeks later showed the intervention children
produced an average of 5.8 target words in English (range 2–9), and an average 2.3 targets in Spanish (range 0–7). Hence,
gains were maintained, but not generalised. Post-intervention for both groups, there was no significant difference in attained
scores (i.e., both groups learned similarly from the intervention).
Mothers’ satisfaction ratings on a questionnaire ranged from 3.2–3.7 out of a maximum of 4.
The children learned fewer Spanish than English words overall; however, there was a wide range. Those who learned the
most Spanish targets were those children whose mothers used the most consistent Spanish input outside of the intervention
sessions, based on information provided in the parent report on children’s language input. They were also mostly dual-parent
families where both parents spoke Spanish, and had a higher maternal education level than the children who learned fewer
Spanish words.
Limitations Relatively small participant size, although very comparable with other intervention studies. Variability in participants in both
presenting vocabulary sizes and degrees of exposure to each language. However, if gains were made regardless of these
variabilities, the result is relatively robust. There was no monolingual comparison intervention; however, this would have
required a much bigger group.
The intervention utilised picture books, and wh- questions. This may not suit all children or mother’s styles or cultural
expectations. Also, some parents may have provided many more than the minimum presentations of each item (3), whereas
some may have only presented the required number.
Summary: The study showed that children with slow expressive vocabulary development can make gains in two languages following
intervention in two languages, compared to controls with no intervention. A relatively simple parent-based intervention was
used, which was positively viewed by the parents concerned.
Table 5: Review articles identified
Thordardottir, E. (2010). Towards evidence-based practice in
language intervention for bilingual children.
Kohnert, K. (2010). Bilingual children with primary language
impairment: Issues, evidence and implications for clinical actions.
Goldstein, B. A. P. (2006). Clinical implications of research on
language development and disorders in bilingual children.