Language and Literacy Promotion in Low Income and Bilingual Children Mariana Glusman, MD Medical Director Reach Out and Read Illinois Assistant Professor of Pediatrics Northwestern University Feinberg School of Medicine Vignettes Is this 3 year old delayed? Spanish speaking parents Older sister speaks English to him Bilingual preschool Puts two words together (Some English some Spanish) Can follow two part commands Mom understands him, strangers don’t Affectionate with family, shy with strangers Older sister was more advanced at this age What would you advice this 5 year-old’s parents? Spanish at home. English in school. Mother has no concerns. Speaks in clear sentences in Spanish at home. Likes to pretend she is a princess Plays well with her cousins. Recognizes many letters. Writes own name. At school is very shy and hardly speaks. Teacher is worried. Answers you in single words. • • Is this normal? Should they start talking with her in English at home? Should this 18 month-old’s parents read to him in English? Parents speak English as a second language. Should you give him bilingual books? What if you only have books in English? GOALS • Understand the magnitude and etiology of language and literacy disparities for children of low SES and for multilingual children in the US • Recognize normal and abnormal language development in dual language learners. • Learn when to refer for Speech Therapy • Learn about strategies to promote language and literacy development Reach Out and ReadLeyendo Juntos, Thirty Million Words Initiative Today 1. Language Development 2. Bilingual Language Development 3. Interventions that promote language and Literacy in low SES and Dual language learners. 1. Language Development Language Development 1. Brain Development 2. Parent-Child Relationship 3. Literacy Development 4. Poverty Language Development http://emedia.leeward.hawaii.edu/hurley/Lin g102web/mod5_Llearning/5mod5.3_acquisiti on.htm 700 New Neural Connections per Second Source: Huttenlocher, University of Chicago, 1979 Use it or loose it Neural Pathways in the Developing Reading Brain How do these neural pathways form? What factors stimulate synaptic connections? How are connections sustained? Early Brain and Child Development • Interaction of genes and experience • The active ingredient is the “serve and return” interaction with parents and caregivers • Based on secure relationships Key aspects of responsive parenting impacting language/cognition • Richness of verbal input – labeling objects and actions (Weizman, 2001) • Verbal scaffolding – structuring language interaction to meet child’s needs; providing child with language that they need (Vygotsky, 1978; Snow, 1977) • Verbal responsivity – responding to vocalizations with imitations or expansions, engaging in backand-forth conversation and asking questions (Hart and Risley, 1994) Average word acquisition (receptive language) • 12 to 16 months: around 40 words • 16-24 months: 130 more new words (Bates et al., 1994) • Between 2-5 yrs.: up to 3000 words per year (Nagy & Herman, 1987) Meaningful Differences in the Everyday Experience of Young Children Hart and Risley (1995) Measured how many words children heard from 9-36 months. Low SES kids have a 30 million word word deficit! Why is that important? Vocabulary is a key indicator for school success as early as kindergarten Language development sets the foundation for literacy development. Early Literacy Development Dialogic Reading Awareness of books More complex vocabulary and syntax. More “serve and return” interactions Motivation to learn to read. Reading is fun! Understanding of printed words; what they represent Using background knowledge and strategies to obtain meaning from print Why Early Literacy Matters Early Language and Literacy Skills Kindergarten readiness 3rd grade Reading Proficiency Graduation from High School Path to success in school and life Generational Cycle Reading Difficulties Decreased language skills Poverty Poverty More than one out of five children in the US live in poverty (NCCP 2013) (16,000,000) “…early childhood is the best investment.” -James Heckman, Nobel Prize Winning Economist “Investment in early education … helps reduce the achievement gap [and] the need for special education, increase the likelihood of healthier lifestyles, lower the crime rate, and reduce overall social costs. … Every dollar invested in high-quality early childhood education produces a 7-10% per annum return on investment.” Heckman, J. The Economics of Inequality, The Value of Early Childhood Education, American Educator. (Spring, 2011) Recap • The brain develops incredibly fast in the first 5 years of life. • Interaction “serve and return” is needed for this to occur. • Language development is dependent on input. • There is a 30,000,000 word gap in low SES children that is related to poorer academic performance. • There is a bidirectional relationship between poverty and reading ability • Any intervention needs to be done early to have maximal effect. Recap-Also for Dual Language Learners! • The brain develops incredibly fast in the first 5 years of life. • Interaction is “serve and return” needed for this to occur. • Language development is dependent on input. • There is a 30,000,000 word gap in low SES children that is related to poorer academic performance. In US overlap between DLL and low SES • There is a bidirectional relationship between poverty and reading ability • Any intervention needs to be done early to have maximal effect. 2. Bilingual Language Development Multilingual Families in the US are Diverse Different ethnic groups Diverse set of values, practices, and resources. Diverse SES Countries of origin • Mexico, Central and South America, Caribbean countries (64%) • Countries in Asia (23%) • Europe and Canada (7%), • Africa and the Middle East (6%) (Capps et al., 2005). More than 350 languages but Spanish predominates (72%)—eight million people— speak Spanish at home (Aud et al., 2011). Bilingual Development is Multifactorial • Setting • • • • • Similarity of L1 and L2 Time • • • • Girls vs. boys Favorable attitude toward the dominant language group Language ability Language • • Isolated families vs. enclaves where the dominant language spoken Family SES, education level, and literacy skills Parents’ desire to pass on their heritage language Exposure to each language (by native and non-native speakers) Person • • • • (Bornstein 2013) Age (or developmental status) of language learner Duration of exposure Historical time-“three-generation rule.” Mechanism • • • • Proportion of parents’ L1 vs. L2 use Reward/discouragement of desirable/undesirable language use Observation and modeling by L2 learners Direct instruction involving formal tuition, curricula, and school classrooms Benefits of Bilingualism • Neural pathways for language learning stay open longer • Increased cognitive flexibility and metalinguistic ability • Slower memory loss with aging True or False? Early exposure to two languages leads to delays T/F FALSE (but a little bit true!) Early exposure to two languages does NOT lead to delays • With time, the human brain is able to learn two languages as easily as one • Initial vocabulary in each language may be smaller but, when you include both languages the total vocabulary is usually the same Longitudinal Studies of SpanishEnglish Bilingual Children in South Florida (Hoff et al.) • Study 1 • 47 Spanish-English bilingual children • 56 English monolingual children, matched for SES • 22 months to 4 years • Study 2 • In progress, over 150 bilingual and 40 monolingual children Compared bilingual and monolingual children from similar educational background Monolingual sample 30 30 25 25 20 20 15 Mother 10 Bilingual sample Father 15 10 5 5 0 0 Mother Father Learning two languages takes longer than learning one language Vocabulary Bilingual children lag 3-4 months on average behind monolingual children, when looking at each individual language Learning two languages takes longer than learning one language They also lag behind in grammatical development for each language (Hoff et al.) Learning two languages takes longer than learning one language Even in reaching the milestone of combining words Note that by 24-25 months months they are not statistically different (Hoff et al.) Total language growth is comparable The children are not confused or impaired, they are learning more The reason for the lag is: • Language development depends on language experience • Children who hear two languages must hear less of each (Hoff et al.) True or False? Bilingual code-mixing is a sign of confusion T/F FALSE: Bilingual code-mixing is NOT a sign of confusion • Code-mixing aids in communication: – 2 languages used appropriately – they code-mix to fill proficiency gaps – code-mixing is grammatical • Social norm in many families • Sometimes there’s no good translation True or False? Early and frequent exposure to English is better T/F FALSE: Early and frequent exposure to English is NOT better • Bootstrapping: Strong HOME language skills facilitate English learning – A larger vocabulary in the home language and a richer knowledge of the world are particularly helpful for literacy development, and for developing the kinds of skills that you need in school. • • • • Using language to read Critical thinking Problem solving Telling stories Quality of English exposure matters over and above quantity of exposure • Proportion of input from native speakers • Exposure to more speakers may be better than exposure to a limited number of speakers Hoff et al. The native speaker effect (Hoff et al.): The relation between English use at home and 4-year-old children’s English and Spanish vocabulary 1 native English, 1 native Spanish parent 2 native Spanish parents 80 70 70 60 60 50 50 40 40 30 30 20 20 10 10 0 0 0 20 40 60 80 Percent English spoken at home English vocabulary score (EOWPVT) 100 0 20 40 60 80 Percent English spoken at home English vocabulary score (EOWPVT) 100 More on the native speaker effect (Hoff et al.): The relation between English use at home and 4-year-old children’s English and Spanish vocabulary 1 native English, 1 native Spanish parent 2 native Spanish parents 80 80 70 70 60 60 50 50 40 40 30 30 20 20 10 10 0 0 0 20 40 60 80 Percent English spoken at home 100 0 20 40 60 80 Percent English spoken at home English vocabulary score (EOWPVT) English vocabulary score (EOWPVT) Spanish vocabulary score (EOWPVT) Spanish vocabulary score (EOWPVT) 100 What about children with delays? • Children who have speech delays are still capable of leaning more than one language at their level of potential • Limiting their instruction to English may be detrimental True or False? Young children are linguistic sponges T/F FALSE: Language is not “absorbed” passively • Wide (innate) individual differences in rates of language learning – Language learning takes time – Requires interaction (media exposure not enough) – Depends on quality of learning environment • language for social communication • language for thinking and literacy 3. Interventions Interventions based on science of language development Children’s language evolves primarily through parent/child Interactions, “going back and forth” (serve & return) The brain’s “architecture” is shaped by early experiences. Parents talking and reading with their child builds specific skills and connections. (repetition matters) Differences in children’s skills are measurable as early as 9 months of age (starting early matters) Thirty Million Words Initiative TMW Provides parents with: 1. Knowledge of child language development (Curriculum-3 T’s: Tune in, Talk more, Take Turns) 2. Belief that THEY can have an impact! 3. Tools and FEEDBACK (video modeling and LENA) Reach Out and Read! The Reach Out and Read Model Advice: Encourage parents to read aloud daily and offer age-appropriate advice Books: From 6 months-5 years, clinicians give children a brand new, developmentally appropriate book at well child visits Environment: The practice is made into a literacy-rich environment with posters, gently used books, library information and volunteer readers where feasible Anticipatory Guidance • Teaching HOW to enhance linguistic environment • How to make joint reading be – A time to learn words and concepts – A time to make connections between books and the world – A time to have a conversation – A time to link reading, learning, and enjoyment Using the Book for Developmental Surveillance • Books are introduced early in the visit and used as a surveillance tool • Books are integrated into the exam within the context of other anticipatory guidance - not as one more thing to do • Capitalize on “teachable moments” during shared observation between the provider, the parent/caregiver, and the child ROR in Real Time Racial and ethnic difference in parent/child reading 90% 80% 70% 60% 50% Latino 40% Black 30% white 20% 10% 0% Read to daily Less than daily Never Number of books Flores et al. Arch Pediatr Adolesc Med. 2005;159:158-165. Leyendo Juntos Leyendo Juntos Reach Out and Read’s Initiative for Spanishspeaking families • Information for parents • Information for providers • Online course Leyendo Juntos Materials • Recommended Book Lists • Handouts for Parents – How do I Make Reading Fun? – Go to the Library! – Getting Ready for School • Handouts for Volunteers – Spanish Phrases and Questions – Tips for Reading Aloud to Non-English Speaking Children • DVD– modeling interactive reading (Bellevue) What books should you choose? • Spanish • Bilingual • English How do I make reading fun? Online Course • • • • • • Demographic information Cultural information Bilingualism Anticipatory Guidance How to identify language delay When to refer Anticipatory Guidance to enhance language • • • • • • • • • Talking about traditions Telling family stories Singing traditional songs Telling poems, making them up! Sayings and riddles Playing with language Encouraging development of writing Praising emergent literacy behaviors MODELING BOOK SHARING How do you evaluate language development in a child when you don’t speak the language? • Must rely on parental report (via interpreter) • Have a high index of suspicion if a parent voices concern. • Keep in mind that parental expectations may be low • Ask about specific language milestones (expressive and receptive) • Obtain information about the child's entire language system • Ask the parents how this child compares to other children • Ask about how the child is doing in school (if in preschool or daycare). Other questions you can ask: • What concerns do you have? • What does your child like to play? • Does your child play “pretend”? • How does your child tell you what he/she wants? Does he/she use words or gestures? • Does he/she know and use names of family members? • Does he/she talk while playing? The ROR book can be a helpful tool • Point to the pictures, ask simple questions and have the interpreter tell you what the child says. • How much of what the child says can the interpreter understand? • Ask the interpreter to ask the parent to point to the pictures so you can observe. – Does the child readily answer? – Are the child and parent comfortable with the book? – Does the child show joint attention • Points to the pictures? • Looks at the pictures that parent is pointing at?) When do you refer? • Not meeting language milestones-taking both languages into account – No words by 12 to 15 months – Not pointing by 15 to 18 months – Does not know colors and numbers by age 4 (if taught!) • Wondering whether or not the child can hear • A history of language issues or a learning disability in native language • Family history of reading, writing or learning difficulties • Low phonological awareness in either native language or in English. • Teacher concerns about delays (converse not the case) When do you refer? Even when not technically delayed, children from low SES backgrounds and DLL environments can benefit from environmental enrichment and targeted language and literacy promoting interventions Vignettes Is this 3 year old delayed? Spanish speaking parents Older sister speaks English to him Bilingual preschool Puts two words together (Some English some Spanish) Can follow two part commands Mom understands him, strangers don’t Affectionate with family, shy with strangers Older sister was more advanced at this age What would you advice this 5 year-old’s parents? Spanish at home. English in school. Mother has no concerns. Speaks in clear sentences in Spanish at home. Likes to pretend she is a princess Plays well with her cousins. Recognizes many letters. Writes own name. At school is very shy and hardly speaks. Teacher is worried. Answers you in single words. • • Is this normal? Should they start talking with her in English at home? Should this 18 month-old’s parents read to him in English? Parents speak English as a second language. Should you give him bilingual books? What if you only have books in English? Recap-Again! • First 5 years of life are crucial for brain development. • “Serve and return” Interaction • Language development is dependent on input • 30,000,000 word gap • In US overlap between DLL and low SES • Bilingualism is NOT a cause of delay • ROR and TMW are evidenced-based, parent driven, successful early intervention programs. Bottom line • Give the ROR book at the BEGINNING of the visit! • Use the book for developmental surveillance • Give anticipatory guidance • MODEL how to use the book! • Get trained (ROR and Leyendo Juntos) Bottom Line (cont.) • “3-T’s” Tune in, Talk More, Take Turns • The quantity and quality of input matter • Parents should speak and read in the language most comfortable to them • Mixing Languages is ok • Exposing children to native speakers is very important (the more, the better) • TV/Media does not count as exposure Bottom Line (cont.) • Children that appear delayed need to be referred, evaluated and treated • Children from low SES may need enrichment even if not diagnosed impairment • Pediatricians, early childhood educators, home visiting programs can work together to give parents tools to help children develop to full potential. In the News! Thanks to Perri Klass, MD National Medical Director, Reach Out and Read Professor of Pediatrics and Journalism, New York University Marilyn Augustyn, MD Medical Director, Reach Out and Read Massachusetts Associate Professor of Pediatrics, Boston University Medical Center Dipesh Navsaria, MPH, MSLIS, MD Assistant Professor of Pediatrics University of Wisconsin School of Medicine and Public Health Erika Hoff, PhD Professor of Psychology, Florida Atlantic University Director Language Development Lab Dana Suskind, MD Professor of Surgery, The University of Chicago, Pritzker Medical School. Gretchen Hunsberger Director of Program Quality and Provider Training For more information: www.reachoutandread.org mglusman@luriechildrens.org