EL-MINIA MED., BULL., VOL. 19, NO. 1, JAN., 2008
Mamdouh
MANAGEMENT OF DELAYED LANGUAGE AFFECTING PHONOLOGY
IN A BILINGUAL CHILD
By
Haitham Mamdouh , M.D.
Department of E.N.T., Phoniatrtics Unit,
El – Minia Faculty Of Medicine
ABSTRACT:
This study was undertaken to understand the phonological system of a bilingual
child and to support or repute the hypothesis that a bilingual child is likely to use a
common phonological system across the two languages during the initial process of
phonological acquisition. The Study was done on a five years old bilingual child .The
child's languages were Arabic and English. His language was normal for his age but
he has delayed language affecting phonology. The child's speech was moderately
unintelligible in the two languages. Therapy was done only in Arabic. Posttherapeutic assessment after seven month of treatment indicated significant improvements in the child's overall speech intelligibility in the two languages, indicating
generalization. This may be hypnotized that a bilingual child is likely to use a
common phonological system that may be shared by the two languages
during early learning stages .
KEYWORDS:
Bilingualism
Phonological intervention
Delayed language affecting phonology
erentiated phonological system may
fail to use sounds that occur in one of
the two languages and they might use
inappropriate phonemes in a particular
language (Schnitzer and Krasinski,
1994).
INTRODUCTION:
Weinrich (1953) defined bilingualism as the practice of alternately
using two languages.
Phonological development and
disorders in bilingual children have
been examined in a number of crosslinguistic studies for several decades
(Ray, 2002; Holm & Dodd, 1999;
Ingram, 1981 and Vogel, 1975).
The question of either single or
separate phonological system is
complicated by the way in which the
bilingual child acquires his or her
languages. A bilingual child may
acquire the two languages simultaneously or successively. In successive
bilingualism, the child normally
acquires one language (the native/
home language) and starts acquiring
the other language during preschool or
later in life. In such situation, the
influence of one language over the
other will be more evident (Ray, 2002).
One of the important issues in
bilingual phonological acquisition
research is whether bilingual children
maintain separate or shared phonological systems. Results of various
studies are discursive, suggesting that
these children use either differentiated
or
undifferentiated
phonological
systems. Children who have an undiff-
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EL-MINIA MED., BULL., VOL. 19, NO. 1, JAN., 2008
In the past, a number of studies
have dealt with the fact that a
developing bilingual child uses either
one or two systems of phonology.
Studies have supported that bilingual
children
develop
two
separate
phonological systems e.g (Holm &
Dodd, 1999; Dodd et al., 1997;
Genesee 1989; Pye, 1986; Ingram,
1981 and Lindholm & Padilla, 1978).
Studies have also supported the
opposite view that bilingual children
are likely to use a single phonological
system in the early stages of learning
e.g (Ray, 2002; Gildersleeve et al.,
1996; Vihman, 1982; Redlinger &
Park, 1979 and Swain, 1972). Many
studies reported in the literature deal
with initial one-system and two–
systems phonology later on e.g (Yavas,
1995; Vihman, 1985; Volterra &
Taeschner, 1978 and Imedadze, 1967).
Mamdouh
unlike balanced bilinguals who acquire
languages simultaneously. Even balanced bilinguals, having native like
language proficiency, show traces of
interference in one or both of their
native language. Bilingual children
tend to make the same type of errors in
both languages and a single deficit
underlies disorders in the two
phonological systems of the child
(Holm and Dodd, 1999).
Holm and Dodd (1999) studied
a Punjabi- English speaking child
whose speech was characterized by
inconsistent errors in both languages.
After therapy, it was found that
intelligibility of the child's speech
improved in both languages even
though therapy had only been provided
in English.
There is a very shortage in the
researches studying management of
phonological errors in whom Arabic
language is one of the two languages
they acquire.
Vogel (1975) studied a
Romanian - English child and stated
that the child was using a single
phonological system for the two
languages, as the child demonstrated
the same phonological processes when
using both languages. Watson (1991)
supported the existence of an initial
"averaged"
system
(combining
characteristics of the two phonological
systems) that slowly differentiates
into two separate systems of
phonology later on. In a study with
bilingual children having different
language histories, Vihman (1985)
noted that a gradual differentiation of
linguistic systems occurs during the
third year of life. Schnitzer and
Krasinski (1994) supported the
existence of a single phonological
system until around the age of two
years, seven months at which the
preexisting
phonological
system
differentiates into two distinct systems.
AIM OF THE WORK :
The aim of this work was to
understand the phonological system of
a bilingual child and to support or
refute the hypothesis that a bilingual
child is likely to use a common
phonological system across the two
languages during the initial process of
phonological
acquisition i.e if
management of phonological errors in
a bilingual child is monitored in only
one language, generalization would or
would not occur to the child's other
language.
MATERIAL AND METHODS :
Subject :
The child (MA) was a fiveyear-old boy born in kingdom of Saudi
Arabia. His father is Saudi (speaks
Arabic) and his mother is from United
States (Speaks English). As reported
Subordinate
bilinguals,
who
acquire languages successively, are
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EL-MINIA MED., BULL., VOL. 19, NO. 1, JAN., 2008
by MA's parents, MA was encouraged
to speak in both Arabic and English
almostly in the same degree. He had
normal pre-, peri- and post-natal
history and he did not demonstrated
any neurological or hearing problems
as reported by his parents.
Mamdouh
Two measures were taken from
each
sample:
(a)
Percentage
Consonants
Correct
(PCC)
on
utterances, (b) Speech Intelligibility
(SI). To calculate the PCC, the number
of correct consonant productions was
divided by the total number of
consonants in the target words and
multiplied by 100 (Shriberg and
Kwiatkowski, 1982). To calculate SI
we used a five – point rating scale
(Ray, 2002): the highest rank, 4,
indicates that speech is intelligible and
can be understood 100% of the time; 3
indicates speech is minimally impaired
and can be understood 70 – 90% of the
time; 2 indicates speech is mildly
impaired and can be understood 50 –
70% of the time; 1 indicates
moderately impaired speech that can
be understood 30 – 50% of the time
and 0 indicates severely impaired
speech that can be understood 10 –
30% of the time.
During MA's first visit to the
clinic, he appeared to be very attentive
and cooperative. Language evaluation
using Arabic Language Test (Kotby et
al., 1995) revealed that his language
(receptive part of the semantics,
expressive part of the semantics,
receptive part of the syntax, expressive
part of the syntax and pragmatics) was
normal for his age. Testing phonology
by Articulation test (Kotby et al., 1985)
revealed that he had multiple
phonological substitutions. Vocal tract
examination revealed no
organic
lesions such as bite anomaly or tongue
tie. IQ assessment using Stanford Binet
Intelligence scale (Binet, 1937) was
89. hearing was also within normal
limits as indicated by pure- tone
audiometry and tympanometry.
Intervention :
Intervention focused on the Arabic
language only. Correction was done in
four steps:
/ s / and /∫/ sounds, followed by / ħ /
and / x / sounds, then / k / sound and
lastly correction of voiced sounds / z / ,
/ / , / g / , / h / , / ʁ /, / d / and / ʕ /.
After the end of each step, two speech
samples were collected from each of
the two languages to tape the progress
made by the child, based on Percentage
Consonant Correct (PCC) and Speech
Intelligibility (SI) to examine wheather
generalization to English language has
taken place or not.
Pre-intervention Assessment:
Before intervention, baseline
measurements
in articulation and
phonology were obtained by two
methods:
1. Articulation Test (Kotby et al.,
1985) for Arabic language and
Goldman-Fristoe Test of Articulation
(Goldman and Fristoe, 1986) for
English language.
2. Collecting two naturalistic speech
samples for each of the two languages.
Speech
was elicited in a variety of
contexts: with story books, pictures and
toys. The aim was
to obtain a sample
which was representative of the subject's
communication competence in conversation. Each sample contained an
average of 175 – 200 words.
Training program:
The therapy was done in the
following program:
* The child is made aware of the
characteristics
of
the
standard
phoneme.
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EL-MINIA MED., BULL., VOL. 19, NO. 1, JAN., 2008
* The child is got sensoriperceptual
training to assist him to compare his
error with the normal speech.
* Production of the standard sound.
* Stabilization and strengthen the use
of the standard sound in isolation, in
syllable, in words then in phrases and
sentences.
* The use of the target sound in
spontaneous speech.
Bowen and Cupples (1998), in
detailed case study, noted that the
strength of phonological therapy
depends on family education, multiple
exemplar techniques and home- work.
Therefore, MA's father was asked to
spend some time each day going over
the tasks have observed during therapy.
He was instructed to correct those
words
produced
incorrectly
in
Mamdouh
spontaneous speech. In order to tape
the generalization of treatment to the
English language, the father was asked
to monitor errors production only in
Arabic language and the mother was
asked to ignore the monitoring of the
English language at home.
Total number of
treatment
sessions was forty– three. The first step
of intervention took eleven sessions,
the second step took nine sessions, the
third step took eight sessions and the
fourth and last step took fifteen
sessions. The duration of each session
was thirty minutes. Two sessions were
scheduled per week. Therapy was
continued for about seven consecutive
months.
RESULTS:
Results of pre-intervention Articulation Tests for Arabic and English Languages:
Phonemes
Replaced by
/ s /, / ʃ / , / z /, / ʤ /
/ k /, / g /, / d /
/ ħ /, / x / , / h /, / ʁ /, / ʕ /
/v/
/ r/
Interdental
/t/
/ʔ/
/f/
/l /
Results of assessment after each step of therapy:
Baseline
1st step
2nd step
3rd step
4th step
PCC
SI
PCC
SI
PCC
SI
PCC
SI
PCC
SI
Arabic Language
English Language
37%
Rate (1)
48%
Rate (1)
55%
Rate (2)
59%
Rate (2)
96%
Rate (4)
47%
Rate (1)
59%
Rate (1)
59%
Rate (2)
73%
Rate (3)
95%
Rate (4)
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EL-MINIA MED., BULL., VOL. 19, NO. 1, JAN., 2008
Mamdouh
DISCUSSION:
Diagnosis
of
phonological
disorders in children acquiring two or
more languages is highly problematic
because knowledge concerning the
phonological structure of many
languages is limited (Holm et al.,
1999). Phoniatricians and related
professionals should be aware of
differences between bilingual and
monolingual phonological acquisition
patterns (Watson, 1991).
phonological errors as his language
was well developed .
It is also necessary to
understand the difference between
normal and disordered patterns of
bilingual phonological development.
Abnormal phonological patterns must
be detected using transcription that
contain sufficient details to represent
the child's entire phonological system,
as influenced by one or more languages. The entire phonological system
should be considered for assessment
and interactive intervention. All
phonemes of the languages should be
assessed in different word positions. In
assessing
the
phonological
development of a bilingual child, the
two languages spoken by the child
should be the focus of attention,
irrespective of the treatment choice
(Ray, 2002) .
Based on the phonological
patterns obtained from the pre –
intervention
Articulation Tests for
Arabic and English languages, it was
hypothesized that MA was using a
unified phonological system. MA's
phonemes, were substituted in a similar
way in the two languages. Gildersleeve
et al., (1996), based on their
observation of common phonological
system in Spanish –English bilinguals,
also emphasized that bilingual children
tend to use an amalgamated
phonological system.
As reported by Stow and Pert
(1998), analysis of spontaneous speech
samples are highly recommended .
Phonological assessment of MA's
speech samples in the two languages
indicated that
the child
had
phonological errors that interfered
significantly with speech intelligibility
in the two languages .
MA's Percentage Consonant
Correct (PCC) and Speech Intelligibility (SI) after each step of therapy
are improved in the two languages.
PCC did not improved in English
language after the second step of
therapy because in this step of therapy
we corrected / ħ / and / x / sounds
which are Arabic sounds.
In this study, MA was a
balanced bilingual child, as he was
encouraged to speak in both Arabic
and English languages almostly in the
same degree.
The successful treatment of
MA's phonological disorder required
forty –three sessions. Therapy was
continued for about seven consecutive
months. This was coupled with regular
work at home under supervision of the
father. During therapy, MA showed
very good self correction skills.
Shriberg and Kwiatkowski (1990)
revealed
that
several
factors
contributed to successful therapy of
phonological disorders: parental input,
Language evaluation of MA
using Arabic Language Test (Kotby et
al., 1995) revealed that his language
was normal for his age. Testing
phonology by Articulation Tests for
Arabic and English Languages
revealed that he had multiple phonological errors. Diagnosis of MA was
delayed language affecting phonology,
so, we could start correction of
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EL-MINIA MED., BULL., VOL. 19, NO. 1, JAN., 2008
reinforcement schedules, intensive
therapy blocks without gaps
and
enhancement of self monitoring skills.
Mamdouh
thorough assessment of the two
languages spoken by a bilingual child
needs to be performed in order to
understand the nature of overall
phonological deficits.
The results of this study
indicated that the effects
of
phonological therapy in Arabic
language were able to generalize to
English language. If the treatment had
a positive impact in Arabic language
only,
then
the
underlying
phonological systems would have been
existing as separate entities. However,
because treating only one language had
a positive outcome on the other
language, it can be assumed that the
two phonological systems were
combined into one in MA's case. This
data supports the existence of a single
phonological system.
CONCLUSIONS:
* Bilingual child is likely to use a
common phonological system that may
be shared by the two languages during
early learning stages.
* It is not essential to treat phonological errors in all languages spoken
by the child as treatment in one
language will be generalized in the
other languages.
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(1998): A tested phonological therapy
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3. Dodd, B., Holm, A., & Li, W.
(1997): Speech disorder in preschool
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(1986): Goldman-Fristoe Test of
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bilingual child with a phonological
This finding is supported by Ray
(2002) in his study on a trilingual
child with multiple phonological errors
in the three languages, therapy was
done in English only and posttherapeutic
assessment
indicated
significant improvements, in the child's
overall speech intelligibility in all three
languages, indicating generalization.
The findings in this study are
also supported by Holm and Dodd
(1999). They assumed that bilingual
children are likely to use the same
phonological planning to process
phonology of each language, therefore,
generalization is likely to occur.
Surprisingly/ v / which is an
English sound and not found in Arabic
was replaced by the voiceless sound / f
/ in MA's speech . After the fourth
step of therapy, It was found that /v /
sound was corrected and this indicates
also generalization .
In light of the present study, it
is not essential to treat all languages
spoken by the child. However, a
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EL-MINIA MED., BULL., VOL. 19, NO. 1, JAN., 2008
disorder. Child Language Teaching &
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Mamdouh
18. Shriberg
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‫‪Mamdouh‬‬
‫‪EL-MINIA MED., BULL., VOL. 19, NO. 1, JAN., 2008‬‬
‫عالج تأخر التركيب الصوتي للغة فى طفل ثنائي اللغة‬
‫هيثم ممدوح محمد‬
‫قسم األنف واألذن والحنجرة ‪ -‬وحدة التخاطب‬
‫كلية الطب – جامعة المنيا‬
‫تمت هذه الدراسة على طفل ثنائي اللغة ينطق اللغةة الررييةة إلاجنيليةيةة إليرةانى مةر تة ر‬
‫فى التركيب الصإلتي للغتير حيث تم تصليح األ طاء الفإلنإللإليية عند الطفل عر طريق يلسات‬
‫ت اطب استمرت حإلالي سيرة شهإلر ياست دام اللغة الرريية فقط‪ ،‬إلفى نهايةة اليرنةاما الرييةي‬
‫إليةةد ر إلحةةإلك الكةةيم نةةةد تحسةةر إلاأل طةةاء الفإلنإللإلييةةة ا تفةةةت فةةى كلتةةا اللغتةةير الررييةةةة‬
‫إلاجنيليةية مما ند يرطى داللة على ار الطفل ثنائي اللغة يقإلم ياست دام نظام فإلنإللإليي (نظةام‬
‫تركيب صإلتي) مشترك لكلتا اللغتير فى المراحل األإللى لترلم اللغة ‪.‬‬
‫‪45‬‬