DO NOT PLACE ANY TEXT OR GRAPHICS ABOVE THE GUIDELINE SHOWN DO NOT PLACE ANY TEXT OR GRAPHICS BELOW THE GUIDELINE SHOWN TO EDIT GRAPHICS IN THE MASTER SELECT: VIEW > SLIDE MASTER TO APPLY PAGE STYLES RIGHT CLICK YOUR PAGE >LAYOUT TO EDIT THE FOOTER IN THE MASTER SELECT: VIEW > SLIDE MASTER Sarah Verdon Sharynne McLeod Sandie Wong Charles Sturt University Research Institute for Professional Practice, Learning and Education Bathurst, Australia ISCAR Conference Sydney, October 2, 2014 Imagining new possibilities for embracing cultural and linguistic diversity in children with communication difficulties

DO NOT PLACE ANY TEXT OR GRAPHICS ABOVE THE GUIDELINE SHOWN DO NOT PLACE ANY TEXT OR GRAPHICS BELOW THE GUIDELINE SHOWN TO EDIT GRAPHICS IN THE MASTER SELECT: VIEW > SLIDE MASTER TO APPLY PAGE STYLES RIGHT CLICK YOUR PAGE >LAYOUT TO EDIT THE FOOTER IN THE MASTER SELECT: VIEW > SLIDE MASTER Speech and language pathology Professionals are known as speech-language pathologists (SLPs), speech and language therapists, othophonists, logopedists Allied health professionals who specialise in the evaluation and treatment of communication and swallowing disorders Work within medical and educational contexts Pathology/impairment-based approach to working with clients Evidence-based, “gold standard” oriented practice

DO NOT PLACE ANY TEXT OR GRAPHICS ABOVE THE GUIDELINE SHOWN DO NOT PLACE ANY TEXT OR GRAPHICS BELOW THE GUIDELINE SHOWN TO EDIT GRAPHICS IN THE MASTER SELECT: VIEW > SLIDE MASTER TO APPLY PAGE STYLES RIGHT CLICK YOUR PAGE >LAYOUT TO EDIT THE FOOTER IN THE MASTER SELECT: VIEW > SLIDE MASTER A contemporary challenge for speech- language pathology: Engaging in effective practice with children from culturally and linguistically diverse contexts

DO NOT PLACE ANY TEXT OR GRAPHICS ABOVE THE GUIDELINE SHOWN DO NOT PLACE ANY TEXT OR GRAPHICS BELOW THE GUIDELINE SHOWN TO EDIT GRAPHICS IN THE MASTER SELECT: VIEW > SLIDE MASTER TO APPLY PAGE STYLES RIGHT CLICK YOUR PAGE >LAYOUT TO EDIT THE FOOTER IN THE MASTER SELECT: VIEW > SLIDE MASTER Challenges for SLPs working with multilingual children Referral Under-referral of multilingual children Insufficient case history information Assessment Limited availability and access to culturally appropriate assessment tools Lack of normative data Lack of confidence in differential diagnosis Intervention Intervention in only one language Choice of language for intervention Lack of culturally appropriate intervention resources

DO NOT PLACE ANY TEXT OR GRAPHICS ABOVE THE GUIDELINE SHOWN DO NOT PLACE ANY TEXT OR GRAPHICS BELOW THE GUIDELINE SHOWN TO EDIT GRAPHICS IN THE MASTER SELECT: VIEW > SLIDE MASTER TO APPLY PAGE STYLES RIGHT CLICK YOUR PAGE >LAYOUT TO EDIT THE FOOTER IN THE MASTER SELECT: VIEW > SLIDE MASTER Purpose To adopt Cultural Historical Activity Theory as a means to identify the major challenges facing speech-language pathologists (SLPs) in their practice with culturally diverse children with speech, language and communication needs and to reconceptualise the enactment of practice in this field

DO NOT PLACE ANY TEXT OR GRAPHICS ABOVE THE GUIDELINE SHOWN DO NOT PLACE ANY TEXT OR GRAPHICS BELOW THE GUIDELINE SHOWN TO EDIT GRAPHICS IN THE MASTER SELECT: VIEW > SLIDE MASTER TO APPLY PAGE STYLES RIGHT CLICK YOUR PAGE >LAYOUT TO EDIT THE FOOTER IN THE MASTER SELECT: VIEW > SLIDE MASTER Aims 1.What are international experts’ perceptions of speech and language therapy practice with children from diverse backgrounds? 2.What tensions arise in the CHAT framework between these perceptions? 3.How can approaches to practice be re-conceptualised to address these tensions?

DO NOT PLACE ANY TEXT OR GRAPHICS ABOVE THE GUIDELINE SHOWN DO NOT PLACE ANY TEXT OR GRAPHICS BELOW THE GUIDELINE SHOWN TO EDIT GRAPHICS IN THE MASTER SELECT: VIEW > SLIDE MASTER TO APPLY PAGE STYLES RIGHT CLICK YOUR PAGE >LAYOUT TO EDIT THE FOOTER IN THE MASTER SELECT: VIEW > SLIDE MASTER Method Recruitment of participants 92 people with specialist knowledge invited via 57 people accepted and formed the: International Expert Panel on Multilingual Children’s Speech 14 formed the face-to-face panel The remaining participants formed the online panel Participants The 14 face-to-face panel members were: Speech and language therapists, phoneticians, and linguists Experts in multilingualism and speech and language acquisition Had worked in 18 countries and spoke a range of 9 languages

DO NOT PLACE ANY TEXT OR GRAPHICS ABOVE THE GUIDELINE SHOWN DO NOT PLACE ANY TEXT OR GRAPHICS BELOW THE GUIDELINE SHOWN TO EDIT GRAPHICS IN THE MASTER SELECT: VIEW > SLIDE MASTER TO APPLY PAGE STYLES RIGHT CLICK YOUR PAGE >LAYOUT TO EDIT THE FOOTER IN THE MASTER SELECT: VIEW > SLIDE MASTER Method Data collection 1.Expert panel members met for a one-day workshop in Cork, Ireland prior to the 14th International Clinical Linguistics and Phonetics Association Conference, A chaired discussion took place to address challenges of, and aspirations for, working with children from culturally and linguistically diverse backgrounds suspected of communication needs

DO NOT PLACE ANY TEXT OR GRAPHICS ABOVE THE GUIDELINE SHOWN DO NOT PLACE ANY TEXT OR GRAPHICS BELOW THE GUIDELINE SHOWN TO EDIT GRAPHICS IN THE MASTER SELECT: VIEW > SLIDE MASTER TO APPLY PAGE STYLES RIGHT CLICK YOUR PAGE >LAYOUT TO EDIT THE FOOTER IN THE MASTER SELECT: VIEW > SLIDE MASTER Method Data analysis 1.Panel discussion was professionally transcribed 2.Data were analysed using Cultural Historical Activity Theory as an heuristic framework to deconstruct the individual elements of SLTs’ practice with multilingual children 3.These elements were then re-assembled to analyze the tensions that occur within and between each element of the framework

DO NOT PLACE ANY TEXT OR GRAPHICS ABOVE THE GUIDELINE SHOWN DO NOT PLACE ANY TEXT OR GRAPHICS BELOW THE GUIDELINE SHOWN TO EDIT GRAPHICS IN THE MASTER SELECT: VIEW > SLIDE MASTER TO APPLY PAGE STYLES RIGHT CLICK YOUR PAGE >LAYOUT TO EDIT THE FOOTER IN THE MASTER SELECT: VIEW > SLIDE MASTER Results Part 1: Identifying elements within the system

DO NOT PLACE ANY TEXT OR GRAPHICS ABOVE THE GUIDELINE SHOWN DO NOT PLACE ANY TEXT OR GRAPHICS BELOW THE GUIDELINE SHOWN TO EDIT GRAPHICS IN THE MASTER SELECT: VIEW > SLIDE MASTER TO APPLY PAGE STYLES RIGHT CLICK YOUR PAGE >LAYOUT TO EDIT THE FOOTER IN THE MASTER SELECT: VIEW > SLIDE MASTER Results Part 2: Tensions and contradictions People Practicalities Policy

DO NOT PLACE ANY TEXT OR GRAPHICS ABOVE THE GUIDELINE SHOWN DO NOT PLACE ANY TEXT OR GRAPHICS BELOW THE GUIDELINE SHOWN TO EDIT GRAPHICS IN THE MASTER SELECT: VIEW > SLIDE MASTER TO APPLY PAGE STYLES RIGHT CLICK YOUR PAGE >LAYOUT TO EDIT THE FOOTER IN THE MASTER SELECT: VIEW > SLIDE MASTER Results Layer 2: Tensions and contradictions People Highlights that children should be considered in the context of their home and community (as a whole person) rather than in the confines of the clinical setting (isolating one aspect of the person) Consideration of cultural views, ideals and beliefs Tensions Arise when there is a mismatch between the ideals and beliefs of different people working towards the same object

DO NOT PLACE ANY TEXT OR GRAPHICS ABOVE THE GUIDELINE SHOWN DO NOT PLACE ANY TEXT OR GRAPHICS BELOW THE GUIDELINE SHOWN TO EDIT GRAPHICS IN THE MASTER SELECT: VIEW > SLIDE MASTER TO APPLY PAGE STYLES RIGHT CLICK YOUR PAGE >LAYOUT TO EDIT THE FOOTER IN THE MASTER SELECT: VIEW > SLIDE MASTER Results Layer 2: Tensions and contradictions Practicalities Highlights the need to take more time to assess and analyze children’s functioning and participation using a variety of tools, in a range of contexts Tensions Contradictions between the ideal and the reality of practice arose in terms of the rules SLTs are bound by in their practice and also the time and funding available to fulfill such aspirations

DO NOT PLACE ANY TEXT OR GRAPHICS ABOVE THE GUIDELINE SHOWN DO NOT PLACE ANY TEXT OR GRAPHICS BELOW THE GUIDELINE SHOWN TO EDIT GRAPHICS IN THE MASTER SELECT: VIEW > SLIDE MASTER TO APPLY PAGE STYLES RIGHT CLICK YOUR PAGE >LAYOUT TO EDIT THE FOOTER IN THE MASTER SELECT: VIEW > SLIDE MASTER Results Layer 2: Tensions and contradictions Policy Highlights that SLTs are bound to work within certain contexts and within specified policies and procedures of different organizations and governments Tensions ‘ Top-down’ changes at organizational and government level are needed to allow SLTs to adopt better strategies Tensions between aspirations of best practice and current policies must also be negotiated in a ‘bottom up’ manner by SLTs

DO NOT PLACE ANY TEXT OR GRAPHICS ABOVE THE GUIDELINE SHOWN DO NOT PLACE ANY TEXT OR GRAPHICS BELOW THE GUIDELINE SHOWN TO EDIT GRAPHICS IN THE MASTER SELECT: VIEW > SLIDE MASTER TO APPLY PAGE STYLES RIGHT CLICK YOUR PAGE >LAYOUT TO EDIT THE FOOTER IN THE MASTER SELECT: VIEW > SLIDE MASTER Implications CHAT highlighted tensions as opportunities for change, not just insurmountable challenges The SLT has the power to continually change their approach to practice and therefore challenge the very nature of the activity system Despite tensions, adopting recommended strategies would ultimately save clinical time by making practice more efficient and enabling goals to be achieved more quickly and effectively “SLT time is minimised because…you’re selecting the most effective and efficient intervention approach but also you are achieving change in the child which long-term means that they are… able to function in a social and work environment”. Expert Panel member

DO NOT PLACE ANY TEXT OR GRAPHICS ABOVE THE GUIDELINE SHOWN DO NOT PLACE ANY TEXT OR GRAPHICS BELOW THE GUIDELINE SHOWN TO EDIT GRAPHICS IN THE MASTER SELECT: VIEW > SLIDE MASTER TO APPLY PAGE STYLES RIGHT CLICK YOUR PAGE >LAYOUT TO EDIT THE FOOTER IN THE MASTER SELECT: VIEW > SLIDE MASTER

DO NOT PLACE ANY TEXT OR GRAPHICS ABOVE THE GUIDELINE SHOWN DO NOT PLACE ANY TEXT OR GRAPHICS BELOW THE GUIDELINE SHOWN TO EDIT GRAPHICS IN THE MASTER SELECT: VIEW > SLIDE MASTER TO APPLY PAGE STYLES RIGHT CLICK YOUR PAGE >LAYOUT TO EDIT THE FOOTER IN THE MASTER SELECT: VIEW > SLIDE MASTER Contributions of this paper The application of Cultural Historical Activity Theory to the practice of speech and language therapy with multilingual children Facilitates understanding of the existing tensions Reveals the futility of trying to implement a one size fits all ‘gold standard’ method of assessment and intervention Facilitates a shift in thinking toward resolving the tension arising in practice with multilingual children Empowers SLTs to change the system that confines their current practice

DO NOT PLACE ANY TEXT OR GRAPHICS ABOVE THE GUIDELINE SHOWN DO NOT PLACE ANY TEXT OR GRAPHICS BELOW THE GUIDELINE SHOWN TO EDIT GRAPHICS IN THE MASTER SELECT: VIEW > SLIDE MASTER TO APPLY PAGE STYLES RIGHT CLICK YOUR PAGE >LAYOUT TO EDIT THE FOOTER IN THE MASTER SELECT: VIEW > SLIDE MASTER For more information Verdon, S., McLeod, S., & Wong, S. (2014). Reconceptualising practice with multilingual children with speech sound disorders: People, practicalities, and policy. International Journal of Language and Communication Disorders. doi: /

DO NOT PLACE ANY TEXT OR GRAPHICS ABOVE THE GUIDELINE SHOWN DO NOT PLACE ANY TEXT OR GRAPHICS BELOW THE GUIDELINE SHOWN TO EDIT GRAPHICS IN THE MASTER SELECT: VIEW > SLIDE MASTER TO APPLY PAGE STYLES RIGHT CLICK YOUR PAGE >LAYOUT TO EDIT THE FOOTER IN THE MASTER SELECT: VIEW > SLIDE MASTER Key references Engeström, Y. (1987). Learning by expanding: An activity-theoretical approach. Helsinki: Orienta- Konsultit. Goldstein, B. A. (2006). Clinical implications of research on language development and disorders in bilingual children. Topics in Language Disorders, 26(4), Hambly, H., Wren, Y., McLeod, S., & Roulstone, S. (2013). The influence of bilingualism on speech production: A systematic review. International Journal of Language & Communication Disorders, 48(1), McLeod, S. (2012). Multilingual speech assessment. In S. McLeod & B. A. Goldstein (Eds.), Multilingual aspects of speech sound disorders in children (pp ). Bristol, UK: Multilingual Matters. Paradis, J., Genesee, F., & Crago, M. (Eds.). (2011). Dual language development and disorders: A handbook on bilingualism and second language learning (2nd ed.). Baltimore, MD: Paul H. Brookes Publishing. World Health Organization (WHO Workgroup for the development of version of ICF for Children & Youth). (2007). International classification of functioning, disability and health: Children and youth version: ICF-CY. Geneva: World Health Organization.

DO NOT PLACE ANY TEXT OR GRAPHICS ABOVE THE GUIDELINE SHOWN DO NOT PLACE ANY TEXT OR GRAPHICS BELOW THE GUIDELINE SHOWN TO EDIT GRAPHICS IN THE MASTER SELECT: VIEW > SLIDE MASTER TO APPLY PAGE STYLES RIGHT CLICK YOUR PAGE >LAYOUT TO EDIT THE FOOTER IN THE MASTER SELECT: VIEW > SLIDE MASTER Sarah Verdon Sharynne McLeod Sandie Wong Charles Sturt University Research Institute for Professional Practice, Learning and Education Bathurst, Australia ISCAR Conference Sydney, October 2, 2014 Imagining new possibilities for embracing cultural and linguistic diversity in children with communication difficulties