A Retrospective Review of Communication Evaluation Practices of Young Latinx Children

Abstract

A retrospective review of initial early intervention and early childhood special education (EI/ECSE) evaluation reports was completed to identify practices specific to the evaluation of Latinx children’s communication development. A records abstraction approach employed entailed a random selection of 294 EI/ECSE evaluation reports completed in Oregon with Latinx children with communication concerns. The reports were coded for documentation of background information, evaluation procedures, and eligibility decisions. Quantitative and qualitative analyses were completed to identify common evaluation practices. Adequate evaluation practices documented included the use of a multidisciplinary evaluation team, administration of multiple evaluation measures, and provision of basic information on children’s language background. EI/ECSE providers did not consistently specify children’s language exposure/use, denote the language of the evaluation, prioritize appropriate assessment measures, and indicate attention to cultural and linguistic differences when determining eligibility. Recommendations for decreasing bias in the evaluation of Latinx children and culturally and linguistically diverse (CLD) populations more broadly are offered.

Moving Through the Pipeline: Ethnic and Linguistic Disparities in Special Education from Birth Through Age Five

“…Reasons for this lack of diagnostic specificity (i.e., getting a "general" communication disorder diagnosis versus an ASD or HI diagnosis) could not be examined in this data set. However, these results reflect similar national patterns regarding Latino/a disparities in ASD diagnosis in particular (Maenner et al, 2020), likely related to biased evaluation practices; bias in diagnostic tools; and/or differences in parental knowledge, social capital, empowerment, and/or involvement in the EI/ECSE eligibility process (Azim et al, 2020;Huerta et al, 2021;Parish et al, 2012;Stahmer et al, 2019;Vanegas et al, 2016;Zuckerman et al, 2013;Zuckerman et al, 2014). It is also unclear why some children are more likely to receive a diagnosis of language versus speech delay, particularly given the lack of evidence that prevalence of CD types should inherently vary by child ethnicity or home language(s).…”

“…For example, we had no measure of parental English proficiency, which has been shown to be a strong predictor of child health and educational differences (Flores et al, 2005). We were also unable to assess in this study whether the EI/ECSE assessment services were culturally and linguistically responsive or compliant with state and federal regulations specific to children from multilingual and multicultural homes; yet, previous reports on this issue suggest they are not (Huerta et al, 2021). Last, the data set only had information on children who had engaged with EI/ECSE; disparities in who accesses this system in the first place may be of critical importance.…”

“…It is also unclear why some children are more likely to receive a diagnosis of language versus speech delay, particularly given the lack of evidence that prevalence of CD types should inherently vary by child ethnicity or home language(s). EI/ECSE providers may not know how or have the resources to properly assess speech production in multilingual or multicultural contexts (Huerta et al, 2021; Guiberson & Atkins, 2012), may misattribute articulation difficulties to language delay when children are from multilingual backgrounds, may fail to notice differences in articulation in a language that they do not speak proficiently, or may overattribute errors in articulation to dialectal differences in a failed attempt to be sensitive to children’s linguistic varieties. Regardless of the cause, differences in ASD and HI identification rates and misdiagnosis of CDs are of serious concern.…”

“…Therefore, EI/ECSE providers may need specific training in identifying early signs of ASD and HI in diverse contexts in addition to administration and interpretation of least-biased approaches that support differential diagnosis of CDs from the natural influences of children’s language(s) and culture(s) on communication development (e.g., dynamic assessment; Castilla-Earls et al, 2020) as required by law (IDEA, 2004). Unfortunately, research demonstrates that Oregon’s EI/ECSE providers are not currently using such practices when evaluating Latino/a children (Huerta et al, 2021), potentially leading to non-condition-focused, or wrong-condition-focused, treatment plans for children from diverse backgrounds.…”

“…Disproportionality in participation of non-White children in special education was first identified over 50 years ago (Dunn, 1968), and widespread inequities in EI and ECSE persist. Such inequities have been tied to differences in cultural perspectives on disability; decreased access to primary care; limited information available in languages other than English or bilingual providers; poor outreach to and collaboration with families; few culturally and linguistically appropriate evaluation tools; infrequent implementation of least-biased assessment practices; difficulties distinguishing disability from natural differences based on language exposure, culture, and/or experience; provider bias and discrimination toward children of color; and restrictive policies and funding (e.g., Hardin et al, 2009; Huerta et al, 2021; Sapiets et al, 2021; Wolfe & Durán, 2013; Zuckerman et al, 2014). Ultimately, systemic racism or the systematic, long-standing marginalization of communities of color within US institutions underlies these challenges (Blanchard et al, 2021).…”