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A continuously challenging issue in the field of speech–language pathology is accurately identifying and diagnosing a language disorder in school-aged (pre-kindergarten through 5th grade) bilingual children, as bilingual children are disproportionately under- and overidentified with a language disorder. The current review focuses on the assessment of bilingual children in pre-kindergarten through fifth grade, aimed to inform teachers, pediatricians, parents, and other relevant professionals of issues surrounding assessment of these dual-language learners. We examine the barriers to assessing bilingual children for language disorders, such as the lack of availability of bilingual tests, underinformative current best practice guidelines, lack of speech–language pathologist (SLP) training/knowledge of bilingualism, and use of interpreters. We discuss the necessary considerations when SLPs use norm-referenced tests with bilingual children, such as norming samples, accurate identification of a language disorder, reliability and validity, test administration, and potential solutions to using otherwise poorly suited norm-referenced tests. We also consider research on several alternative measures to norm-referenced assessments, including dynamic assessment, nonword repetition, language sampling, nonlinguistic cognition, and parent report. We conclude by synthesizing the information in this review to offer six principles of best practices for bilingual assessment.

Purpose: To improve the credibility, reproducibility, and clinical utility of research findings, many scientific fields are implementing transparent and open research practices. Such open science practices include researchers making their data publicly available and preregistering their hypotheses and analyses. A way to enhance the adoption of open science practices is for journals to encourage or require submitting authors to participate in such practices. Accordingly, the American Speech-Language-Hearing Association's Journals Program has recently announced their intention to promote open science practices. Here, we quantitatively assess the extent to which several journals in communication sciences and disorders (CSD) encourage or require participation in several open science practices by using the Transparency and Openness Promotion (TOP) Factor metric. Method: TOP Factors were assessed for 34 CSD journals, as well as several journals in related fields. TOP Factors measure the level of implementation across 10 open science–related practices (e.g., data transparency, analysis plan preregistration, and replication) for a total possible score of 29 points. Results: Collectively, CSD journals had very low TOP Factors ( M = 1.4, range: 0–8). The related fields of Psychology ( M = 4.0), Rehabilitation ( M = 3.2), Linguistics ( M = 1.7), and Education ( M = 1.6) also had low scores, though Psychology and Rehabilitation had higher scores than CSD. Conclusion: CSD journals currently have low levels of encouraging or requiring participation in open science practices, which may impede adoption. Open Science Form: https://doi.org/10.23641/asha.21699458

How we perceive and learn about our environment is influenced by our prior experiences and existing representations of the world. Top-down cognitive processes, such as attention and expectations, can alter how we process sensory stimuli, both within a modality (e.g., effects of auditory experience on auditory perception), as well as across modalities (e.g., effects of visual feedback on sound localization). Here, we demonstrate that experience with different types of auditory input (spoken words vs. environmental sounds) modulates how humans remember concurrently-presented visual objects. Participants viewed a series of line drawings (e.g., picture of a cat) displayed in one of four quadrants while listening to a word or sound that was congruent (e.g., “cat” or ), incongruent (e.g., “motorcycle” or ), or neutral (e.g., a meaningless pseudoword or a tonal beep) relative to the picture. Following the encoding phase, participants were presented with the original drawings plus new drawings and asked to indicate whether each one was “old” or “new.” If a drawing was designated as “old,” participants then reported where it had been displayed. We find that words and sounds both elicit more accurate memory for what objects were previously seen, but only congruent environmental sounds enhance memory for where objects were positioned – this, despite the fact that the auditory stimuli were not meaningful spatial cues of the objects’ locations on the screen. Given that during real-world listening conditions, environmental sounds, but not words, reliably originate from the location of their referents, listening to sounds may attune the visual dorsal pathway to facilitate attention and memory for objects’ locations. We propose that audio-visual associations in the environment and in our previous experience jointly contribute to visual memory, strengthening visual memory through exposure to auditory input.

How does the mind process linguistic and non-linguistic sounds? The current study assessed the different ways that spoken words (e.g., “dog”) and characteristic sounds (e.g., ) provide access to phonological information (e.g., word-form of “dog”) and semantic information (e.g., knowledge that a dog is associated with a leash). Using an eye-tracking paradigm, we found that listening to words prompted rapid phonological activation, which was then followed by semantic access. The opposite pattern emerged for sounds, with early semantic access followed by later retrieval of phonological information. Despite differences in the time courses of conceptual access, both words and sounds elicited robust activation of phonological and semantic knowledge. These findings inform models of auditory processing by revealing the pathways between speech and non-speech input and their corresponding word forms and concepts, which influence the speed, magnitude, and duration of linguistic and nonlinguistic activation.

Objective The purpose of the study was to determine whether listeners were less likely to believe a statement that is produced in an atypical voice, as compared to a typical voice. It was hypothesized that an atypical voice, characterized by abnormal roughness, strain, and pitch, would elicit increased skepticism. This hypothesis was based on previous evidence that there are negative stereotypes against individuals who have a voice disorder, and that increased difficulty processing an utterance can lead to disbelief. Methods In Experiment 1, 36 listeners rated obscure trivia statements (such as “the elephant is the only mammal that cannot jump” and “the first public library was opened in Vienna in 1745”) as definitely false, probably false, probably true, or definitely true. The statements were produced by a speaker who used their typical voice and simulated an atypical voice (of severe deviance according to the CAPE-V), as well as two additional control speakers with typical voices. Experiment 2 was a replication of Experiment 1 with a new set of 36 listeners and a new set of speakers. In addition, Experiment 2 examined whether reduced credibility was due to negative stereotypes and/or processing difficulty, through questionnaire data and correlation analyses. Results The results were largely consistent with the hypothesis that statements produced in an atypical voice would be perceived as less credible. In both experiments, the percentage of definitely false ratings was higher for the atypical voice than for the typical voice and control voices, with a large effect size in Experiment 1 and a medium effect size in Experiment 2. Further, Experiment 2 suggested that reduced credibility was due to negative stereotypes but not processing difficulty. Conclusion The current study reveals a social consequence of having a voice disorder, i.e., decreased perceived credibility, with implications for job-related success.

Can experience change perception? Here, we examine whether language experience shapes the way individuals process auditory and visual information. We used the McGurk effectmdash;the discovery that when people hear a speech sound (e.g.,ldquo;bardquo;) and see a conflicting lip movement (e.g.,ldquo;gardquo;), they recognize it as a completely new sound (e.g.,ldquo;dardquo;). This finding suggests that the brain fuses input across auditory and visual modalities demonstrates that what we hear is profoundly influenced by what we see. We find that cross-modal integration is affected by language background, with bilinguals experiencing the McGurk effect more than monolinguals. This increased reliance on the visual channel is not due to decreased language proficiency, as the effect was observed even among highly proficient bilinguals. Instead, we propose that the challenges of learning and monitoring multiple languages have lasting consequences for how individuals process auditory and visual information.

Wrong-drug errors, thought to be caused primarily by drug names that look and/or sound alike, occur at a rate of about one error per thousand dispensed prescriptions in the outpatient setting and one per thousand orders in the inpatient setting.1 ,2 Most are relatively benign, but some cause severe or even fatal harm.3–5 One of the best known attempts to reduce drug name confusion has been the use of mixed case or ‘Tall Man’ lettering.6 The idea is to use capital letters to maximise the visual perceptual difference between two similar drug names. Thus, vinblastine and vincristine become vinBLAStine and vinCRIStine. If some look-alike/sound-alike (LASA) mix-ups are caused by errors in visual perception, the reasoning goes, then making the names more visually distinct should reduce the probability of confusion and error. After being endorsed by the US Food and Drug Administration (FDA),6 the Institute for Safe Medication Practices (ISMP),7 The Joint Commission8 and others, the practice has become widespread.9 However, apart from limited evidence of effectiveness in laboratory settings, no evidence shows that this technique prevents drug name confusion errors in clinical practice. Zhong et al 10 attempted to assess the effect of Tall Man lettering on drug name confusion errors in a large scale, longitudinal, observational study. They conclude that this widely disseminated error-prevention strategy had no measurable effect on the rate of drug name confusions in 9 years of data from 42 children's hospitals in the USA. Below we comment on methodological issues in the Zhong et al study, review laboratory research on Tall Man lettering and consider policy implications. The authors are to be commended for conducting a large-scale, empirical test of the effect of Tall Man lettering on the drug name confusion error rate in real-world clinical settings. The …

The current study examined the impact of language experience on the ability to efficiently search for objects in the face of distractions. Monolingual and bilingual participants completed an ecologically-valid, object-finding task that contained conflicting, consistent, or neutral auditory cues. Bilinguals were faster than monolinguals at locating the target item, and eye movements revealed that this speed advantage was driven by bilinguals' ability to overcome interference from visual distractors and focus their attention on the relevant object. Bilinguals fixated the target object more often than did their monolingual peers, who, in contrast, attended more to a distracting image. Moreover, bilinguals', but not monolinguals', object-finding ability was positively associated with their executive control ability. We conclude that bilinguals' executive control advantages extend to real-world visual processing and object finding within a multi-modal environment.

We examined how well typical adult listeners remember the speech of a person with a voice disorder (relative to that of a person without a voice disorder). Participants (n = 40) listened to two lists of words (one list uttered in a disordered voice and the other list uttered in a normal voice). After each list, participants completed a free recall test, in which they tried to remember as many words as they could. While the total number of words recalled did not differ between the disordered voice condition and the normal voice condition, an investigation of the serial-position curve revealed a difference. In the normal voice condition, a parabolic (i.e., u-shaped) serial-position curve was observed, with a significant primacy effect (i.e., the beginning of the list was remembered better than the middle) and a significant recency effect (i.e., the end of the list was remembered better than the middle). In contrast, in the disordered voice condition, while there was a significant recency effect, no primacy effect was present. Thus, the increased ability to remember the first words uttered by a speaker (relative to subsequent words) may disappear when the speaker has a voice disorder. Explanations and implications of this finding are discussed.

The effects of bilingual education on reading and math achievement were examined by comparing test scores across different elementary school programs. Results revealed that bilingual Two-Way Immersion (TWI) programs benefited both minority-language and majority-language students. Minority-language students in TWI programs outperformed their peers in Transitional Programs of Instruction, while majority-language students in Two-Way Immersion outperformed their peers in Mainstream monolingual classrooms. Bilingual Two-Way Immersion programs may enhance reading and math skills in both minority-language and majority-language elementary school children.

Musical experience may benefit learning of a new language by increasing the fidelity with which the auditory system encodes sound. In the current study, participants with varying degrees of musical experience were exposed to two statistically defined languages consisting of auditory Morse code sequences that varied in difficulty. We found an advantage for highly skilled musicians, relative to lower-skilled musicians, in learning novel Morse code-based words. Furthermore, in the more difficult learning condition, performance of lower-skilled musicians was mediated by their general cognitive abilities. We suggest that musical experience may improve processing of statistical information and that musicians’ enhanced ability to learn statistical probabilities in a novel Morse code language may extend to natural language learning.

Aims and objectives: The objectives of the present research were to examine the cognitive consequences of trilingualism and explain them relative to the cognitive consequences of bilingualism. Approach: A comparison of cognitive abilities in trilinguals and bilinguals was conducted. In addition, we proposed a cognitive plasticity framework to account for cognitive differences and similarities between trilinguals and bilinguals. Data and analysis: Three aspects of cognition were analyzed: (1) cognitive reserve in older adults, as measured by age of onset of Alzheimer’s disease and mild cognitive impairment; (2) inhibitory control in children and younger adults, as measured by response times on behavioral Simon and flanker tasks; and (3) memory generalization in infants and toddlers, as measured by accuracy on behavioral deferred imitation tasks. Results were considered within a framework of cognitive plasticity, which took into account several factors that may affect plasticity including the age of learning a third language and the extent to which additional cognitive resources are needed to learn the third language. Findings: A mixed pattern of results was observed. In some cases, such as cognitive reserve in older adults, trilinguals showed larger advantages than did bilinguals. On other measures, for example inhibitory control in children and younger adults, trilinguals were found to exhibit the same advantages as bilinguals. In still other cases, such as memory generalization in infants and toddlers, trilinguals did not demonstrate the advantages seen in bilinguals. Originality: This study is the first comprehensive analysis of how learning a third language affects the cognitive abilities that are modified by bilingual experience, and the first to propose a cognitive plasticity framework that can explain and predict trilingual-bilingual differences. Significance: This research shows that the cognitive consequences of trilingualism are not simply an extension of bilingualism’s effects; rather, trilingualism has distinct consequences, with theoretical implications for our understanding of linguistic and cognitive processes and their plasticity, as well as applied-science implications for using second and third language learning in educational and rehabilitative contexts to foster successful cognitive development and aging.

The ability to remember events - referred to as episodic memory - is typically subject to decline in older adulthood. Episodic memory decline has been attributed in part to less successful executive functioning, which may hinder an older adult's ability to implement controlled encoding and retrieval processes. Since bilingual older adults often show more successful executive functioning than monolinguals, they may be better able to maintain episodic memory. To examine this hypothesis, we compared bilingual and monolingual older adults on a picture scene recall task (assessing episodic memory) and a Simon task (assessing executive functioning). Bilinguals exhibited better episodic memory than their monolingual peers, recalling significantly more items overall. Within the bilingual group, earlier second language acquisition and more years speaking two languages were associated with better recall. Bilinguals also demonstrated higher executive functioning, and there was evidence that level of executive functioning was related to memory performance. Results indicate that extensive practice controlling two languages may benefit episodic memory in older adults.

Recent research suggests that bilingual experience reconfigures linguistic and nonlinguistic cognitive processes. We examined the relationship between linguistic competition resolution and nonlinguistic cognitive control in younger and older adults who were either bilingual or monolingual. Participants heard words in English and identified the referent among four pictures while eye-movements were recorded. Target pictures (e.g., cab) appeared with a phonological competitor picture (e.g., cat) and two filler pictures. After each eye-tracking trial, priming probes assessed residual activation and inhibition of target and competitor words. When accounting for processing speed, results revealed that age-related changes in activation and inhibition are smaller in bilinguals than in monolinguals. Moreover, younger and older bilinguals, but not monolinguals, recruited similar inhibition mechanisms during word identification and during a nonlinguistic Stroop task. Results suggest that, during lexical access, bilinguals show more consistent competition resolution and recruitment of cognitive control across the lifespan than monolinguals.

Background Drug name confusion is a common type of medication error and a persistent threat to patient safety. In the USA, roughly one per thousand prescriptions results in the wrong drug being filled, and most of these errors involve drug names that look or sound alike. Prior to approval, drug names undergo a variety of tests to assess their potential for confusability, but none of these preapproval tests has been shown to predict real-world error rates. Objectives We conducted a study to assess the association between error rates in laboratory-based tests of drug name memory and perception and real-world drug name confusion error rates. Methods Eighty participants, comprising doctors, nurses, pharmacists, technicians and lay people, completed a battery of laboratory tests assessing visual perception, auditory perception and short-term memory of look-alike and sound-alike drug name pairs (eg, hydroxyzine/hydralazine). Results Laboratory test error rates (and other metrics) significantly predicted real-world error rates obtained from a large, outpatient pharmacy chain, with the best-fitting model accounting for 37% of the variance in real-world error rates. Cross-validation analyses confirmed these results, showing that the laboratory tests also predicted errors from a second pharmacy chain, with 45% of the variance being explained by the laboratory test data. Conclusions Across two distinct pharmacy chains, there is a strong and significant association between drug name confusion error rates observed in the real world and those observed in laboratory-based tests of memory and perception. Regulators and drug companies seeking a validated preapproval method for identifying confusing drug names ought to consider using these simple tests. By using a standard battery of memory and perception tests, it should be possible to reduce the number of confusing look-alike and sound-alike drug name pairs that reach the market, which will help protect patients from potentially harmful medication errors.

Most of the world's population has knowledge of at least two languages. Many of these bilinguals are also exposed to and identify with at least two cultures. Because language knowledge enables participation in cultural practices and expression of cultural beliefs, bilingual experience and cultural identity are interconnected. However, the specific links between bilingualism and cultural identity remain largely unidentified. The current study examined which aspects of bilingualism relate to identification with first- and second-language cultures. Two-hundred-and-nine bilinguals completed a questionnaire probing linguistic background and cultural affiliations. Regression analyses indicated that cultural identification was predicted by age of language acquisition, language proficiency, foreign-accentedness, and contexts of long-term language immersion and current language exposure. Follow-up analyses revealed that the language-culture relations were mediated by the age and manner in which the second language was acquired. These findings are situated within a proposed framework of bilingual cultural identity. By identifying features of bilingualism that are relevant for cultural identity, the current research increases our understanding of the relationship between language and culture.

Learning how to speak a second language (i.e., becoming a bilingual) and learning how to play a musical instrument (i.e., becoming a musician) are both thought to increase executive control through experience-dependent plasticity. However, evidence supporting this effect is mixed for bilingualism and limited for musicianship. In addition, the combined effects of bilingualism and musicianship on executive control are unknown. To determine whether bilingualism, musicianship, and combined bilingualism and musicianship improve executive control, we tested 219 young adults belonging to one of four groups (bilinguals, musicians, bilingual musicians, and controls) on a nonlinguistic, nonmusical, visual-spatial Simon task that measured the ability to ignore an irrelevant and misinformative cue. Results revealed that bilinguals, musicians, and bilingual musicians showed an enhanced ability to ignore a distracting cue relative to controls, with similar levels of superior performance among bilinguals, musicians, and bilingual musicians. These results indicate that bilingualism and musicianship improve executive control and have implications for educational and rehabilitation programs that use music and foreign language instruction to boost cognitive performance.

A remarkable feat of human memory is the ability to vividly remember details from many past experiences ranging from meaningful, distant memories, such as a family member’s wedding over a decade ago, to mundane, recent memories, like dinner last night.

We examined the influence of bilingual experience and inhibitory control on the ability to learn a novel language. Using a statistical learning paradigm, participants learned words in two novel languages that were based on the International Morse Code. First, participants listened to a continuous stream of words in a Morse code language to test their ability to segment words from continuous speech. Since Morse code does not overlap in form with natural languages, interference from known languages was minimized. Next, participants listened to another Morse code language composed of new words that conflicted with the first Morse code language. Interference in this second language was high due to conflict between languages and due to the presence of two colliding cues (compressed pauses between words and statistical regularities) that competed to define word boundaries. Results suggest that bilingual experience can improve word learning when interference from other languages is low, while inhibitory control ability can improve word learning when interference from other languages is high. We conclude that the ability to extract novel words from continuous speech is a skill that is affected both by linguistic factors, such as bilingual experience, and by cognitive abilities, such as inhibitory control.