The identification of speech disorders in Pakistani heritage children

Abstract

This thesis investigates aspects of the identification of speech disorders in Pakistani heritage children who speak Mirpuri, Punjabi and Urdu and who live in England. It provides the first normative data on this population. The majority of health and education professionals are monolingual English speakers. Consequently it was hypothesised that Pakistani heritage children with speech disorders would not be identified as readily as their monolingual English-speaking peers. A two-year survey of referrals to a speech and language therapy department confirmed a statistically significant under-referral of Pakistani heritage children with speech disorders. Questionnaires completed by education staff and interviews conducted with referral agents confirmed that lack of appropriate assessment tools and normative data regarding speech sound development in the target languages were hampering identification. The development of a speech screening tool targeting the Pakistani heritage languages is outlined. This speech screen was subsequently used with 246 children aged 1 ;04 - 7; 11 to develop normative data including age of phoneme acquisition and occurrence of phonological error patterns. Use of the speech screen with children attending an education nursery confirmed its validity as a screening tool. Parent questionnaires conducted with parents contradicted previous findings and indicated that parents within the target community were not able to identify speech difficulties in their own children. This was the first time that such a questionnaire had been delivered in a verbal format: the parental mother tongue has no written form. Three case studies of individual children are presented. These confirm that therapy delivered in Mirpuri which targets underlying deficits in the speech processing chain will have an effect on other languages spoken by a child. This thesis contributes to theories regarding phonological development and disorder across different populations and provides evidence to support professionals in the development of evidence-based services to Pakistani heritage children with speech disorders.