IDENTIFICATION AND TREATMENT OF CHILDHOOD LANGUAGE IMPAIRMENT INMULTICULTURAL POPULATIONS



NIH GUIDE, Volume 21, Number 38, October 23, 1992



PA NUMBER:  PA-93-011



P.T. 34, AA



Keywords:

  Language Acquisition & Development 

  Learning Disabled Education 



National Institute on Deafness and Other Communication Disorders



PURPOSE



Many children who are members of multicultural populations, such as

African-, Asian-, and Hispanic-Americans, are often incorrectly

identified as language impaired because culturally appropriate

language assessment instruments are largely unavailable.  In

addition, those multicultural children with genuine language

disorders in need of remediation may go unrecognized.  The need for

culturally sensitive assessment tools to evaluate the language of

multicultural children has long been recognized, yet progress in this

area is lacking.  The National Institute on Deafness and Other

Communication Disorders (NIDCD) encourages applications to develop or

expand upon currently available diagnostic, as well as treatment

procedures, for language-impaired children from multicultural

environments.



HEALTHY PEOPLE 2000



The Public Health Service (PHS) is committed to achieving the health

promotion and disease prevention objectives of "Healthy People 2000,"

a PHS-led national activity for setting priority areas.  This Program

Announcement (PA), Identification and Treatment of Childhood Language

Impairment in Multicultural Populations, is related to the priority

areas of diabetes and chronic disabling conditions and special

population objectives.  Potential applicants may obtain a copy of

"Healthy People 2000" (Full Report:  Stock No. 017-001-11474-0 or

Summary Report:  Stock No. 017-001-11473-1) through the

Superintendent of Documents, Government Printing Office, Washington,

DC 20402-9325 (telephone 202-783-3238).



ELIGIBILITY REQUIREMENTS



Applications may be submitted by domestic and foreign, for-profit and

non-profit organizations, public and private, such as universities,

colleges, hospitals, laboratories, units of State and local

governments, and eligible agencies of the Federal government.

Applications from minority individuals and women are encouraged.

Foreign institutions are not eligible for the First Independent

Research Support and Transition (FIRST) (R29) Award or the Small

Business Innovation Research (SBIR) (R43) Awards.



MECHANISM OF SUPPORT



The support mechanisms for grants in this area will be the

investigator-initiated research grant (R01), the FIRST (R29) award,

and the SBIR (R43) award.



RESEARCH OBJECTIVES



The United States has a culturally diverse population, with the rate

of increase in the minority population accelerating in recent years.

According to recent census figures, 23 million people over the age of

five speak a language other than Standard English in the home.

Almost half of these individuals reportedly do not speak English at

all or do not speak it proficiently.  A disproportionate number of

children from these environments are identified as language impaired.

Dialectal varieties of English are not considered a disorder or a

pathological form of speech or language, although dialect speakers

may have language disorders within the dialect.  To make accurate

diagnoses of language impairment, it is important to distinguish

between those aspects of linguistic variation that represent a

difference or diversity from those that represent a disorder.



In recent years, researchers and clinicians have questioned the

validity of most speech and language assessment measures for

multicultural children.  Because of these children's diverse

cultural, economic, and linguistic backgrounds, these procedures and

instruments, by their content and design, often discriminate against

children whose native language is not Standard English.  Thus, high

proportions of these children are incorrectly identified as language

disordered and are subsequently placed into special education or

communication disorders programs.  Appropriate assessment of language

skills and proper academic placement are critical if multicultural

children are to achieve their potential.  Nonetheless, few

standardized tests address the issues of cultural and linguistic

diversity in their construction.  In addition, most available

instruments have not been standardized on children from different

cultural, economic, or linguistic backgrounds.  These problems make

appropriate diagnosis and treatment difficult.



Examples of issues to be addressed in applications submitted in

response to this PA include, but are not limited to, the following:



Language Impairment



o  Definition and characteristics of impaired language in specific

cultures at varying ages (including phonology, syntax, semantics,

pragmatics)



o  Bilingual proficiency and language disorders, including factors

such as type of exposure to English, age of acquisition of English,

and code switching



Assessment



o  Means of differentiating between language differences and

disorders across cultural groups (that is, procedures for

differentiating disordered language from normal language differences

due to a nonstandard dialect of English, or to the acquisition of

English as a second language)



o  Development of evaluative measures that are culturally fair, or

modifications/adaptations of existing measures that would make them

more culturally sensitive



o  Establishment of cultural norms for determining presence or

absence of communication disorders



o  Development of language sampling procedures or observational

techniques that are valid within specific cultures



o  Differing assessment models (e.g., natural context, questionnaire)

and their validity



o  Factors that influence assessment process, such as the effect of

ethnic group membership of the examiner on test scores; the test

environment; examiner's fluency in the child's language



Treatment



o  Factors that impede efficacy of treatment in the clinical

management of children from multicultural environments



o  Impact of cognitive factors, interpersonal and ecological factors,

preferred learning style, and cultural systems of belief on response

to treatment



o  Development of effective, innovative intervention strategies or

models of service delivery, and frameworks for treatment within

specific cultures



o  Factors related to effective language intervention, including

effects of using only the first language, both the first and second

languages, or English-only treatment; language skills of

speech-language pathologist in both languages; effects of

communication events within clinical setting on the level of

linguistic performance



STUDY POPULATIONS



SPECIAL INSTRUCTIONS TO APPLICANTS REGARDING IMPLEMENTATION OF NIH

POLICIES CONCERNING INCLUSION OF WOMEN AND MINORITIES IN CLINICAL

RESEARCH STUDY POPULATIONS



NIH policy is that applicants for NIH clinical research grants and

cooperative agreements are required to include minorities and women

in study populations so that research findings can be of benefit to

all persons at risk of the disease, disorder or condition under

study; special emphasis must be placed on the need for inclusion of

minorities and women in studies of diseases, disorders and conditions

which disproportionately affect them.  This policy is intended to

apply to males and females of all ages.  If women or minorities are

excluded or inadequately represented in clinical research,

particularly in proposed population-based studies, a clear compelling

rationale must be provided.



The composition of the proposed study population must be described in

terms of gender and racial/ethnic group.  In addition, gender and

racial/ethnic issues must be addressed in developing a research

design and sample size appropriate for the scientific objectives of

the study.  This information must be included in the form PHS 398 in

Sections 1-4 of the Research Plan AND summarized in Section 5, Human

Subjects.  Applicants are urged to assess carefully the feasibility

of including the broadest possible representation of minority groups.

However, the NIH recognizes that it may not be feasible or

appropriate in all research projects to include representation of the

full array of United States racial/ethnic minority populations (i.e.,

Native Americans [including American Indians or Alaskan Natives],

Asian/Pacific Islanders,African-Americans, Hispanics).  The rationale

for studies on single minority population groups should be provided.



For the purpose of this policy, clinical research is defined as human

biomedical and behavioral studies of etiology, epidemiology,

prevention (and preventive strategies), diagnosis, or treatment of

diseases, disorders or conditions, including but not limited to

clinical trials.



The usual NIH policies concerning research on human subjects also

apply.  Basic research or clinical studies in which human tissues

cannot be identified or linked to individuals are excluded.  However,

every effort should be made to include human tissues from women and

racial/ethnic minorities when it is important to apply the results of

the study broadly, and this should be addressed by applicants.



For foreign awards, the policy on inclusion of women applies fully;

since the definition of minority differs in other countries, the

applicant must discuss the relevance of research involving foreign

population groups to the United States' populations, including

minorities.



If the required information is not contained within the application,

the application will be returned.



Peer reviewers will address specifically whether the research plan in

the application conforms to these policies.  If the representation of

women or minorities in a study design is inadequate to answer the

scientific question(s) addressed AND the justification for the

selected study population is inadequate, it will be considered a

scientific weakness or deficiency in the study design and reflected

in assigning the priority score to the application.



All applications for clinical research submitted to the NIH are

required to address these policies.  NIH funding components will not

award grants or cooperative agreements that do not comply with these

policies.



APPLICATION PROCEDURES



Applications for R01 and FIRST (R29) awards are to be submitted on

the grant application form PHS 398 (rev. 9/91) and will be accepted

at the standard application deadlines as indicated in the application

kit.  Applications for SBIR (R43) awards are to be submitted on the

grant application form PHS 6246-1 (rev. 1/92) and will be accepted at

the SBIR application deadlines as indicated in the application kit.

These kits are available from most institutional offices of sponsored

research, the NIDCD Program Administrator cited below, and the Office

of Grants Inquiries, Division of Research Grants, National Institutes

of Health, Westwood Building, Room 449, Bethesda, MD 20892, telephone

(301) 496-7441.  The title and number of the announcement must be

typed in Section 2a on the face page of the application.  FIRST (R29)

award applications must include at least three sealed letters of

reference attached to the face page of the original application.

First (R29) award applications submitted without the required number

of reference letters will be considered incomplete and will be

returned to the applicant without review.



The completed original application and five legible copies of the PHS

398, or two copies of the PHS 6246-1, must be sent or delivered to:



Division of Research Grants

National Institutes of Health

Westwood Building, Room 240

Bethesda, MD  20892**



REVIEW CONSIDERATIONS



Applications will be reviewed for scientific and technical merit by

an appropriate Initial Review Group within the Division of Research

Grants, NIH, in accordance with the standard NIH peer review

procedures.  Following scientific-technical review, the applications

will receive a second-level review by the appropriate National

Advisory Council.



AWARD CRITERIA



Applications will compete for available funds with all other

applications.  The following will be considered in when funding

decisions:



o  Quality of the proposed project as determined by peer review

o  Availability of funds

o  Program balance among research areas of the announcement



INQUIRIES



Written and telephone inquiries concerning this PA are encouraged.

The opportunity to clarify any issues or questions from potential

applicants is welcome.



Direct inquiries regarding programmatic issues to:



Judith A. Cooper, Ph.D.

Deputy Director, Division of Communication Sciences and Disorders

National Institute on Deafness and Other Communication Disorders

Executive Plaza South, Room 400-B

6120 Executive Boulevard

Rockville, MD  20892

Telephone:  (301) 496-5061

FAX:  (301) 402-6251



Direct inquiries regarding fiscal matters to:



Sharon Hunt

Grants Management Officer

National Institute on Deafness and Other Communication Disorders

Executive Plaza South, Room 400-B

6120 Executive Boulevard

Rockville, MD  20892

Telephone:  (301) 402-0909



AUTHORITY AND REGULATIONS



This program is described in the Catalog of Federal Domestic

Assistance No. 93.173.  Awards are made under authorization of the

Public Health Service Act, Title IV, Part A (Public Law 78-410, as

amended by Public Law 99-158, 42 USC 241 and 285) and administered

under PHS grants policies and Federal Regulations 42 CFR 52 and 45

CFR Part 74.  This program is not subject to the intergovernmental

review requirements of Executive Order 12372 or Health Systems Agency

review.



.


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