LANGUAGE OUTCOMES IN SCHOOL-AGED CHILDREN ADOPTED FROM EASTERN ...

226 Pages·2005·2.85 MB·English

LANGUAGE OUTCOMES IN SCHOOL-AGED CHILDREN ADOPTED FROM
EASTERN EUROPEAN ORPHANAGES

by

Susan D. Hough

B.A. Pennsylvania State University, 1976

M.A. University of Pittsburgh, 1979

Submitted to the Graduate Faculty of

Education in partial fulfillment

of the requirements for the degree of

Doctor of Philosophy

University of Pittsburgh

2005
UNIVERSITY OF PITTSBURGH

SCHOOL OF EDUCATION

This dissertation was presented

by

Susan D. Hough

It was defended on

April 25, 2005

and approved by

Dr. Naomi Zigmond, Professor, Department of Instruction and Learning

Dr. M.Virginia Swisher, Associate Professor, Department of Instruction and Learning

Dr. Heidi Feldman, Professor, Dept of Pediatrics, School of Medicine.

Dr. Nancy Hepting, Associate Professor, Armstrong Atlantic State University,
Department of Speech Pathology

Dr. Louise Kaczmarek, Associate Professor, Department of Instruction and Learning
Dissertation Director

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Copyright by Susan D. Hough
2005

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LANGUAGE OUTCOMES IN SCHOOL-AGED CHILDREN ADOPTED FROM
EASTERN EUROPEAN ORPHANAGES

Susan D. Hough, Ph.D.

University of Pittsburgh, 2005

Developmental studies by pediatricians and surveys of adoptive parents of children that have
been adopted to the United States from foreign countries indicate that many of these children are
experiencing substantial difficulties with the acquisition of their new language. Language
difficulties may compromise the adopted child’s abilities to understand, negotiate, and adjust to a
new family and environment (Jenista, 1993). Reports range from 100% of the children having
difficulties (Willig, 1995) to 34% (Groza,1995), with the majority of researchers reporting
incidences in the 30-50% range (Johnson et al. 1996; Hough, 1996). These figures are in-line
with research from countries such as Norway (Dalen, 2001a; Saetersdal & Dalen, 1987),
Denmark (Rorbech, 1997) and Holland (Hoksbergen, 1997). To date, no studies directly
assessing the language skills, long-term outcomes, or the types of language difficulties
experienced by these children after experiencing an abrupt language switch have been
completed. This study evaluated the language skills of a group of 44 school-aged, post-
institutionalized Eastern European adoptees (EEA-PI) to determine the extent, and the types, of
problems present in the areas of semantics, morphology, syntax, pragmatics, and reading, and
explored the factors of institutionalization that might predict language development. Results
showed that as a group, EEA-PI children, in comparison to the normative data on the
standardized and spontaneous speech measures, performed lower than age expectations on all of
the measures, with the exception of measures of listening (receptive language). The disparity
within the group’s performance was notable. Though institutional factors of time in institution,
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age of adoption, and time in U.S. did not correlate with measures of receptive and expressive
language, they were significant for reading and nonword repetition scores. This research furthers
our professional knowledge regarding long-term language outcomes and the selection of
appropriate diagnostic measures for these children and other children experiencing early neglect
in our country.

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TABLE OF CONTENTS

PREFACE.....................................................................................................................................xii
1. INTRODUCTION..................................................................................................................1
1.1. Description of Eastern European Orphanages................................................................3
1.2. Description of Children in Eastern European Orphanages.............................................5
2. REVIEW OF THE LITERATURE........................................................................................8
2.1. Definitions of Terms.......................................................................................................8
2.2. Effects of Institutionalization on Child Development..................................................10
2.2.1. Medical conditions and physical development.....................................................10
2.2.2. Motor and sensory development...........................................................................13
2.2.3. Cognitive development.........................................................................................14
2.2.4. Psycho-social development...................................................................................15
2.3. Effects of Length of Institutionalization.......................................................................19
2.4. Speech/Language Development and Institutionalization..............................................23
2.4.1. Early learning periods for language......................................................................23
2.4.2. Role of the environment in early language development.....................................28
2.4.3. Communication problems in neglected children..................................................32
2.4.4. Attachment and speech/language development....................................................36
2.4.5. English as a Second Language (ESL)...................................................................38
2.5. Research on the Speech and Language Skills of Eastern European Adoptees............45
2.5.1. Social competence and communication................................................................47
2.6. Early pragmatic skill development...............................................................................48
2.6.1. Later developing pragmatic skills.........................................................................50
2.6.2. Impact of institutionalization on pragmatic skills.................................................51
2.6.3. Reading; Oral Language and its Relation to Reading Difficulties.......................53
2.7. Long-Term Effects of Institutionalization on Language Development........................54
2.8. Summary of the Literature............................................................................................61
2.8.1. Overall developmental concerns...........................................................................61
2.8.2. Effects of Length of Institutionalization...............................................................63
2.8.3. Speech and language issues..................................................................................63
3. STATEMENT OF THE PROBLEM....................................................................................66
4. METHODOLOGY...............................................................................................................70
4.1. Participants....................................................................................................................70
4.1.1. Recruitment...........................................................................................................70
4.1.2. Demographics.......................................................................................................71
4.2. Measures/Instrumentation.............................................................................................75
4.2.1. Screening Tests.....................................................................................................76
4.2.2. Language Tests.....................................................................................................76
4.2.3. Language Sample Analysis...................................................................................82
4.3. Testing Procedures........................................................................................................87
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5. RESULTS.............................................................................................................................89
5.1. Reliability of Data Collection.......................................................................................89
5.2. Question 1. Types of Language Difficulties.................................................................90
5.2.1. Semantics..............................................................................................................93
5.2.2. Syntax...................................................................................................................96
5.2.3. Morphology...........................................................................................................98
5.2.4. Pragmatics.............................................................................................................98
5.2.5. Expressive language............................................................................................100
5.2.6. Receptive language.............................................................................................101
5.2.7. Overall language levels.......................................................................................102
5.2.8. Discrepancy analysis...........................................................................................103
5.2.9. Reading levels.....................................................................................................105
5.2.10. Relationship between reading and language.......................................................105
5.2.11. Summary of results.............................................................................................106
5.3. Question 2. Abilities to learn new vocabulary............................................................110
5.4. Question 3: Factors predicting the language development of EEA-PI children.........111
5.4.1. Hierarchical Multiple Regression.......................................................................115
5.4.2. Scatterplots..........................................................................................................120
6. DISCUSSION.....................................................................................................................140
6.1. Demographics.............................................................................................................140
6.2. Research Question 1. Types of language difficulties.................................................141
6.3. Research Question 2. Learning new vocabulary........................................................148
6.4. Implications.................................................................................................................156
6.5. Abrupt Language Switch............................................................................................156
6.6. Discussion of Limitations...........................................................................................158
6.6.1. Data collection methodology limitations............................................................158
6.6.2. Subject information limitations...........................................................................158
6.6.3. Use of a control group.........................................................................................160
6.6.4. Assessment methodology limitations.................................................................162
6.7. Future Directions........................................................................................................163
7. SUMMARY........................................................................................................................166
APPENDIX A.............................................................................................................................168
International Adoption Speech and Language Survey............................................................168
APPENDIX B.............................................................................................................................173
Consent to Participate in Clinical Research............................................................................173
APPENDIX C.............................................................................................................................177
Language Sample Video Taping Protocol..............................................................................177
APPENDIX D.............................................................................................................................180
Report to Parents Sample........................................................................................................180
APPENDIX E.............................................................................................................................187
Request for Participation of International Adoption Agencies...............................................187
APPENDIX G.............................................................................................................................191
Test Score Summary Table (Shaded cells represent scores in the Deficit Range; Colors
represent Tests).......................................................................................................................191
BIBLIOGRAPHY.......................................................................................................................194

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LIST OF TABLES

Table 1 Statistics 1998, 2001 & 2002 (Immigration and Naturalization Services)........................4
Table 3 Le Mare et al.’s research findings....................................................................................56
Table 4 Descriptive Data for the 44 EEA-PI Children (in months)..............................................72
Table 6 Test Battery Summary.....................................................................................................75
Table 7 Inter-rater Reliability for Language Measures (Pearson Correlation Coefficients)........92
Table 8 Children’s Scores on Standardized Language Tests and Spontaneous Measures..........95
Table 9 Children’s Scores on Children’s Communication Checklist (CCC).............................100
Table 10 Children’s Scores on the Woodcock Reading Mastery Test: NU/R............................105
Table 11 Percentages of Children with Language Scores Below 1 SD across Language Domains
by Age and Gender.............................................................................................................107
Table 15 Correlations Between Language Tests........................................................................113
Table 16 Correlations between Language Tests and Institutional Factors.................................113
Table 17 Summary of Multiple Regression Analysis for Institutional Variables Predicting
Adoptees’ Reading Levels (N=44)....................................................................................114
Table 18 Summary of Multiple Regression Analysis for Institutional Variables Predicting
Adoptees’ NonWord Repetition Scores (N=44)................................................................115
Table 19 Summary of Hierarchical Regression Analysis for Variables Predicting Overall
Language Scores by Institutional Variables (N=44)...........................................................117
Table 20 Summary of Hierarchical Regression Analysis for Variables Predicting Receptive
Language Scores by Institutional Variables (N=44)...........................................................118
Table 21 Summary of Hierarchical Regression Analysis for Variables Predicting Pragmatic
Language Scores by Institutional Variable (N=44)...........................................................118
Table 22 Summary of Hierarchical Regression Analysis for Variables Predicting Reading Scores
by Institutional Variable (N=44)........................................................................................119
Table 23 Summary of Hierarchical Regression Analysis for Variables Predicting Nonword
Repetition Scores by Institutional Variables (N=44)..........................................................119

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LIST OF FIGURES

Figure 1 Differences between the language development of children adopted internationally and
native-speaking children in first language acquisition..........................................................41
Figure 2 Medication Use in EEA-PI children...............................................................................74
Figure 3 Comparison between Average Language Scores of Typical and EEA-PI children.... 108
Figure 4 Percentages of EEA-PI chidlren scoring below 1 SD (or 1.25) on the language tests by
gender. N= 25 boys, 19 girls...............................................................................................109
Figure 5 Relationship of Test Scores with Institutional Variables.............................................112
Figure 6 Scatterplot of Language Composite Quotient Scores from the Test of Language
Development (TOLD P/I:3) vs. Chronological Age. (r = .110).........................................121
Figure 7 Scatterplot of Language Composite Quotient Scores from the Test of Language
Development (TOLD P/I:3) vs. Time in Institution (r = .098)...........................................122
Figure 8 Scatterplot of Language Composite Quotient Scores from the Test of Language
Development (TOLD P/I:3) vs. Time in U.S. (r=.173)......................................................123
Figure 9 Scatterplot of Language Composite Quotient Scores from the Test of Language
Development (TOLD P/I:3) vs.Age at Adoption. (r =-.122)..............................................124
Figure 10 Scatterplot of Type-Token Ratios vs. Chronological Age (in months).(r = -.057)....125
Figure 11 Scatterplot of Type-Token Ratios vs. Time in Institution in months (r = -.030).......126
Figure 12 Scatterplot of Type-Token Ratios vs. Time in US (in months) (r = -.074)................127
Figure 13 Scatterplot of Mean Length of Utterances in morphemes vs. Chronological Age (in
months) (r =.318)................................................................................................................128
Figure 14 Scatterplot of Mean Length of Utterances in morphemes vs. Time in Institution (in
months) (r = .012)..............................................................................................................129
Figure 15 Scatterplot of Mean Length of Utterances in morphemes vs. Time in U.S. (in months).
(r =.246)..............................................................................................................................130
Figure 16 Scatterplot of Reading Scores from the Woodcock Reading Mastery Tests- Total
Reading Cluster vs. Chronological Age (in months). (r = .027).........................................131
Figure 17 Scatterplot of Reading Scores from the Woodcock Reading Mastery Tests- Total
Reading Cluster vs. Time in Institution (in months). (r= -.387).........................................132
Figure 18 Scatterplot of Reading Scores from the Woodcock Reading Mastery Tests- Total
Reading Cluster vs. Time in U.S. (in months). (r = .319)...................................................133
Figure 19 Scatterplot of Reading Scores from the Woodcock Reading Mastery Tests- Total
Reading Cluster vs. Age at Adoption (in months). (r = -.339)...........................................134
Figure 20 Scatterplot of Nonword Repetition Total Percentage of Phonemes Correct (TOT.PPC)
Score vs. Chronological Age (in months). (r = .307)........................................................135
Figure 21 Scatterplot of Nonword Repetition Total Percent Phonemes Correct Score (TOT.PPC)
vs. Time in Institution (in months). (r = .-.345)..................................................................136
Figure 22 Scatterplot of Nonword Repetition Total Percentage of Phonemes Correct (TOT.PPC)
vs. Time in U.S. (in months). (r = .481).............................................................................137
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Figure 23 Scatterplot of Nonword Repetition Total Percentage of Phonemes Correct (TOT.PPC)
score vs. Age at Adoption (in months) (r = -.305.............................................................. 138

Figure 24 Summary Chart of EEA-PI Children Patterns of Language.......................................139

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