Language development in Arabic-speaking children in the early years: tackling the roots of academic and social inequalities

Lead Research Organisation: Newcastle University
Department Name: Sch of Education Comm & Lang Sci

Abstract

The developmental period from 0-4 years lays the foundations of an individual's life-course, setting the trajectory for their long-term outcomes in health, education, employment and wellbeing. Language is at the heart of this trajectory. Because "skill begets skill" (Heckman, 2008), addressing language difficulties at this stage brings much greater gains and economic returns than when children are older. In the Arab world policy-makers tend to focus on later remedial programmes, with much reduced chances of 'narrowing the gap', especially for socially disadvantaged children.
Across any population ~7% of children do not reach expected levels in language development. This corresponds to ~23 million children and adolescents with language difficulties in Middle Eastern and North African countries. Whilst these difficulties are found across the social spectrum, their prevalence is higher in socially disadvantaged families, reaching up to 40% in some UK schools.

This 4-year project is a multi-disciplinary collaboration between two UK universities (Newcastle and Plymouth) and the University St Joseph (Beirut), the Jordan University of Science and Technology, and Birzeit University (West Bank), with activities covering Egypt, Jordan, the West Bank and Lebanon. It brings together a team of linguists, psychologists, speech and language therapists, paediatricians and educators to develop the necessary knowledge and tools for effective Early Years policy in Levantine countries and Egypt.
Our aim is to address the lack of culturally sensitive and standardised tools to measure language development in Arabic-speaking children, as a primary indicator of healthy development and the foundation skill for education. For this, we need to show the feasibility of a multi-dialect approach, and we need to quantify the effects of social disadvantage, multilingualism and childcare mode on language development. We also need to estimate how war-related traumas impact trajectories of language development in the region. Finally, we need to raise awareness of the importance of early language skills in the public and policy makers, empower end users with tools to screen children for language delays and provision for language-centered curricula, and disseminate the expertise of local practitioners for prevention and interventions.
In WP1, we adapt and standardise the Communicative Development Inventory (CDI) across all four countries. The CDI is the Gold Standard parental questionnaire to assess vocabulary and language development in infants aged 8 months to 4 years.
In WP2, we focus on Lebanon, where the multiethnic and multilingual situation creates an acutely complex picture. Using the CDI as an investigation tool, we define an accurate measure of social disadvantage and examine how the diversity of childcare mode impacts language skills. We evaluate the most efficient way to account for multilingualism by comparing the Arabic CDI to the Lebanese trilingual CDI. Finally, with the CDI, the ASQ (5 developmental domains) and the SDQ (socioemotional skills), we paint a full picture of developmental trajectories in Syrian and Palestinian refugee children in settlements and camps, to circle back contextualised information to NGOs and policy makers.
In WP3, we set up a key stakeholder group and co-design appropriate methods to maximise the impact of knowledge gathered from WP1 and 2. In particular we develop an app version of the standardised CDI, providing free assessment and culture-specific, parent-centred activities. We co-create a series of social media campaigns, professional training events, seminars for practitioners and policy makers. With refugee families, we promote and evaluate Early Years activities geared towards getting children ready for school and reducing dropout rates. Beyond the focus on Lebanon, we assess the exportability of these initiatives to partner countries, with the long-term goal of reaching out to the rest of the Middle East.

Planned Impact

Families of young children across the Arab world will be the direct beneficiaries of this research, along with the health professionals and Early Years (EY) practitioners who support them. The project will raise awareness of the importance of language in the EY and will be the first to make available freely accessible digital tools (Arabic CDI) to assess a child's Arabic knowledge up to the age of 4 in Egypt, Jordan, Lebanon and West Bank. This will enable the above stakeholders to detect early signs of language delay in monolingual and multilingual children and to address these before children start school. Outcomes of the project will produce country and dialect-specific information about the best course of action if the child's language is not progressing as expected, grounded in contextual knowledge.

Given the links between poor language and social disadvantage, early detection and intervention will improve the life chances of children in the region, with a preventative focus on those who need support the most. EY and health practitioners in charge of routine health checks will benefit from improved language focus in EY curricula and free resources to promote robust language skills. NGOs working with refugees in Lebanon will be supported to deliver high quality, language-centered early education, with tools for detection of language difficulties, and materials adapted to the socio-emotional needs of the children in camps and settlements. Digital innovations for parental involvement will enable these communities to informally access the EY curriculum and increase the children's chances to join formal education. Local and national policy makers will have access to a wealth of information on communities at risk of poor language outcomes, enabling them to implement and evaluate large-scale changes where EY provision may currently be lacking. Outside MENA, researchers and practitioners in dire need of assessment tools for Arabic-speaking children (monolingual or multilingual) will be able to support the children and their families, with long-lasting societal benefits for the host communities.

In doing so, the work will contribute to the attainment of four interrelated UN goals (2018) for sustainable development: 3-good health and wellbeing; 4-quality education; 5-gender equality; and 10-reduced inequalities.

Central to the success of these goals is a multidisciplinary team and participatory design methods to co-create the range of interventions tailored to the specific social, cultural and service contexts. To achieve this we have teamed up with existing (USJ, JUST, Birzeit) and new collaborators in the region consisting of EY educators, health professionals, policy makers, and parent groups (see Team Map), and will host an initial stakeholder workshop in Lebanon to set the agenda and the mechanisms to monitor progress.

A first indicator of impact will be an exponentially growing activity on the Arabic CDI app, both in Traffic and Landing Page Conversion rate, within and beyond Egyptian and Levantine borders. A second KPI will be that the public and policy discourse in the region recognises the fundamental importance of language development to child outcomes, with a wider impact reached if policy makers recommend the CDI use, for example in routine vaccination health visits in Egypt. It must be noted that Egypt is the most influential cultural and political country in MENA, ensuring maximum visibility of information disseminated through its channels. A third KPI will be a rise in Syrian and Palestinian refugees' enrolments in primary schools and a decrease in subsequent dropouts, following the dissemination of language-centered EY curriculum.

Activities will be concluded by the production of a policy report aimed at the Ministries of Health/Education in the Levant and Egypt, offering contextualised solutions to the provision of language-centered, equitable and affordable EY education in MENA countries.

Publications

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Barnett SE (2022) Validation of a measure of parental responsiveness: Comparison of the brief Parental Responsiveness Rating Scale with a detailed measure of responsive parental behaviours. in Journal of child health care : for professionals working with children in the hospital and community

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Khattab G (2023) Promoting early language development in the Arab world and Sustainable Development Goals 3, 4, 10 and 17. in International journal of speech-language pathology

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Kouba Hreich E (2020) Supporting language development in Lebanese preschools: SLT and pre-KT practice and perception of roles. in International journal of language & communication disorders

 
Description Member of the Advisory Board for the Action Project Committee for Speech and Language, Centre for Applied Education Research (CAER)
Geographic Reach Local/Municipal/Regional 
Policy Influence Type Participation in a guidance/advisory committee
Impact Advice to schools in the Bradford region on promoting language skills, particularly in children from disadvantaged backgrounds of children who have English as an Additional Language. The advisory board supported the CAER to compile advice for school leaders on this issue, including the provision of information about language support intervention and sources of expert advice to families on language assessment and intervention.
URL https://caer.org.uk/#for-schools
 
Description Developmental Language Disorder - Prevention and Intervention
Amount € 190,680 (EUR)
Organisation Marie Sklodowska-Curie Actions 
Sector Charity/Non Profit
Country Global
Start 09/2021 
End 08/2023
 
Description Evaluation of the NSPCC Look, Say, Sing, Play Campaign
Amount £124,537 (GBP)
Organisation National Society for the Prevention of Cruelty to Children 
Sector Charity/Non Profit
Country United Kingdom
Start 01/2021 
End 12/2022
 
Description Evidence review of universal, population and targeted interventions which support speech, language and communication (slc) development in the early years'
Amount £15,000 (GBP)
Organisation Welsh Local Government Association 
Sector Public
Country United Kingdom
Start 01/2022 
End 12/2022
 
Description Mechanisms of change underlying increased intelligibility for children with cerebral palsy following speech and language therapy focusing on breath support and speech rate
Amount £116,716 (GBP)
Funding ID NIHR130967 
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start 11/2020 
End 10/2021
 
Description Sleep Boost: can supporting sleep boost language outcomes for pre-schoolers who require intervention?
Amount £4,954 (GBP)
Organisation Newcastle University 
Sector Academic/University
Country United Kingdom
Start 09/2021 
End 12/2021
 
Description Supporting access to books and reading to promote health and well-being in disadvantaged groups - a realist evaluation of Community Reading Coach provision in five Local Authority areas [The 'Read-well' project]
Amount £96,000 (GBP)
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start 02/2021 
End 01/2023
 
Title Language development in young children: an indirect intervention in Lebanon 
Description Our Co-Is in Lebanon have designed a language support collaborative protocol between speech and language therapists and nursey educators. The protocol was published in 2020 (Moitel Messarra Camille, Edith Kouba-Hreich, Trecy Martinez-Perez, Sami Richa, and Christelle Maillart. (2021). "Le développement langagier des jeunes enfants: une intervention indirecte menée au Liban." Approche Neuropsychologique des Apprentissages chez l'Enfant (ANAE) 173 : 443-454.). 
Type Of Material Improvements to research infrastructure 
Year Produced 2020 
Provided To Others? Yes  
Impact The protocol has been implemented in selected nurseries in Lebanon each year. It was implemented again this year with three educators from a nursery in Beirut to confirm is efficacy, and for continuous improvement. This model has also been selected by Occitadys, a French association (https://occitadys.fr/) to be used in France following a presentation about the intervention to a group of 25 French SLTs at a workshop who were trained to implement it in nurseries. 
URL https://orbi.uliege.be/handle/2268/265648
 
Title Mapping the languages of Lebanon 
Description This is a questionnaire that is designed to collect information on a large scale about language use in Lebanon but that can be adapted to be used in any setting. it has a first part (5mins) that can be filled by any adult and a second part (10mins) focusing specifically on parents of children aged 0-5. The questionnaire was designed in Qualtrics and will be available to download and use by any researchers wishing to replicate this work in other countries 
Type Of Material Improvements to research infrastructure 
Year Produced 2023 
Provided To Others? Yes  
Impact The data collections is still ongoing and we will be adding more info on this next year. 
 
Title The Arabic CDI Toddler 
Description This is a simple language assessment tool, freely available for students, academics, parents and practitioners who are interested to evaluate vocabulary development in monolingual Arabic infants and toddlers (comprehension and production 
Type Of Material Database/Collection of data 
Year Produced 2021 
Provided To Others? Yes  
Impact The tool has only recently become available 
URL http://www.psy.plymouth.ac.uk/babylab/arabiccdi.html
 
Description '20 questions' - Defining the active ingredients in language interventions for children with or at risk of Developmental Language Disorder 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact CEU bearing CPD course
Year(s) Of Engagement Activity 2022
URL https://www.speechpathology.com/slp-ceus/20q-with-ann-kummer/
 
Description A talk at the University of Paris 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact Invitation to deliver a talk at the University of Paris, Integrative Neuroscience and Cognition Center (INCC), UMR 8002, Language and Cognition Team
Year(s) Of Engagement Activity 2021
 
Description Allow me to be indirect...Strong evidence supports an indirect intervention approach for kids with developmental language disorder (DLD) 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Paper regarding the influence of funding on provision for DLD featured in the Informed SLP
Year(s) Of Engagement Activity 2022
URL https://www.theinformedslp.com/review/allow-me-to-be-indirect
 
Description Promoting oral language in early years contexts: sharing evidence and best practice in Early Childhood Education and Care 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact We held a 2 day conference online for practitioners, policy makers and clinicians: Promoting oral language in early years contexts: sharing evidence and best practice in Early Childhood Education and Care In this free two-day workshop we will share examples of research and best practice inside and outside of Lebanon around four key themes in the promotion of robust language development in Early Childhood Education and Care settings (ECEC):
• Developing and delivering language enriching curricula
• Public health approaches to promote early language development
• Collaborations between ECEC and Speech and language therapy for whole setting change
• Developing early educator's responsive interaction through training and coaching

Additional panel sessions explored
• Strengths and areas of development in ECEC provision across participating countries
• Approaches to the adaptation of innovations across contexts

Contributors included the ministers for health and for education in the Lebanon and was simultaneously translated in French English and Arabic with ~ 100 attendees
Year(s) Of Engagement Activity 2022
 
Description Radio interview 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact A member of our team was interviewed by a Lebanese radio station (Aghani Aghani) about our project. The main aims were: 1) to raise awareness about the importance of early oral language development; 2) to talk about our upcoming collaboration with the Lebanese Ministries of Education and Social Care around reviewing the KG curriculum and 3) to inform the general public about a large scale questionnaire that we are running in Lebanon about the language(s) used across the whole country; the information will be used to enable health professionals and early years educators to develop/acquire the relevant tools for supporting children's language development.
Year(s) Of Engagement Activity 2023
 
Description Stakeholder workshop 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact We delivered a workshop to 30 Egyptian Speech and Language Therapists in Cairo. The workshop consisted of a mixture of information sessions and focus groups; the info sessions introduced the attendees to our 1) BULBUL project; 2) the tools we have developed for assessing early language development in Egyptian-speaking children, with a focus on the Arabic Communicative Development Inventory (CDI); 3) Parent-child interaction interventions; and 4) public health approaches to child language. The focus groups explored 1) SLT practice in Egypt regarding parent child interaction intervention and 2) he potential to facilitate public health practices for child language in Egypt through using the Arabic CDI.
Year(s) Of Engagement Activity 2022
 
Description TV interview 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact A member of our team was interviewed by a Lebanese local TV station (OTV) about our project. The main aims were: 1) to raise awareness about the importance of early oral language development; 2) to talk about multilingualism and inform the public about its benefits while also dispelling myths around it and 3) to inform the general public about a large scale questionnaire that we are running in Lebanon about the language(s) used across the whole country; the information will be used to enable health professionals and early years educators to develop/acquire the relevant tools for supporting children's language development.
Year(s) Of Engagement Activity 2022
URL https://www.youtube.com/watch?v=5YCczwYF_14&ab_channel=OTV
 
Description TV interview 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Two members of our team were interviewed by a Lebanese TV station (Aljadeed TV) about our project. The main aims were: 1) to raise awareness about the importance of early oral language development; 2) to talk about multilingualism and inform the public about its benefits while also dispelling myths around it and 3) to inform the general public about a large scale questionnaire that we are running in Lebanon about the language(s) used across the whole country; the information will be used to enable health professionals and early years educators to develop/acquire the relevant tools for supporting children's language development.
Year(s) Of Engagement Activity 2022
URL https://www.youtube.com/watch?v=PoN3DOzt8-Q&ab_channel=ALJadeed
 
Description Training 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Floccia, C. (2022). UK Bilingual Toddler online assessment. Training provided at the Leicestershire County Council for an audience of 30 early years professionals, 2nd February.
Year(s) Of Engagement Activity 2021
 
Description Workshop on Parental Guidance 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact This workshop on guidance for parent on early language development was delivered by our Lebanese Co-I to Speech and Language Therapy Masters students at the Saint Joseph University of Beirut
Year(s) Of Engagement Activity 2022
 
Description Workshop on Understanding Oral Language Development in the Early Years from a Multi-disciplinary Perspective 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact In January 2021, 35 stakeholders from across the UK and the Levant met for a two-day workshop to discuss how to effectively support children's oral language development in Lebanon and the wider MENA region. Attendees included speech and language therapists, paediatricians, NGO staff involved in education-related projects, and children's literature authors. The stakeholders learned about the project and took part in discussions around two main themes:
- What do we need for an effective multidisciplinary approach to oral language development in the early years?
- Imagining the future for services to support children's language development

The researchers involved in the project gained knowledge on existing practices in terms of multi-disciplinary approaches to supporting children's language development in the Levant. Workshop attendees reported interest in taking part if future similar events and in continuing professional development opportunities in the area of supporting oral language development in the early years.
Year(s) Of Engagement Activity 2021
URL https://research.ncl.ac.uk/bulbul/forstakeholders/januarystakeholdermeeting/
 
Description Workshop on early prevention 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact This workshop on early language intervention was delivered by our Lebanese Co-I to Speech and Language Therapy Masters students at the Saint Joseph University of Beirut
Year(s) Of Engagement Activity 2022