1. COMMUNICATION DISORDERS IN BI-/MULTI-LINGUAL CONTEXTS
Bilingualism is a perplexing reality in any human being who possesses it. Demographically, bi/multilingualism has been defined as the presence and use of two or more languages in a modern nation or state (Asher & Simpson, 1994). According to Reich (1986) 47.3% of the world's population speaks more than one language. However, deBot (1992) reports that the majority of the world's population is bilingual. It is well known that India is one of the largest bi/multilingual country. Indian constitution (8th Schedule) lists over 18 languages for official\administrative purpose, while more than 1652 mother tongues were reported spoken in India according to the Census of India 1961. Many of these languages and dialects may or may not have scripts but are in active use. The nature of bilingualism is not also the same across the country. This being so, it is interesting to study what has been done to cope with the complexities involved in bi/multilingualism vis-à-vis SLP/Communication disorders in India.
In what follows here, I have made an attempt to review the situation with reference to SLP in the past unto present and suggest a few future trends in order meet the clinical and research needs of the field.
2. CONTRIBUTIONS IN THE PAST
It is aptly said that necessity is the mother of invention. The Indian research and applications in the field of speech and hearing in the past developed a variety of ways to meet the needs of bi/multilingualism, since the inception of Speech and Hearing as a distinct field in India which took shape in 1960s. The first and foremost step was the founding of All India Speech and Hearing Institute in Mysore in 1965. AIISH was started in 1965 formally at Mysore in South India.
3. MARCH TOWARDS THE PRESENT
In 1970s and 80s, the fruitful collaboration between the newly started Central Institute of Indian Languages in Mysore and All India Speech and Hearing Institute instilled interest in speech and hearing students for language-oriented SLP research in India. The linguistics researchers at the Central Institute of Indian Languages recognized, mainly through their participation as visiting teachers of psycholinguistics and linguistics courses in AIISH, how their structural description of Indian languages could be useful for speech and hearing programs in India. Although only a few showed greater interest and involvement in such a collaboration (for example, Professors M. S. Thirumalai, N. K. Sinha, K. Rangan, Ranjit Singh Rangila, and P. N. Duttabaruah)they certainly helped in our understanding of the complexity of Indian languages and the consequent bi-/multi-lingualism that prevails in India. Several Masters and Ph.D dissertations benefitted from this contact.
In1980s, other government institutions and centers like All India Institute of Medical Sciences, New Delhi, and A.Y.J. National Institute for the Hearing Impaired, Bombay offering graduate courses in speech and hearing, and clinical services for North and Western Regions came up. Then came the Regional Rehabilitation Centers with their branches in Chennai (Tamilnadu), Hyderabad (Andhra Pradesh), Cuttack (Orissa), and New Delhi catering to the clinical needs clientele speaking Tamil,Telugu, Urdu, Hindi and Oriya. Essentially the clinicians spoke the major language of the area and assessment and intervention was conducted in the language of the client.
At AIISH we had already set the tradition (from the very inception of the institute) of assigning student clinicians to clients based on commonality of language as we had started getting a major inflow of students as well as clintelle from the neighboring state of Kerala speaking Malayalam language. The practice continues even today. The other NGOs like ISH at Bangalore and Shetty's at Mangalore, started in early 1990s offering initially undergraduate courses and later Postgraduate courses. The GOs Like NISH and ICCONS at Trivandrum started in Mid 1990s and are yet to start such courses.
4. DEVELOPING STANDARDIZED TESTS IN INDIAN LANGUAGES
Three decades ago, there were meager normative data available for quantification of speech and language skills in monolingual population. In the absence of standardized language tests clinicians often relied upon informal approaches for identification and quantification of a speech/language problem such as a delay/deviance, misarticulation, etc. No attempt was made to arrive at a language age or magnitude of the delay. Conclusions as to the presence of a language disorder was left to the clinician's intuitive judgment and her/his knowledge of norms based on western literature. This procedure was useful in identifying gross delays and disorders. This, in addition to Professor Rathna's strategy detailed above, worked to satisfy the basic clinical needs.
Much research in the area of language disorders during 70s and 80s focused on developing tests based on data from monolingual population. When monolingual population was not available steps were taken to ensure that the language of consideration was mother tongue and the individual studied in the same medium of instruction. (In India, schools offer choices of a variety of medium of instruction. Often a student can choose between regional language, Hindi or English as his/her medium of instruction, depending upon the school he/she chooses to atttend. The regional language could be the mother tongue in several cases such as Hindi, Bengali, Assamese, Oriya, Kannada, Tamil, etc). This was how the articulation tests, norms on articulatory acquisition and other aspects of language acquisition were studied. This was probably in line with the trend in the western world in 1960s and 70s (by Templin, 1957; Carrow, 1968; Sander, 1972; Brown, 1973).
The advent of purely linguistics-oriented approaches such as those of 'form, content and use' model by Bloom and Lahey (1978), and the various profiles of linguistic abilities by Crystal (1989) and others provided considerable insight into communication abilities of individuals with limited spoken language skills and those with mild/subtle language delays/deviance. It also became clear that a formal knowledge (of structures and functions) of a given language under consideration is necessary to administer and score the tests. We already had Phonological tests by Rathna, et al (1974) and LPT by Karanth (1986) and several monolingual language norms and studies on Bilingualism (such as Thirumalai & Chengappa, 1986), developed with the assistance of scholars from the adjacent Central Institute of Indian Languages at Mysore. The latter provided phonological and grammatical inventories on different Indian languages.
5. DEVELOPING AGE EQUIVALENT LANGUAGE AND ARTICULATION TESTS
Through the developments in psycholinguistics and related domains came the wealth of information which has facilitated not only quantification and differential diagnosis, but also intervention for specific disorders. Although the exigencies leading to Rathna's approach still remain, it would be grossly inadequate in the present context where language pathology necessitates highly specific treatment of issues. This led to several language specificity oriented programmes at the national level.
The first attempt towards developing age equivalent language and articulation tests in different Indian languages was a research project entitled "Development and Standardization of Language Profile Test and Articulation Test in Seven Indian Languages" jointly undertaken by the Regional Rehabilitation Training Center and A.Y.J. National Institute for the Hearing Handicapped, Bombay in 1990. The project aimed at developing LPT with reference to Phonology, Semantics and Syntax keeping in view the comprehension and production aspects in the lines of LPT developed by Karanth(1986) and articulation tests developed on the basis of Rathna et al (1972). From the raw scores it was possible to calculate the language and articulatory ages and levels of the children as well as adults. These have been useful in assessing language acquisition/mastery in mono- as well as bi/multilingual children in those languages. But considering that the normative data were collected on the monolingual population how far it would be assisting in faithful diagnosis and assessment in bi/multilingual clients would be debatable. To facilitate research in these related issues, a course on 'bi/multilingualism - cultural and ethnic issues' has been recently included in the curriculum at the Master's level at AIISH.
6. DEVELOPING TESTS FOR MULTILINGUAL CHILDREN
There is a general assumption that multilingual environment has an adverse effect on first language acquisition in children with language delay. The clinician often finds it difficult to help parents of such children to foster one language as s/he may find situations where the language spoken at home, extended families, neighborhood, community, medium of instruction in school they wish to opt for are all different. How do we take a decision when there are so many permutations and combinations of languages presented? Take a situation in Mumbai, a cosmopolitan city in Maharashtra as seen in AYJIHH (Mani Rao & Geetha Mukundan, 1998).
Family pattern % of children with communication disorders (total sample = 74)
The family pattern given under 4 appears dominant. The second largest group appears to be the monolingual (Marathi) having the regional language as home language too. Besides Marathi and Hindi, 15 other languages were identified: English, Bhojpuri,Gujarati,Kannada, Konkani, Kutchi, Malayalam, Marwadi, Punjabi, Sindhi, Tamil, Telugu, Tulu, Urdu and Sign language. The children had SLPs like Delay and Language deficits with Hearing Loss, Misarticulations, Stuttering, Voice disorders, etc. In such situations, selection of one language as against the others for speech training is indeed difficult.
7. MATERIAL DEVELOPMENT IN INDIAN LANGUAGES FOR SLP
This has been one of the primary and continuous goals of AIISH clinic. The student assignments include works necessary for assessment and management in different Indian Languages known to them. We get cases of child language disorders with SLI, Autism, Aphasia, Learning Disability, besides others like Mental Retardation, cerebral Palsied, etc., (in addition to cases like Voice, Articulation and Fluency disorders) and adult disorders like Aphasia, and Dyslexia/Dysgraphia. Patients could be monolingual/bi/multilingual, literate/illiterate population. They would usually be handled using their mother tongue/most familiar or fluent language/both the languages/all the languages for assessment and therapy in that order! Accordingly the clinicians in consultation with the supervisors prepare the reports and therapy programmes/home training programmes in the given language/s.
8. DATA BASE IN INDIAN LANGUAGES
Several of the Masters dissertations include database from Indian languages. They include development of a test, standardization of a test, an assessment protocol, a therapy program on monolingual or a bilingual/multilingual subjects. We have had several dissertations/research projects with cross-linguistic/bi/multilingual focus such as the following:
The list is by no means exhaustive but just a sample of the kind of work being done.
9. FUTURE RESEARCH
Need based investigations such as the following need to be addressed:
10. TO CONCLUDE
India offers a great opportunity and challenge to enterprising students of speech and hearing discipline. The problems we face in India are manifold. We know that we have not enough trained manpower yet to deliver clinical services to all. We live in a nation that is historically multilingual and multicultural. Our cities are becoming increasingly multilingual and multicultural. In the diversity, however, lies the challenge and our strength. We have broken new grounds to meet the exigencies and I do believe that given the short history of speech and hearing as a distinct discipline in India we will succeed in devising tests, other diagnostic tools and delivery services that will specifically take care of the special needs of Indian languages and multilingual patients.