Clinical Bilingual Evaluations: Exploring Ways to Overcome Barriers in the Direct Assessment of Both Languages When There Is a Suspicion of Language Disorder

Abstract

Purpose: Speech-language pathologists report barriers to conducting culturally appropriate bilingual language evaluations when there is a suspicion of language disorder. One barrier is that there may not be personnel available to directly assess language development in a language other than English. The purpose of this clinical focus article is to demonstrate the potential for speech-language pathologists to incorporate direct assessment data from a language they cannot speak fluently when there are barriers to a comprehensive bilingual evaluation. First, we review the clinical markers of bilingual language disorders. Second, we review the evidence from audiology that uses closed-set tasks to assess speech recognition in languages the clinician cannot speak fluently. Last, we explore potential methods for applying such practices in clinical language evaluations when there is a suspicion of language disorder. Conclusions: Closed-set tasks, such as receptive language tests, could be a promising way for speech-language pathologists to incorporate direct assessment data from a language they cannot fluently speak into bilingual language evaluations. Other structured tasks, such as sentence repetition tasks, may not yield valid language data without the clinician having adequate competency in the test language. This clinical focus article emphasizes the great need to diversify the profession of speech-language pathology to promote equity and access to clinical language evaluations and interventions for culturally and linguistically diverse children.