July 28, 2015

Teacher or tutor helping school boy to study

Assessment of the Bilingual Patient

Bilingual speech therapy can be very effective for patients who speak two languages. Before doing a bilingual speech language assessment, a therapist should answer the following:

  • What languages are spoken at home and by whom?
  • At what age did the child learn a second language?
  • In which language does the child watch TV?
  • What language does the child’s siblings and friends speak?
  • What language is primarily taught at the child’s school?
  • What are the child’s scores on school language proficiency tests?

If the child shows significant and regular exposure to both languages, a bilingual test should be performed. Ideally, a bilingual Speech Language Pathologist or SLP should do the evaluation, using culturally and linguistically adapted tests in both languages to compare potential deficits in each language. This will provide an accurate overall picture of a child’s language abilities.

Simply translating an English standardized assessment to another language could result in problems including inaccurate one to one translation, varied syntactic structures from language to language and inability to report standard scores since the test was not normed on bilingual populations. An example of an appropriate test to use for bilingual preschoolers is the PLS-5 Spanish. This test allows for items to be administered in both languages as necessary and results in a valid standardized score for bilingual children. The CELF-P as well as the CELF are also available in both English and Spanish to be used in determining language deficits.

The purpose of a bilingual assessment by an SLP is to determine if the patient has a speech or language disorder and what the strengths and weaknesses are in each language. If the patient scores a standardized score within normal limits in either language, there is no disorder present and the patient does not qualify for our services. They may qualify in school for an English as a Second Language program as determined by the language proficiency/language dominance testing administered by a bilingual education teacher.

Many parents believe or wish speech language therapy services could “teach” their child how to better speak English or Spanish. However, we must educate the public, other professionals and colleagues and parents about what our role as the bilingual SLP entails and what defines a true language disorder.

When a disorder is present, it usually causes problems with similar aspects of both languages. For example, a child who has not developed the concept of plurals, will most likely miss the plural “s” in both English and Spanish, or may not comprehend spatial concepts or use past tense verbs appropriately in either language.  Usually a language disordered child will score below the average range in both languages.

The bilingual SLP should be knowledgeable in what typical language development and structure looks like in both languages and should have the expertise to determine if the low scores are caused by the child learning two languages simultaneously. For example, if the errors appear to be caused by the influence of the other language on the language being evaluated, this particular error is predictable given the structure of the other language and is not to be scored as incorrect on standardized testing.

For more information about bilinigual speech pathology and how it can help your child, please fill out our request for care form and someone will get back to you soon!

Magdalene Lima-Fiallos, MS, CCC-SLP

Speech Language Pathologist

Epic Fort Worth Clinic



 Speech-Language Services for Bilingual Students