July 29, 2015

Happy teacher explaining something to a student at school

How To Plan Treatment for a Speech or Language Disordered Bilingual Patient

When it comes to treatment planning for a bilingual patient, decisions are not always easy. Choosing the right therapist and best treatment are based on a variety of factors:

  • Scores from languages tests
  • Language history form obtained from the family
  • Child’s preferred mode of communication
  • Degree of severity of the language disorder
  • Child’s age
  • What portion of the patient’s daily life is spent using either or both languages

To give you an example, if a child has equal disorders in both English and Spanish but he’s in an all English speaking academic program, plays with English speaking friends and family, watches TV in English and converses mostly in English with his primary caregiver, it makes sense for therapy to focus on English speech and language goals.

If a young patient is in an English program at school but communicates only in Spanish at home with his primary caregivers who do not understand English, it would be valid for therapy to be bilingual. Also, if the patient is in a bilingual program at school, is equally disordered in both languages and is in a truly bilingual setting at home, there is a valid reason for bilingual therapy.

Therapy should first focus on the speech and language therapy deficiencies common to both languages that show up during bilingual testing. After that, therapy can focus on specific weaknesses in each language.

Using an interpreter

The first choice is to provide the patient who truly needs bilingual therapy with a bilingual therapist if possible. However, it’s an acceptable practice for bilingual therapy to be provided with a monolingual therapist if an interpreter is present.

Interpreters and therapists should follow certain guidelines to ensure the effectiveness of the bilingual speech and language therapy program. The treating therapist and interpreter should go over the specific long and short term goals to be addressed in each therapy session before the session begins. Before interpreting begins for parent consultations, the interpreter should be provided with a list of speech and language therapy terms to be translated ahead of time. Both the therapist and the interpreter should speak no more than two to three sentences at a time to allow for interpretation.

The interpreter should also be trained ahead of time on what the job expectations include, such as strictly interpreting word for word what the therapist says to the child and what the child’s responses are to the therapist. The interpreter needs to understand this expectation extends to the informational sessions with parents. An interpreter is not allowed to counsel, advise, advocate for or interject personal opinions during interpretation between the therapist and the parent or patient. Likewise, the monolingual therapist should allow the interpreter to provide all the prompts in the other language and should not attempt to speak the language being interpreted if they are not an expert in that language.

When these guidelines are followed, bilingual speech language therapy with an interpreter can be a highly effective alternative to therapy with a bilingual therapist.

Getting Help

Bilingual therapy is becoming increasingly common across the country and in Texas with our large population of bilingual children and families. Our therapists take into consideration all the factors related to the patient’s communication success including age, language and cultural environment, family involvement, schedules, socioeconomic status, access to multicultural language experiences, and cultural and family attitudes.

Our bilingual therapists here at Epic are highly trained, qualified and experienced to do their challenging jobs effectively.  Epic takes on this challenge with care and consideration and continues to provide the highest quality health care service available. For more information about bilinigual speech therapy 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