By: Marva Mount, MA, CCC-SLP, F-NAP, Vice President Professional Services

The reality for most practicing speech-language pathologists (SLPs) is that they are typically English speaking only, yet they are tasked with evaluating students who have a primary language other than English. It is critical that we understand what best practices are for such situations to make recommendations that are culturally and linguistically appropriate for our bilingual students.

Evaluating students for speech and language disorders presents unique challenges for monolingual SLPs, particularly when working with children from diverse linguistic and cultural backgrounds. Adhering to professional best practices is crucial to ensuring accurate diagnoses, equitable services, and compliance with ethical and legal standards.

1. Understand Linguistic and Cultural Differences. The foundational best practice is recognizing that language differences are not disorders. Monolingual SLPs must understand the characteristics of typical second language acquisition as opposed to bilingual language development to avoid misinterpreting language difference as impairment.

• Consult Resources: Utilize research-based resources to learn about the linguistic structure, dialectal variations, and typical communication patterns of the student’s native language and culture.
• Acknowledge Dialects: Recognize that linguistic variations, such as African American English (AAE) or Appalachian English, as examples, are rule-governed linguistic systems, not disorders. Evaluation must focus on comparing a student's speech/language skills to their relevant linguistic community, not solely to Standard American English (SAE).

2. Prioritize Language Proficiency and History. Gathering comprehensive background information is a non-negotiable step to distinguish a disorder from a difference or from a lack of exposure to the dominant language.

• Detailed Case History: Collect an exhaustive language history from parents/caregivers, including:
  • Age of first exposure to each language
  • Contexts and frequency of language use (home, school, community)
  • Language model proficiency (parents/caregivers, other family members)
  • Developmental milestones in the native language (L1). A true disorder must be evident in all languages a child speaks.
• Establish Dominance: Determine the child's language dominance and proficiency across different communication domains (e.g., academic, social). This dictates which language(s) should be used during the evaluation.

3. Use Trained Interpreters and Translators. Using a trained, objective professional is a critical best practice when a monolingual SLP needs to assess a non-English-speaking student. Using family members or school staff who are not trained in interpreting may be unethical and may compromise the validity of the evaluation.

• Trained Professional: Whenever possible, use only qualified interpreters (oral communication) and translators (written documents) who understand the specialized vocabulary of speech-language pathology and education. If such staff is unavailable, ensure that information is disclosed and used with caution when reporting results.
• Pre- and Post-Session Briefing: The SLP must meet with the interpreter before the session to review the goals, materials, and procedures and after the session to discuss observations and findings.
• SLP Control: The SLP remains in control of the evaluation process, directing the interpreter on when and how to relay information.

4. Employ Non-Biased and Dynamic Assessment Methods. Standardized, norm-referenced tests in English are often linguistically and culturally biased and are inappropriate for establishing a diagnosis for students who are not proficient in English. In the case of some language tasks, the translation into the primary language may involve far more difficult tasks. Best practices demand the use of non-biased alternatives.

• Criterion-Referenced and Informal Tools: Use informal measures like language samples, observations in various settings, and caregiver interviews.
• Dynamic Assessment (DA): This approach assesses a student's learning potential rather than just current performance. It involves a "test-teach-retest" method to see how a student responds to mediated learning. A student with a true language impairment will typically show less responsiveness to mediation than a student with a language difference.
• Portfolio Assessment: Analyze a student's collected schoolwork over time to look for patterns in academic and linguistic struggles when possible (think RTI/MTSS interventions).

5. Collaborate with a Multidisciplinary Team. Comprehensive and non-biased evaluation is a team effort. The monolingual SLP must actively seek input from others who have frequent contact with the student.

• Teachers (ESL/General Education): Gather data on the student's academic performance, peer interactions, and classroom participation.
• Bilingual Professionals: Consult with a bilingual SLP or a professional in the student's L1, if available, for their insights on developmental norms and evaluation methods.
• Parents/Caregivers: Their input on the child's development, social communication, and communication skills in the home language is invaluable for making an accurate diagnostic decision.

6. Trauma-Informed Evaluation Information. Finally, the consideration of trauma is an indispensable and often distinguishing factor in contemporary bilingual speech and language evaluations in current times, moving beyond traditional concerns of language difference versus disorder. Experiences of adverse childhood experiences, chronic toxic stress, and the sociopolitical distress faced by immigrant families can significantly impair the cognitive functions essential for language learning and processing, such as attention, memory, and executive function. These trauma-related difficulties can lead to communication behaviors—like selective mutism, difficulty following directions, reduced expressive vocabulary, and emotional dysregulation—that mimic core symptoms of a language disorder, increasing the risk of misdiagnosis and inappropriate special education placement for bilingual students. Therefore, a trauma-informed approach is required, integrating the principles of safety, trustworthiness, and empowerment into the assessment process to ensure accurate identification of true language impairment versus a trauma-based response.

This video provides an overview of trauma-informed assessment practices for bilingual children, which is relevant to this topic: Trauma-Informed Speech-Language Assessment Practices for Bilingual Children.

7. Document Rationale and Recommendations. The final report must clearly and transparently detail the rationale for all procedures used, especially when standardized testing was modified or omitted.

• Specify Modifications: Detail all accommodations, translations, or informal methods used, and explain how the results were interpreted while accounting for linguistic differences.
• Compliance Statement: Ensure the evaluation adheres to federal mandates (e.g., Individuals with Disabilities Education Act [IDEA]), which require assessment tools to be administered in the student's native language or other mode of communication and to be non-discriminatory.
• Clear Recommendations: The report must provide concrete recommendations for intervention, specifying if the goals should target the student's L1, L2 (English), or both, based on the evaluation findings and family input. The goal is to facilitate effective communication by understanding the student’s individual strengths and weaknesses and how those strengths and weaknesses are affected by the student’s native language.
• SMART Goals and Objectives: Monolingual SLPs writing SMART (Specific, Measurable, Achievable, Relevant, Time-Bound) goals for bilingual students must demonstrate an explicit understanding of bilingualism and culturally responsive practice. Goals should avoid language reductionism, meaning they should not exclusively target the student's less proficient language (often English) simply because it is the SLP's native language. The most professional practice is to write goals that target the underlying disorder across both languages (e.g., targeting the phonological pattern of final consonant deletion in both English and Spanish) or focus on skills transferrable across languages, always specifying the language(s) of instruction and ensuring the goal is truly achievable given the student's dual language exposure and dominant communication needs.

Conclusion
Ultimately, the success of a monolingual SLP serving bilingual students rests on a commitment to cultural humility and ethical diligence. By moving beyond a monolingual standard, prioritizing trauma-informed assessment, utilizing trained interpreters, and relying on non-biased, dynamic measures, SLPs ensure that evaluation results accurately distinguish a true speech or language impairment from a language difference. This dedication not only meets legal and ethical mandates but also upholds the principle of educational equity, ensuring that every bilingual student receives appropriate services without the harm of misdiagnosis. The highest professional standard is achieved when the evaluation process respects and validates the student’s entire linguistic and cultural reality.

Resources
ASHA Position on Social Dialects and Language Variations
ASHA Multilingual Service Delivery Practice Portal
ASHA Code of Ethics
ASHA Practice Portal on Collaborating with Interpreters
ASHA Research/Dynamic Assessment
Bilinguistics: Trauma-Informed Speech-Language Assessment Practices for Bilingual Children