By: Marva Mount, MA, CCC-SLP, FNAP, Vice President for Professional Services

Working as a monolingual speech-language pathologist (SLP) with a bilingual child can feel like navigating a ship without a compass, especially when a trained interpreter isn't available. However, clinical excellence in these situations isn’t about speaking the child’s language; it’s about cultural humility, strategic assessment, and leveraging the family as partners.

Here is a guide on how to provide high-quality, ethical care when you are the sole linguistic resource in the room.

1. Shift Your Mindset: Difference vs. Disorder

The most critical step for a monolingual SLP is distinguishing between language difference (normal bilingual development) and language impairment.

• Silent Period: Understand that children in the early stages of learning a second language (L2) may go through a silent period in which they focus on listening. This is not a receptive delay.
• Codeswitching: Treat codeswitching as a sophisticated linguistic tool, not a sign of confusion.
• Transfer Errors: Research the phonological and grammatical rules of the child’s primary language (L1). For example, a Spanish speaker may add an “e” to the beginning of a word like “Spanish,” such as “eSpanish,” as Spanish does not have s-clusters as we think of them in English, which is why a Spanish speaker would add an “e” to make it possible given the phonotactics (“eS-pa-nish,” or es-poon, for example).

2. Conduct a Linguistic Deep Dive

Without an interpreter, your best tool is a thorough case history. You need to map out the child's linguistic ecosystem.

Focus Area	Questions To Ask (Via Translation Apps or Forms)
Language Exposure	What percentage of the day is spent in L1 vs. L2?
Dominance	Which language does the child use to express frustration or tell stories? Does language differ between settings, such as daycare vs. home/extended family or parents vs. siblings/friends?
Milestones	Did the child meet milestones (first words, combining words) in their first language?
Family History	Do siblings or parents have a history of speech or literacy struggles?

3. Use Dynamic Assessment (DA)

Standardized tests are notoriously biased against bilingual children because many are normed on monolingual English speakers. The PLS-5 Spanish and the CELF-4 Spanish, BESA, etc., are normed for Spanish speakers. However, the issue is that “bilingual” is such a large and wide range of development. It is difficult to distill it down to one “correct” trajectory of development for every single bilingual child. When you can't get an accurate score, use dynamic assessment.

The Test-Teach-Retest Model:

1. Test: Pick a skill the child struggles with (e.g., using plural markers).
2. Teach: Spend 10 to 15 minutes using mediated learning. Use gestures, pictures, and intense modeling to teach the concept.
3. Retest: See how quickly the child picks up the new skill.
   • Result: If they learn it quickly, it’s likely a language difference. If they struggle despite high-quality teaching, it may be a disorder.

4. Maximize High-Tech and Low-Tech Tools

Technology can fill the gap when a human interpreter is missing, though it should be used with caution regarding nuance.

• Translation Apps: Use apps like Google Translate or SayHi for basic functional communication with the child or parent.
• Visual Schedules and Augmentative and Alternative Communication (AAC): Visuals are a universal language. Use Picture Exchange Communication Systems (PECS) or digital AAC boards to bridge the gap.
• Video Modeling: Use wordless videos (like "Simon's Cat" or Pixar shorts) to elicit narrative samples. Since there are no words, the child can narrate in whatever language they feel comfortable in, and you can analyze their non-verbal communication and syntax structure.

5. Empower the Cultural Informant

If a professional interpreter isn't available, a family member often becomes the bridge. While not ideal for formal testing, they are invaluable for informal observation.

• The Double-Check: Ask the parent, "Does he/she sound like his/her siblings or his/her cousins his/her age when he/she speaks [L1]?"
• Parent-Report Measures: Use validated tools like the Alberta Language Development Questionnaire (ALDeQ), which is designed to identify language impairment in bilingual children via parent report, regardless of the SLP's language.

6. Therapy Goals: Target the Core

When you can only provide therapy in English, focus on language-neutral or cross-linguistic skills that will benefit both languages:

• Phonological Awareness: Skills like segmenting often transfer across languages.
• Functional Communication: Focus on "Power Words" (Help, Stop, More, Want) that improve quality of life immediately.
• Narrative Structure: Teaching a child how to tell a story (Beginning -> Middle -> End) is a cognitive-linguistic skill that applies to any language they speak.

Important Note: Always document that the assessment was conducted in English due to the unavailability of an interpreter and acknowledge that results may underestimate the child's true linguistic potential.

To help you distinguish between a true disorder and a natural language transfer, here is a breakdown of common linguistic patterns you might encounter. Understanding these helps you avoid misdiagnosing a child who is simply applying the rules of their first language (L1) to English (L2).

Quick Reference: Difference vs. Disorder

To keep your observations organized during a session, you can use this mental checklist:

Observation	Likely a Difference (L1 Transfer)	Potential Disorder (Red Flag)
Error Pattern	Follows the rules of the child's L1	Not typical for either English or L1
Intelligibility	Higher when speaking with family/L1 speakers	Low even when speaking to L1 speakers
Learning Rate	Improves quickly with modeling (dynamic assessment)	Slow progress despite frequent modeling
Social Skills	Uses gestures, eye contact, and plays well	Struggles with social engagement in both languages

How To Document These Findings

When writing your report without an interpreter, use phrasing like: "The student demonstrated [Specific Error, e.g., s-cluster epenthesis]. This pattern is consistent with phonological transfer from Spanish to English and is not considered a clinical deficit at this time."

This interview form is designed to be scannable and simple, making it easier for translation apps (like Google Translate or SayHi) to process without losing meaning.

When using this with a family, you can point to the questions on your screen or print them out. The goal is to determine if the child’s struggles exist in both languages, which is the hallmark of a true language disorder.

Bilingual Initial Case History Form

The purpose of this form is to determine if the child is a typical language learner or potentially language-impaired.

1. Language Exposure and Dominance

• What was the first language the child heard?
• What language does the child speak most at home?
• What language does the child speak most with friends/siblings?
• On a scale of 1–10 (10 being perfect):
  • How well does the child understand [L1]?
  • How well does the child speak [L1]?

2. Developmental Milestones (in L1)

• At what age did the child say their first words in [L1]? (Expected: 12 months)
• At what age did they start putting two words together? (Expected: 24 months)
• Does the child struggle to find the right word in their native language?
• Does the child follow directions at home in [L1] without needing gestures?

3. Family Perception and History

• Does the child’s speech sound different or "behind" compared to their siblings or cousins at the same age?
• Does anyone else in the biological family have trouble with reading, writing, or speaking?
• When the child speaks [L1], do strangers understand them?

 Strategic Tip: The Sentence Repetition Hack

If you have a parent or older sibling who is fluent in the L1, you can perform an informal sentence repetition task. This is one of the most clinically significant markers for language impairment across almost all languages.

In the absence of an interpreter, ask the parent to say a long, grammatically complex sentence in their native language (e.g., "The big brown dog chased the cat up the tall tree because he was hungry").

1. Ask the child to repeat it exactly.
2. Watch the parent's reaction. You don't need to understand the words; you are looking for the parent's "internal norm."
   • If the parent looks surprised or says, "No, he left the words," or if the child significantly shortens the sentence, this is a red flag.
   • Typical bilingual children can usually repeat long strings in their dominant language, even if they struggle with English.

Documentation Language for Your Report

When you use this form, you can document your findings like this: "In a structured parent interview conducted via translation software, the mother reported that the child met all early language milestones in [L1] on time. However, she noted that the child currently struggles to follow complex directions in both [L1] and English. This suggests a deficit in receptive language processing that transcends linguistic boundaries.”
 

Shared Observation
When you can't rely on shared language, you must rely on shared observation. Wordless resources are the gold standard for this because they remove the English barrier, allowing you to see the child's true ability to organize thoughts, sequence events, and use social logic.

Here is a curated list of language-free tools to use in your next session.

Top Wordless Picture Books

These are essential for gathering a narrative language sample. You can have the child tell the story in their L1 (if a family member is there to react) or in English.

Book Title	Best For...	Why SLPs Love It
"Frog, Where Are You?" (Mercer Mayer)	Assessment	The industry standard for SALT (Systematic Analysis of Language Transcripts)
"A Ball for Daisy" (Chris Raschka)	Emotions	Features a clear problem (broken ball) and a range of emotions
"Chalk" (Bill Thomson)	Action/Inference	Hyper-realistic art of drawings coming to life; great for "What happens next?"
"Journey" (Aaron Becker)	Complex Narratives	High-level world-building for older elementary students
"Pancakes for Breakfast" (Tomie dePaola)	Sequencing	Clear step-by-step process with a humorous "fail" at the end

Wordless YouTube Channels and Shorts

Videos are often more engaging for quiet kids. Since there is no dialogue, you can pause the video to ask, "What is he thinking?" or "What is the problem?"

• Simon’s Cat: Short, 2- to 3-minute clips that are perfect for identifying cause-and-effect and simple intentions
• Piper (Pixar Short): Excellent for social-emotional learning and describing nature/actions
• Ormie the Pig: Great for problem-solving. A pig tries increasingly absurd ways to reach a cookie jar.
• The Literacy Shed: A website that curates high-quality animated shorts specifically for educational storytelling
• "Snack Attack": A great short for perspective-taking. An old woman thinks a teenager is stealing her cookies.

Clinical Activity: The Silent Director

This is a high-value way to work with a bilingual child when you don't speak their L1:

1. Watch together: Play a 2-minute "Simon's Cat" video.
2. The Director Role: Tell the child, "I am the writer, but I forgot the words! You are the director. Tell me what they are saying."
3. The Double Re-Tell: First, let the child tell the story in their primary language (L1) to a parent or into a recording app. Watch their facial expressions and hand gestures (this shows their cognitive narrative ability).
   • Then, ask them to tell it in English.
   • The Comparison: If they can tell a complex story in L1 but only use single words in English, it’s a language difference. If the story is "jumbled" and confusing in both languages, it's a red flag for a disorder.

A Quick Digital Cheat Sheet

If you are mid-session and need something right now, search YouTube for these specific keywords: "Wordless animated shorts for kids" or "CGI wordless short film."

When you use wordless materials, your documentation should focus on executive function, narrative structure, and communicative intent, rather than just English grammar. This shows that you are assessing the engine of language, not just the output of a specific language.

Here are three templates, ranging from strong performance to clinical concern.

Option 1: The Difference Profile (Positive Narrative Skills)

Use this when the child struggles with English but demonstrates strong cognitive-linguistic mapping.

"To assess narrative language skills in a language-neutral context, [Student Name] was presented with the wordless picture book 'A Ball for Daisy.' Despite limited English expressive vocabulary, the student demonstrated strong underlying narrative competence. They correctly identified the 'initiating event' (the ball popping) and used appropriate facial expressions and gestures to convey the character's distress. The student successfully sequenced the story using 'first/then' logic and provided a logical resolution. These findings suggest that the student’s core linguistic processing is intact, and current difficulties are likely related to English language acquisition rather than a systemic language disorder."

Option 2: The Disorder Profile (Red Flags Noted)

Use this when the child struggles to organize the story even without a language barrier.

"[Student Name] viewed the wordless animated short 'Ormie the Pig' to elicit a language sample. Even when prompted in a simplified format, the student struggled to identify the primary goal-directed behavior or the 'problem' in the story. Narrative output was characterized by 'labeling' (e.g., 'pig,' 'cookie') rather than 'chaining' events together. The student was unable to predict what might happen next, even with visual cues. Because these difficulties persist in a non-verbal task, they represent clinical red flags for a language-processing impairment that likely impacts both the primary language and English."

Option 3: The Dynamic Assessment Note

Use this when you do a "Test-Teach-Retest" during the session.

"A dynamic assessment was conducted using a wordless sequencing task. Initially, [Student Name] was unable to sequence three pictures from the story. A brief mediated learning session was provided, focusing on the concepts of 'beginning' and 'end' using visual icons. Following this 10-minute intervention, the student was able to independently sequence the same pictures and generalize the skill to a new set. This high modifiability and rapid rate of learning are typical of a 'Difference' profile, suggesting that the student has the cognitive capacity to acquire these skills once the linguistic labels are established."

Pro Tip for Your Reports

When using these templates, always include a disclaimer at the bottom of your Assessment section: "Formal standardized scores were not reported as they are not valid for this student's linguistic background. Findings are based on informal observations, dynamic assessment, and the use of language-neutral materials to ensure a non-biased clinical picture.”

Using Visual Cue Cards

Since you are working without an interpreter, visual cue cards act as a universal bridge. They allow the child to point to their answer or use the card as a scaffold for their English words.

Below is a layout for a narrative tool kit you can create. These cards focus on the universal grammar of stories that exist in every language.

The Story Grammar Visual Kit

You can draw these on index cards or create a simple digital board. Using these while watching a wordless video (like Simon's Cat) helps the child organize their thoughts visually.

Icon Idea	Label	Question for the Child
👤 Person Icon	Who?	"Who is in the story?"
🏠 House/Tree Icon	Where?	"Where are they?"
❗ Exclamation Point	Problem	"Oh no! What is wrong?
💡 Lightbulb Icon	Idea/Plan	"What will they do?"
🏁 Checkered Flag	The End	"How did it finish?"

How To Use These Cards Digitally or in Print

1. The Point-and-Say Method

Instead of asking an open-ended "What happened?," point to the Problem Card. Even if the child doesn't have the English word "hungry," they can point to the card and then mimic eating or point to the cat in the video. This proves they understand the story logic, even if they lack the English labels.

2. The Emotion Meter

Bilingual children often have hidden social-emotional vocabulary in their L1. Use a visual scale of faces (happy, sad, angry, scared, confused).

• Prompt: "How does the bird feel?"
• Action: The child points to "scared."
• SLP Goal: You can then provide the English label: "Yes, he is scared. He is afraid."

3. "First, Then, Last" Strip

Create a simple strip with three boxes. As you watch a wordless short film, place a physical object or a drawing in each box to represent the sequence.

• Box 1: The cat sees the bird.
• Box 2: The cat jumps!
• Box 3: The bird flies away.

Summary Checklist for Your Next Session

If you have a bilingual child on your schedule tomorrow and no interpreter, follow this four-step emergency plan:

1. Select a wordless video (e.g., Ormie the Pig).
2. Set out your visual cues: (Who, Where, Problem, Feeling)
3. The "silent observation": Watch the child's face. Do they laugh at the right parts? Do they look surprised? (This is a sign of intact social-cognitive processing.)
4. The "record and reflect": Record the child describing the video. Later, you can use a translation app or a colleague to see if their L1 grammar sounds organized, even if you don't understand it at the moment.

Writing individualized education program (IEP) goals for bilingual children can be tricky because you don’t want to penalize a child for not knowing English, but you still need to address their underlying communication needs.

The most effective goals for this population are language-neutral or cross-linguistic. These focus on the structure of communication rather than the specific vocabulary of one language.

Sample IEP Goals for the Bilingual Student

1. The Narrative Structure Goal (Cognitive-Linguistic)

Focuses on the ability to organize thoughts, which should happen in both L1 and L2.

"When presented with a wordless visual stimulus (video or book), [Student] will identify the three core story elements (character, problem, and resolution) using their preferred mode of communication (English, L1, or visual cues) in four out of five opportunities."

2. The Dynamic Learning Goal (Rate of Acquisition)

Focuses on how quickly the child picks up new concepts, a key indicator of a healthy "language engine."

"Given a brief model and two to three visual prompts, [Student] will generalize a new linguistic concept (e.g., a new spatial concept or category) to a novel task within the same session with 80% accuracy."

3. The Strategic Repair Goal (Functional Communication)

Focuses on the child’s ability to "bridge the gap" when they don't have the word.

"To improve functional communication, [Student] will use compensatory strategies (e.g., gesturing, pointing to a visual choice board, or using a circumlocution like 'the thing for eating') to convey a need when the specific English word is unknown in four out of five observed instances."

Tracking Progress Without the L1

How do you mark "met" or "not met" when you don't speak their language? Use a multimodal data sheet.

Date	Skill	Response Mode		Result
10/12	Identified "Problem"	Gestural (pointed to card)		100%
10/19	Retold Sequence	Mixed (English words + L1)		80%
10/26	Shared "Idea"	Visual (drew a picture)		100%

This works because even if the child didn't use an English sentence, they demonstrated the cognitive skill of sequencing and problem-solving. This proves their "communication engine" is working.

Final Strategy: The Bridge Letter

Since you are a monolingual SLP, you may want to include a short statement in the Present Levels (PLAAFP) section of the IEP to protect yourself and the student:

"Due to the student's bilingual background and the current unavailability of a trained interpreter, progress is being monitored through dynamic assessment and language-neutral tasks. Goals are designed to support the underlying linguistic framework that supports both [L1] and English development."

Summary Checklist for Success

• Don't wait for English: Treat the logic of communication now.
• Value gestures: A point is a win for receptive language.
• Partner with parents: Use them as the barometer for what is normal in their culture.
• Keep it visual: If you can see it, you can treat it.

This teacher cheat sheet is designed to be a one-page reference you can hand to a general education or ESL teacher. It helps them understand that the child’s silence or errors are often a sign of a busy bilingual brain, not necessarily a lack of intelligence or a permanent disability.

Teacher Cheat Sheet: Supporting Our Bilingual Learner

Student: ____________________  SLP: ____________________

1. The Silent Period Is Normal

Many bilingual children go through a phase in which they stop speaking almost entirely as they map the new language.

• The Goal: Focus on receptive language. If they can follow a two-step direction, their brain is working hard!
• Teacher Tip: Don't force them to speak in front of the class yet. Allow them to point, nod, or draw to show they understand.

 

2. "Wait Time" x 2

A bilingual child’s brain must translate your question, find the answer, and then translate that answer back into English.

• The Goal: Give them at least 10–15 seconds of thinking time before prompting again.
• Teacher Tip: Count to 10 silently in your head after asking them a question.

3. Use the Preview-View-Review Strategy

This is the most effective way to help a child with limited English access the curriculum.

• Preview: Briefly introduce the topic with pictures or video (no language needed).
• View: Teach the lesson.
• Review: Summarize the big idea using a visual or a simple graphic organizer.

4. Language Differences vs. Red Flags

Not every mistake needs a referral to the SLP.

It’s probably a DIFFERENCE if...	It might be a DISORDER if...
They follow the "grammar rules" of their first language (e.g., "The house red").	They are disorganized and confusing in both languages.
They are very social and use gestures to get their point across.	They seem frustrated and give up communicating entirely.
They learn new routines quickly through observation.	They struggle to follow simple routines even after weeks of practice.

5. Quick Classroom Scaffolds

• Visual Schedules: Use icons for math, lunch, and recess.
• Sentence Starters: Give them the first few words: "I see a..." or "The character is..."
• Peer Buddies: Pair them with a language model (ideally someone who speaks their L1, but a kind English speaker works too!).

A Note for the Teacher

"As the SLP, I am monitoring [Student's Name] communication. Even if they aren't speaking perfect English yet, we are looking for cognitive growth. If you notice they are struggling to solve simple problems or interact with peers even without words, please let me know!"

This communication log is designed to bypass the language barrier. It uses simple visual icons so parents can give you feedback on the child’s communication at home without needing to write complex sentences in English. You can print this on a half sheet of paper and send it home weekly.

Home-to-School Communication Log

Student Name: ____________________ | Week of: ________________

Parents: Please circle the icons that show how your child communicated at home this week!

1. How did they tell you what they wanted?

(Mostly used...)

• 👉 Pointing/Gestures (Pointing to juice, pulling your hand)
• 🗣️ Native Language [L1] (Using full sentences in your home language)
• 🇺🇸 English (Using English words or phrases)
• 🖼️ Pictures/Device (Pointing to a book, photo, or tablet)

2. How was their mood/frustration?

• 😊 Happy: They could tell us what they needed easily.
• 😐 Okay: They struggled a little but kept trying.
• 😫 Frustrated: They cried or got angry because we didn't understand.

3. Social check-in

• Did they tell a story? (Even if just a few words about their day)
• Did they follow directions? (Picking up toys, coming to dinner)

Why This Helps You as the SLP

When you collect these logs, you are gathering longitudinal data that is language-blind.

• Scenario A: If the parent circles "Native Language" and "Happy" every week, but the child is "Silent" and "Frustrated" with you, you have clear evidence of a language difference/ESL struggle.
• Scenario B: If the parent circles "Gestures" and "Frustrated" for a 7-year-old who speaks the native language at home, you have clear evidence of a language disorder that exists in the L1.

Pro-Tip: The Voice Memo Alternative

If the parent has a smartphone, tell them (via a translation app):

"If your child says something amazing in [L1], record a 10-second video on your phone and show it to me next time I see you."

Watching a video of a child being fluent and animated in their native language is the fastest way for a monolingual SLP to rule out a social-communication disorder or a severe expressive delay.

Final Review of Your Monolingual SLP Toolkit

1. Mindset: Difference vs. Disorder
2. Assessment: Dynamic (Test-Teach-Retest) and Case History
3. Materials: Wordless Books and Videos
4. Scaffolds: Visual Who/Where/Problem Cards
5. Documentation: Narrative-Focused Templates
6. Collaboration: Teacher Cheat Sheets and Parent Communication Log

This Bilingual Evaluation Checklist serves as your step-by-step protocol. It ensures that even without an interpreter, you are meeting ethical standards, reducing bias, and gathering enough data to make a confident clinical decision.

Monolingual SLP: Bilingual Evaluation Checklist
Phase 1: Pre-Evaluation (The Paper Trail)

• Linguistic History: Determine the age of onset for English and the percentage of daily exposure for each language.
• Parent Interview: Complete the Bilingual Case History (using translation apps). Focus on milestones in the first language (L1).
• Teacher Consultation: Provide the Teacher Cheat Sheet and ask about the child's silent period length and peer interactions.

Phase 2: The Assessment (The Language Engine Test)

• Dynamic Assessment (Test-Teach-Retest): Pick a skill (e.g., pronouns, plurals, or sequencing). Record how much cueing is needed for the child to learn it.
• Narrative Sample: Use a wordless picture book or video short.
  • Observe "Story Logic" (Did they understand the problem?)
  • Observe "Non-Verbal Intent" (gestures, eye contact, facial expressions)
• Sentence Repetition (Informal): Have a family member model a long sentence in L1 and observe the child’s ability to mimic the length and rhythm.
• Oral Peripheral Exam: Rule out structural/motor issues that would affect speech in any language.

Phase 3: Analysis (Difference vs. Disorder)

• Phonological Check: Look up language transfer patterns for the child's specific L1. (Are the errors predictable based on their native tongue?).
• Error Consistency: Are errors present in both languages (red flag), or only in English (likely a difference)?
• Modifiability: Did the child improve during the "teach" portion of your dynamic assessment? (High modifiability = Difference)

Phase 4: Documentation and Reporting

• Include Disclaimer: State that standardized scores are invalid and that an interpreter is unavailable.
• Narrative-Based Goals: Ensure goals focus on the structure of communication (sequencing, problem/solution) rather than just English vocabulary.
• Functional Recommendations: Suggest classroom scaffolds (visual schedules, wait-time).