Language diversity is on the rise in U. S. schools. The U.S. Census Bureau reports that in 2019, nearly 68 million people in the U.S. spoke a language other than English at home. English learners (ELs) in U.S. schools speak over 400 different languages, according to the U.S. Department of Education. Now more than ever, speech-language pathologists (SLPs) are serving linguistically diverse children and families. 

Identifying speech and language disorders, learning disabilities, and other conditions can be challenging when more than one language is involved. Speech and language disorders occur at roughly the same rates in mono- and multilingual students. But over- and under-diagnosis can happen because of the time and skill it takes to distinguish between language differences and other conditions that can affect how people speak, read, write, and process language.   

The Diagnostic Role of the SLP   

SLPs are specially trained to distinguish between language differences that stem from linguistic or cultural factors and those that are linked to health conditions and speech-language disorders. Even so, an accurate diagnosis can be difficult to formulate. Here are just a few of the reasons why: 

• Developmental patterns differ from one language to another, making it harder to recognize when a delay is happening.   

• Lots of different factors (personal, cultural, and linguistic) can interact to delay the acquisition of language.  

• Communication difficulties such as speech sound disorders may be attributed to language learning difficulties.  

• Cultural beliefs may prevent parents or caregivers from seeking a diagnosis. 

• Parents and caregivers may not be aware of available resources and services. 

Despite the challenges, the Individuals with Disability Education Act (IDEA) requires that assessments be administered in a way that doesn’t discriminate based on racial or cultural factors. The IDEA also requires practitioners to administer valid, reliable assessments in a language and form most likely to yield accurate results. 

Researchers around the world have investigated which strategies help ensure that speech and language assessments for ELs are fair and accurate. Here’s an overview of research-supported best practices.  

Research-Based Best Practices  

The body of research on multilingual language development is always growing. The strategies described below can be used along with your own clinical judgment to create a fair and culturally sensitive assessment environment. 

Start with hearing and oral function tests.  

When a multilingual child is experiencing symptoms of a speech or language disorder, it’s important to confirm whether a medical or structural condition might be at the root of a speech sound difference. For many children, hearing screenings take place in infancy and health exams follow periodically. However, some children may not have had access to these services.  

Plan the evaluation using a “converging evidence” approach. 

A converging evidence model bases a diagnostic or eligibility decision on what most of the evidence indicates, rather than relying on a single measure. The practitioner gathers information from multiple sources, including: 

• Reports of parent, practitioner, and educator concerns 
• Descriptions of a student’s communication behaviors, including pre-linguistic skills such as taking turns and displaying joint attention 
• Detailed history of a student’s language development and experience 
• History of speech or language disorders in family members 
• Information on risk factors such as hearing loss or other health conditions 
• Analysis of single-word and narrative speech samples in both of the student’s languages 
• Validated speech and language assessments appropriate for English learners (in both languages if possible)  

This approach is likely to take longer and involve more collaboration than evaluations of single-language speakers. The extra time and effort may seem like a heavy lift if your caseload is already overwhelming. But a diagnosis based on multiple measures in multiple settings is more likely to be accurate. Investing time up front will yield better information later. 

Consider culture in your case history. 

Every student has a unique background to consider. If you’re working with an EL, it’s a good idea to build a clear picture of the child’s language exposure and culture. You can ask questions such as these: 

• When was the child first exposed to each language? 
• How much of each language does the child hear or use every day? 
• In what setting did the child learn each language? 
• Who speaks each language to or with the child? 
• Which language feels more comfortable to the child? 
• Which language is the child better at using? 

In addition to building a language profile, it’s important to learn as much as you can about the family’s values, concerns, and beliefs—especially as they relate to education and health. You can ask questions like these: 

• What beliefs does the family have about child-raising? 
• How does the family view disabilities, disorders, and learning differences? 
• How does faith factor into the family’s view of healthcare and education? 
• What issues is the family most concerned about? 
• What are their priorities when it comes to interventions or treatment? 

To make the evaluation process more uplifting and positive, you may want to explore and document a child’s strengths as well as needs. This approach allows the child and parents to share a child’s capabilities and gifts. Later, you’ll be able to tap those strengths as you design intervention plans. 

Incorporate academic artifacts.  

If you’re a school-based SLP, you may already have access to some very valuable information. You may want to take a look at the student’s academic writing. You may also want to observe how the student uses language in classroom, which can give you insight into a student’s    

•       verbal and non-verbal communication,
•       response to instructions,
•       ability to ask and answer questions,
•       self-advocacy communication skills, and
•       capacity for interacting with others.

Keep in mind that academic language and content-area language skills take much longer to develop than conversational skills. Some experts think it takes as long as seven years for most English learners—and that’s if direct, explicit instruction in academic language has taken place. 

Adopt a dynamic assessment model. 

Some researchers recommend a pretest-teach-retest strategy known as dynamic assessment (Castilla-Earls et al., 2020). This method allows you to set a baseline and track a student’s response to instruction (RTI).  

Evaluating the RTI can help you decide whether a student has a language difference or a language disorder. Dynamic assessment can also help you determine how much support a student needs to improve their skills. 

Consider including language sample analysis in the evaluation.

Language sample analysis may not be ideal in every evaluation, but it is considered by some researchers to be a “naturalistic and unbiased indicator of linguistic development in preschool-age bilingual children” (Gulberson, 2020).

Transcribing language samples and analyzing them can be time-consuming, and it’s best carried out by bilingual SLPs. Despite these obstacles, it can be a useful tool in a comprehensive evaluation. Many SLPs develop their own methods of gathering samples during their interactions with a child (Gulberson, 2020).

Some practitioners prefer to ask someone who knows the language to take the test. A recording of that individual’s test responses can be compared to the student’s test results (McLeod et al., 2017). A family member who speaks the child’s language might be a good option for this task. You can separately record both the child and family member producing single words, then compare the two productions. A family member may even be able to help you identify which of the child’s sound productions is correct.  

Boost your transcription skills.  

The International Expert Panel on Multilingual Children’s Speech recommends that SLPs participate in training in the International Phonetic Alphabet and its extensions. If you regularly work with multilingual students, you may already feel comfortable with phonetic and phonemic transcribing. If you’re building skill in this area, you may want to explore resources to help you extend your knowledge of the articulation of sounds in languages around the world.   

The International Phonetic Association has created charts that link speech sounds to symbols. The University of Glasgow’s Seeing Speech site offers animations that show exactly how sounds are produced.   

Choose assessments with age, grade, culture, and development in mind. 

Before you choose a test, review the vocabulary test items and images to be sure they are a good match for the experience level of the child you’re evaluating. If you’re not sure whether a test is appropriate, you may want to speak with one of the publisher’s Assessment Consultants, who can guide you to tools that suit the child’s needs.  

Many assessments have been accurately translated into languages other than English by trained assessment translators. It is not usually a good idea to try and adapt a test to another language on your own.  

Include non-word repetition tasks.  

Phonological processing can be tested with non-word repetition tasks. Asking students to repeat non-word sounds can be an effective way to distinguish between those who have speech or language conditions and those who are typically developing language learners, studies show (Schwob et al., 2020). Varying the complexity of the non-word sounds and including sound patterns that are not similar to words can be especially useful (Taha et al., 2021).  

Assess morphosyntax as an indicator. 

Some practitioners find a “disorder within diversity” approach useful in evaluating speech and language disorders among English language learners (Oetter, 2018). One of the promising methods often used with this framework is morphosyntax assessment. 

Studies suggest that morphological markers may differ in bilingual students with language disorders. Researchers have found that clitics and verbs are particularly useful in distinguishing between Spanish-speaking students with and without developmental language disorder (Castilla-Earls et al., 2020; Jacobson et al., 2019). Verb error patterns have also been linked to phonological impairment in dual language speakers (Hasselaar et al., 2020).  

Collaborate with an experienced interpreter.

A trained, experienced interpreter can assist objectively with an assessment, but it’s a good practice to train the interpreter before the test date. The interpreter should understand the goals and purpose of the assessment. They should also have a basic understanding of language development and language disorders, experts say (McLeod et al., 2017). 

One of the benefits of working with interpreters is that they may be able to provide cultural insights that help you better serve the student and family. An interpreter can also report on intelligibility and may be able to share how a student compares with other children the same age (Jasso & Potratz, 2020).  

Include validated, reliable standardized assessments appropriate for the child. 

Normed speech and language assessments can provide you with valuable insights about a student’s English proficiency, as well as their speech and language skills. They can illuminate a student’s strengths and areas where they need extra support. That information is vital when planning interventions, writing individual education plans (IEP), and monitoring progress.  

With ELs, standardized test scores should not be the sole factor you consider when making diagnostic decisions. Even so, test results can prompt important questions about where and why deficits exist. It's always up to you, as an SLP, to use your clinical skills and professional judgment as to which measures to use, how to adapt them, and how to interpret the scores.

WPS is pleased to offer trusted assessments to help you elevate your speech-language assessment of English learners.  

Tools and Resources  

Numerous online resources have been developed to help SLPs serve English learners and their families. Here are a few to consider. 

Phonemic Inventories

To understand how the speech sounds inherent in one language can influence the way sounds are produced in another language, you may want to learn more about the phonemic system of your student’s first language. ASHA’s phonemic inventories can be a good starting place.  

These inventories can help you identify sounds unique to each language, along with those that are common to both languages. This database also provides insights into cultural considerations for speakers of each language.  

Intelligibility in Context Scale

The International Expert Panel on Multilingual Children’s Speech provides an easy-to-complete family questionnaire that measures a child’s intelligibility in the home language. It can be used to gather information about speech sound disorders and childhood apraxia of speech. 

The Intelligibility in Context Scale is available in many languages and has both monolingual and bilingual formats.  

Cross-Linguistic Phonology Project

The University of British Columbia’s School of Audiology and Speech Sciences offers a variety of phonological development tools in its Cross-Linguistic Phonology Project. Transcription resources are available in English, French, Spanish, and Mandarin. The site also offers word lists and phonology tests in 14 languages.  

WPS Assessment Consultants

Choosing the right tests for English learners can be a challenge. WPS Assessment Consultants are experienced speech-language pathologists, school psychologists, occupational therapists, and educators who understand the complexities of assessment. We stand ready to help you evaluate your options and choose the best assessment for the child in your care—and we’re available to train and support you as you move through the assessment process. 

Key Messages  

Each English learner is unique—with particular physical and mental characteristics, a distinctive language history, and a singular pattern of speech and language capabilities. Speech-language pathologists are specially positioned to diagnose and plan interventions for English learners with differences, delays, or disorders. 

To do so effectively, SLPs must maintain cultural sensitivity, assess in multiple languages when possible, collaborate with native speakers, and base decisions on a wide variety of information sources.  

Further Reading: 

•  The WPS In-Depth Guide to Reading Assessment 

• WPS Dyslexia Assessment Tool Kit

• Infographic: Types of Phonological Processes 

Videos:

• Unraveling the Complexities of Pragmatics 
• Evaluating Spoken Language Skills with CASL-2 
• Unlocking Potential: WPS & SLPs 

Research and Resources: 

Castilla-Earls, A., Bedore, L., Rojas, R., Fabiano-Smith, L., Pruitt-Lord, S., Restrepo, M. A., & Peña, E. (2020). Beyond scores: Using converging evidence to determine speech and language services eligibility for dual language learners. American Journal of Speech-Language Pathology, 29(3), 1116–1132. https://doi.org/10.1044/2020_AJSLP-19-00179 

Castilla-Earls, A., Auza, A., Pérez-Leroux, A. T., Fulcher-Rood, K., & Barr, C. (2020). Morphological errors in monolingual Spanish-speaking children with and without developmental language disorders. Language, Speech, and Hearing Services in Schools, 51(2), 270–281. https://doi.org/10.1044/2019_LSHSS-19-00022 

Castilla-Earls, A., Ronderos, J., McIlraith, A., & Martinez, D. (2022). Is Bilingual Receptive Vocabulary Assessment via Telepractice Comparable to Face-to-Face?. Language, speech, and hearing services in schools, 53(2), 454–465. https://doi.org/10.1044/2021_LSHSS-21-00054 

Dam, Q., Pham, G., Potapova, I., & Pruitt-Lord, S. (2020). Grammatical characteristics of Vietnamese and English in developing bilingual children. American Journal of Speech-Language Pathology, 29(3), 1212–1225. https://doi.org/10.1044/2019_AJSLP-19-00146   

Guiberson M. (2020). Alternatives to traditional language sample measures with emergent bilingual preschoolers. Topics in Language Disorders, 40(2), E1 E6. https://doi.org/10.1097/tld.0000000000000208 

Hasselaar, J., Letts, C., & McKean, C. (2020). Verb morphology in German-speaking children with developmental language disorder and phonological impairment. Clinical Linguistics & Phonetics, 34(7), 671–691. https://doi.org/10.1080/02699206.2019.1692076  

International Expert Panel on Multilingual Children’s Speech (2012). Multilingual children with speech sound disorders: Position paper. Bathurst, NSW, Australia: Research Institute for Professional Practice, Learning & Education (RIPPLE), Charles Sturt University. Retrieved from http://www.csu.edu.au/research/multilingual-speech/position-paper

Jacobson, P. F., & Thompson Miller, S. (2019). Identifying risk for language impairment in children from linguistically diverse low-income schools. International Journal of Speech-Language Pathology, 21(2), 143–152. https://doi.org/10.1080/17549507.2017.1406987

Jasso, J., & Potratz, J.R. (2020). Assessing speech sound disorders in school-age children from diverse language backgrounds: A tutorial with three case studies. https://pubs.asha.org/doi/10.1044/2020_PERSP-19-00151

Jodache, S., Howe, T. & Siyambalapitiya, S. (2019). “Are we…providing them with an equal service?” Speech-language pathologists’ perceptions of bilingual aphasia assessment of Samoan-English speakers. Clinical Archives of Communication Disorders 4(1), 41-51. http://dx.doi.org/10.21849/cacd.2019.00024 

McLeod, S., Verdon, S., & International Expert Panel on Multilingual Children's Speech (2017). Tutorial: Speech assessment for multilingual children who do not speak the same language(s) as the speech-language pathologist. American Journal of Speech-Language Pathology, 26(3), 691–708. https://doi.org/10.1044/2017_AJSLP-15-0161

Oetting J. B. (2018). Prologue: Toward accurate identification of developmental language disorder within linguistically diverse schools. Language, Speech, and Hearing Services in Schools, 49(2), 213–217. https://doi.org/10.1044/2018_LSHSS-CLSLD-17-0156

Schwob, S., Eddé, L., Jacquin, L., Leboulanger, M., Picard, M., Oliveira, P. R., & Skoruppa, K. (2021). Using nonword repetition to identify developmental language disorder in monolingual and bilingual children: A systematic review and meta-analysis. Journal of Speech, Language, and Hearing Research, 64(9), 3578–3593. https://doi.org/10.1044/2021_JSLHR-20-00552

Taha, J., Stojanovik, V., & Pagnamenta, E. (2021). Nonword repetition performance of Arabic-speaking children with and without developmental language disorder: A study on diagnostic accuracy. Journal of Speech, Language, and Hearing Research, 64(7), 2750–2765. https://doi.org/10.1044/2021_JSLHR-20-00556 

van der Straten Waillet, P., Colin, C., Crowe, K., & Charlier, B. (2022). Speech-language pathologists' support for parents of young d/Deaf multilingual earners. Journal of Deaf Studies and Deaf Education, 27(4), 324–337. https://doi.org/10.1093/deafed/enac024