Why do I need to work with an SLP with training in multilingualism?

This is a question that an average SLP might ask themselves when faced with a case of a child who is linguistically and culturally different from them – my preferred terminology for this situation is culturally mismatched. From the perspective of a bilingual and bicultural SLP, the answer to this question may be more transparent if you have had the chance to reflect on the role of culture and language variety in addition to other factors that can impact language development, such as language acquisition history, dialect, and pragmatics. I acknowledge that along our educational journeys most of us did not receive (and have not yet received) adequate training to support critical thinking in the areas of language variety, multilingual/multidialectal language development, and cultural differences.

Here are some of the top reasons for choosing to work with a multilingual or bilingual SLP and how it would most benefit a monolingual SLP and the multilingual client:

1. Training in multilingual language development. As I talked about in my last post: In addition to understanding dialectal variation, multilingual language acquisition, and expected patterns of communication within dialects, having an awareness of cultural considerations, power dynamics, and implicit bias (for reflecting on one’s own prejudices) is crucial.
2. Recognition the risk for over-identification as well as under-identification for SLP services. There are multiple factors that can influence a student’s performance, especially on standardized instruments. Best practice and current research indicates that all SLPs should move away from standardized instruments for bilingual children (more on this in a later post). Current research is showing that bilingual/multilingual students are at risk for both under- and overidentification, which may be partially influenced by what age they are identified for an initial referral in the schools.
3. Training in culturally responsive assessment methods and how to make clinical decisions to what measures to use. Culturally responsive assessment looks at student language input and output across all the student’s languages and then from there a decision can be reached on what tools and measures to use.
4. Training in how to conduct a parent interview and what questions to ask. Without knowledge from the family, there are so many missed opportunities for obtaining important linguistic, medical, and developmental history. Almost equally important is what you ask. I always refer to the Leaders Project Critical Questions to help SLPs find a starting point in learning about this process.
5. Training in identifying crucial elements of speech and language patterns across language patterns. In an ideal world, SLPs would have received coursework in linguistics to gain an understanding of the way that spoken languages can vary across the world. Here are some speech and language considerations that SLPs may not have been exposed to in their training programs:
   • Tonal languages; here is a video explaining tones in Thai
   • Languages that contain mostly monosyllabic words, such as Vietnamese
   • Languages and dialects that do not have or have a limited set of final consonants (e.g., depending on the dialect, in Spanish, there are only five final consonant sounds)
   • Languages with much fewer lexemes (i.e., vocabulary) than English; here is a list of dictionaries by number of words across multiple languages on Wikipedia
6. Training in critical awareness of how to distinguish culture from language. Understanding and asking caregivers about the many ways in which culture can present in language and pragmatics is crucial for determining a disorder. Children of non-Western cultural backgrounds may have different social interaction patterns relating to gesturing, eye contact, speaking volume, etc.
7. Training enough to know their own linguistic boundaries. Bilingual or multilingual SLPs know when they need to use an interpreter to make sure they are not engaging in over- or under-identification for SLP services.
8. Training in treatment selection and ratios of language input in therapy. Treatment needs may vary depending on the child’s speech or language deficits. Children may need a balanced language approach (e.g., using English and Spanish 50%/50% or may need more flexibility such as code-switching).
9. Training in designing therapy and making recommendations. Tailoring recommendations can be just as important as the diagnostic process. Without a clear understanding of where to go therapeutically, progress may be hindered.
10. Perspectives that support the family. The bilingual or multilingual SLP will have knowledge of implicit bias, how to reduce bias in an evaluation process, and how to be culturally responsive to families’s needs. Part of this process is achieved through clinical tools such as ethnographic interviews.

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