Multilingual Populations: Is it a disorder or a language difference?
Many children grow up multilingual, or speaking multiple languages. The prevalence of speech, language, and hearing disorders in the multilingual population is similar to that of the monolingual population. Some multilingual children might appear to talk less than their peers or be hard to understand. This leads to an important question: What is just a language difference and what is the result of speech or language disorder? Multilingual individuals are more likely to be both over- and under-diagnosed with a speech or language disorder (McLeod, et. al., 2017).
For clinicians working with multilingual populations, it is important to take additional measures in order to accurately assess the speech and language skills of a multilingual child. The main question of an assessment becomes: Is it a speech or language disorder or just a language difference? To obtain a comprehensive case history, a clinician must ask about the first exposure to all languages spoken, daily exposure and use of language, communication partners, and communication contexts/environments. Clinicians must also refresh their knowledge of multilingual development and keep in mind that language competency changes over time depending on the child’s language contexts, language exposure, and communication partners.
With multilingual populations, there often is cross-linguistic transfer (the transfer of elements including sound production, grammar, and vocabulary) from one language to another. All languages spoken are mediated through a central language processing mechanism, which means that when a child has a speech or language disorder, it impacts their performance in all of their languages. Clinicians must take extra care when transcribing language samples, determining the speech sound inventory, and assessing expressive and receptive language skills in all languages spoken. Due to the lack of standardized assessments with norms for multilingual populations, clinicians should use informal measures, include strength-based assessment and dynamic assessment, and utilize an interpreter/parent to gather as much data as possible. This will help a clinician come to an accurate diagnosis.
There are many online resources available to help guide speech-language pathologists in their preparation to work with multilingual clients (see the article referenced). By staying up-to-date on the latest research, staying informed of the resources available, and adapting assessment procedures to best fit the client’s needs, clinicians will be able to ethically assess multilingual clients and provide them with the necessary guidance.
Sources Cited: McLeod, S., Verdon, S., Baker, E., Ball, M. J., Ballard, E., David, A. B., … 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. DOI: 10.1044/2017_AJSLP-15-0161