Advances in healthcare in combination with an increasingly diverse population have raised the likelihood that SLPs will encounter patients that may only speak a language other than English (non-English speaker), another language in addition to English (bilingual), or greater than one language and English (multilingual). As a result, SLPs must be prepared to meet the growing demands posed by patients that present with language profiles that may or may not include English. When evaluating non-English speakers in languages with which the SLP is unfamiliar, it is expected that the SLP will seek a qualified bilingual SLP or the services of a qualified interpreter for each language that is not spoken by the clinician–this is a vital step needed to help formulate an accurate diagnosis. The stakes are increased when the patient has suffered an unfortunate medical event such as a stroke. The need for pinpointing an accurate diagnosis is even greater for the bilingual or multilingual patient.
Among SLPs in the U.S. it is well known that there is a shortage of qualified clinicians equipped to appropriately and effectively manage speech and language disorders, especially when other languages are involved. The issue is complicated when the patient speaks and understands more than one language. With monolingual speech and language evaluations, the SLP is tasked with identifying a clear, consistent, and reliable form of communication upon which he or she will build skills in the hopes of restoring the patient’s previous level of speech and language functioning. By evaluating the patient’s communication skills across modalities, e.g., writing, speaking, auditory comprehension, the SLP is given a clear starting point. When the patient speaks more than one language the issues of accurate diagnosis and effective intervention are compounded.
For a truly individualized, efficient, and evidence-based course of intervention it is critical that the bilingual or multilingual patient’s speech and language skills be thoroughly evaluated in all languages that he or she spoke prior to the event, e.g., stroke, traumatic brain injury. As with a monolingual evaluation, assessing the patient’s language in all previously spoken languages provides the SLP with a clear, consistent, reliable form of communication upon which he or she will build skills in the hopes of restoring as much functional communication as possible. Not evaluating all of the patient’s languages puts the patient at a huge disadvantage when prognosis is considered.
If you or someone you know needs the services of a licensed and certified speech-language pathologist, please be sure to discuss your concerns with a physician, a speech-language pathologist, or another qualified provider. You can also find a provider through the ASHA ProFind service or visit us at www.bilingualspeech.org for more information.
