Does the speech & language therapist need to speak all of your languages?

So your multilingual child is going to see a speech and language therapist (SLT) and you’re wondering if the SLT needs to be multilingual too. The short answer here is no. What the SLT needs to be is culturally competent. What does that mean? It means that they need to be up to speed on how speech and language development happens in multilingual children. To know about the different patterns of development depending on whether your child has been acquiring their languages from before age 3 and/or if they’re adding another language starting when they go to school. They need to know about the factors that influence speech and language development in multilingual children. That’s things like the amount of time your child has been exposed to their languages, the opportunities that your child has for using their languages, if the languages are similar like Italian and Spanish or different like English and Russian. They need to find about your languages: what are the speech sounds in the languages? What combinations of sounds are found in your languages? Like Russian and Polish have more complex consonant combinations (called clusters in SLT jargon) compared with English. They need to know about the grammatical systems of the languages. Things like in English, we put the subject first then the verb. Mary Pat ate cake. In Irish it’s the verb that comes first D’ith Mary Pat an cáca. This is important for making sense of the way your child uses their languages. They need to find out about your culture and what’s appropriate or not for your child’s situation. That means things like expectations about eye contact, play, gestures and so on.

 

A 2015 Australian study paper which collected data from 14 sites in 5 countries on 4 continents describes culturally competent speech and language therapy as:

 

#1 SLTs being aware of cultural and linguistic influences in children’s lives so that assessments of their speech, language, and communication strengths and needs are accurate and culturally sensitive

 

#2 using several sources of data in assessment to draw appropriate conclusions about whether or not your child has a speech, language, and/or communication issue. This means talking with you and other family members involved in your child’s life, their teachers, and so on.

 

#3 finding out about the impact of any speech and language issues on your child’s daily life by talking with you, your child, their teacher etc.

 

#4 collaborating with you and teachers to work out strategies that will support your child’s speech and language development and increase their ability to participate fully in their daily lives.

The SLT’s job is to work out if your child has a problem with speech and language or if the patterns they’re seeing are because your child hasn’t had enough time to get things straight in all of their languages. What kinds of problems are we talking about? Things like not pronouncing words clearly making it hard for people to understand what your child says. Not combining words by twenty-four months. Not understanding what is being said to them. Not initiating interaction with you. Stuttering. Having a hoarse voice. And many more. It’s a complex process to work out the nature of a child’s speech and language difficulties and it takes time. Just like speech and language development are complex processes that take years to evolve.

There are real challenges for speech and language therapists in terms of a general shortage of multilingual SLTs, a shortage of assessment and intervention resources in a wide range of languages, a lack of easy access to skilled interpreters, and not enough time allowed within the system for assessment of all of your child’s languages. Another issue can be organizational rules that SLT can only be delivered in English in some states in the US for example.

But there are enough resources out there to conduct an assessment and work out a plan on the basis of the information gathered. Of course, the ideal situation is where the SLT speaks the languages you need, has the requisite cultural knowledge for your situation, and has access to valid, reliable, and sensitive assessment measures and intervention materials for all of your child’s languages. In that Australian study, one of the SLTs spoke 10 languages well enough to allow her to deliver therapy in their home languages as well as focusing on the community language without having to rely on the services of an interpreter.

Alarms bells should ring if your SLT doesn’t ask about all the languages your child needs now and will need in the future and doesn’t ask in detail about who uses the languages with your child in what situations and for what purposes. When it comes to speech sounds for example, the SLT can work closely with you on sounds that are unique to your languages and unfamiliar to the SLT and difficult for him/her to pronounce. It’s a great opportunity for collaboration and for learning from each other. If the SLT tells you to drop one of your languages, then they are not following best practice guidelines or the research evidence. In that case, this blog post this blog post  will give you a range of ways to respond.

That 2015 Australian paper identified 6 Overarching Principles of Culturally Competent Practice for SLTs working with multilingual families. Here they are:

 

#1 identification of culturally appropriate and mutually motivating therapy goals meaning finding out what’s important and culturally relevant to you and your family when it comes to speech and language goals

 

#2 knowledge of languages and culture which means doing some research in advance about your languages and culture and talking with you about them too in order to find out more

 

#3 use of culturally appropriate resources meaning that they check with you if there are any items or pictures or activities that aren’t suitable

 

#4 consideration of the cultural, social, and political context including things like the policies of the system when it comes to the language of assessment and intervention

 

#5 consultation with families and communities which will vary from place to place in terms of how much and in what ways parents and communities are involved

 

#6 collaboration between professionals including SLTs, teachers, interpreters.

 

These are things to look out for when you meet the SLT. All of a multilingual children’s languages need to be taken into account across assessment and intervention. It’s not just about languages though, it’s knowing and finding out about culture too. And supporting your child’s current and future language needs.

Hope you found this post helpful and I’d be delighted if you passed it on to your friends.

Let’s get talking!

MP

What I read so you don’t have to

 Verdon, S., McLeod, S., & Wong, S. (2015). Supporting culturally and linguistically diverse children with speech, language and communication needs: Overarching principles, individual approaches. Journal of Communication Disorders 58: 74-90.

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