A child says a sentence differently from the way it appears in an English textbook. Is that a sign of a language disorder? Not necessarily. The child may be using the rules of a home language or dialect, learning English as an additional language, or communicating in a way that makes sense in their community. The child might also have a language disorder. A thoughtful evaluation looks beyond one sentence or one test score.
What is a language difference?
A language difference is a pattern of communication explained by a person's language experience or dialect. Languages and dialects have their own rules for sounds, words, grammar, and conversation. A child learning another language may draw on patterns from a language they already know. A multilingual child may also use words from two languages in one conversation, a practice called code-switching. These patterns alone do not indicate a disorder. An accent or dialect is not a speech-language disorder. [1, 2]
For example, an English learner may know the word for an object in Spanish but not yet in English. If we count only English words, we miss part of what that child knows. Similarly, a dialect feature should not be scored as an error simply because it differs from the English variety used by a test. These examples describe possibilities; they do not diagnose an individual child. [1, 2, 4]
What is a language disorder?
A language disorder involves persistent difficulty understanding and/or using language that affects communication and participation. It may involve learning words, understanding directions or stories, putting sentences together, or explaining ideas. A multilingual child can have a language disorder; speaking more than one language does not cause one. Signs of a disorder are generally evident across the languages a child uses, although they can look different in each language. Their visibility also depends on the child's experience and opportunities to use each language. [1, 3, 4]
The key question is not “Does this child speak English like a monolingual English speaker?” It is “How does this child communicate and learn within the languages and communities they know?” [1, 2, 4]
| What we observe | What it may mean | What else we need to learn |
|---|---|---|
| A child has difficulty finding some English words but readily names and explains those ideas in a home language. | English vocabulary may still be developing. | Language exposure, vocabulary across languages, and classroom opportunities. |
| A child uses a dialect grammar pattern consistently. | The pattern may follow the rules of that dialect. | The child's dialect and whether there are difficulties beyond its expected patterns. |
| Caregivers describe longstanding difficulty understanding or expressing ideas in a familiar home language, and similar concerns appear at school. | A language disorder may be present. | Developmental history, samples across languages, hearing and other relevant factors, and response to supported teaching. |
No single row is a diagnosis. Children can have a language difference and a disorder, so clinicians must avoid both unnecessary referrals and missed support. [1, 2, 4]
What does a culturally responsive evaluation look like?
1. Start with the family's knowledge. Ask which languages and dialects the child hears and uses, with whom, and in which settings. Ask what the child does well, when concerns began, and whether the same concerns occur in a language the child knows well. Avoid assumptions based on ethnicity or a language label. [1, 2]
2. Look at communication across languages and contexts. Observe play, conversation, storytelling, and classroom participation. Gather language samples in the languages the child uses, with a qualified interpreter or language-matched clinician when needed. Skills and symptoms may look different across languages; equal proficiency is not required. [1]
3. Check whether a test fits the child. A standardized English score may be misleading when the child is not represented by the test's comparison group. Simply translating an English test does not produce a valid standardized score in another language. Test items may still help describe skills when used appropriately and their limitations are clearly reported. [1, 2, 5]
4. See how the child learns with support. In dynamic assessment, an SLP may try a skill, teach it, and try it again. How the child responds to instruction adds useful information beyond what the child knew at the start. Research supports this as a promising part of multilingual assessment, while reviews caution that study quality and language coverage remain limited. It should not stand alone as a definitive test. [1, 5, 6]
5. Bring the evidence together. Family and teacher perspectives, language history, observations, samples, suitable assessment tools, and learning during supported teaching help form a fuller picture. A recent study of Spanish-English bilingual children found that results from one language varied with exposure, while considering a child's stronger performance across languages reduced that exposure-related effect. That finding reinforces why an English-only snapshot can be incomplete. [1, 4]
What can families and teachers do?
- Keep using the languages that connect your family. You do not need to stop speaking a home language because a child is learning English or receiving speech-language support. [1, 3]
- Share examples, not just scores. Describe what the child understands, says, or communicates with gestures or other tools in everyday life and in each familiar language. [1, 5]
- Ask how the evaluation considered language and dialect. Useful questions include: “Which languages were assessed?”, “How was our family's input included?”, and “Were the test norms appropriate for my child?” [1, 2, 5]
- Seek an evaluation when concerns persist. Do not dismiss significant communication difficulties as “just bilingualism.” A qualified SLP can help determine what support is appropriate. [1, 3]
Our approach at Culturally Speaking SLPs
We believe a child's languages, relationships, interests, and lived experiences belong at the center of care. Understanding a language difference helps us recognize a child's strengths. Identifying a disorder accurately helps us offer support when it is needed. Both require listening to families and seeing the whole child.
This article offers general education and cannot determine whether a specific child has a language disorder. An individualized evaluation is needed for clinical decisions.
References and further reading
1. American Speech-Language-Hearing Association (ASHA). (n.d.). Multilingual service delivery in audiology and speech-language pathology. Practice Portal.
2. ASHA. (n.d.). Cultural responsiveness. Practice Portal.
3. ASHA. (n.d.). Spoken language disorders. Practice Portal.
4. Peña, E. D., Bedore, L. M., & Granados Vargas, A. (2023). Exploring assumptions of the bilingual delay in children with and without developmental language disorder. Journal of Speech, Language, and Hearing Research, 66(12), 4739–4755.
5. ASHA. (n.d.). Assessment tools, techniques, and data sources. Practice Portal.
6. Hunt, E., Nang, C., Meldrum, S., & Armstrong, E. (2022). Can dynamic assessment identify language disorder in multilingual children? Clinical applications from a systematic review. Language, Speech, and Hearing Services in Schools.