SLP and Bilingual Clients: Pioneering a New Approach

Laura Finkel, MS, SLP-CCC, became an educator because she saw a trend in speech-language pathology (SLP) that she felt passionate about amplifying. Bilingual in English and Spanish, Finkel is an expert in an emerging assessment tool that helps to clarify bilingual SLP clients’ speech and language issues. She joined USAHS in 2021 as a clinical coordinator for the Master of Science in Speech-Language Pathology (MS-SLP) program on our campus in Austin, Texas.

“As SLPs, we are all responsible for understanding how to identify a language difference versus a language disorder,” Finkel says. This can be more challenging to parse out with clients who are bilingual, such as children who live in a Spanish-speaking home and study in an English-speaking school. She says that in a school that follows a monolingual English model, bilingual children are often misdiagnosed as having a language disorder and placed in special ed class. Conversely, teachers might miss a true language disorder because they assume the child is still learning English.

According to Finkel, there’s a relatively new process that can help SLPs make an accurate diagnosis: electronic language sampling. “It’s a beautiful therapy technique and assessment tool,” she says.

Language Sampling: A New Approach to Assessment

In electronic language sampling, the SLP records the child’s speech while they engage in an organic activity together, such as playing, telling stories, or discussing the child’s favorite game. “The child’s communication is authentic because they’re discussing a relatable topic,” Finkel says. The data gathered is therefore more reliable than data from a standardized test, “and the activity builds rapport and trust.”

Next, the SLP transcribes the sample and analyzes it. For bilingual students, the SLP looks at the influence of the child’s native language on English grammatical structures. This “contrastive analysis” helps the SLP determine which issues are related to bilingualism and which may stem from other factors. With a bilingual Spanish/English student, Finkel typically takes two samples, one in each language.

“Language sampling is a process that anyone can learn, that considers the whole child and involves the family,” Finkel says. “You can show the parent exactly what the child said.” Despite a perception among some practitioners that language assessments are too time-consuming (transcription and analysis may take the therapist up to three hours), she notes that standardized testing is a longer process for the child and less engaging.

But assessment is just one piece of a holistic pie that can include standardized tests—ideally, just fewer of them, Finkel says. The SLP may also conduct ethnographic interviews, which means interviewing family members and other caregivers in culturally responsive ways.

During their second-trimester residency, our MS-SLP students get hands-on experience with software that analyzes language samples. Students assess a child using language sampling during their pediatric residency, and they assess a bilingual adult in their fifth-trimester residency. They also may work with bilingual patients in the virtual pro bono clinic and during their practica. An upcoming residency will feature a trilingual guest speaker who will teach contrastive analysis.

“USA is so innovative—we’re always on top of the newest technology,” Finkel says. In interprofessional clinical simulations, our SLP students get a chance to role-play parent meetings, discharge, and communicating with occupational therapy and physical therapy students. “I’m so impressed with how much the faculty value clinical skills,” she says. “I’ve never seen clinical and academic faculty work so closely together.”

The Need for Bilingual SLPs

Finkel says that it’s detrimental to push children toward a monolingual English model at the expense of their native language. “The benefits of bilingualism are huge,” she says. “You can’t just switch languages and succeed—it’s best to continue learning in both languages at the same time.”

In the Texas public schools, more than one million children (about 20%) are English learners. However, only 8.2% of SLPs identified as multilingual in a 2021 survey conducted by the American Speech-Language-Hearing Association (ASHA). And in a 2019 survey, 92% of ASHA members identified as white. Although those demographics are beginning to shift toward more diversity, the nation still has a shortage of bilingual and bicultural SLPs.

“There’s a big moment now,” Finkel says. “The field is in a reckoning about this. We need more SLPs who are bilingual and bicultural—who can help to involve the family more and build their trust.” She notes that bilingual SLPs can also help members of an interprofessional care team work together, by serving as an interpreter between team members, families, and children.

Finkel notes that two-thirds of USAHS’ MS-SLP faculty members are bilingual, with Spanish and Arabic among the languages spoken. She says that in the long term, the program is hoping to add a bilingual endorsement that students could optionally earn.

A Journey of Passion

While an undergrad at UT Austin, Finkel studied Spanish, then traveled to Spain for a work-study program. She taught English in an elementary school where some students were receiving special ed services such as SLP. She went on to earn her master’s in speech-language pathology. One of her practicum mentors was a bilingual SLP, which proved to be “a wonderful way to get experience.” Then she served as an SLP in the Chicagoland and Austin schools. She worked on interprofessional teams with general education teachers, OTs, and PTs; some of her caseloads included speakers representing more than 20 languages. She notes that whereas other states silo bilingual students and special ed students, Texas has robust programs in which children can receive evidence-based special education services in their native language.

After nine years working in the schools, Finkel joined USAHS last fall. “I wanted to go into academia so I could teach language sampling in a way that is engaging and relevant and not for research only.”

At ASHA’s virtual conference in November 2021, she gave a presentation about language sampling as an assessment tool. She spoke about how to make changes at the policy level and how to educate SLPs about the importance of authentic communication. Increasing students’ interest and confidence in language sampling is her passion. “It can be hard to switch from doing things the old way. I became an educator because I wanted to be part of the switch. It makes my academic heart beat.”

 

The University of St. Augustine for Health Sciences (USAHS) offers a Master of Science in Speech-Language Pathology (MS-SLP) program. Designed for working students, the MS-SLP is an online program with four required on-campus residencies on either the USAHS Austin or Dallas campus. The program offers two intakes per year, in January and September. Join a collaborative cohort of peers who learn under the mentorship of expert faculty-practitioners. Prepare to make a difference in the lives of clients across the lifespan with a meaningful career in speech therapy! 

For students with a bachelor’s degree in a field other than communications sciences and disorders (CSD) or SLP and for students with a CSD or SLP degree whose undergraduate program did not include the required leveling coursework, we offer SLP leveling courses for completing the necessary prerequisites to enter the graduate program.

The Master of Science (M.S.) education program in Speech-Language Pathology {distance education} at the University of St. Augustine for Health Sciences is a Candidate for Accreditation by the Council on Academic Accreditation in Audiology and Speech-Language Pathology (CAA) of the American Speech-Language-Hearing Association, 2200 Research Boulevard, #310, Rockville, MD 20850, 800-498-2071 or 301-296-5700. Candidacy is a “preaccreditation” status with the CAA, awarded to developing or emerging programs for a maximum period of 5 years. 

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