Providing equitable access for bilingual children: Adaptation of language assessments and interventions

Royal College of Speech and Language Therapists’ guidelines state that speech and language therapists (SLTs) should provide assessment and therapy in both/all of the child’s languages (RCSLT, 2018). This is easier than in the past as more assessment and therapy packages in languages other than English (LOTE) are published. Normative monolingual data is emerging for LOTE for a range of languages. However, the bilingual child is not comparable to monolingual populations speaking eith of their languages. The aim of devising standardised assessments for language combinations seems untenable withou relying on estimated measures of language exposure. Use solely of standardised tests for identication purposes is in any case not recommended for any child and these are meaningless in the case of children who speak LOTE. Attempts at classifying clients as eectively monolingual or waiting until they ‘catch up’ with monolingual children perpetuates the misconception that bilingual speakers are two monolinguals in one person and cannot provide an accurate picture of overall language ability. Furthermore, standard toys and picture materials may be unfamiliar to children fr minority ethnic communities, or be otherwise unsuitable for cultural reasons. Bilingual children ma attempt to speak in only one of their languages and avoid code switching for pragmatic reasons (Stow, Pert & Khattab, 2012), leading to inaccurate results. SLTs must reject traditional ‘snapshot’ assessments and consider alternative approaches. For identication this should minimally include dynamic assessment and careful consideration of the child’s exposure and opportunities to use English. Diagnostic assessment will involve embracing an SLT-interpreter led approach, delivering descriptive and structured informal assessments as part of dynamic assessment cycle. Culturally adapted toys and pictures allow the child to be assessed fairly and to engage in therapy. Translation issues aecting meaning, syntax, phrase structure and morphology must be addressed. Only in this way can the profession truly provide an equitable serv with outcomes comparable to monolingual children. SLTs often feel under condent to implement this approach, citing time pressures, and preferring t reply on standardised assessments whilst acknowledging this as a awed approach. Despite eviden based RCSLT clinical guidelines promoting an equitable approach being available for many years, equitable practice is inconsistently applied. We will illustrate the process of using culturally and linguistically sensitive adaptation, in contrast to translation, drawing on the ‘Bilingual Assessment of Simple Sentences’ (BASS)(Pert & Stow, 2019), th ‘Multilingual Toolkit’ (Letts & Sinka, 2011), and the ‘Building Early Sentence Therapy (BEST) package (McKean, Stow & Pert, 2010). These examples will illustrate how an equitable service can be provide for these children, based on accurate and informative information gathering. They will also show th RCSLT clinical guidelines recommending double the time to achieve the same client outcomes are valid and cost eective. Three key learning outcomes 1. To apply RCSLT clinical guidelines on assessment and therapy to bilingual children. 2. To select culturally and linguistically appropriate stimulus materials to engage bilingual childr in assessment and intervention. 3. To show how equitable outcomes can be achieved for bilingual children and their families by adapting assessment and therapy procedures as appropriate. Brief outline of submission Despite RCSLT clinical guidelines, SLTs rarely feel condent working with interpreters, bilingual children and their families. This paper provides actual worked examples of how cultural and linguist adaptation of language assessments and interventions, in contrast to direct translation, can deliver equitable outcomes