My bilingual child is being assessed. What should I expect?

What a good bilingual speech and language assessment should include, what to tell the therapist, and how to understand the results.

Quick answer: what should a bilingual assessment look like?

• Your child should not simply be assessed as though they were a monolingual English speaker.
• The therapist needs to understand both languages, how much of each your child hears and uses, which dialect you speak, and how their development has gone so far.
• That does not mean every child needs formal standardised testing in both languages.
• The real question is whether what you are seeing fits a child still building a second language, or a difficulty with language itself.
• What you tell the therapist is part of the assessment, not an optional extra.

Guidance on multilingual assessment is direct about the last point: the clinician gathers a language history covering when and how each language was acquired, which dialect is used, which languages are used at home and at school, and length of exposure to each.[1] Nobody else can supply most of that.

Read this article in Arabic

1. Before the assessment: what should I tell the therapist?

Write this down before you go. It is more than you will remember on the day.

• Which languages your child hears, and which they speak
• When each language was introduced
• Who speaks which language with them
• Which languages are used at home, at nursery and at school
• Roughly how much of each they hear and use now
• Which language seems strongest, and whether that has changed
• Your dialect, specifically: Jordanian, Palestinian, Egyptian, Gulf, and so on, not just “Arabic”
• What worries you in each language, separately
• Hearing history, including ear infections and any missed hearing tests
• Developmental and medical history
• Any previous therapy or assessment, with reports if you have them
• What the nursery or school has said
• Any family history of speech, language or literacy difficulties

One thing worth saying plainly:

Do not simplify your child’s language history because you think it will make the assessment easier. The complexity is the useful part. A therapist cannot safely interpret a score without it.

2. Does my child need to be assessed in both languages?

Information should be gathered about all the languages your child uses. That is not the same as running the same standardised test twice. Guidance recommends obtaining single-word and connected-speech samples in every language the client uses, working with an interpreter where necessary.[1] In practice that can mean parent and teacher report, conversation and play, a story retell, informal tasks built with a native speaker, observation, or dynamic assessment, in any combination.

What if the therapist only speaks English? That does not, on its own, make the assessment invalid. An international expert panel of 46 researchers wrote a tutorial on doing it properly, concluding that therapists “have the ability and resources to undertake a speech assessment of multilingual children, including children who speak nondominant languages not shared by the SLP”.[2]

One method is worth knowing about, because you may be asked to take part. The therapist may record your child saying a set of words, then record you saying the same words, and compare the two.[2] You share a dialect with your child, so your pronunciation is the fairer target to measure against than a textbook.

What matters is not whether the therapist speaks Arabic. It is whether they have a method for finding out what is happening in Arabic.

3. What if my child speaks a dialect of Arabic?

“Arabic-speaking” is not enough information, and treating it as though it were can lead to mistakes in assessment.

Dialect is not sloppiness. Guidance describes it as “a rule-governed, systematic variation of a language”, covering grammar and meaning as well as accent, and clinicians are expected to tell dialect features apart from communication disorders.[1] The same tutorial instructs clinicians to give a child credit for a “mispronunciation” when it could be the result of dialect or of one language influencing the other.[2]

Three things to raise:

• Jordanian, Palestinian, Egyptian and Gulf Arabic differ from one another in sounds and in grammar.
• Spoken Arabic is not Modern Standard Arabic. MSA is first met at school and is structurally distinct from the variety your child grows up speaking,[13] so hearing it in lessons does not make it their everyday language.
• Because dialects vary in this way, a form that is right in your dialect may be wrong in another, and the other way round.

Writing on assessment for Arabic-speaking children makes the clinical stakes plain: because there is so little research on Arabic language development and so few appropriate resources, Arabic-speaking families run the same risk of over-identification and under-identification of language impairment as other minority-language groups.[14]

A difference from Standard Arabic is not automatically an error. UK guidance on speech sounds recommends comparing a multilingual child’s development with other children of the same age who speak the same language, and advises against referral when speech sounds in the home language are developing as expected.[3] Not against a textbook.

4. What will actually happen during the assessment?

It usually looks less like a test and more like a long conversation with tasks in it. Depending on your child’s age and the concern:

• A parent interview and case history, often the longest part
• Information from nursery or school
• Hearing information, or a hearing screen
• Play and conversation
• Understanding language: following instructions, answering questions
• Expressive language: what your child produces themselves
• Speech sounds, and how easily an unfamiliar person can understand them
• Telling or retelling a story
• Vocabulary
• For older children, possibly reading, spelling or sound awareness
• One or more language samples, recorded and analysed afterwards
• Dynamic assessment
• Formal standardised tests, where they are appropriate

Your child does not have to do all of this in one sitting, and a therapist who cannot finish should say so rather than scoring an incomplete picture.

5. Will my child be given a standardised test?

Possibly. The thing to understand is what the score does and does not mean.

A standardised test compares your child to the children it was built on. Guidance is unusually blunt here: scores “are not valid and are not reported for an individual who is not reflected in the normative sample for a given assessment”, but the same assessments “may still provide valuable descriptive information” about what a child can and cannot do in the language of the test.[1]

Both halves matter. If an English vocabulary test was built on monolingual English-speaking children, a lower score may partly reflect how much English your child has heard rather than a difficulty with language. That is not a guess. In a study of 595 Spanish-English bilingual children aged five to twelve, scores from testing in a single language were significantly associated with how much exposure a child had to that language. When the child’s better score across their two languages was used instead, that association disappeared and the differences tracked ability rather than exposure.[4]

So why use the test at all? Because the items still show what your child did and did not manage. The problem is not administering the test. It is reporting the standard score as though your child belonged to the group it was normed on.

This cuts both ways. Bilingual children are both over-identified and under-identified with language disorder: over-identified when adults hold the wrong developmental expectations, under-identified when adults wait, assuming the child simply needs more time with English.[5]

6. What is dynamic assessment?

Test, teach, test again. The therapist sees what your child can do, teaches the skill briefly, then looks at what changed.[1] It is useful because it depends less on how much English your child has already had the chance to learn.

Here is the part that is usually explained wrongly. What separates children with a language disorder from children who are simply still learning the language is not how much their score improves. Pooled across studies, gain scores were generally not useful for telling the groups apart. What did tell them apart, consistently, was the clinician’s rating of modifiability: how much support the child needed, how responsive they were, how much effort the teaching took.[6]

It is promising, and it is not a solved problem. The authors of the systematic review rated the methodological quality of all ten included studies as poor, citing small samples, a narrow range of language pairs and design problems.[7] They described dynamic assessment as possibly “a suitable and time-efficient complementary method” of diagnosis.[7] In other words, it can contribute useful evidence, but it should be interpreted alongside the rest of the assessment. A large-scale study of 634 school-age children found that modifiability scores were not meaningfully different across demographic groups including multilingualism, which is a genuinely good sign.[8]

One limitation worth stating, since it is your child we are talking about: almost all of this research has been done with Spanish-English bilingual children, mostly on storytelling tasks. I could not find a published dynamic assessment study specifically involving Arabic-English bilingual children. Applying it to your child is a reasonable extension of the evidence, not something the evidence has directly tested.

7. How does a therapist tell bilingualism apart from a language disorder?

Not from one low English score. From a pattern, across languages and settings.

The principle underneath it: signs of a communication disorder appear across all of the languages a person uses, but the symptoms usually differ from one language to another.[1]

That nuance does a lot of work. A disorder need not look identical in Arabic and English, because languages are built differently and the same difficulty surfaces differently in each. But it should be visible in both.

Bilingual people are, in RCSLT’s words, “vulnerable to misdiagnosis where diversity is mistaken for disorder”.[9] A careful assessment is how that gets avoided.

8. What if my child seems much better in one language?

Uneven is normal. A dominant language, meaning the one your child is currently stronger in, is not the same as an only language, and bilingual children can have different strengths in each.[10]

Vocabulary is distributed rather than duplicated, which is why a measure of total vocabulary provides the best indicator of a young bilingual child’s language learning capacity.[10] School words usually arrive in English, family and religious words in Arabic. Neither is the whole child.

How quickly each language develops is related to the relative amount of input in that language.[11] So a weaker language, on its own, tells you about opportunity before it tells you about ability.

There is more on this in “My child mixes Arabic and English. Is that normal?” and “Everyday routines that build both of your child’s languages”.

9. Should I speak English during the assessment so my child does better?

No, unless English is genuinely how you and your child talk to each other.

The therapist needs to see the child you actually have, not the version of your child working in an unfamiliar family language. Switching to English for the appointment changes the thing being measured.

Speak to your child the way you speak to them at home. That is the data.

10. What if an interpreter is used?

The therapist stays responsible for the assessment. Guidance is explicit that the clinician plans the session, selects the materials and administers the assessment, while the interpreter assists in gathering information and provides language support.[12] A trained interpreter is not simply there to translate individual words. Guidance on assessing children whose language the therapist does not share describes the need for someone familiar with the relevant languages and dialects.[2]

Three practical points.

You should not be expected to act as the clinician’s interpreter during your own child’s assessment. Family members can present conflicts of interest and have no interpreting training, and guidance names evaluations specifically as a high-stakes situation where that matters.[12] You are there as the parent, which is a full-time job in the room already.

An interpreter is not a bilingual therapist, and neither is a bilingual assistant. Multilingual assistants “are not interpreters”, though they may interpret to meet an unanticipated need.[12]

Interpretation changes what the scores can be used for. When a test standardised on English speakers is translated, on paper or on the spot, “it is not appropriate to report standard scores”.[12] The information gathered can still provide valuable descriptive evidence.[1]

11. What should I bring?

• Any previous reports, from anyone
• Hearing test results
• Nursery or school reports and any written concerns
• Short videos or voice recordings, if something only happens at home
• Specific examples of what worries you, written down
• Your list of languages and dialects
• Developmental history
• Your questions

You do not need to prepare your child, rehearse answers or practise beforehand. A coached performance can hide the thing you came to find out.

12. What should I ask afterwards?

The part parents most often wish they had done. Ask:

• What did you find in each language?
• How did you account for the fact that my child is bilingual?
• Were the tests normed on children like mine?
• Which of these scores are valid to interpret, and which are descriptive only?
• What seems related to how much English my child has heard, and what concerns you beyond that?
• Did you find difficulties in both languages?
• What are my child’s strengths?
• Do you recommend therapy, monitoring, or nothing for now?
• Which languages should we use at home?
• If therapy is in English, how will Arabic be taken into account?

A good therapist will welcome these. They are the questions they have already asked themselves.

13. Reasons to ask more questions

Not signs of a bad therapist. Signs that something needs explaining before you accept it.

The last one has a clear answer behind it. RCSLT states that bilingualism “does not cause or contribute to a speech, language, communication or feeding and swallowing disorders”,[9] and clinicians are advised to advocate for the benefits of multilingualism to families made to feel they should avoid using certain languages with their children.[1]

14. What happens after the assessment?

“No diagnosis” does not mean the assessment was a waste. Knowing that what you are seeing fits a bilingual child building two languages is a real result, and the one most parents came hoping for.

The one thing to take away

A good bilingual assessment is not about making your child fit a monolingual test.

It is about understanding what your child can do, what they have actually had the opportunity to learn, and whether their difficulties still make sense once both languages are in the picture.

If your worry is that your child is not saying much in either language, start with “My bilingual child isn’t talking yet. When should I worry?” If the concern is that people cannot understand them, see “Why is my child so hard to understand?”

Frequently asked questions

Can a speech therapist assess my child if they don’t speak Arabic?

Yes, provided they have a method for finding out what is happening in Arabic. An international expert panel concluded that therapists can assess multilingual children including those who speak languages the therapist does not share.[2] That means working with a trained interpreter, taking a full language history, using language samples and informal tasks, and involving you directly, sometimes by recording you saying the same words as your child so your dialect is the comparison point.[2] What should worry you is not a therapist who lacks Arabic. It is a therapist with no plan for gathering information about it.

Does my child need to be tested in both languages?

Information should be gathered about all the languages your child uses, ideally including speech samples in each.[1] That is not the same as sitting the same standardised test twice. Parent and teacher report, conversation, storytelling, observation and dynamic assessment all count as gathering information.

Can an English language test diagnose DLD in a bilingual child?

Not on its own. Standardised scores are not valid for a child who is not represented in the test’s normative sample, although the test can still give useful descriptive information about what the child managed.[1] Single-language test scores have been shown to be significantly associated with how much exposure a bilingual child has had to that language.[4] A diagnosis should rest on a pattern across both languages, not one number.

Will using an interpreter affect the results?

It affects what can be reported, not whether the assessment is worth doing. When a test standardised on English speakers is translated or interpreted, “it is not appropriate to report standard scores”.[12] The information gathered can still provide valuable descriptive evidence. The therapist remains responsible for planning and administering the assessment throughout.[12]

What if my child won’t speak during the assessment?

Common, and not a wasted appointment. A therapist can learn a great deal from play, from watching how your child responds to you, from what you report, and from recordings you bring from home. Say beforehand if your child is slow to warm to strangers. If the session genuinely did not show what your child can do, ask for another rather than accepting conclusions drawn from a silent hour.

Should I speak Arabic or English during the appointment?

Whichever you genuinely use with your child. If you switch to English to help them perform, you change what is being measured. The therapist needs to see your child communicating as they actually do at home.

Can bilingualism make my child score lower on a language test?

On a single-language test, yes, and this is well documented. Scores from testing in one language are significantly associated with how much exposure the child has had to that language; when the child’s better score across both languages is used, that association disappears.[4] A lower English score can reflect English experience rather than language ability. That is exactly why it should not be read as though your child were monolingual.

What is dynamic assessment?

Test, teach, test again: the therapist checks a skill, teaches it briefly, then looks at what changed.[1] The useful signal is not how much the score improves, since gain scores have generally not distinguished children with and without language disorder. It is the clinician’s rating of how readily the child responds to teaching and how much support they needed.[6] Reviewers rate the quality of this research as poor and describe dynamic assessment as a complementary method,[7] and I could not find a study specifically involving Arabic-English bilingual children.

How do you tell language difference from language disorder?

By looking for a pattern rather than a score. Signs of a communication disorder appear across all of a person’s languages, although the symptoms usually differ from one language to another.[1] The therapist weighs that against how much opportunity the child has had in each language, the nature of the errors, how readily the child learns with support, developmental history, and what parents and teachers have seen over time.

Should I stop speaking Arabic if my child has a language disorder?

No. Bilingualism does not cause or contribute to speech, language, communication or feeding and swallowing disorders,[9] so dropping Arabic does not remove the difficulty. A language disorder is a difficulty with language itself; removing one of your child’s languages does not remove that underlying difficulty. It removes the language you communicate in most naturally with your child, and the one connecting them to their family. If you are told otherwise, ask for the clinical reason.

Where to go next

• What to Expect from Your Child’s Speech-Language Therapy Sessions — What happens at the first appointment, what sessions look like and how progress is measured.
• What Do Speech-Language Pathologists Do? — What a speech-language pathologist (speech and language therapist) does, and how they can help your family.

References

1. American Speech-Language-Hearing Association. Multilingual service delivery in audiology and speech-language pathology (Practice Portal). https://www.asha.org/practice-portal/professional-issues/multilingual-service-delivery/
2. McLeod, S., Verdon, S., & the International Expert Panel on Multilingual Children’s Speech (2017). Tutorial: Speech assessment for multilingual children who do not speak the same language(s) as the speech-language pathologist. American Journal of Speech-Language Pathology, 26(3), 691–708. https://doi.org/10.1044/2017_AJSLP-15-0161
3. Royal College of Speech and Language Therapists. Speech sound disorders. https://www.rcslt.org/speech-and-language-therapy/clinical-information/speech-sound-disorders/
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. https://doi.org/10.1044/2023_JSLHR-23-00117
5. Bedore, L. M., & Peña, E. D. (2008). Assessment of bilingual children for identification of language impairment: Current findings and implications for practice. International Journal of Bilingual Education and Bilingualism, 11(1), 1–29. https://doi.org/10.2167/beb392.0
6. Orellana, C. I., Wada, R., & Gillam, R. B. (2019). The use of dynamic assessment for the diagnosis of language disorders in bilingual children: A meta-analysis. American Journal of Speech-Language Pathology, 28(3), 1298–1317. https://doi.org/10.1044/2019_AJSLP-18-0202
7. 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, 53(2), 598–625. https://doi.org/10.1044/2021_LSHSS-21-00094
8. Petersen, D. B., Konishi-Therkildsen, A., Clark, K. D., DeRobles, A. K., Frahm, A. E., Jones, K., Lettich, C., & Spencer, T. D. (2024). Accurately identifying language disorder in school-age children using dynamic assessment of narrative language. Journal of Speech, Language, and Hearing Research, 67(12), 4765–4782. https://doi.org/10.1044/2024_JSLHR-23-00594
9. Royal College of Speech and Language Therapists. Bilingualism. https://www.rcslt.org/speech-and-language-therapy/clinical-information/bilingualism/
10. Hoff, E., & Core, C. (2015). What clinicians need to know about bilingual development. Seminars in Speech and Language, 36(2), 89–99. https://doi.org/10.1055/s-0035-1549104
11. Hoff, E., Core, C., Place, S., Rumiche, R., Señor, M., & Parra, M. (2012). Dual language exposure and early bilingual development. Journal of Child Language, 39(1), 1–27. https://doi.org/10.1017/S0305000910000759
12. American Speech-Language-Hearing Association. Collaborating with interpreters, transliterators, and translators (Practice Portal). https://www.asha.org/practice-portal/professional-issues/collaborating-with-interpreters/
13. Saiegh-Haddad, E. (2003). Linguistic distance and initial reading acquisition: The case of Arabic diglossia. Applied Psycholinguistics, 24(3), 431–451. https://doi.org/10.1017/S0142716403000225
14. Khamis-Dakwar, R., & Khattab, G. (2014). Cultural and linguistic considerations in language assessment and intervention for Levantine Arabic speaking children. Perspectives on Communication Disorders and Sciences in Culturally and Linguistically Diverse (CLD) Populations, 21(3), 78–87. https://doi.org/10.1044/cds21.3.78