Clinical Education for Bilingual Speech-Language Pathologists

DSC_5301 - CopyThere is a large and continually growing need for qualified bilingual speech-language pathologists in the United States. Given the roughly 400 languages spoken in the United States (Ryan, 2013), it is not surprising that there is a great demand for speech and language services in languages other than English. Bilingual speech-language pathologists account for less than 6% of membership of the American Speech-Language-Hearing Association (ASHA, 2016). The discrepancy between the language diversity that exists in the US and the number of available clinicians results in lack of service providers for speakers of languages other than English.

The goal of any speech-language pathology (SLP) graduate program is to ensure that all students graduate with the tools needed to work with the client populations that they will face once they leave campus. Given the diversity of languages spoken in the US, there is a very high likelihood that future clinicians will, at some point, work with a client who is an English/dual language learner. In the realm of clinical education, there are currently about 50 programs in the US that offer a specific focus in bilingual speech-language pathology. Though there are many commonalities among these programs, there are some significant differences from program to program. The clinical clock hour requirement with bilingual clients, for example, ranges anywhere from 50 to 150 hours from program to program.

Taking all of these differences into consideration, an important question arises: how can we ensure that we are adequately preparing our students to work with bilingual clients?

Although there are no universally agreed-upon standards for bilingual clinical preparation, ASHA does provides some guidance. In addition to having native or near-native proficiency in the language(s) that the client speaks, bilingual service provider must also “…be able to independently provide comprehensive diagnostic and treatment services for speech, language, cognitive, voice, and swallowing disorders using the client’s/patient’s language and preferred mode of communication.” (ASHA, 2017). Importantly, though, ASHA does not accredit or approve bilingual clinical education programs. In addition, individuals classified as “qualified bilingual service providers” by ASHA, are self-identified. In the absence of clear standards about the type and quantity of training that makes someone “qualified,” it is incumbent upon each clinician to make a determination as to whether to meet these criteria or not. Clearly, this has the potential to result in a great degree of variability in the quality of education and training of clinicians who work with bilingual populations.

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One of the major difficulties that bilingual clinical training programs deal with is the issue of providing support for specific languages. There are essentially two types of bilingual speech-language pathology program models: 1. Those that focus on a specific language (e.g. Spanish, French, or Mandarin), and 2. Those that allow speakers of all languages. Those programs that only focus on one language have the advantage of developing resources for a single language population, which resolves a major logistical issue. The obvious downside is that these programs exclude speakers of other languages, limiting the access to bilingual clinical education to those who speak a specific language. On the opposite end of the spectrum are those programs that serve students from a range of languages. These programs have the benefit of serving a wider range of students, who speak a variety of languages.

Of course, accounting for many languages presents a host of logistical issues, the most challenging of which is how we can provide clinical experiences that adequately prepare future clinicians to work with speakers of a given language.

With regard to the clinical preparation, in our field we have long relied on supervised clinical practicum experiences as the main method by which student clinicians develop requisite skills. Language-specific clinical preparation for bilingual clinicians is equally important. In order to provide these types of experiences for students, two things are required: 1. Supervision and, 2. A client Population. An ideal bilingual clinical experience would consist of supervision provided by a qualified bilingual speech-language pathologist and a caseload that consists of mostly bilingual clients. In reality, though, it is extremely difficult to achieve this ideal scenario. Given the inherent variability of on-campus client populations and the availability of off-campus supervisors, we are frequently bound by what is readily accessible and not necessarily what is ideal. It is possible that our student clinicians work with only a few bilingual clients who speak the target language. It is also possible that we place our students with monolingual English-speaking supervisors who have a caseload of bilingual clients at an off-campus practicum site.

There are some notable challenges related to providing future bilingual speech-language pathologists with the knowledge and skills needed to work with bilingual clients. Although these things may be difficult to overcome, the need for greater number of qualified bilingual service providers is only increasing. It is our collective responsibility as clinical educators to ensure that future speech-language pathologists are provided with the tools they need to work with bilingual populations.

For more information about the certificate program in bilingual speech-language pathology being developing in HESP, click here.


American Speech-Language-Hearing Association [ASHA] (2016) Demographic Profile of ASHA Members Providing Bilingual Services. http://www.asha.org/uploadedFiles/Demographic-Profile-Bilingual-Spanish-Service-Members.pdf

American Speech-Language-Hearing Association [ASHA] (n.d.). Bilingual Service Delivery (Practice Portal). Retrieved November 27, 2017 from www.asha.org/Practice-Portal/Professional-Issues/Bilingual-Service-Delivery.

Ryan, C. (2013). Language Use in the United States: 2011 (United States, US Census Bureau).


JAOJose A. Ortiz is a speech-language pathologist, and faculty member in the department of Hearing and Speech Sciences at the University of Maryland, College Park, where he serves as the director of the Language-Learning Early Advantage Program (LEAP). He has long had an interest in the processes of communication development, with a focus on bilingual language development, and technology-enhanced service delivery.  He continues to be active in the local community, helping to facilitate educational workshops for caregivers of individuals with communication disorders and serving as an advocate for bilingual education.

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