Multilingual speech assessment

The world is multilingual and multicultural. Many children move to different countries where the majority language is not their first and/or are born into multilingual homes. Relocation and international mobility may be initiated because of parental work, curiosity, a family's desire for a different lifestyle, poverty, instability, wars and many other reasons (Weichold, 2010). Children may arrive in a country, for example, with or without their birth parents, as refugees or after international adoption. Even if children are not internationally mobile, many children encounter different languages in their daily lives. Countries such as India, South Africa and Belgium have a number of official languages. For example, in India different languages are used at home, in education, business and religion, necessitating multilingualism in day-to-day contexts. Even in countries that have one official language, such as the USA, many children speak one language at home (e.g. Spanish) and another at school (e.g. English).Most multilingual children have no difficulty acquiring the languages they speak (see Goldstein and McLeod, Chapter 10). However, some children may have difficulty acquiring all languages (and would benefit from intervention from a speech-language pathologist (SLP)); whereas others may only have difficulty with second and subsequent languages (and would benefit from support from a specialist such as a second language teacher). Differential diagnosis between these two possibilities can be a complex task. A comprehensive assessment is necessary in order to prevent under-diagnosis (describing children with disordered speech as typical), thereby denying children access to appropriate intervention, or over-diagnosis (describing children with typical speech as disordered), thereby extending already over-subscribed SLP resources to children who do not need them. Indeed,ntal disability, syndrome or cerebral palsy resulting in dysarthria. A holistic assessment can assist with determining whether there is a potential cause.'There is no reason why bilingualism should lead to a greater or lesser need for speech and language therapy (SLT). If there are proportionately more or less bilingual than monolingual children receiving SLT then this difference may be an indication of inequality' (Winter, 2001: 465). SLPs need to compare and contrast children's abilities to speak each of their languages to determine whether these children have a speech sound disorder (SSD), are at risk for one or are developing typically, and if an SSD is identified, to determine appropriate goals and to decide when intervention should conclude. Thus, there are at least five purposes for undertaking an assessment: screening, diagnosis, description, monitoring of progress and determining outcomes of intervention.The International Classification of Functioning Disability and Health: Children and Youth Version (ICF-CY; World Health Organization, WHO, 2007) can be used to inform SLP practice regarding assessment for children with SSD (cf. McLeod & McCormack, 2007). Using the ICF-CY framework, a holistic multilingual assessment should consider children's environmental and personal factors; speech, language, voice and hearing functions; structure and function of the oromusculature; and children's ability to participate in society. One of the reasons for undertaking a holistic diagnostic assessment is because environmental and cultural factors play an important role in children's capacity, functioning and performance in different situations. Additionally, it cannot be assumed that multilingual children, particularly those who were born in a different country, are refugees or who have been adopted internationally, have received routine developmental checks. It is possible that children's speech difficulties may be as a result of an undiagnosed hearing loss, cleft palate (or submucosal cleft), developme