Methods of Diagnosing Speech Sound Disorders in Multilingual Children.
Karla N Washington, Kathryn Crowe, Sharynne McLeod and 6 others
PMID 40408157WHAT IT FOUND
Assessing multilingual children's speech in both home and community languages changed diagnosis for several children, and combining evidence can reduce overdiagnosis compared with English-only norm-referenced assessment.
Key findings
01For nine children, or 45%, the diagnostic decision varied depending on the approach used.
02When Vietnamese and English speech assessments were both included, only two of four children had a speech sound disorder.
03Converging evidence for diagnosing a speech sound disorder requires at least speech accuracy, speech intelligibility, and reported concern.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The article combines several case examples rather than reporting one controlled trial, so it does not test whether these methods improve patient outcomes. The evidence is preliminary in some cases, including the Icelandic-Polish analysis, and does not establish a universal diagnostic standard. The studies were conducted in specific language contexts, so results may not transfer to other multilingual pairs without adaptation. The article relies on parent and teacher report, and misdiagnosis can still occur if language history or home-language proficiency is incomplete. The FOCUS validation was conducted in Jamaican Creole-English children and was not tested as an intervention outcome.
Declared interests
The work was funded by public research bodies, including U.S. National Institutes of Health, Canadian Institutes of Health Research, Australian Research Council, and Belgian Kids Fund for Pediatric Research. The article does not report commercial sponsorship of the assessment approaches described.
The easy way to misread this
Do not read this as proof that a specific assessment tool or protocol will improve every multilingual child's diagnosis. The evidence comes from case examples and preliminary analyses, and the recommended approach still requires local language adaptation, family collaboration, and converging evidence.