Research
Difference vs Disorder in communication skills
Source
California Department of Education (CDE), 2012Summary
Bilingual and multilingual children evaluated for language disorders are often misdiagnosed, due to a range of factors. These misdiagnoses represent both over-identification and under-identification of language disorders. Over-identification occurs when a child is incorrectly labeled as having a language disorder when no language impairment is present. This often occurs when bilingual children are inappropriately evaluated in only one of their languages and/or using assessments that use normative data from only monolingual peers. This can lead to bilingual children receiving unnecessary services and being diagnosed with disorders that they do not have. Under-identification often occurs when a child’s language impairment is incorrectly labeled as being “due to speaking/learning a second language.” In these instances, a “wait and see” approach is often inappropriately advised in the hope that the child will “catch up” once their English language skills are stronger. This means that children with language impairments are often denied appropriate services until much later. In order to most appropriately evaluate bilingual children, a “difference vs disorder” approach is advised. This is when both languages are evaluated in order to see if language delays are present across both languages. If a child has strong native language skills but is still learning English, this may reflect a language difference, rather than a true disorder. However, if language impairment is present across both languages, it is more indicative of a true language disorder.
Key Takeaway
It is important to gather information about language skills for all languages spoken, rather than just testing in English. English-only testing of bilingual children often leads to both over- and under-identification of language disorders. Using a “difference vs disorder” approach can promote more equitable services.