Key Issues 

        Lack of appropriate training and education is one of the biggest barriers when conducting culturally and linguistically appropriate assessments. It’s necessary to point out that usually, the time dedicated to bilingual services in graduate school is minimal unless you go to a specialized college. This is the reason why many monolingual speech-language pathologists struggle with differentiating a language impairment vs a language difference and consequently, the identification of the need of an interpreter or a prepared bilingual clinician to refer these children. Also, some bilingual clinicians also lack the necessary education and training to conduct culturally and linguistically appropriate services and evaluations. And this goes in hand with the misconception that you are a bilingual clinician because you know two languages. When considering the linguistic and cultural characteristics and needs of this population, clinicians may require additional training separate from their own graduate education specific to working with bilingual students but might also benefit from a network or support group of other bilingual clinicians. While it's estimated that our job needs will continue to be high (Bureau of Labor Statistics, 2021), ASHA (2021) has identified a high need for bilingual speech-language pathologists. ASHA mentions in one of the Key Issues for Bilingual Service Delivery “Bilingual clinicians who have the necessary clinical expertise to treat the client may not always be available”. In my professional experiences, I was the only bilingual clinician in both of my working experiences available to assess and service this population. Looking back, that was not only overwhelming and directly increasing my workload, but also unfortunate considering that in both places, there was a strong Hispanic and immigrant community in need of services, and I was not formally prepared to appropriately service this population. For these reasons, these issues represent one of our principal barriers.

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        When talking about time, I referred to not only the lack of time in a clinician’s schedule to complete a more thorough and complete bilingual evaluation but also to the fact that administering all these testing components might seem very complex and time-consuming. This is something that adds to clinicians’ stress and workloads in a negative way. In a recent review of the literature, Ewen et al. (2020) examined the stress levels, burnout rates, and job satisfaction rates of speech-language pathologists that could impact recruitment and job retention. Even though the authors reported that findings were difficult to make, they were able to conclude that in the United States, there are high rates of job satisfaction in our field, but high caseload and workload numbers that directly impact the satisfaction and increase stress and burnout within clinicians. In my own experience, in both the school systems and in the private sector, I was faced with the reality that there was not enough time provided in my schedule to complete monolingual o bilingual assessments. In occasions, I had to split the components of the evaluation into 2 or 3 sessions to accommodate to my assigned “evaluation time” and I had to always complete the analysis and writing component of the evaluation at home. The lack of time provided from my superiors and the need for my own personal time to be compliant with my due dates added a great amount of stress and frustration. These barriers of time directly impact the openness or possibility of completing a culturally and linguistically appropriate language evaluation with all of its recommended components.

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        My last barrier is the need for standardized scores for justifying services. Norm-referenced or standardized tests allow speech-language pathologists to compare your child’s performance on a particular day to that of other children of the same age. Unfortunately, when it comes to multiculturally diverse students, standardized test scores leave clinicians at a disadvantage when it comes to diagnosis since most of the available tests do not have representation of all dialects and cultural backgrounds in their normative samples, affecting their reliability and validity. Using “cognitive referencing” is the name to describe the practice of comparing  language scores as a factor for determining eligibility for speech-language intervention. ASHA does not recommend using cognitive referencing or other specific criteria for eligibility or dismissal of services for educational settings but,  Federal, state, and/or other local guidelines determine the qualifying criteria. Since this barrier can change from area or state, it is the clinician’s responsibility to identify the qualifying criteria for their area. In my professional experiences,standard scores were needed to justify services for both the school setting and private setting when submitting the requests to the health insurances. Considering this, completely eliminating standardized and norm-referenced testing when conducting bilingual evaluations, might not be a possibility if we need to justify services. Other secondary barriers that might also be affecting clinicians are lack of testing materials available at their place of service, lack of fluency in the minority language, lack of interpreters, administration requirements, and lack of continuing education for refreshments on new research, tools, assessments, or best practices.