Miscommunication: Hispanic youth wrongfully diagnosed

Hispanic bilingual students are being hindered academically in Arizona and across the country, because some speech-language pathologists do not have the resources or training necessary to correctly diagnose speech disorders in children.

As students come to school for the first time, they go through various screenings to ensure they are developing at a standard rate. This is when bilingual children can be separated from their peers – from the very beginning.

“Living in the area we live in (Southern Arizona), we tend to see misdiagnosis quite often,” said Veronica Dominguez, the bilingual speech-language pathologist at Ocotillo Early Learning Center.

There are nearly 5 million ELLs or English Language Learners in public schools in the United States, according to Pew Research Center. Bilingual students are even more likely to be found in western states like Arizona.

One in 4 kindergarteners in the U.S. is Latino, according to Child Trends. These Latino students are four times more likely to be identified as having a speech disorder than their white peers.

The speech, language and hearing sciences building at the University of Arizona in Tucson, Ariz.
Photo by: Paige Helfinstine

Leah Fabiano-Smith, Ph.D., an associate professor of speech, language and hearing sciences at the University of Arizona, is doing research on the misdiagnosis of bilingual students here in Tucson. For bilingual students who are misdiagnosed, it is due to problems with speech production.

“Historically in the field of speech-language pathology, research has been done on monolingual English-speaking children, so all of our assessment measures and all of our treatment approaches have all been done on children that speak English,” said Fabiano-Smith.

Speech and language impairments fall into two major categories: One has to do with placing words and ideas in correct order to form a sentence (known as language and syntax.) The other involves the formation of speech sounds (known as articulation.) Bilingual students are typically misdiagnosed because they can’t be understood.

Spanish-English speaking children often have trouble pronouncing b’s, t’s, f’s and r’s. Speech-language pathologists employed in schools typically get less than an hour with a student to determine if they have a speech disorder. If diagnosed, the student is often taken out of the classroom to begin receiving special education services.

“It’s an issue that we’re seeing in our field now that kids are being misdiagnosed,” said Dominguez. “English language learners especially are being misdiagnosed because they are being diagnosed as having a disorder when it’s truly just a language difference.”

Veronica Dominguez and her son working in a classroom at Ocotillo Early Learning Center in Tucson, Ariz.
Photo by: Paige Helfinstine

Dominguez says at Ocotillo Early Learning Center teachers try to limit taking children out of the classroom by providing teachers with multiple aides to assist the students who need extra help.

“A lot of these kids get placed, and once we are working with them we realize this kid doesn’t have a disorder,” said Dominguez. “It’s more a difference than a disorder due to their language history and their language background. They are learning English; they don’t have a speech and language disorder.”

Fabiano-Smith and Dominguez agree there are a few tests emerging to help with the diagnosis of bilingual students, but tests like the Bilingual English-Spanish Assessment (known as BESA) are difficult to get a hold and not widely known. These tests are often regional and based off a small population of bilingual students.

“Speech-language pathologists are faced with this challenge of how do I accurately diagnose children when I don’t have the resources and the training that I need to do that,” said Fabiano-Smith.

Fabiano-Smith believes there needs to be a test with a much larger sample of bilingual children, in order to help more pathologist and students. Dominguez believes in the meantime speech-language pathologists need to go above and beyond to make sure they are correctly diagnosing children.

“We have to change the way we are evaluating kids,” said Dominguez. “We have to really take into consideration their background, their culture, their experience and exposure. We really have to look at their language sampling and all those other functional things to have a more valid picture of the child’s skills.”

Paige Helfinstine is a reporter for Arizona Sonora News, a service from the School of Journalism with the University of Arizona. Contact her at phelfinstine@email.arizona.edu

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