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The Misdiagnosis of Speech Disorders in ESL Patients

Speech language pathology

By Kris Lamey

Misdiagnosed speech disorders for ESL learners can go uncorrected for months, impacting the student's education. Therefore, language pathologists who can differentiate between speech problems associated with ESL learners and speech disorders due to a physical or mental disability are highly sought after.

Visit Med Travelers for more information on opportunities to practice speech pathology all over the country. Whether your specialty is ESL learners or another challenging area, you can get an idea what jobs are available.


Misdiagnosed speech disorders in ESL students

Misdiagnosed speech disorders for ESL learners can have serious consequences if students are incorrectly assigned to special education classes. “In my 20 years of experience working with multicultural, multilingual pediatric (CLD) populations with special health care needs,” says Dr. Love Johnson, , a multilingual speech-language pathologist, “a high incidence continues to occur in the over-identification of ESL patient diagnoses with a neuro-communicative delay or disorder.”

Numerous studies indicate that an ESL student's testing should be evaluated using both languages. This would mean that the scoring would only depend on whether the student answered correctly, regardless of which language he used. Speech professionals who understand and can identify this are able to help students more effectively.

Reasons for incorrect diagnoses

Johnson attributes the incorrect diagnoses to a lack of understanding on the part of the language pathologist giving the test and standardized tests that are based on biased content and standards.

Johnson notes that "over-identification or a false positive, usually occurs due to: 1) the lack of or underutilization of licensed interpreters; 2) inappropriate use of English-only standardized tests administered to populations whose racial, ethnic and linguistic demographic profiles do not match that of the exam; and 3) lack of providers proficient in all language modalities (reading, writing, listening and speaking) to render differential diagnosis between an in-proficiency versus a delay or disorder."

Need for cultural sensitivity in traditional testing

Cultural sensitivity can resolve many of these issues for a fairer evaluation for ESL learners. According to Johnson, "linguistic and cultural proficiency of the provider paired with a bilingual exam and/or interpreter is best practice in addressing the CLD patient and family needs, leading to appropriate identification (versus over-identification) and efficient health care utilization of rehabilitation services."

Students with reading disabilities struggle with phonological and visual/spatial processing. Phonological awareness lets students identify and manipulate sounds. However, students learning a second language face challenges with this methodology. For example, the word "shoes" has an "sh" sound that's new to Spanish speakers. This can lead to assumptions about why the child is pronouncing the word wrong, which can result in misdiagnosed speech disorders.

Greater understanding is needed

An improved definition of learning disabilities is needed for culturally and linguistically diverse students. Researchers and educators working with ESL learners should collaborate to reduce the number of foreign-language students unnecessarily placed in special education classes.


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