Can I call myself a bilingual speech-language pathologist?

I have worked as a bilingual speech-language pathologist for more than 20 years now.  I started learning Spanish when I was 21 years old—a junior in college.  I loved it.  I ended up adding a major in Spanish literature.  When I finished my program, I could talk about Don Quixote and El Cid all day long but if you asked me for directions, I would rely heavily on my English skills and gestures to convey my message.

okay gesture pointing gesture secret gesture

I found the field of bilingual speech-language pathology

As I was finishing college, I started planning my next step. I found the field of bilingual speech-language pathology that married my love of Spanish, lingustics, and making a difference in people’s lives, and knew it was what I wanted to do. I realized though, that my Spanish skills were not where I wanted them to be. So I took a train south to Oaxaca, Mexico, where I spent a month in an intensive language program and another four months working as a teacher. I gradually understood more and more of what people said to me.  I also became more and more comfortable expressing myself in Spanish.

I made mistakes

After I returned from Mexico I dove into a Master’s program in Bilingual Speech Language Pathology at the University of Texas at Austin. Even after five months in Mexico, I still often struggled to find the words I wanted to say in Spanish.  I needed a whole new vocabulary to talk about speech therapy things in Spanish.  Over the years I’ve mastered that for the most part but I still make mistakes and find times when I have to describe what I am talking about when I don’t know the name of it.  The subjunctive mood in Spanish has always tripped me up a bit because there isn’t an exact equivalent in English.  Recently, I was working with a teenager and I used the indicative instead of the subjunctive. My student kindly corrected me, and we moved on, continuing to build her ability to sequence ideas into a cohesive story.

Why am I sharing this story?

Well, I’m perplexed by contradictory messages coming from our field.  On the one hand, I read, hear about, and experience first hand the critical shortage of speech-language pathologists.  Edgar & Rosa (2007) described a “paucity of qualified speech-language pathologists (SLPs) to serve students in the public school setting.  Roth (2013) stated, “…it may seem like qualified SLPs are disappearing, and no wonder, because the SLP shortage is affecting every school and every school administrator to some degree or another.”  And then there’s the extremely limited pool of bilingual SLPs in our field (Roberts, 2008; Guiberson & Atkins, 2012).

Limits on SLPs from other language backgrounds

On the other hand, I see a push to put limits on speech language pathologists from other language backgrounds because of errors they make in English.

On August 6, 2018 I received an email from ASHA Headlines with the subject line: Peer Review: Definition and Description of Language Proficiency

It started like this:

In response to concerns from state licensing boards about the English proficiency skills of internationally trained professionals providing clinical services in the US, the International Issues Board (IIB) submitted a request in 2014 to the Council for Clinical Certification in Audiology and Speech-Language Pathology (CFCC), to increase international applicants’ English proficiency passing scores for ASHA Certification.

So let me get this straight…

We have a critical shortage of Speech-Language Pathologists…only 3% of speech-language pathologists are bilingual, and we are going to spend our energy on limiting certification of international applicants?

I have some ideas for supporting bilingual speech-language pathologists:

  • Let’s pair these bilingual speech-language pathologists with other SLPs in the field to support them in learning the field-specific vocabulary in our field.
  • Let’s decipher the enormous list of school acronyms for them.
  • Let’s set up practice modules for IEP meetings, parent feedback sessions, intervention sessions,…
  • Let’s overlook grammatical errors that result from language influence. (For 20 years people have overlooked an occasional grammatical error I make in Spanish.  And not only that, the families I work with tell me they are grateful for my support of their children and for my knowledge about how to help them improve their speech and language skills.)

I’ll make one last point then get off my soap box.  Research show us that at least 95% of speech-language pathologists work with someone from another language background.  Perhaps when it comes to diversity in our field, we can all support each other in one way or another.


Edgar, D. L. & Rosa-Lugo, L. I. (2007).  The critical shortage of speech-language pathologists in the public school setting:  Features of the work environment that affect recruitment and retention.  LSHSS, 38, 31-46.

Guiberson, M., & Atkins, J. (2012). Speech-language pathologists’ preparation, practices, and perspectives on serving culturally and linguistically diverse children. Communication Disorders Quarterly33(3), 169-180.

Roth, K. (2013).  Understanding and Managing the growing SLP shortage.  SPED Ahead.  Preschence Learning.

Roberts, Dana Marie, ” The Challenges of Bilingual Speech-Language Therapy: Perspectives from Speech-Language Pathologists” (2008). Syracuse University Honors Program Capstone Projects. 539.
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Written by: Ellen Kester

11 Comments on “Can I call myself a bilingual speech-language pathologist?”

  1. Matt from Ohio September 21, 2018 at 6:23 am #

    This was a fantastic post! As a male SLP whose Spanish level is just in the intermediate stage, I often wonder if I’ll ever ‘feel’ totally ready to provide bilingual services. Very inspired to keep improving but not let perfection be the unrealistic end goal.

    • September 24, 2018 at 7:54 am #

      Glad you are inspired and making a difference!

  2. September 21, 2018 at 7:29 am #

    I am from Miami, where I’ve worked with several SLPs who had a limited grasp of English. I am not bilingual, although I have some Spanish, and they struggled to communicate with me in everyday English. In my setting, however, all the patients were fluent Spanish speakers. In fact, many had not been exposed to very much English at all. The bilingual therapists were more appropriate choices to work with this population than I was. I envied them their Spanish fluency and worked hard to keep up with them. What a tragedy it would be to keep them from the profession by requirements that weren’t relevant to their work. On the other hand, I don’t believe they could ever have provided effective school-based therapy to monolingual English students and I’m pretty sure they would agree. Is it naive to suggest that individual companies and practices can be trusted to hire the therapists who have the skills needed for their specific site? SLPs work in all kinds of settings. To have profession wide requirements for complete fluency seems weird to me.

  3. September 21, 2018 at 9:25 am #

    Thank you so much for this post! I’m working in a dual language school in Colorado. I have been developing my Spanish language skills over the past 10 years in various ways, but still feel insufficient as a bilingual speech pathologist. I totally agree that we should not be limiting support for those who are attempting to connect with our students and families in their home language. While I’ve certainly improved and gained confidence, I know I have a long ways to go. Thanks for addressing these concerns!

    • September 26, 2018 at 11:28 am #

      Hi Katie,
      Thanks for your comments. Keep pushing forward!

  4. Natalie James September 21, 2018 at 6:47 pm #

    I personally disagree. While I understand there is a national shortage of SLPs, I don’t believe that the answer is to lower the standard to which we hold ourselves and each other accountable.

    I am a bilingual SLP with almost 20 years of experience providing bilingual therapy services in a public school district. I wish there was a Spanish language proficiency test that could be used to determine if someone has the linguistic skills necessary to call themselves a bilingual SLP. Knowing some Spanish words and phrases does not make a person qualified to remediate language impairments in Spanish. Making a tense error (which could be a dialectic difference among speakers) or gender agreement error (which research has shown occurs even in native Spanish speakers who live in an English dominant culture) is one thing. But if someone is unable to converse in a language, or knows very little about the linguistic features of that language, then that person should not call themselves a bilingual SLP or be “treating” students or clients in broken Spanish (or English, for that matter). Maybe an “SLP who knows some Spanish” would be a more appropriate title.

    I believe that ASHA should do more to advocate for our profession. Why is there no SLP or communication professionals union I could join? Why do so many districts hire SLPs as “teachers” when we are so much more? Why are there no national caseload caps under IDEA? Since 2008, most professionals in public education have been enduring budget cuts AND increased caseloads and workload demands, and SLPs are no exception. In the medical setting SLPs face expectations of up to 90% billable time.

    I often feel like I have to choose between working extra, unpaid hours every week, or failing to provide my students with quality services. Since that’s not an option, I end up working 60+ hours nearly every week. Maybe we should focus on why there is a shortage in the field instead of lowering our standards.

    • September 23, 2018 at 9:03 pm #

      Hi Natalie,
      I agree with you that we should not lower our standards. The current standard for bilingual SLPs is that we speak each language with native or near-native proficiency. Near native proficiency means that we can understand what others say to us and can explain what we need to explain. I agree that we should uphold that standard. As someone who has employed bilingual SLPs for many years, I interview potential employees in English and Spanish. We have had native English speakers with near-native Spanish proficiency and native Spanish speakers with near-native English proficiency, in addition to speakers of many other languages. A couple of times, we have had English speakers whose Spanish is functional but not at the near-native level. We have worked with them to improve their Spanish but have not put them in a position of serving Spanish speakers until we felt comfortable that they could fully understand the families and express the things that need to be expressed. I view it as an employer’s responsibility to ensure that their team is capable of operating at the level necessary to perform the duties required by the employer. So, I am totally in agreement with you that speaking a few words and phrases of Spanish does not make one a Spanish-English bilingual SLP. Further, SLPs who do not understand the patterns of Spanish should not be considered bilingual SLPs. I recall observing a home-health SLP working in a daycare once who was working on /z/ with a student and pronouncing zapato with /z/ instead of /s/. That’s clearly not what we want here.

      I would argue that people from other language backgrounds who have received a master’s degree in speech pathology, passed the Praxis exam, and completed all of the ASHA required hours to do a clinical fellowship, have to have reached a certain level of English capacity. Rather than push them out of the field, I’d love to see us embrace these individuals and give them the support they need to be successful SLPs.

  5. Natalie James September 25, 2018 at 7:50 pm #

    Thank you for your thoughtful response.

    “I would argue that people from other language backgrounds who have received a master’s degree in speech pathology, passed the Praxis exam, and completed all of the ASHA required hours to do a clinical fellowship, have to have reached a certain level of English capacity.”

    Yes! I completely agree.

    “Rather than push them out of the field, I’d love to see us embrace these individuals and give them the support they need to be successful SLPs.”

    I would not want to push anyone into or out of this field. It really takes a certain tenacity to make it through to our CF year. And then the real work begins!
    After I read your reply, I went back and re-read the original post including the quote from the ASHA Headlines email. When considering the “international applicants’ English proficiency passing scores for ASHA Certification,” I started to wonder if there were any graduate level SLP accredited programs in Puerto Rico. If so, wouldn’t imposing an English language standard for ASHA accreditation be discriminatory to Americans from Puerto Rico? Or would such individuals be exempt?

    I would at least want professionals trained in other countries to have their own associations that we could partner with through ASHA to connect like-minded SLPs from different linguistic backgrounds. There could be an ASHA accreditation transition program. I would be interested in supporting something like that. I’m sure there are others who would enjoy fostering connections and working with other professionals in such a way as well.

    • September 26, 2018 at 11:24 am #

      You bring up a good point that I think we all need to consider. The needs throughout our country vary greatly, especially when we consider US territories like Puerto Rico. I don’t know that there is a one-size-fits-all solution. I value our field’s high standards and I value supporting people from all backgrounds. I like that you are putting some ideas out there that would move us in a positive direction.

  6. March 31, 2022 at 6:36 pm #

    Anyone still keeping an eye on this one? While I wouldn’t say I’m a fully bilingual SLP, in practice 18% of my caseload speaks Spanish and English. My Spanish is good; I have a bachelor’s degree, studied in Seville, can carry on a conversation. My bilingual sessions aren’t perfect, but the kids improve and the parents seem happy. Obviously in a perfect world every child who needed it would be served by a bilingual service provider fluent in their home language, but we live in the real world. Is it wrong to use the Spanish I have to provide the best therapy I can? Should I be sending these kids on to find someone better than I am that may or may not be accessible? Where’s the balance?

    • April 1, 2022 at 2:37 pm #

      Hi Devon,
      ASHA has that list of “best” practices that always makes me chuckle a bit. It is a list of best practices in services for bilingual students. At the top is a fully trained SLP with native proficiency in the language(s) spoken by the child. Then it goes into trained interpreters, then interpreters. Maybe the 4th or 5th one down is a professional with knowledge in cultural and linguistic diversity and knowledge of the language… That is where I think most people operate. I think the key, which you highlighted in the second part of your message, is that you/we have the ability to accurately assess, write great goals, and get them out of therapy. Yes, send them to “someone better” when that person comes along. On the intervening years (decades!) we’ll just keep doing a great job.
      Thank you for your comment.

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