5 Things to Know About Spanish Speech Therapy in the United States

***Before you read this useful post, I know you need bilingual speech therapy resources, you have two options:

1) There aren’t many bilingual speech-language pathologists

According to the American Speech-Hearing-Language Association (ASHA), there are roughly 160,000 speech pathologists, audiologists, speech support personnel, and speech and hearing scientists in the United States. An ASHA survey showed that there are 7,214 bilingual service providers which includes 3,923 bilingual Spanish-speaking, ASHA-certified speech pathologists in the United States. Yay, I am one of those rare bilingual Spanish-speaking SLPs.

There is a shortage of speech-language pathologists in the United States and, further, an extreme shortage of bilingual speech pathologists. That is because you need a masters to work as a speech pathologist and there is a limited number of graduate programs for speech pathologists. Graduate programs are expensive for universities to set up because they need to have both an academic and clinical staff as well as a setting for students to treat clients under supervision. Some bilingual speech pathologists do not get a lot of clinical experience working with the bilingual population in graduate school. It can be because of a lack of awareness in Spanish-speaking areas about those services being available on campus, though this is variable by location. There is an overall shortage of people who can provide speech therapy in Spanish.

To qualify for speech therapy in the school, a student has to show deficits in both English and Spanish. I have been referred students who were having trouble communicating in the classroom, but when I’ve tested those students, they performed poorly in English, but they did well in Spanish. That means that the student has the linguistic knowledge in grammar, semantics, syntax and comprehension in Spanish. If that is the case, they do not have a speech or language impairment. Those kiddos are learning English and should not receive speech therapy. In my professional experience, I have only seen those students less than 1% of the time. Most of the time I am referred students have speech deficits in both languages.

Therapy is conducted in Spanish, not in English. If a student is Spanish-dominant, I work with that student in Spanish. However, as they gain more experience and exposure in English at school, they transition to English (usually second and third grade). That can be tricky for me as I try to figure out which language is the most appropriate for treatment. In most cases, I follow the child’s lead. If they engage me in English, I will engage them in English as well, as long as they have a strong command (and many acquire fluency over the course of one school year). Most of my students start speak basic English, but I continue to speak in Spanish to them. I want to be sure they have a solid foundation in Spanish before they branch out into English.

Many bilingual students with speech impairments do not have a dominant language. They attempt some monosyllabic words in English because they are easier to say than their Spanish equivalents (e.g. “bird” is easier to say that “pajaro” and “ball” is easier than “pelota”). Their parents often tell me their kids speak more English. But when I evaluate those students in both languages, I can see that those kids struggle in both languages. Often times they have strengths in Spanish comprehension and English at the one word level. Many present with language confusion, which means that they are mixing both languages in one utterances and have low comprehension in both languages. Their language mixing is not consistent with the typical “code switching” seen with bilingual people. Code switching or code mixing is when a person says some words in one language and some words in another. For example, “You know that lady? The one with the canasta?” (canasta means basket). In that example, there was only one word in Spanish. Children with language confusion would say something ungrammatical and go back and forth in one language.