Working with bilingual children: When to recommend speech therapy

When occupational therapy practitioners (OTPs) notice that a bilingual child is having trouble communicating during a session, they confront a challenging question: is this child demonstrating signs of a language disorder that warrant a referral to speech therapy? Or is this child developing language typically for a bilingual speaker? Making appropriate developmental recommendations for bilingual children is an increasingly relevant skill. In 2019, nearly one in five people in the United States reported speaking a language other than English at home compared to one in ten in 1980 (Dietrich & Hernandez, 2022). This article outlines typical characteristics of bilingual language development that can be misinterpreted as a language disorder; and signs that a bilingual child might not be developing speech and language typically.