What Does a Bilingual Speech Therapist Do?

Lisa Rukovena, MA, CCC-SLPo ¿Qué hace un terapeuta de habla bilingüe?

Interviewed by Erika Goyer

Every family wants the best possible start for their child when it comes to language development. Some families are lucky enough to expose their baby to more than one language from the very beginning! More and more babies are fortunate to be growing up in bilingual households. And – fortunately – many of the myths about introducing a child to a second language have been proven false. We now know with confidence that acquiring a second language doesn’t cause delays in language development. In fact, we are beginning to learn how two languages may be better than one!

If your child is having problems with their language development there is help. Interventions and therapies for bilingual children with language delays are more readily available than ever before. And they are making a positive impact on families. We interviewed Lisa Rukovena, MA, CCC-SLP from RiverKids Pediatric Home Health to find out more about this special discipline within speech-language pathology.

What is your title and what was your program of study?

A bilingual Speech-Language Pathologist (aka, SLP or Speech Therapist) has the same credentials as a monolingual SLP which usually entails a Master’s of Art (MA) or a Master’s of Science (MS) in Communication Science and Disorders. SLPs also hold State Licensure that is required for practicing in each state. I hold a license through the State Board of Examiners for Speech-Language Pathology and Audiology which is a department of Texas Department of State Health Services. A national certification is optional – though most SLPs do hold it. The title is Certificate of Clinical Competence (referred to as “Cs”)

The MA program that I attended at the University of Texas offers a curriculum specially designed for developing the knowledge and skills needed for working with linguistically diverse populations including speakers of languages other than English. An SLP who speaks a second language is not necessarily qualified to do therapy in that other language unless she or he is also familiar with the pattern of language acquisition in the second language, the differing grammatical structures, the pattern of bilingual acquisition (what it looks like when a child begins developing two languages rather than just one) as well as typical versus atypical errors for bilingual speakers. Bilingual SLPs who do not attend a specialized bilingual/multicultural program can participate in continuing education opportunities to acquire this specialized training.

What does a bilingual speech therapist do?

As a Bilingual SLP who works with the pediatric population, I work with children who have speech and language impairments and whose language exposure is mostly to Spanish. Most evaluations that I perform are in Spanish, but for children who are also exposed to English, evaluations are completed in both languages. The type of therapy activities and the language in which therapy is conducted is determined by each child’s individual needs. My joy comes from both the therapy process that largely consists of directed play activities and from watching children develop the ability to interact successfully with their family and friends.

 Visit NICHCY, National Dissemination Center on Children with Disabilities – en español to find out more about Speech and Language Impairments – Trastornos del Habla y Lenguaje.


When would a family come and see you?

A formal evaluation by a Speech-Language Pathologist is the only way to confidently rule out or identify communication impairment. I recommend to families that, if they have concern regarding their child’s speech or language development, it is best to have an evaluation conducted. If the evaluation rules out impairment, which is the best possible result, the family’s mind can be put at ease. On the other hand, if the evaluation indicates need for therapy, then therapy can be begun and the family can rest assured that their child is receiving the assistance they need.

What would you tell families they should expect at their first appointment?

Regardless of the setting (School District, Out-Patient Clinic, Early Childhood Intervention, or Home Health), parents can expect more or less similar experiences for that first appointment. The first time the family meets with the SLP, there will be a review of the institution’s policies and procedure as well as the parent’s rights and responsibilities. Once those things are explained, there will be a consent form to sign by the parents to give permission to the SLP to perform an evaluation of their child. Depending on the setting there may be other forms to complete or sign, but generally speaking, parents should plan to be impressed by the amount of paperwork that will be presented.

Once the paperwork is out of the way, the SLP and child can begin the evaluation. What this looks like exactly will depend on the age and skills of each child. The evaluation may consist of any combination of the following activities: parent interview/questionnaires, play interaction with the child, clinical examination of the child’s mouth, formal testing involving following instructions and answering questions.

Some of the questions a family may be asked are:

  • What concerns do you have for your child? – ¿Cuales preocupaciones tiene usted para su hijo?
  • How does your child let you know what he/she wants? – ¿Cómo su hijo le muestra a usted lo que quiere?
  • What are some of the facial expressions/gestures/cries/sounds/words that your child uses to communicate? – ¿Cuales son los gestos/gritos/sonidos/palabras que su hijo/a usa para comunicar?
  • What percentage of your child’s words can you understand? Can others understand? –  ¿Qué porcentaje de las palabras que dice su hijo/a puede usted entender? Puede alguien más entender?

To assess the child a therapist might ask your child to:

  • look at pictures.
  • answer questions.
  • repeat words.
  • follow directions.
Truman doing his homework by cafemama available through CC BY-NC-SA 2.0


During these activities, the SLP is listening to the way your child says their words and the way that they combine words into phrases. The SLP is also watching to see how easily your child is able to follow directions and other “nonverbal” skills. Evaluation sessions usually last about an hour or just over an hour. At the end of that time your child will likely receive a sticker or some other child-approved payment for all of their hard work.

Although such testing sounds intimidating, and it can be, SLPs have a bag of tricks to help kids feel as comfortable as possible so that they can open up and show off their communication skills. We are extra generous with high-fives, stickers, and bubbles  to let kids know how much we appreciate their cooperation and hard work.

What roles do the parents need to play in their child’s therapy?

Parents and their participation are key to their children’s progress and success, but let me start by outlining the role of the SLP. In my experience, children tolerate correction from a therapist more easily than correction from their parents. My advice to parents is to let the therapist be the “bad guy” when it comes to really pushing them to learn a new skill.

A therapist will always provide recommendations as to how parents can functionally support their child’s needs during daily routines. Bath time, bedtime, brushing teeth, dinnertime, in the car – all of these moments and routines provide hidden opportunity to engage with children in a way that targets their therapy goals. Children spend many more hours with their parents than with their therapists so when parents are partners in this process, children’s outcomes are much greater.

♥ Read more about Speech Development in Bilingual Children by Playing With Words 365


Bilingualism Across the US (infographic)

Photo credit: Bestcollegesonline.com via Speechbuddy.com

Why is it important for a child to receive bilingual therapy? How is what you do with them different?

Children are often two or three years old before a delay in speech/language development is detected. This means that, by the time children receive speech therapy, they have several years of exposure to the language that is used in their home. Rather than starting from scratch with a completely new language (English), therapy in the native language can built upon the linguistic skills that the child understands and can use. By establishing a solid linguistic base in the first language during the preschool years, children show greater long term outcomes related to second language acquisition and school performance. Cognitive and linguistic research has consistently supported strong first language acquisition as a positive indicator for later learning.

That being said, it is equally important that the bilingual SLP be qualified to treat a child in their native language. Just like with anything else, we would not expect someone to be able to teach a skill that they do not themselves either possess or at least understand. For children receiving speech therapy in a language other than English, it is important that the treating therapist have at least an intermediate proficiency in that language as well as specific knowledge about how the different linguistic features develop and about the grammar of that language.

What resources would you recommend for parents who want to find out more about your field?

What would you want Spanish speaking families to know about accessing speech therapy for their children?

I believe that it is very important that all parents understand that they are the ones to ultimately decide what services their children receive. They are also key decision makers regarding therapy goals, schedule, etc. Although each therapeutic setting is different, in many settings parents have say over which provider they would like working with their child. The medical and educational settings in which therapy is provided can be intimidating for parents so I would like parents to remember that they have a voice in this process.

Equally as important as being an active participant in decision making, parents must be an active participant in observing their child’s therapy, talking to their child’s SLP, and applying the recommendations for supporting their child at home. The role of the parent in their child’s therapy outcomes cannot be overstated. Parents are key to their children’s success!

Erika Goyer is the mother of three boys. Her oldest son Carrick Michael was born at 27 weeks gestation and weighed 1 pound, 14 ounces. Carrick died soon after his birth due to complications of prematurity. Erika went on to have two more high-risk pregnancies and two healthy sons.


  1. Jackeline Lopez says:

    Need information about your services, to my grandson. He have 2 years old. Necesito ayuda e información para mi nieto de dos años. Espero respuesta. Wait for anwers. Thanks. Gracias

  2. a.carr says:

    Hi Jackeline,
    You can reach Lisa at http://riverkidstexas.com/contact-us/
    Se puede llegar a Lisa en http://riverkidstexas.com/contact-us/


  3. We are creating lots of bilingual speech therapy materials at http://www.speechtherapytalk.com. Let us know what you need and my husband and I will get making it!

  4. Christina Ma says:

    Hi, I was wondering if you know whether or not bilingual speech therapists’ salaries tend to be higher than monolingual therapists?

  5. Leigh Ann Torres says:

    Hi Christina,
    We unfortunately do not have any information on that! I would check with online salary comparison sites such as payscale.com, although the information is not a guarantee.

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