Obtaining the Knowledge & Skills Needed to Practice as a Bilingual Clinician in a Non-Bilingual Graduate Program
Nate Cornish, M.S., CCC-SLP, Director of Clinical Services, Bilingual Therapies, Inc.
Nate Cornish, M.S., CCC-SLP is a bilingual speech-language pathologist, clinical director of Bilingual Therapies, and moderator of the ¡Adelante! blog. Previously, Nate provided bilingual speech-language services to secondary students and served on a city-wide bilingual assessment team in the Washington, DC Public Schools. Nate is the current president of The Hispanic Caucus, a related professional organization of ASHA.
Greetings ¡Adelante! readers! I’m exercising some “moderator liberty” (or perhaps using the “blog bully pulpit”) in submitting this article. However, I’m very excited about this topic because it describes my own experience as well as that of many of the professionals I work with at Bilingual Therapies.
As a bit of background, during my undergraduate years I looked forward to the prospect of attending a bilingual graduate program. I did my homework, visited campuses, spoke with professors, and then applied to the schools that I thought would be a good fit. There were a number of wonderful options in front of me after the acceptance letters came in, including a few bilingual programs. However, at the end of the day I chose to attend the University of Nebraska, a program that does not offer formal curriculum or clinical experience in bilingualism. Although I think I would have had a different and equally great experience at another school, I have never regretted my choice!
There are many reasons for making decisions about our academic careers, and not everyone who wants to work with bilinguals ends up attending a specialized bilingual program or studying with someone who is doing research in bilingualism. So how does this group of future professionals obtain the knowledge and skills needed to provide competent services to bilingual clients? In this article I will talk through:
- The knowledge and skills that ASHA has identified for those who represent themselves as a “Bilingual SLP”
- Legal regulations of bilingual SLPs
- Possible benefits of studying in a specialized bilingual program
- Possible benefits of attending programs that do not specialize in bilingualism
- Some tips for learning what you need to know from the literature
- Some tips for getting the clinical experience you need
What Are the Knowledge and Skills that ASHA Has Identified For Those Who Represent Themselves as a “Bilingual SLP?”
ASHA does not currently have a specific “certification” for those who would represent themselves as bilingual. There are a number of possible reasons for this, not the least of which is the difference in resources that we have for various languages. For example, we can verify a clinician’s language proficiency in Spanish rather easily, but how would we do that for a speaker of Ndebele? We can verify someone’s knowledge of typical language development in French better than we can for Quiché. It would simply be difficult to apply certification standards equally to all clinicians who may be qualified to provide bilingual services.
Instead, ASHA has provided a “definition” for those who may represent themselves as bilingual service-providers. For the most part, this definition works on the honor system. Clinicians have the ethical responsibility to meet the ASHA-specified criteria before telling current clients, future clients, employers, other professionals, etc. that they are a “Bilingual SLP.” While it seems like the professions may run the risk of having less-than-qualified individuals providing services, clinicians are answerable to ASHA under a number of points within the association’s “Code of Ethics,” such as:
- Principle IA: Individuals shall provide all services competently.
- Principle IIB: Individuals shall engage in only those aspects of the professions that are within the scope of their professional practice and competence, considering their level of education, training, and experience.
- Principle IIIA: Individuals shall not misrepresent their credentials, competence, education, training, experience, or scholarly or research contributions.
So how does ASHA define a competent bilingual SLP? You can view the entire document that details this information on the ASHA web site. However, here are the key points:
- The clinician must speak or sign two or more languages with native or near-native proficiency in the areas of lexicon, semantics, phonology, morphology/syntax and pragmatics.
- The clinician must understand language acquisition processes for both monolingual and bilingual speakers of those languages.
- The clinician must be able to administer formal and informal tests in the languages and distinguish between a difference and a disorder.
- The clinician must be able to provide appropriate intervention strategies in the client’s language.
- The clinician must recognize cultural factors that would impact services.
Is There Any Legal Regulation of Bilingual SLPs?
The answer to this is actually pretty brief, but I think some background is important to mention. Part of my professional responsibilities includes helping bilingual clinicians across the United States obtain the appropriate licensure to practice in school districts. Every state is a little different (well, sometimes very different). I’ve had the unusual experience of becoming familiar with the requirements of a number of them. However, it’s impossible to be an expert on professional legal requirements, including the regulation of bilingual clinicians, in every jurisdiction in the country. (In other words, I think what I’m about to say is based on a good idea of what is happening in most places around the country, but I’m willing to bet that there are some exceptions that I don’t know about.) The best thing you can do is find out what is happening in the state and city where you plan to practice. A good place to start is on ASHA’s “State-by-State” web page.
So, all that said, to my knowledge there are only two states that have some form of regulation for bilingual SLPs. These states are Illinois and New York and the regulation for both is specific to clinicians who work with school-age clients, (i.e., it does not apply to SLPs working in hospitals, rehab centers, etc.). New York’s regulation appears a little more complicated; however, because I am more familiar with the process in Illinois I will use it as an example of what this regulation can look like: Illinois school-based clinicians must submit an application, take a language proficiency test that is administered by the Illinois State Board of Education, and show proof of having taken university-level coursework on testing bilingual children. Provisional approvals may be granted to clinicians who have taken the language test and are in the process of obtaining the required coursework.
In short, for most SLPs there is not a bilingual-specific credential required. Where it is required, the SLP will probably have to do things like pass a language proficiency test and demonstrate completion of specific coursework. Even though it’s not likely that you will need a special license to practice as a bilingual, it’s important to verify that when you are learning about the other credentialing requirements in your jurisdiction.
What Are the Benefits of Studying in a Specialized Bilingual Program?
Of course, the more information and experience you can get during graduate school, the better. As you will have noticed in ASHA’s definition, speaking a second language is only one piece of what makes someone a competent bilingual clinician. Having access to coursework, clinical experience and knowledgeable individuals will make acquiring the skills you need a process that is definitely rich, and probably simpler than in a non-bilingual program.
It’s also important to understand that not all bilingual programs offer the same type or amount of support and resources. There may be very formal programs that offer a specialized curriculum, clinical experience, research opportunities and may even culminate in a “bilingual certificate.’ Other programs may not have a specialized curriculum, but do offer bilingual clinical practicum with experienced bilingual clinicians. Still others may simply have someone on faculty who does research in the area of bilingualism and may be available to provide guidance. Each of these will give you access to resources that students in non-bilingual programs may have to work a little harder to obtain.
As I mentioned previously, ASHA does not currently have bilingual certification, and very few legal jurisdictions do, either. Thus obtaining a graduate school’s “bilingual certificate” is ultimately not always going to give you an advantage in getting the credentials you need to practice. However, if either ASHA or your state eventually does adopt regulations for bilingual clinicians, the coursework you have in a bilingual program could potentially help you out. For right now, attending a bilingual program may also give you a leg-up with potential employers who might see your academic history as proof that you have the skills you need to work with their bilingual clients.
Are There Benefits of Attending Programs That Do Not Specialize in Bilingualism?
I just mentioned that students in non-bilingual programs may have to work harder- so what advantage could there be with that going on? For starters, you may have the opportunity to develop other interests that your bilingual program counterparts don’t get. Every accredited graduate school needs to present certain material (more accurately, a LOT of material), which can make for a busy couple of years! If your program specializes in bilingualism, you may be using any elective credits on that specialization. Going to a non-bilingual program could give you a chance for a broader educational program where you can spend your electives on other courses.
Because the bilingual niche of our profession is relatively new, a lot of what we know comes from coupling our understanding of the dynamics of bilingualism with our understanding of other areas. Attending a program that is strong in another clinical subset of the profession, (like fluency, adult neurogenics, or AAC), may give you a deeper understanding of that subject area than you might get in a bilingual program. As long as you are also getting the information you need on how bilingualism works, your experience can actually give you some unique tools for addressing these issues in bilingual populations.
Tips for Learning What You Need to Know from the Literature
You’re either already well aware, or soon will be well aware, of how much information is jam-packed into a graduate program. There’s barely any time for your required reading, let alone elective reading about bilingualism! A solution that worked for me in grad school was to work with my professors to do some academic multi-tasking. For example, if you’re doing a project in your aphasia class, see if you can do it on language recovery patterns in bilingual aphasic patients. If you have to report on some journal articles about phonological treatment, ask if you can read-up on bilingual phonological treatment. If you’re writing your thesis on traumatic brain injury, ask if you can study and write on the dynamics of cultural and linguistic plurality in TBI patients. It’s been my experience that many professors are more than willing to work with you on this and may even appreciate the unique perspective you bring to these assignments.
Where do you find information on bilingualism in the literature? Here are a few of my favorite tricks:
- The ASHA Journals: You get free access if you’re an ASHA member. If not, your university media center probably has access. Simple keyword search for things like “bilingual, Spanish, CLD” have gone a long way for me. (You can also find a list of ASHA-recommended readings here.)
- The Perspectives Journal of ASHA’s Division 14 (CLD Populations). You must be a member to access online, but it’s $35 you won’t regret spending. (You can check out a free sample issue here.)
- Journals from other professions (e.g., bilingual education, psychology, neurolinguistics, etc.):
- Bilingual Research Journal
- International Journal of Bilingual Education and Bilingualism
- Bilingual topics from multiple journals can be found by doing a keyword search through Google Scholar
- Handouts from Workshops and Conferences. There are some that are archived and able to be downloaded by the public. Here are a couple:
- The ASHA Leader. This isn’t peer-reviewed, but there are some useful articles in their archives.
- Newsletters from CLD organizations in the profession. These are also not peer-reviewed, but often have useful and accessible info:
- Books and other publications. The Hispanic Caucus keeps a pretty comprehensive list of books on bilingual and Hispanic issues in communication sciences and disorders.
Tips for Getting the Clinical Experience You Need
I mentioned some ways of getting the information you need in a non-bilingual specific curriculum. The one area that I can’t find any substitute for is clinical experience. In my own and observed experiences, one of the most valuable things you can do is to partner with a knowledgeable bilingual clinician in working with bilingual clients. Beyond finding someone who speaks a second language, you want to work with someone who can share their understanding of the dynamics of language in monolingual and bilingual speakers, the strengths and limitations of formal assessment, the purposes and procedures of informal assessment, the science and the art of providing therapy to individuals with bilingual needs, and the legal/ethical ins and outs of working with CLD clients.
Even if you attend graduate school in a part of the country that isn’t stereotypically rich in cultural and linguistic diversity, it’s important to remember that stereotypes can be deceiving and the country doesn’t look like it did even ten years ago. Areas that generally experienced less diversity are now the places that are seeing the largest per capita growth of culturally and linguistically diverse communities. In the case of the Hispanic Community in the US, according to the Pew Hispanic Center (2008), the states with the largest percent growth between 2000 and 2006 were:
- Arkansas (69.3%)
- Tennessee (60.9%)
- Georgia (60.1%).
Compare that to growth of the Hispanic Community in states like:
- Texas (26%)
- California (19.8%)
- New York (10%).
Keeping that in mind, graduate schools all over the country will probably be excited to have bilingual students in their program and may be accommodating in helping you find creative solutions to work with bilingual caseloads and access bilingual supervisors. In my case at the University of Nebraska, the closest available bilingual supervisor lived almost 500 miles away in Colorado. However, the school arranged for me to perform a 12 – week practicum there, and one of the university clinical supervisors even made the drive from Lincoln, Nebraska to Fort Collins, Colorado a few times to perform site visits with us!
Temporarily moving for a bilingual practicum required some flexibility and mobility on my part as well. However, it was worth it! Be open and consider your level of flexibility as you discuss possibilities with the graduate programs that you are considering. Also, be aware that advances in tele-practice and distance mentoring programs like ASHA’s S.T.E.P. may also open doors for you to learn from experienced bilingual clinicians.
I would also keep in mind that speech pathologists are generally resourceful people! Just because they don’t speak the client’s language doesn’t mean they don’t find ways of providing meaningful therapy. This really hit home for me in graduate school when one of my supervisors and I worked with Arabic and Farsi-speaking students (two languages that I don’t speak). She exemplified how to provide best practice and affect change where there isn’t a lot of research, information, or language support available. Now that I’m well into my professional life, I’ve sometimes found myself scratching my head with some of the Hispanic individuals I’ve worked with, even though I speak Spanish! I think the skills I gained working with that supervisor, as well as other monolingual supervisors, has proven useful in these moments.
So in short, there may be more CLD individuals than you think in the area where you attend graduate school. The language skills you bring with you to the graduate clinical experience will probably be put to good use, and your school may be flexible in finding you the bilingual support you need (as long as you are willing to be flexible, too). You may also learn more about working with bilinguals from your monolingual supervisors than you think.
Good luck as you weigh the many considerations you have to account for in finding a graduate program that is right for you! Fortunately, there are a growing number of resources out there to help you have a rich experience and meet your goals of competently working with bilinguals, even if you choose a non-bilingual program.