It is very important to know and acknowledge that when working with children, there is a difference between assessing a patient that is bilingual and identifying a speech impairtment with clear cut signs and difficulties. It is very important to take into account the child's language background to be able to provide the appropriate assessment, diagnosis and best treatment for them (Low, A., Koh, G., Ee-li Young, S., & Chandler-Yeo, H. , 2019)
Although in majority graduate programs in the United States for this career, their main focus is on a monolingual English model [usage of one language]. This is not the end of hope for children with speech disorder meaning there still are approaches to be used for them to help them in diagnosis and assessments to see progression and improvement.
To this day, there is still a growing percentage of children in The United States of America who speak a second language and are in bilingual environment
12% of the children speak Spanish in the U.S population, which indicates children with a speech impairments challenges for receiving adequate treatment for the child (Shin &Kominski, 2010).
In research found stated that Spanish–English-speaking or any bilingual child demonstrate two separate sound systems, one for each language, that interact with one another systematically and infrequently (e.g. Bunta, Fabiano-Smith, Goldstein & Ingram, 2009; Fabiano-Smith & Goldstein, 2010a; 2010b; Fabiano-Smith & Barlow, 2010).
It is speculated that if a bilingual child diagnosed with a speech disorder, it is more than likely that the disorder will fall in the same category in both languages spoken, meaning the child has two phonological systems, but a single underlying deficit can affect both (Holm & Dodd, 1999b; Holm, Dodd, Stow & Pert, 1999).
Spanish is widely the second language most spoken in the world which is right behind Manderin (Fernández Vítores, 2017) indicating a growing demographic of bilingual children to this day.
Although these statistics don't aquire for the research being availble to be able to help bilingual children with Speech Sound Disorders (SSD) or Phonological Disorders which limits diagnostic approaches for clinicians to work with which are one of the most prevelant categories of communication disorder in young children (Law et al., 2000).