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Why Did You Use That Test? Exploring Speech-Language Pathologists' Clinical Decision Making in Bilingual Language and

Emily Wood^1,2, Mariya Kika¹, Olivia Daub³

¹Department of Speech-Language Pathology, University of Toronto, Ontario, Canada.

American Journal of Speech-Language Pathology

|July 17, 2025

Summary

Speech-language pathologists (SLPs) often use static assessments for bilingual children due to service access needs, despite awareness of dynamic assessment benefits. Systemic factors, not just individual knowledge, influence these clinical decisions.

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Area of Science:

Speech-language pathology
Bilingualism
Clinical assessment

Background:

Speech-language pathologists (SLPs) frequently use static norm-referenced assessments (SAs) for bilingual children, despite potential bias.
Dynamic assessments (DAs) are less biased but underutilized.
Limited research exists on SLPs' reasons for assessment choices and their understanding of validity beyond psychometrics.

Purpose of the Study:

To explore factors influencing SLPs' choice and use of assessments for bilingual children.
To examine how SLPs conceptualize and apply validity in assessment practices.
To understand clinical decision-making in bilingual language and literacy assessment.

Main Methods:

Semistructured interviews with 21 Canadian SLPs.
Interviews guided by the Theoretical Domains Framework and Kane's Validity Framework.
Reflexive thematic analysis to identify key themes.

Main Results:

SLPs rarely used the term "dynamic assessment" but incorporated teaching into testing.
Static assessments were used for bilinguals due to diagnostic and service access requirements, often with caveats.
Systemic issues, alongside individual knowledge, perpetuate current assessment practices.
Bilingual literacy assessment involved more varied methods and less reliance on scores.

Conclusions:

Clinical decision-making in bilingual assessment is complex, influenced by individual and systemic factors.
Efforts to improve assessment practices must address systemic issues, not solely individual clinician knowledge.