Cultural and Linguistic Adaptation of Diagnostic Language Assessments: A Scoping Review

Diagnostic language assessments are central to identifying developmental language disorder; however, many widely used tools were developed and normed within monolingual Western contexts. Their application in multilingual and multicultural settings raises concerns about linguistic, cultural and psychometric validity. Although adaptation of diagnostic tools is frequently reported, the scope and quality of published adaptation research has not been systematically mapped.

This scoping review aimed to map the literature on the cultural and linguistic adaptation of diagnostic language assessment tools for multilingual and multicultural child populations, to describe the adaptation and validation approaches used, and to identify gaps relevant to future diagnostic tool development.

A scoping review was conducted following the Arksey and O'Malley framework and reported in line with PRISMA-ScR guidelines. Searches were conducted across four electronic databases for peer-reviewed studies published between 2014 and 2025. Studies (n = 14) were included if they reported the translation, cultural adaptation, or contextual modification of diagnostic language assessments for children aged 3-12 years. Data were charted on study characteristics, assessment tools, adaptation frameworks, validation methods and reported challenges.

Fourteen studies met inclusion criteria, representing 10 countries. Adapted tools assessed a range of language domains. Most studies reported multi-step adaptation processes and referenced established international frameworks; however, the depth of cultural adaptation and the rigour of psychometric validation varied substantially.

Diagnostic language assessment adaptation research remains fragmented and methodologically inconsistent. The limited evidence base across diverse multilingual settings highlights an urgent need for contextually grounded, psychometrically robust diagnostic tools to support equitable assessment in multilingual settings.

What is already known on this subject Diagnostic language assessments are often developed in monolingual Western contexts and may not be valid for multilingual children. Translation and cultural adaptation of assessments are increasingly reported, but practices vary widely. What this paper adds to existing knowledge This review provides a systematic mapping of diagnostic language assessment adaptations, highlighting substantial variation in adaptation depth and validation quality. Only 14 studies across 10 countries were identified, indicating that the evidence base for culturally and linguistically adapted diagnostic language assessments remains limited and geographically fragmented. What are the potential or actual clinical implications of this work? Clinicians should exercise caution when using translated diagnostic tools and adopt multi-method, culturally responsive assessment practices. The findings provide a framework to guide future diagnostic tool adaptation and development in multilingual contexts.