The Communication Bridge: When Languages Meet Clinical Practice
In Australia’s culturally diverse landscape, speech pathologists increasingly find themselves at the intersection of complex communication disorders and language barriers. The need to work effectively with professional interpreters has never been more critical, particularly as migration patterns shift and our population ages. When communication itself is the clinical focus, the dynamics between speech pathologist and interpreter become especially nuanced and challenging.
A recent systematic review by Huang, Siyambalapitiya, and Cornwell (2019) published in the International Journal of Language & Communication Disorders explores this complex interprofessional relationship. The review examines how speech pathologists and interpreters collaborate to manage culturally and linguistically diverse (CALD) adults with acquired communication disorders (ACDs). While this research focuses on adult populations, the findings offer valuable insights that can inform paediatric practice, where early intervention and cultural sensitivity are paramount.
Why is interpreter-mediated speech pathology increasingly important in Australia?
Australia’s population continues to diversify, with 29.3% of the population born overseas according to recent Australian Bureau of Statistics data. In paediatric contexts, many children with communication disorders come from homes where English is not the primary language. Speech pathologists are therefore legally and ethically bound to provide equitable services to these children and their families, often necessitating the engagement of professional interpreters.
Huang and colleagues’ systematic review reinforces the growing importance of effective interpreter-mediated services. As they note, “As levels of migration and ageing populations continue to rise globally, there will be an increasing need for speech pathologists to work with professional interpreters.” This demographic reality applies equally to paediatric populations, where communication between the clinician, interpreter, child, and family creates an even more complex dynamic.
What unique challenges emerge when speech pathologists and interpreters collaborate?
The systematic review identified several key challenges that emerge when speech pathologists and interpreters work together. Chief among these were speech pathologists’ uncertainty about the accuracy of interpretations and unclear role expectations from both professions.
These challenges are particularly significant in paediatric contexts. When assessing and treating children with communication disorders, subtle linguistic nuances, developmental variations, and cultural perspectives on childhood and disability may be crucial to accurate diagnosis and effective intervention. Speech pathologists report concerns about whether testing materials designed for English-speaking populations are being appropriately adapted during interpretation, and whether culturally-specific communication behaviours are being accurately represented.
Additionally, the review highlighted that most interpreter participants were primarily involved in assessment tasks using face-to-face service delivery. This suggests potential gaps in interpreter involvement across the full spectrum of speech pathology services, including intervention, counselling, and parent training—all critical components of paediatric practice.
How can speech pathologists and interpreters improve their collaboration?
The review identified two primary strategies that appear to facilitate more effective interprofessional practice: pre-session briefings and targeted training for both professions.
Pre-session briefings provide an opportunity for speech pathologists to explain specialised terminology, outline session goals, and clarify roles before the clinical encounter. This preparation allows interpreters to better understand the communication tasks they will be mediating and alerts them to specific linguistic features that may be clinically relevant. In paediatric contexts, these briefings might include discussion of developmentally appropriate language, speech sound targets, or strategies for engaging young children.
Training emerged as another crucial strategy. Speech pathologists need specific training in how to work effectively with interpreters, while interpreters benefit from specialised training in the unique requirements of communication-focused clinical work. This might include understanding the nature of various communication disorders, recognising the importance of preserving linguistic errors in interpretation, and adapting standardised assessment protocols appropriately.
For paediatric speech pathologists, this training could incorporate additional elements related to interpreting developmental language, working with families from diverse cultural backgrounds, and navigating different cultural perspectives on childhood development and disability.
How might these findings apply to paediatric speech pathology practice?
Although Huang et al.’s systematic review focused on adults with acquired communication disorders, many findings have direct relevance to paediatric practice. The interprofessional challenges and recommended strategies likely apply across age groups, though paediatric contexts introduce additional layers of complexity.
In paediatric speech pathology, interpreters must navigate not only the language barrier between clinician and family but often must also interpret for the child. This may involve adapting communication style to be developmentally appropriate while maintaining clinical accuracy. Additionally, interpreters in paediatric settings must understand family dynamics and cultural perspectives on parenting, education, and developmental expectations.
Speech pathologists working with children from CALD backgrounds must consider how standardised assessments, typically normed on English-speaking populations, should be adapted when mediated through an interpreter. They must also develop culturally responsive intervention approaches that respect family values and communication styles while addressing the child’s communication needs effectively.
The strategies recommended in the review—pre-session briefings and specialised training—could be adapted specifically for paediatric contexts. This might include:
- Briefing interpreters on developmental language expectations
- Discussing culturally appropriate ways to engage with children and families
- Training interpreters to preserve developmental errors in children’s speech and language
- Developing protocols for interpreter-mediated play-based assessment
- Creating resources to support parent coaching through interpreters
What gaps remain in current research and practice?
Huang et al.’s systematic review reveals significant gaps in our understanding of interpreter-mediated speech pathology services. The authors note that most research has focused predominantly on speech pathologists’ perspectives, with limited exploration of interpreters’ experiences and perceptions. Furthermore, while strategies like pre-session briefings and training have been proposed, “the efficacy and utility of the strategies has not been investigated to date.”
These limitations are particularly notable for paediatric practice, where research on interpreter-mediated services appears even more sparse. Future research should investigate:
- How interpreters perceive their role in paediatric communication assessments and interventions
- The effectiveness of specific training programs for interpreters working in paediatric speech pathology
- Best practices for interpreter-mediated parent coaching and family-centred care
- How cultural perspectives on childhood development and communication are navigated in interpreter-mediated sessions
- The validity and reliability of interpreter-mediated paediatric assessment protocols
Bridging Worlds: Moving Forward in Culturally Responsive Practice
The systematic review by Huang et al. provides valuable insights into the complex relationship between speech pathologists and interpreters. For paediatric speech pathologists, these findings underscore the importance of developing clear protocols for interpreter-mediated services, investing in specialised training, and implementing consistent pre-session briefings.
As Australia becomes increasingly diverse, the ability to provide culturally and linguistically responsive services will become an even more fundamental clinical competency. By acknowledging the challenges inherent in interpreter-mediated speech pathology and proactively implementing evidence-based strategies to address them, we can work toward more equitable outcomes for all children with communication disorders, regardless of their linguistic background.
Speech pathologists must advocate for systems-level changes that support effective interpreter services, including adequate funding, specialised training, and policies that recognise the additional time and resources required for interpreter-mediated sessions. By doing so, we honour our professional commitment to providing high-quality, accessible services to all children and families who need them.
If you or your child need support or have questions, please contact us at Speech Clinic.
How do I know if my child needs an interpreter during speech therapy?
If your family speaks a language other than English at home and you feel more comfortable communicating in that language, or if your child’s strongest language is not English, an interpreter should be considered. Speech pathologists have a professional obligation to provide services in your preferred language, and using an interpreter ensures that assessments are accurate and that you fully understand your child’s diagnosis and treatment plan.
Will using an interpreter slow down my child’s speech therapy progress?
No, quite the opposite. When therapy is conducted in your family’s preferred language, it can actually enhance progress because it ensures clear communication between all parties. Research suggests that incorporating a child’s home language into therapy can support overall communication development, and interpreter-mediated sessions allow for more accurate assessment and more effective parent coaching.
What qualifications should interpreters have when working in speech pathology?
Interpreters working in speech pathology settings should ideally have professional certification and specific training in healthcare interpretation. The systematic review highlights the importance of interpreters who understand the unique requirements of communication-focused clinical work. While not all interpreters will have specialised training in speech pathology, pre-session briefings can help prepare them for the specific requirements of your child’s session.
How can I help make interpreter-mediated speech therapy more effective for my child?
You can contribute significantly by sharing information about your child’s communication in your home language, explaining any cultural factors that might influence communication patterns, and providing feedback about the interpretation process. Let your speech pathologist know if you have concerns about how information is being interpreted or if cultural nuances are being missed. Your insight as a parent is invaluable in ensuring culturally responsive care.
Are telehealth speech pathology sessions effective when using interpreters?
While the systematic review found that most interpreter services were delivered face-to-face, telehealth services with interpreters are increasingly common and can be effective. Modern telehealth platforms can accommodate multiple participants, allowing for three-way communication between the speech pathologist, interpreter, and family. This approach can sometimes increase access to qualified interpreters, particularly for less common languages, though it may require additional preparation to ensure smooth technological integration.
