Speech and Language Therapy Services for Multilingual Children with Migration Background: A Cross-Sectional Survey in Germany.

Speech, language, and communication needs are particularly common among multilingual and migrant children. More than every third child in Germany has a migrant background. In the city of Bremen, this figure is even higher, including refugee children. The availability of comprehensive data on the provision and uptake of speech and language therapy (SLT) services is still inadequate, especially for multilingual children. However, health-monitoring programs report that migrants differ in many health-related areas from the majority population, mainly in barriers in health care. This study examines the current provision of SLT services for multilingual children following a medical prescription for the specific case of suspected language disorder. Information was obtained from speech-language pathologists (SLPs) representing 28 practices in different districts across one of the moderately largest cities affected by sociospatial polarization. The SLT practices were clustered according to the proportion of minor migrants and minor welfare recipients in the district. The survey included the number and proportion of multilingual children on the SLT caseloads, as well as the age of children by time of referral, physician and SLP diagnoses, application and type of assessment materials, intervention goals, and sociodemographic data of practicing SLPs. Questionnaire responses were analyzed using descriptive statistics and an explanatory interpretive approach. Findings suggest that multilingual children experience later referral compared to monolingual German-speaking children, with approximately half of the multilingual children demonstrating a developmental language disorder (DLD). The SLP's level of experience determines the accuracy of differential diagnosis between communication disorders and typical linguistic variations. Consequently, participation in continuing education focusing on service provision of the multilingual and multicultural clientele is essential. This study highlights the obstacles and the needs for increased multiprofessional awareness and an enhanced professional knowledge to provide effective and swift diagnosis earlier to allow multilingual children with a DLD to access relevant services on equal terms with native resident children.