Your child speaks two languages, but something about their speech or language development has you concerned.
Maybe they use plenty of words at home but rarely speak at preschool. Perhaps they understand what you say in Spanish but struggle to follow instructions in English. Or maybe they’re having trouble communicating in both languages, and you’re wondering whether it’s time to seek professional help.
These situations can be confusing because bilingual children don’t always develop their two languages at the same pace.
Some differences are expected. Others may signal a speech or language difficulty that deserves attention.
The challenge is knowing when to give your child more time and when to ask for an evaluation.
This guide explains the warning signs to watch for, when monitoring may be appropriate, and how to get a speech-language evaluation that takes your child’s bilingual development into account.
Quick Answer: When Should a Bilingual Child Have a Speech-Language Evaluation?
A bilingual child should be considered for a speech-language evaluation when they have persistent difficulties understanding or using language, are not meeting expected developmental milestones, lose previously acquired skills, or experience communication problems that interfere with everyday life.
Concerns that appear across both languages are particularly important, but difficulties do not have to look identical in both languages to justify an evaluation.
Consider seeking professional advice if:
- Your child has difficulty understanding familiar words, questions, or instructions.
- Your child uses fewer words or shorter sentences than expected for their age, considering both languages.
- Communication difficulties interfere with play, relationships, or daily routines.
- Your child has stopped making expected progress or has lost previously acquired communication skills.
- Family members, caregivers, or teachers consistently notice communication difficulties.
- You suspect hearing problems or have concerns about your child’s overall development.
You do not need to wait until your child becomes fluent in both languages before requesting an evaluation.
A speech-language pathologist (SLP) can help determine whether your child’s communication patterns reflect typical bilingual development or whether further assessment and support are needed.
How Do You Know Whether Your Bilingual Child Needs an Evaluation?
The most useful starting point is to look at how your child communicates in everyday situations.
A child who struggles to speak English at preschool but communicates comfortably in Spanish at home may simply need more time and opportunities to learn English.
A child who consistently struggles to understand familiar instructions or express basic needs may have a difficulty that deserves professional attention.
However, the distinction isn’t always clear.
Bilingual children can have genuine speech or language disorders, and those disorders may affect their languages differently.
The goal isn’t to diagnose your child at home. It’s to recognize when their communication development deserves a closer look.
Look at Your Child’s Overall Communication, Not Just English
One of the most common mistakes is judging a bilingual child’s development using only their English abilities.
Suppose your three-year-old speaks Spanish with family members but recently started attending an English-speaking preschool.
Their teacher reports that they rarely answer questions and sometimes appear confused during group activities.
Before assuming there’s a language delay, consider what your child can do in Spanish.
Can they ask for things they want? Do they understand familiar instructions? Can they combine words to express ideas? Do they participate in conversations appropriate for their age?
Strong communication in Spanish may suggest that limited English exposure is contributing to the difficulties observed at preschool.
But if your child also struggles with familiar language at home, that provides another reason to seek professional advice.
Our guide to language delay vs. bilingual development explains these differences in greater detail.
Consider Your Child’s Age and Developmental Milestones
Bilingual children generally follow the same broad language-development milestones as monolingual children.
Learning two languages does not, by itself, cause a speech or language delay.
For example, by around 18 months, many children are attempting several words beyond familiar names such as “mama” or “dada.”
By around 24 months, most children are beginning to combine at least two words, such as “more milk” or “Daddy go.”
These milestones apply to overall language development, not just English.
If your child says “more” in English and “agua” in Spanish, both words contribute to their expressive vocabulary.
When tracking vocabulary, parents can consider words used across both languages. Some assessments also examine the number of different concepts a child expresses, counting translation equivalents separately from total word production.
Milestones are useful guides, not diagnostic tests. Children develop at different rates, and an individual milestone cannot determine whether a disorder is present.
Still, missing an expected milestone is a good reason to discuss your concerns with your pediatrician rather than assuming bilingualism explains the delay.
You can also review our bilingual toddler language milestones guide for a closer look at what to expect.
Signs Your Bilingual Child May Need a Speech-Language Evaluation
Some communication patterns deserve more attention than others.
The following signs do not automatically mean your child has a disorder. They do indicate situations in which professional guidance may be helpful.
1. Your Child Has Difficulty Understanding Language
Understanding language is just as important as speaking it.
A child may have difficulty understanding spoken language even when they can say several words or repeat familiar phrases.
Possible signs include:
- Frequently struggling to follow familiar, age-appropriate directions.
- Having difficulty identifying familiar objects when named.
- Appearing confused by simple questions.
- Needing repeated demonstrations to understand everyday requests.
- Having trouble understanding familiar conversations or stories.
Consider whether these difficulties occur when someone speaks a language your child knows well.
For example, a child who doesn’t understand “Put your shoes by the door” in English may understand the equivalent instruction perfectly in Spanish.
That difference could reflect English-language experience.
But if the child consistently struggles with familiar instructions in Spanish as well, an evaluation becomes especially important.
Hearing difficulties, attention, developmental differences, and other factors can also affect comprehension, so an SLP may recommend additional assessment.
2. Your Child Has Trouble Expressing Their Needs and Ideas
Some children understand much more than they can say.
This difference between receptive language (understanding) and expressive language (using language) can occur during typical development, but persistent expressive difficulties may warrant evaluation.
Watch for difficulties such as:
- Using very few meaningful words across both languages for their age.
- Not beginning to combine words when developmentally expected.
- Having trouble asking for help or expressing basic needs.
- Struggling to communicate ideas even with familiar family members.
- Showing limited growth in vocabulary or sentence complexity over time.
Remember to consider your child’s communication across their languages.
A child who knows “milk” in English and “leche” in Spanish has learned two word forms, even though they refer to the same concept.
Also consider gestures, pointing, and other ways your child communicates.
These abilities provide useful information, although strong gestures do not automatically rule out a language delay.
3. Communication Difficulties Affect Everyday Activities
Sometimes the clearest warning sign is not a particular word count or milestone.
It’s how much difficulty your child experiences during ordinary activities.
For example, your child may struggle to:
- Ask for something they need.
- Tell a caregiver when something is wrong.
- Participate in age-appropriate play.
- Communicate with familiar family members.
- Explain what happened during a simple event.
- Join conversations with other children.
Frustration alone doesn’t indicate a language disorder. Toddlers can become frustrated for many reasons.
But frequent communication breakdowns that interfere with daily life deserve attention, particularly when they persist despite support.
An evaluation can help identify whether your child needs additional language support, speech therapy, or another type of assistance.
4. Your Child’s Language Development Has Stalled or Skills Have Been Lost
Language development is not perfectly steady.
Children sometimes make noticeable progress in one area while another skill develops more slowly.
You may also notice changes in which language your child prefers, especially after starting daycare or preschool.
These shifts can be normal.
However, losing previously acquired language or communication skills is different from temporarily favoring one language over another.
Contact your child’s pediatrician promptly if your child:
- Stops using words they previously used consistently, without an apparent language-preference explanation.
- Loses the ability to understand familiar language.
- Stops communicating in ways they previously used.
- Shows a noticeable loss of social communication skills.
A loss of skills should not be dismissed as a normal consequence of bilingualism.
A prolonged lack of progress, even without regression, is also worth discussing with a professional.
5. Your Child’s Speech Is Difficult to Understand
Speech and language are related, but they are not the same.
Speech refers to how sounds are produced. Language involves understanding and expressing meaning.
A bilingual child may pronounce certain sounds differently because of the sound patterns of their home language.
For example, a sound used in English may not exist in Spanish, or it may be produced differently.
These differences are not automatically speech disorders.
However, an evaluation may be helpful if your child’s speech is substantially harder to understand than expected for their age, including when speaking with familiar listeners.
Other reasons to seek advice include persistent difficulty producing sounds that would ordinarily be expected in the child’s languages, or speech difficulties that cause frequent communication breakdowns.
An SLP familiar with bilingual speech development can distinguish language-related pronunciation differences from possible speech sound disorders.
6. Your Child Has Hearing Concerns or Frequent Ear Infections
Hearing plays an important role in speech and language development.
Children learn words and speech sounds through repeated opportunities to hear and interact with others.
Hearing difficulties can interfere with those opportunities.
Possible warning signs include:
- Frequently failing to respond when spoken to.
- Needing unusually loud speech or repetition.
- Appearing inconsistent in their responses to sounds.
- Having recurrent ear infections or known middle-ear problems.
- Showing speech or language difficulties alongside suspected hearing changes.
These signs do not necessarily indicate hearing loss, but they deserve attention.
If you suspect a hearing problem, ask your pediatrician about an audiology evaluation.
A hearing assessment may also be recommended when a child has unexplained speech or language difficulties, even if they appear to hear some sounds normally.
7. Family Members or Teachers Share Your Concerns
Parents, grandparents, caregivers, and teachers often observe children in very different situations.
Their observations can help reveal patterns that might otherwise be missed.
For example, a teacher might notice that your child has difficulty joining group activities, while a grandparent reports that the child also struggles to explain simple ideas at home.
When concerns appear across settings, that information is worth sharing with a professional.
However, you don’t need agreement from everyone before requesting an evaluation.
A parent may notice a genuine difficulty that isn’t obvious to a teacher, especially when the child uses different languages in different environments.
Your observations matter.
When Might Monitoring Be Appropriate Instead of an Immediate Evaluation?
Not every difference in bilingual language development requires speech-language therapy.
Sometimes a child is progressing appropriately but has had fewer opportunities to learn or use one language.
In these situations, a clinician may recommend monitoring development while continuing to provide meaningful language experiences.
The important distinction is that monitoring should be an informed decision, not simply waiting and hoping that a concern disappears.
Your Child Is Making Steady Progress
A child who continues learning new words, combining words into longer messages, and understanding increasingly complex language is showing encouraging development.
Progress may be more noticeable in one language than the other.
For example, a child might begin using longer English sentences after starting preschool while continuing to understand Spanish at home.
That doesn’t necessarily indicate a problem.
What matters is the child’s overall communication development and whether their abilities are appropriate for their age and language experiences.
If you’re uncertain whether progress is adequate, discuss your observations with your pediatrician or an SLP.
Difficulties Are Mainly Related to Limited Exposure
Imagine a child who has spoken Mandarin at home since birth and recently started attending an English-speaking daycare.
The child may initially understand very little English.
They might watch other children, follow routines by observing what happens, and use gestures rather than spoken English.
This can be part of adapting to a new language environment.
The child may also speak less in the unfamiliar setting while continuing to communicate comfortably at home.
However, quiet behavior alone cannot establish that development is typical.
If your child has persistent difficulties communicating, understanding familiar language, or participating in daily activities, seek professional advice rather than assuming the problem is simply limited English exposure.
Your Child Mixes Languages or Prefers One Language
Language mixing is common in bilingual children.
A toddler might say, “I want agua,” or use a Spanish word in an otherwise English sentence.
This does not mean the child is confused.
Children often use the words available to them, and their language choices can depend on the person, setting, or topic.
Likewise, a child may prefer English after starting school, even if Spanish was previously their stronger language.
These patterns alone are not reasons to request a speech-language evaluation.
The concern is whether your child can communicate effectively and continues developing language skills, not whether they use both languages equally.
How to Monitor Your Child’s Communication at Home
If your pediatrician or SLP recommends monitoring, you don’t need complicated testing procedures.
A few simple observations can help you notice meaningful changes.
Keep a Short Communication Journal
Once or twice a week, write down a few examples of what your child says or understands.
You might note:
- New words used in either language.
- Examples of two-word phrases or longer sentences.
- Instructions your child understands.
- Ways your child asks questions or requests help.
- Situations where communication becomes difficult.
For example:
“Tuesday: Asked Grandma for more juice in Spanish and followed a two-step instruction during lunch.”
Over time, these notes can help you see whether communication is becoming more varied and effective.
Observe Your Child in Familiar Situations
Children often communicate most naturally when they feel comfortable.
Pay attention during meals, playtime, reading, and other daily routines.
Notice how your child interacts with people who speak their preferred language.
If possible, ask family members who use the other language what they’ve observed.
You may discover strengths that aren’t apparent in preschool or daycare.
Share Your Observations With a Professional
You don’t need to calculate sentence lengths, count every word, or analyze recordings like a speech-language pathologist.
A few specific examples are often more helpful than a large collection of measurements.
If your child continues making progress and a clinician has no immediate concerns, monitoring may be reasonable.
But if development stalls, new difficulties appear, or your concerns persist, request further evaluation.
Monitoring should never become a reason to postpone help when warning signs are present.
How to Get a Speech-Language Evaluation for Your Bilingual Child
If you’re concerned about your child’s communication development, there are several ways to seek professional guidance.
The best starting point often depends on your child’s age and the services available where you live.
Start With Your Pediatrician
Your child’s pediatrician can review developmental milestones, discuss your concerns, and recommend appropriate next steps.
Before the appointment, prepare a few examples of what your child can and cannot do in each language.
You might explain:
“My daughter understands Spanish well, but her preschool teacher says she rarely responds in English.”
Or:
“My son has difficulty following familiar instructions in both languages, and we’re concerned that his vocabulary isn’t growing.”
The pediatrician may recommend developmental screening, hearing testing, or a referral to a speech-language pathologist.
You can also ask about publicly funded evaluation services.
Contact Early Intervention if Your Child Is Under Three
In the United States, early intervention programs serve infants and toddlers who may have developmental delays or disabilities.
These programs operate under Part C of the Individuals with Disabilities Education Act (IDEA).
You can contact your state’s early intervention program directly to request an evaluation.
You do not need to wait for a formal diagnosis or a pediatrician’s referral.
The program will determine whether your child qualifies for services based on applicable state eligibility requirements.
Services may include speech-language therapy and other developmental supports.
You can find your state’s program through the CDC’s Early Intervention resource.
Request a School-Based Evaluation for Children Age Three and Older
If your child is three or older, you can contact your local public school district to ask about an evaluation for special education services.
This option may be available even if your child is not currently enrolled in public school.
Explain your concerns and ask how to submit an evaluation request.
If your child uses a language other than English, ask how the evaluation team will account for their linguistic background.
Under IDEA, evaluations must follow requirements designed to reduce cultural and linguistic bias, including appropriate use of the child’s native language or other communication mode unless doing so is clearly not feasible.
A school evaluation determines whether the child qualifies for educational services under applicable eligibility criteria.
Consider a Private Speech-Language Pathologist
A private SLP is another option, particularly if you want an independent assessment or need help with concerns that may not be fully addressed through school services.
When contacting a clinician, ask about their experience evaluating bilingual children.
You can also ask whether they work with trained interpreters when they do not speak the child’s home language.
A clinician does not necessarily need to speak every language your child uses, but they should have an appropriate plan for considering those languages during assessment.
Private evaluations may involve insurance coverage or out-of-pocket costs, so it’s worth asking about fees before scheduling.
What Should Parents Expect During a Bilingual Speech-Language Evaluation?
A bilingual evaluation should consider your child’s communication abilities in the context of their language experiences.
The SLP will usually begin by discussing your child’s developmental history, language exposure, and the concerns that led you to request help.
Depending on your child’s age and needs, the evaluation may include:
- Observing communication during play or conversation.
- Assessing understanding and expression.
- Gathering information about both languages.
- Reviewing hearing and developmental history.
- Using appropriate formal or informal assessment tools.
- Discussing observations from parents, caregivers, or teachers.
The exact activities vary.
A toddler may be evaluated primarily through play, caregiver interaction, and developmentally appropriate tasks.
An older child may participate in more structured language activities.
The important point is that the clinician should not make a diagnosis based solely on a child’s performance in English without considering their broader language background.
If you’d like to understand how professionals interpret these findings, read our guide to how speech therapists identify language disorders in bilingual children.
Questions to Ask Before and After the Evaluation
An evaluation is more useful when you understand what the clinician is looking for and how the results will guide decisions.
Before the appointment, consider asking:
- How will you account for my child’s experience with both languages?
- Will you collect information about communication at home?
- Do you have experience assessing bilingual children?
- Will hearing be assessed or reviewed?
- What should I bring to the appointment?
After the evaluation, useful questions include:
- What communication strengths did you identify?
- Which difficulties are concerning, and why?
- Could any of the findings reflect differences in language exposure?
- Does my child need speech-language therapy, monitoring, or another type of support?
- What can we do at home to encourage communication?
- When should we review my child’s progress?
Ask for explanations in everyday language.
You should leave the evaluation understanding what the findings mean and what happens next.
What If the Evaluation Shows No Language Disorder?
Not every child referred for a speech-language evaluation receives a diagnosis.
Sometimes the findings indicate that a child’s communication differences are consistent with their bilingual language experiences.
For example, a child may have age-appropriate language skills in Spanish but still be developing English proficiency.
In that situation, speech-language therapy for a disorder may not be necessary.
The clinician may instead recommend continued opportunities to use both languages, appropriate classroom language support, or monitoring.
Other evaluations may identify a speech or language disorder that would benefit from treatment.
Some children need further assessment before a clear conclusion can be reached.
Whatever the result, the purpose of the evaluation is to understand your child’s needs and identify appropriate support.
A referral does not mean something is necessarily wrong, and an evaluation is not a commitment to therapy.
Final Thoughts
Deciding whether your bilingual child needs a speech-language evaluation can be difficult, especially when their abilities vary between languages and settings.
Some differences, such as mixing languages, preferring one language, or having less vocabulary in a recently introduced language, are common parts of bilingual development.
Other signs deserve closer attention.
Persistent difficulty understanding or using language, communication problems that affect daily life, missed developmental milestones, hearing concerns, or loss of previously acquired skills are all reasons to seek professional advice.
You don’t need to determine the cause yourself.
If something about your child’s communication concerns you, speaking with your pediatrician or a qualified speech-language pathologist is a reasonable next step.
An appropriate evaluation can help distinguish expected bilingual development from difficulties that need additional support, while respecting the languages your family uses every day.
Frequently Asked Questions
At what age should a bilingual child have a speech-language evaluation?
There is no minimum age at which parents must wait to request help.
If your baby or toddler is not meeting expected communication milestones, loses skills, or shows other concerning signs, speak with your pediatrician.
Children under three may qualify for evaluation through early intervention programs, while children age three and older may be evaluated through their local public school system.
Does speaking two languages cause speech delays?
No. Learning two languages does not cause a speech or language disorder.
Bilingual children may have different vocabulary strengths in each language, and their language preferences may change with exposure.
However, genuine communication difficulties should not automatically be attributed to bilingualism.
Should my child be evaluated if they speak well in one language but struggle in English?
Not necessarily because of English difficulties alone, but an evaluation or professional consultation may be appropriate depending on your child’s age, language history, and overall communication.
Strong abilities in a familiar home language can be reassuring.
However, persistent communication difficulties, missed milestones, or other developmental concerns should still be discussed with a professional.
Can my child be evaluated before becoming fluent in English?
Yes. Your child does not need to become fluent in English before receiving a speech-language evaluation.
An appropriate assessment considers the languages your child uses and their opportunities to learn each one.
Is it better to wait and see if my bilingual toddler catches up?
If your child is missing developmental milestones or you have persistent concerns, it is better to seek professional guidance than to wait without a plan.
Monitoring may be appropriate when a clinician determines that your child is developing as expected and continues making progress.
If skills are lost or communication difficulties become more noticeable, seek further advice promptly.
Will my child automatically need speech therapy after an evaluation?
No. An evaluation does not automatically lead to speech-language therapy.
The results may indicate typical bilingual development, a need for additional language-learning opportunities, a speech or language disorder, or a need for further assessment.
Recommendations should be based on your child’s individual communication abilities and needs.