More than every third child in Germany has a migrant background. In parts of the city of Bremen, this figure is even higher. The availability of data on the access and provision of speech pathology services is still inadequate in Germany. This accounts even more for multilingual children. Speech, language and communication needs are particularly common amongst children including multilingual and migrant children. However, health-monitoring programs report that migrants like children from socioeconomically disadvantaged families differ in many health-related aspects from the majority population in Germany, i.e. that they are more likely to experience barriers in health care. This study was designed as a first, regional examination of speech pathology services for multilingual and/or migrant children with suspected language impairment (LI) in the city of Bremen. Information was obtained from speech language therapists (SLT) representing 30 practices in different districts across Bremen, a city affected by socio-spatial polarization, and practices were clustered according to the proportion of minor migrants and minor welfare recipients. The survey addressed i.e. consultation number and proportion of multilingual children, age of child by time of referral, physician vs. SLT diagnosis, used assessment materials, intervention goals, information of practicing SLT. Findings show that multilingual children experience later referral compared to monolingual German speaking children, partly nonconformities regarding initial and SLT diagnosis. Results also indicate a future shortage of SLTs in Bremen. The study highlights obstacles and the need for increased multiprofessional awareness and professional knowledge to help multilingual children with LI access needed services earlier.

Diversity Multilingual children Speech Language Therapy Socio economic status Misdisgnosis Service provision

doctor patient relation Germany speech and language rehabilitation polarization human pathology recipient clinical study social status migrant family male female patient referral welfare professional knowledge diagnosis awareness monitoring Child