Can I give the BESA with an Assistant if I don’t Speak Spanish?

I’ve been asked this question a couple of times now, the most recent was a few days ago, so I thought I’d write about it here. The bottom line is YES, WITH TRAINING. But, let me explain.

The BESA is designed for bilinguals and for monolinguals we have both in the norm. If children use at least 30% English or Spanish then we recommend that you test in both, use conceptual scoring (on the semantics subtest) and then compare each subtest (pragmatics, phonology, morphosyntax, and semantics) and use the best language in each of those.

Something to keep in mind is that the BESA is not a translated test. We selected the best markers from each language for each domain and used those to determine the final item sets. This markers approach helps us take into consideration the structure (grammar and phonology) of each of the two languages. For example, Spanish marks gender which is important. But, English does not. Articles and direct object clitics are hard in Spanish. But, past tense isn’t as hard in Spanish as it is in English. With respect to phonology, Spanish has longer words, and doesn’t allow as many syllable final sounds as English does. In terms of semantics, vocabulary frequency and familiarity is often different between languages. So, we selected items that were familiar yet difficult enough for kids with language impairment in Spanish and in English and ended up with different configurations of items between the two languages.

What does this have to do with using an assistant? Well, if the assistant is trained as an interpreter, they won’t be interpreting the test. You would not give the English test and ask them to interpret it to Spanish. First, there’s a Spanish version. Second, the interpreted version would not be valid. This means that your interpreter has to learn the Spanish test well enough to give it reliably. This is not necessarily what they know how to do. You as the monolingual SLP give up a certain amount of control because you don’t know Spanish. So, you might not know what the patterns of results mean. This doesn’t mean that you CAN’T work with an assistant to give the BESA, but I think you need to do a couple of things.

  • Familiarize yourself with the items and know what they target.

Even if you don’t know Spanish, I think if you going to work with Spanish-English bilinguals (or other home language-English bilinguals) it is incumbent to learn something about the patterns of acquisition of that language. You need to know how it is structured and what kinds of things are difficult and easy in that language. This is so that you know what to target in intervention and what the developmental patterns are. Patterns or errors that are developmental in one language may not be so in another language. In the manual, we do discuss what each target is testing and what the expectations are developmentally and possible errors if children have impairment.

  • Train your assistant

Go over all the test items with them and what it is you are looking for. Have them practice elicitation procedures with you (or someone else) to make sure they do not inadvertently cue the correct response (or mislead the child into giving an incorrect one). We have had undergraduates from CSD and students from other disciplines successfully learn to give and score the BESA. It’s doable but it might take some training and practice (remember diagnostic methods? it takes practice to learn where to sit, how/when to turn pages, what to write down, when to continue, etc.)

  • Observe your assistant when they are giving the test

Ultimately, you as the licensed SLP are for making the diagnostic decision using test data, observations, interviews, etc. It is up to YOU to know what the results mean. It is up to YOU to ensure that the protocol was followed appropriately. Even if you don’t speak Spanish, I think it’s not a bad idea to follow along to make sure that the items are given correctly (Spanish after all has a shallow orthography so, you should be able to follow along to an extent). Make sure that the items are correctly scored (you might audiorecord and listen together with your assistant).

So, yes I do think that you can give the BESA with a trained assistant. But, like any other test, someone who isn’t trained in test administration can’t just pick it up and give it. Train your assistant, and be there when it’s given. I think if you follow these instructions you can likely give the BESA in a reliable way.

 

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