Speech language therapists (SLTs) are often challenged in their work with patients with different communication vulnerabilities. Even though SLTs are trained experts in communication, experiences from the field indicate that they often feel uncertain in interactions with multilingual patients and their families. This paper explores how language discordance between SLTs and multilingual parents influences regular institutional interaction. A discourse analysis is conducted on 33 authentic transcripts of specific discourse types between SLTs, parents, and their children within a multilingual constellation. Three emerging themes are discussed: (a) applied interactional strategies (b) involving the child in interaction and (c) addressing future parental engagement in therapy. By reconstructing discourse it is apparent that the knowledge of SLTs and parents does not always align, which influences the transfer of this knowledge, resulting in less achievement of interactional goals. When a language discordance is present, the participants have no equal access to interpretative processes in communication due to different linguistic and cultural frameworks, leading to less successful interactions and an asymmetrical relation between the participants. In successful interactions, alignment and shared decision-making are achieved through discourse by actively involving the patients and the parents, creating shared responsibility, and applying supportive communicative strategies for inclusive multilingualism.
Twilt et al. (2026) studied this question.