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The aim was to study the language profiles of a well-characterised sample (n = 50) of Spanish–English bilingual children consecutively referred to psychiatric services.Spanish and English language profiles were assessed with the Woodcock Language Proficiency Battery-Revised (WLPB). Profiles included language ability levels, deficits and dominance in five expressive and receptive/expressive domains, and academic (school-related) language proficiency levels.General language ability was low for 69% in either language and for 51% in both. Language dominance data suggested that expressive skills were dominant in English. In 73% of the children, ability to function at school in the strongest language is ‘limited’, defined by the WLPB as incorrect responses to 50% of the items typically answered correctly by children of the same age. Classroom language demands, also according to the WLPB, would be ‘extremely difficult’ to ‘impossible’ for 40% of the children in at least one language, and for 19% in either language.Language deficits, present in many psychiatrically-referred bilingual children, ought to be suspected by the clinician. The typical language demands of schooling appear to be overwhelming for many of these children, with ensuing implications for psychosocial adaptation and educational attainment. Thorough language ability assessments of both languages are often necessary for the early detection of language deficits and for understanding how dual language abilities relate to psychiatric symptoms. Therefore, language assessment services need to be closely linked to programs serving psychiatrically-referred bilingual children. Other implications of this research for clinical practice are discussed.