A Bilingüe conversation with Keila Gutiérrez, MA, CCC-SLP, bilingual speech-language pathologist and founder of Desert Lily Bilingual Speech Therapy
If you're raising your child in two languages and something about their speech feels off, you've probably asked yourself some version of this: Am I confusing them? Should we just switch to English?
I asked Keila Gutiérrez, a bilingual speech-language pathologist in southern Arizona, about 45 minutes from the Mexican border. She works with bilingual families every day, and she's also a mom raising her own son bilingually through a speech delay. Her first answer was the one every parent needs to hear.
The short answer: keep speaking Spanish
"Do not stop speaking Spanish. If you take anything away from listening to this, keep speaking Spanish to your children." — Keila Gutiérrez
The advice to "just pick one language" usually comes from a good place, from relatives, friends, even professionals. It feels like common sense: two languages are harder, so make it simpler. But Keila is clear that it isn't backed by research, and dropping the home language doesn't benefit the child or the family.
Here's what she wants parents to know:
- Bilingualism does not cause speech delays. Monolingual, bilingual, and multilingual children can all have a speech or language delay. When a child has one, it's the skill of language that's hard, not the fact that there are two languages.
- Bilingual children hit the same milestones. Language develops on the same timeline whether a child is learning one language, two, or three.
- Code-switching is a good sign. Mixing a word from Spanish into an English sentence isn't confusion. "You know language so well that you can mold it to fit your needs," Keila says.
- Language lives in relationships. Your home language is how your child will talk to their abuela, their cousins, and the people who love them. It's tied to identity and culture, and it opens doors later in school and work.
Keila compares it to math: "I'm not great at math. It's just a harder skill for me. It doesn't matter which language I'd speak. It's just harder for me." For some children, acquiring language is simply a harder skill, and that's what a speech-language pathologist can help with.
Signs it's worth a closer look
Every child develops at their own pace, and being stronger in one language than the other is normal. These are the signs Keila says are worth checking out:
- Around age 2, your child isn't saying words in any language. Look at English and Spanish together. If words aren't showing up in either one, that's a reason to look into it.
- You have trouble understanding what your child is saying. This matters most in the preschool years.
- By about age 4, someone who doesn't know your child can't understand them most of the time. It won't be perfect at this age, but Keila notes that recent research across many languages (English, Spanish, Portuguese, Romanian, and more) points to this as the standard.
- In school, your child is struggling with reading and writing. These difficulties sometimes show up alongside speech and language challenges.
- Your gut is telling you something. You know your child better than anyone.
Keep in mind that a speech-language pathologist looks at much more than how many words your child says. They look at how your child plays and interacts, whether they use gestures and sounds with intention, how they listen, and the sounds they make. "You see the tip of the iceberg," Keila says, "and we look at all the depths of it."
What to do first: a step-by-step guide
Step 1: Check one or two trusted milestone sources
Don't overwhelm yourself. Pick one or two credible sources, like the American Speech-Language-Hearing Association (ASHA) at asha.org, and see what they say children typically do at your child's age.
This does two things. It helps you see that your concern is grounded in real information, "not just mommy brain, not just first-time mom," as Keila puts it. And it gives your pediatrician data to work with, since referrals are based on data.
Step 2: Talk to your pediatrician
For younger children, your pediatrician is a great first stop. Go in with what you've noticed and what you've read.
What you can say:
"I'm concerned about my child's speech and I'd like to have it looked into. I've been reading ASHA's milestones, and here's what I'm seeing at home. My child is bilingual in English and Spanish, so I want to make sure both languages are considered."
If you get pushback, it's okay to say it again: "I'm concerned, and I really want to get this looked into."
Step 3: Talk to your child's teacher
If your child is in preschool or school, ask the teacher whether they've noticed anything. Teachers see a lot of children and are trained to spot possible difficulties. They don't diagnose, but their perspective helps.
Step 4: Know the difference between a screening and an evaluation
These two words sound alike but mean different things:
- A screening is a quick, broad check: we wonder if this is harder for your child. Pediatricians, teachers, and some online tools can do screenings.
- An evaluation is formal testing by a speech-language pathologist to find out whether something is actually difficult and whether there's a diagnosis.
If a screening, your pediatrician, or your child's teacher suggests there may be something to explore, the next step is an evaluation.
Step 5: Ask for a bilingual evaluation
You can ask your pediatrician for a referral. You can also request an evaluation through your local public school district.
In a school, the evaluation is done by a team, and they look at whether your child's communication is affecting their learning. Tell them up front that your child speaks more than one language and that you want someone on the team trained to evaluate bilingual children.
What you can say:
"My child is bilingual in Spanish and English. I'd like to request a speech and language evaluation, and I want to make sure both languages are considered. Who on the team has training in evaluating bilingual children?"
Good to know: in the U.S., children under 3 can also be evaluated through your state's Early Intervention program, and children 3 and older through your local school district. Both are generally free for families, and you can usually contact them directly without a referral.
Step 6: Find the right speech-language pathologist
Many families find a provider on their own, often through a simple Google search, and then ask their pediatrician to send the referral there. You're allowed to be proactive.
What to look for:
- Licensed in your state. Speech-language pathologists must be licensed in the state where you live.
- Trained in assessing bilingual or multilingual children. This matters more than anything else. An SLP who speaks your language is ideal, but not required. A trained SLP can use approaches like dynamic assessment, and can work with an interpreter, a teacher, or support staff to evaluate your child accurately.
Questions to ask a provider:
- Are you able to assess my child in both languages?
- Do you have experience evaluating bilingual children?
- Is your staff trained in bilingualism?
Step 7: Figure out the cost
Coverage depends entirely on your insurance, so call your insurance company and ask what's covered. It may be covered through an employer plan or Medicaid (in Arizona, that's AHCCCS).
If the provider you want doesn't take your insurance, you still have options:
- Ask about private pay rates.
- Ask whether they can submit an out-of-network claim.
- Ask the provider directly: "What are my options?"
Step 8: If you hear "no," keep advocating
Even with years of training and her own clinic, Keila had a hard time getting speech therapy for her son. She was told he didn't qualify, and she tried again. She ended up paying out of pocket for a provider she knew could help him.
"Keep advocating for your children. That is the best thing that I did for my child."
She sees it as an investment. A child's brain grows more in the first three years than at any other time in life, with another big growth period from ages three to five. Early support matters.
If your child qualifies for an IEP
If a school team finds that your child is eligible for services, your child will get an IEP (Individualized Education Program), a plan with goals to support them in the area where they need help, sometimes communication.
Having an IEP means your child receives special education services. That phrase can feel scary. Keila's message, as a professional and as a mom who has been through it: it's okay. It's support, and it's okay if you feel lost in the process at first. She did too.
How to keep Spanish alive while your child gets support
Therapy at school or in a clinic may happen in English. Here's how Keila keeps Spanish part of her family's life, and why she says there's no single right way.
- Know your why. Keila had to turn off her "speech brain" and ask herself why she wants her son to have Spanish. Her answer: she wants him to have access to the language. That goal helps her let go of perfect fluency.
- Share the load. It isn't all on you. Keila's husband has a 1,000-day Duolingo streak. Her mom takes her son for intentional Spanish time. Find your village.
- Focus on conversational Spanish. You don't need to translate every therapy word. Give your child Spanish they can use with the people they love. Most of us have "pockets" of our lives in each language anyway, like kitchen vocabulary in Spanish and work vocabulary in English.
- Narrate your day. When her son was younger, Keila talked through their day in Spanish.
- Hold on to traditions. Tamales at Christmas (her son's job is the olives), tostadas, arepas for breakfast. Food, family, and ritual carry language.
- Keep your love language. Mi niño, mi niño hermoso, mi bebé. The words you use to love your child stay with them.
"It looks different for every family. It just does. And that's okay."
Watch the full conversation
This guide covers the highlights, but Keila shares much more in the full episode above, including her personal story and what speech-language pathologists actually look for in an evaluation.
About Keila: Keila Gutiérrez, MA, CCC-SLP, is a bilingual speech-language pathologist and the founder of Desert Lily Bilingual Speech Therapy in southern Arizona. Follow her on Instagram at @desertlilybilingualspeech. If you're in Arizona and looking for services for your bilingual child, visit desertlilyspeech.com.
This article is for general information and isn't a substitute for professional advice. If you're concerned about your child's speech or language development, talk to your pediatrician or a licensed speech-language pathologist.