Bilingual children with primary language impairment: issues, evidence and implications for clinical actions.

UNLABELLED: A clear understanding of how to best provide clinical serves to bilingual children with suspected or confirmed primary language impairment (PLI) is predicated on understanding typical development in dual-language learners as well as the PLI profile. This article reviews general characteristics of children learning two languages, including three that challenge the diagnosis and treatment of PLI; uneven distribution of abilities in the child's two languages, cross-linguistic associations within bilingual learners, and individual variation in response to similar social circumstances. The diagnostic category of PLI (also referred to in the literature as specific language impairment or SLI) is described with attention to how language impairment, in the face of otherwise typical development, manifests in children learning two languages. Empirical evidence related to differential diagnosis of PLI in bilingual children is then reviewed and issues related to the generalization of treatment gains in dual-language learners with PLI are introduced. LEARNING OUTCOMES: As a result of this activity, the careful reader will be able to (1) describe general characteristics of typically developing dual-language learners, (2) explain how primary language impairment (PLI) manifests in bilingual children, and (3) identify key clinical issues and approaches to assessment and treatment on bilingual PLI.