The Bilingual Assessment Gap

A shortage of assessments built for Arabic speakers

Most standardised speech and language assessments were developed for English-speaking populations. When a clinician needs to assess an Arabic-speaking patient, the options have traditionally been limited: informally translate an English test on the spot, adapt materials that were never validated for Arabic, or rely on an interpreter to bridge the gap.

Each of these workarounds introduces uncertainty. A test translated in the moment loses its standardisation. Cultural and linguistic differences — dialect, grammar, and the way meaning is built in Arabic — mean an English-designed task may not measure what it claims to. The result is reduced confidence in findings, for both clinician and patient.

The hidden cost of language barriers

Language support is not only a clinical challenge — it carries a significant cost. NHS research has estimated that interpreting and translation services cost an average of around £726,000 per Trust per year, with a combined estimated spend approaching £114 million across reporting Trusts over a three-year period.

Standardised, in-language assessments can help services use these resources more effectively — reducing reliance on interpreted assessment sessions while improving the consistency and quality of the clinical picture.

Source: published NHS research on interpreting and translation expenditure (2019–20 to 2021–22).

Who this affects

Aphasia and related communication disorders affect people across every community. Published research estimates an incidence of around 66 cases of aphasia per 100,000 people in the UK — and for patients whose main language is Arabic, the absence of appropriate assessments compounds an already difficult experience.

Arabic-speaking communities are present across the UK, with some of the largest concentrations in:

Why translated and informal assessments fall short

Assessments improvised from English-language tools tend to share the same weaknesses:

• They are not standardised, so results can't be reliably compared against norms or across clinicians.
• They are often informally translated or adapted, introducing inconsistency between sessions.
• They may not reflect the linguistic structure of Arabic — its morphology, grammar, and dialectal variation.
• They lack normative data appropriate to Arabic-speaking populations.
• Delivery is inconsistent across different clinical settings.

Together, these factors make it harder to reach an accurate clinical picture — and harder to plan effective therapy.

How SALT Labs closes the gap

SALT Labs provides standardised, culturally and linguistically appropriate Arabic assessments, delivered through a secure digital platform. Rather than adapting English tools, our assessments are developed from the ground up for Arabic speakers — by clinical linguists, speech and language therapists, and researchers — and grounded in peer-reviewed evidence.

For services, this means a consistent, evidence-based way to assess Arabic-speaking patients: standardised delivery, digital scoring and reporting, secure data handling, and a stronger foundation for therapy planning. The assessments support clinical decision-making — they don't replace the therapist's professional judgment.