{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T22:19:19Z","timestamp":1770848359514,"version":"3.50.1"},"reference-count":51,"publisher":"University of Toronto Press Inc. (UTPress)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Communication &amp; Medicine"],"published-print":{"date-parts":[[2026,1,1]]},"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.3138\/commed-2024-0011","type":"journal-article","created":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T21:22:28Z","timestamp":1770844948000},"page":"97-116","source":"Crossref","is-referenced-by-count":0,"title":["\u201c\n                    <i>I do not know these words, neither does he<\/i>\n                    \u201d: Unravelling multilingual and multiparty communication in speech and language therapy"],"prefix":"10.3138","volume":"20","author":[{"given":"Sione","family":"Twilt","sequence":"first","affiliation":[{"name":"Rotterdam University of Applied Sciences, Rotterdam, The Netherlands"},{"name":"Utrecht University, Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan D. ten","family":"Thije","sequence":"additional","affiliation":[{"name":"Utrecht University, Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karin","family":"Neijenhuis","sequence":"additional","affiliation":[{"name":"Rotterdam University of Applied Sciences, Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rick","family":"de Graaff","sequence":"additional","affiliation":[{"name":"Utrecht University, Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1696","reference":[{"key":"r1","volume-title":"Language Shock, Understanding the Culture of Conversation","author":"Agar Michael","year":"1994"},{"key":"r2","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1515\/9783110214222.121","volume-title":"Handbook of Communication in Organisations and Professions","author":"Aronsson Karin","year":"2011"},{"issue":"2","key":"r3","first-page":"179","volume":"1","author":"Backus Ad","year":"2013","journal-title":"Journal of Applied Linguistics"},{"key":"r4","volume-title":"Analyzing Talk in the Social Sciences: Narrative, Conversation and Discourse Strategies","author":"Bischoping Katherine","year":"2015"},{"key":"r5","volume-title":"Patient-Provider Communication: Roles for Speech-Language Pathologists and Other Health Care Professionals","author":"Blackstone Sarah W.","year":"2015"},{"issue":"1","key":"r6","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1146\/annurev.anthro.29.1.447","volume":"29","author":"Blommaert Jan","year":"2000","journal-title":"Annual Review of Anthropology"},{"key":"r7","first-page":"10","volume":"1","author":"Blumenthal Mirjam","year":"2007","journal-title":"Logopedie en Foniatrie"},{"key":"r8","first-page":"27\u201368)","volume-title":"The Riches of Intercultural Communication, Interactive, Contrastive, and Cultural Representational Approaches","volume":"1","author":"B\u00fchrig Kristin","year":"2022"},{"issue":"4","key":"r9","doi-asserted-by":"crossref","first-page":"352","DOI":"10.3109\/17549500903312107","volume":"12","author":"Carroll Clare","year":"2010","journal-title":"International Journal of Speech-Language Pathology"},{"key":"r10","volume-title":"Superdiversiteit, een nieuwe visie op integratie [","author":"Crul Maurice","year":"2013"},{"key":"r11","volume-title":"Tolken in de zorg: een overzicht van huidige inzet, financiering en knelpunten [Interpreting in Healthcare: An overview of current use, funding, and challenges]","author":"De Groot Eva","year":"2022"},{"key":"r12","volume-title":"Talk at Work: Interaction in Institutional Settings","author":"Drew Paul","year":"1992"},{"key":"r13","first-page":"36","volume-title":"Sprachverhalten im Unterricht","author":"Ehlich Konrad","year":"1977"},{"key":"r14","volume-title":"Muster und institution. 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