Clinical judgment is the knowledge an evaluator develops over years of practice and ongoing education about typical language development and second language acquisition in a certain community.
Disability is determined based on comparison to what is considered “normal” in an individual’s community. An evaluator can only compare a child to his or her speech community to determine whether or not he has a language impairment. Therefore, the evaluator must be familiar with what is typical and expected in the community. For this reason, it is very important to avoid linguistic or cultural bias during evaluations.
For example, mainstream, middle class, Standard American English speaking communities may expect a child to name objects with the encouragement of an adult, as well as to begin to converse with adults at a young age. However, communities with other cultural backgrounds may expect a child to be quiet and obedient around adults. An evaluator needs this information to make an accurate diagnosis of any potential delay or disorder.
According to the NYCDOE Committees on Preschool Special Education Standard Operating Procedures Manual (2008), “A distinguishing characteristic of preschool assessment is the emphasis given to judgment-based assessment, which is the collection and evaluation of perceptions of individuals who have contact with a young child across many settings.” Good clinical judgment takes years to fully develop and requires frequent contact with typically developing children from the community in which the evaluator works. Without good clinical judgment, there is a much greater risk of misidentification and over referral of children from bilingual, diverse, or lower socioeconomic status backgrounds.
Clinical Judgment/ Informed Clinical Opinion Part 1
Clinical Judgment/ Informed Clinical Opinion Part 2
New York City Department of Education (2008). Standard Operating Procedures Manual.