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The severity of child psychiatric disorders is commonly associated with child language delays. However, the characteristics of these associations in the fast-growing population of bilingual children remain unknown. To begin to address this gap, we studied a unique sample of Spanish-English bilingual children with significant parent-reported psychopathology (n = 29), focusing on their language proficiencies and psychiatric severity using the Child Behavior Check List. We present cross-sectional analyses of associations of general and specific language proficiency in Spanish and English with the severity of specific psychiatric syndromes. We found Spanish language-proficiency scores to have negative correlations with a wide range of psychiatric symptoms, particularly externalizing (i.e., delinquency and aggression) symptoms (r = -.38 to -.61, p &lt; or = .05). English scores were similarly associated. Dual language tests covering multiple specific language dimensions explained a large proportion (51%) of overall variance in aggression symptoms and also important proportions (40%) of total and attentional symptoms. While children's proficiency levels in both Spanish and English showed similar associations with the symptom severity measures (explaining close to 20% of the symptom variance; r(sp) = -.44, p &lt; .01), these proficiency levels explain nonconverging variance in children's symptomatology. The findings suggest that clinical evaluation of language functioning is often needed in such populations and that it should be comprehensive and include both languages. Such thorough evaluation of bilingual children suffering from psychopathology will help us to precisely identify (1) language deficits, (2) specific relations of these deficits to the child's psychopathology, (3) differential implications of communication at home (e.g., in Spanish) and at school (e.g., in English) for clinical presentation and the child's competence in those differing contexts, and (4) language of choice for therapy, evaluation, and educational services. The findings are discussed in the context of clinical and conceptual implications and future research needs.

Bilingual Children: Cross-sectional Relations of Psychiatric Syndrome Severity and Dual Language Proficiency