Well-documented Romance-Germanic differences in the use of accent in speech to convey information-structure and focus cause problems for the assessment of prosodic skills in populations with clinical disorders. The strategies for assessing the ability to use lexical and contrastive accent in English and Spanish are reviewed, and studies in the expression of contrastive accent in Spanish- and English-speaking typically-developing children are described. These studies used similar tasks requiring pre-final contrastive accent. Results were, however, strikingly different (English greater than Spanish). Using the same tasks, studies of English-speaking individuals with autism and Williams syndrome showed marked difficulty with the expression of contrastive stress, but the use of such tasks with Spanish speakers may merely reflect cross-linguistic differences. This study presents the methodology and results of these tasks, and suggests alternative methods of assessing the ability to discern and use contrastive accents in Spanish. (Contains 3 figures.)