April 26, 2019
by Mary Pat

What to expect from a speech and language therapy assessment

So you’re a parent of a bilingual little girl who has just turned three. She doesn’t use very many words but she is interested in interacting and seems to understand a lot. You’d like to know her language level. You’d like a speech and language therapist (SLT) to assess her. How do SLTs do this? Read this post to find out what you can expect to happen during an SLT assessment.

Now of course, what happens will vary from situation to situation depending on the reason your child was referred but I’m keeping it simple here with a focus on a child who might be late to talk. And it’s important to remember that assessment is a process that takes time. You don’t always get a clear answer after the first session. And the idea of a language level is complex!


What to expect from your SLT assessment:

# 1 General discussion with you about your concerns- questions like:

  • What are you most concerned about? When did you start to get concerned? What made you become concerned?
  • Have you seen your child learn more words over time?
  • Questions about your child’s early development like was everything okay in the pregnancy and birth?
  • How is your child’s hearing? Has it been tested lately? Have they had ear infections?
  • What is a typical day in your child’s life like? What’s the daily routine?
  • How are they currently communicating? What do they like to communicate about?
  • Who they spend most of their time with? Where do they spend their time? At home? Day care? Play groups? How much time in each?
  • If they’re in day care is it monolingual or multilingual?
  • How many languages do they need to learn?
  • What languages are they currently exposed to? How much of each language (roughly)?
  • Who speaks what language to whom?
  • What languages are they overhearing?
  • At what age(s) did they start being exposed to the different languages? Both from birth? One first and then another one later?
  • Which language do they speak best in?
  • When did they say their first word? What kinds of words are they using (nouns, verbs, adjectives, prepositions- you can read more about early words )
  • How about understanding the different languages?
  • What games do they like to play? Favourite toys?
  • Do you enjoy sharing books together? How often would you read together?
  • How much of your child’s speech can you understand?


#2 Next up would be some measures of your child’s languages – the words they’re understanding and using in all of their languages. There’s a serious lack of resources for SLTs to test all the languages that their clients speak. That means that the SLT may have to rely on informal observations as opposed to tests. But there are some options like the McArthur Bates Communicative Development Inventories which are available in a range of languages. (The SLT would have to contact the authors of the particular language version in question to see if it’s suitable for your child). This inventory looks at language development from earliest signs of comprehension or first non-verbal gestures, to early vocabulary used and the beginnings of grammar. It’s suitable for children between the ages of 8 and 37 months. And it’s available in a range of languages. Basically, there are lists of words and you tick if your child uses them.


Another option is the Receptive and Expressive Emergent Language Scale (REEL 3) which starts from birth to 3 years and although not designed with bilingual children in mind, the information does give insight into a child’s language development. It looks at understanding and use of language and has a vocabulary checklist too. The SLT could take all the languages into account when using this test and look at the answers you give as opposed to relying on the scores. I also  like Amy Wetherby’s First Words Project which you can access here.  There’s useful information 16 gestures by 16 months and 16 actions with objects by 16 months. The website and materials are available in English, Spanish, and Haitian Creole. A word of caution though- some of the gestures or objects for example may not be relevant to your culture so just bear this in mind.


# 3 It’s also important to think about what your child does with the words they have. It’s not enough to have lots of words, your child needs to use them to communicate. There are other checklists like the Pragmatics Profile (by Dewart and Summers, available here.) This will help identify the way your child communicates using their whole body, sounds, gestures and words. How do they get your attention? Do they greet familiar people and wave bye bye for example? Do they reject something that they don’t like? How do they do that? With words? Facial expression? Pushing the thing away and saying no? There’s also the option of the Language Use Inventory which is being adapted in 10 languages across the world. You can find out more about it here. You might also be asked about any word combinations that your child is using. And if they mix the languages. (Mixing languages isn’t a problem- you can read more about that here. )


# 4 Language samples: this means the SLT would collect samples of your child talking with different people in different places. (Either video or audio recording) Like at home with you, in day care with friends, in day care with the staff, at home with siblings and so on. The idea here is that language varies according to who your child is talking with, where the talking is happening, and what they’re talking about. An interpreter might also be involved for testing in the languages other than the community language.


# 5 Your child’s speech So far we’ve talked about your child’s language- the words they understand, use, and combine. The SLT will also take into consideration the way your child pronounces their words- their speech. They might ask you to fill out the Intelligibility in Context Scale which is available in a range of languages here. It’s got 7 items. Things like Do you understand your child? Do immediate members of your family understand your child?  You circle one of the following options: Always Usually Sometimes Rarely Never. The SLT may get your child to name some pictures to get a map of the sounds they’re using and may also ask your child to make some individual sounds like /k/ or /s/ for example. There’s a useful book called Difference or Disorder that gives information about a range of languages in terms of the speech sounds and the grammar. (Here’s the link)


While all of this is going on the SLT will be observing your child; listening to the quality of their voice, watching out for signs of stuttering, making notes of the speech sounds they’re using, their teeth, use of a soother/pacifier, observing their play, looking at gestures and working out what other investigations they need to make. So while on the surface it might look a lot like playing and having fun, you can see that there’s a LOT going on! It’s not straightforward and it takes time to put all the pieces of the puzzle together to work out if your child has a speech, language, or communication impairment. Establishing the language level your child is functioning at is complex. It’s important to remember that especially when it comes to multilingual children, there is a lot of individual variation in how children’s languages develop. Even if you have a group of children speaking the same two languages, you get a lot of variation. Thinking in terms of the age your child is and comparing them with others of the same age isn’t that helpful to be honest as, once again, there is a lot of individual variation. Here’s a video explaining three crucial things about multilingual children and their language development.

If you’re an SLT reading this, what else would you add in? Be sure to leave a comment below.

If you’re a parent reading this and worried about your child’s language development, what would you like your child to be able to language-wise? Be sure and leave a comment below.

It you like this post, please pass it on!

Let’s get talking! MP

March 12, 2019
by Mary Pat

6 Reasons Why Dropping A Language Is A Bad Idea

So you’re a multilingual family, you’re worried about your child’s speech and language development, and a health care professional has told you to focus on one language only. Here are 6 reasons why that advice is wrong.

#1 It shows a lack of understanding about how multilingual language development happens a.k.a they don’t know what they’re talking about but it doesn’t stop them giving wrong advice!

For multilingual children, language skills are distributed across all of their languages. Their skills vary depending on the task that they’re doing and who they’re talking to. You’re not raising 2 monolingual speakers of each language in the one child. Balance is an illusion.  As babies and toddlers and pre-schoolers, your child’s home language may be the dominant one. They’ll have vocabulary to do with home, family, books, television, and play in their home language. Later then when they go to school, they develop school-related vocabulary. They may not have these words in their home language because they don’t use the education language at home.  They may tell stories differently in their home language as opposed to telling stories for school. This is normal for multilingual children. So dropping your home language and focusing on the less developed language puts your child at even more of a disadvantage. Why? Because by dropping languages, your child is prevented from using their stronger language to develop the weaker language.

 #2 Focusing on one language is not a cure for language problems in multilingual children, and it won’t improve things either- quite the opposite! The “dropping a language” approach takes language out of its social context. It forgets that the point of language is to communicate, to connect, to signal identity, to empathise, to entertain, to play, to create, to imagine ……. As Kathryn Kohnert ( a respected researcher in the area) explains: “Language and communication are part of a dynamic system that can be expanded with rich input and diverse opportunities for learning and use”.


#3 It presupposes that using two or more languages is a choice

Using two or more languages in your everyday life is not necessarily a choice. It’s more a description of what you need in your life circumstances. Your child needs two or more languages to communicate successfully in different environments with different people for different purposes. Focusing on only one language means that your child would become monolingual in a multilingual family or community. This makes language problems worse because it means cutting off a whole set of language skills. And doing so can isolate your child from family members such as grandparents and cousins. And it can also isolate them within their local community. As Kathryn Kohnert so eloquently puts it: “Discounting one of the languages limits [your child’s] resources, negates previous communication experience, and denies future opportunities.”


#4 Being multilingual does not make language problems worse

Monolingual children who have language problems learn language (yes more slowly and maybe not to the same level as their unaffected peers). And multilingual children who have language problems learn their languages at a slower pace and maybe not to the same level as their bilingual peers who don’t have language problems. But they can get to the same level as their monolingual peers who have language problems if given similar language opportunities.


#5 Working on both languages in speech and language therapy doesn’t have a negative effect on the community language

There’s evidence to show that bilingual vocabulary treatment with preschool children benefits both the community language as well as the home language. There’s enough research to show that supporting the home language in young bilingual children who have language delay, makes it easier to learn a second language. So working on both languages benefits both languages which is what bilingual children need. By not focusing on the home language in pre-schoolers and instead focusing on the majority language, the language problems could actually be made worse. Because in that scenario, you get rapid erosion of the home language coupled with slow learning of the second language. It’s not fair to expect a child with language problems to learn the second language without being able to use their home language to help them.


#6 There are distinct cognitive and social advantages to being multilingual

Being bilingual gives children distinct advantages cognitively and socially. Better problem solving. A larger working memory and not just for tasks that involve language. Greater earning potential. Being multilingual delays the onset of dementia and multilingual people who experience language problems after having a stroke tend to have better language outcomes. (Now of course the research isn’t as black and white as that but there are documented advantages)


For most people, two or more languages in their family is the way of their life. When it comes to multilingual children with language problems, Kathryn Kohnert puts it like this: “Should children with varying degrees of physical co-ordination, artistic ability, or aptitude for maths be encouraged to engage in sports, drawing/painting, or algebra? Most people would say Of Course!” You wouldn’t dream of telling a child who wasn’t great at PE to stop trying different physical activities. So why would it be any different when it comes to languages?


When it comes to speech and language therapy then, the bottom line is that intervention for multilingual children must explicitly support all languages needed by them. They need their languages in order to access and succeed in the different areas of their lives. This includes family relations, school, their local community, hobbies, etc.. Lifelong goals for academic and job-related achievements along with social, emotional, and communicative well-being are important for all children. Focusing on only one language may mean that intervention is less effective. And it can also have negative knock-on effects on the child’s participation in their community which isn’t justifiable.


Dropping a language is a problem because it’s like telling someone who is right handed to stop using their left hand completely. Try doing that for a while and see how you get on!

Hope you like the post! Please pass it onto your friend!

Let’s get talking!


What I read so you don’t have to:


Kathryn Kohnert (2013). Language disorders in bilingual children and adults. Oxford: Plural Publishing.


Pham, Kohnert, & Mann (2011). Addressing clinician–client mismatch: a preliminary intervention study with a bilingual Vietnamese–English pre-schooler.  Language, Speech, and Hearing Services in Schools 42:401-422.


Elin Thordardottir (2010). Towards evidence-based practice in language intervention for bilingual children. Journal of Communication Disorders 43:523-537.


February 6, 2019
by Mary Pat
Comments Off on Can your child who has Down syndrome learn two or more languages?

Can your child who has Down syndrome learn two or more languages?

If you’re a parent of a child with Down syndrome and you’re raising your child using two languages or more, it’s possible that somewhere along the way, you’ve been told to drop one of  language. After all, children with Down syndrome struggle with language development so wouldn’t it be easier to focus on just one language only? This is simply not true. “Common sense” is wrong in this case. The research tells us that health care professionals should support you in raising your child who has Down syndrome as a multilingual child. In fact, dropping a language can actually make things worse. It can end up limiting your child’s participation in a range of situations. It can negatively affect their social, emotional, and educational progress.

If your child has Down syndrome and needs to use 2 or more languages in their everyday lives, then that is what they need. While multilingual children with Down syndrome will of course vary in the degree to which they acquire their languages, they still need to use two or more languages to function effectively and fully in their day to day lives. Multilingualism isn’t always a choice. And if it is a choice, children with Down syndrome can become multilingual. (Remember multilingual does not mean fluent in listening, speaking, reading, and writing. Language abilities in these 4 modes vary across languages in multilingual children in general. And children with Down syndrome will have cognitive and language challenges but this still doesn’t mean they can’t acquire two or more languages.)

So what does the research actually tell us? Now, compared with topics like being a late talker or having developmental language disorders, there isn’t a lot of research involving multilingual children with Down syndrome. But here’s what I found from 1993 – 2016. More research definitely needs to be done. Many of the studies only involve small numbers of participants. And what’s true for someone in a study may not be true for your situation. And all research has limitations. Bearing all that in mind, let’s have a look at what’s out there.

One study in 1993 involved a 23 year old Italian woman with Down syndrome who had been exposed to English, French, and Italian since childhood. When her languages were tested, she was able to have conversations in all three languages and understand English television shows. Her French abilities were weaker because it was the language she spoke least often. Nothing to do with having Down syndrome then- that would be the same pattern for any multilingual person.

Another study involved twins with Down syndrome who were born to deaf parents. They learned both English and British Sign Language to the point where they could communicate effectively in both. Yes, they showed impairments in both languages compared with monolingual children but that’s not that surprising. They also showed a preference for English even though BSL was the home language. But most multilingual children show preferences for their different languages at different times and in different settings.

A 2005 study by Kay Raining Bird (she’s done a lot of the research), found that there wasn’t a significant difference between monolingual and bilingual children with Down syndrome when it came to any of the tests of English that they did. Again the children with Down syndrome, whether they were monolingual or bilingual, did have language delays but not because of being raised with two or more languages. Now, there was considerable variation in 2nd language abilities in the children with Down syndrome. This means that some children with DS may have more difficulty learning two languages but it doesn’t meant they can’t learn two. And once again, it’s important to think about what your child needs language-wise. If they need two languages, they need two languages. And there’s a lot of individual variation in language development between individual multilingual children and groups of matched multilingual children who don’t have Down syndrome. Kay Raining Bird concluded that children with Down syndrome can be successful in acquiring two languages. And that bilingual children with Down syndrome perform in their stronger language at least as well as monolingual children with Down syndrome when the children are compared with children at a similar level of development.

A 2008 Canadian study of vocabulary and grammar in children aged between 5 and 8 years old found that the bilingual children with Down syndrome did show language delays in both languages but bilingualism was not the cause of these delays. Children who have Down syndrome do struggle with language development affecting expressive language in particular. However, being bilingual does not make these language problems worse. All of the four children with Down syndrome in the study were developing functional second language skills. Just like any child, the variations in their vocabulary was related to the input they were receiving in each language. (English and French were the languages)

Next up is another Canadian study from 2014 also involving Kay Raining Bird. In this study, 14 children with Down syndrome (average age 12 years, 5 months) were involved. And the focus of the study was on word learning and again the researchers found that being bilingual did not have a detrimental effect on the language development of children with Down syndrome.

Next, from the UK, a case study of one girl aged 6 years 11 months when the study started and 9 and a ½ when the study ended. She was born in Belarus to multilingual parents who spoke Russian, English, and Belarusian. She moved to the UK when she was 6 months old. Russian was her home language with limited exposure to English until she started school at age 4 and became more exposed to English. Her parents read to her in Russian daily and extensively and started to teach her to read words in Russian when she was 30 months old. In this study they wanted to look at her speaking and word level reading. They showed that when it came to spoken language, the little girl was as proficient in Russian as she was in English with slightly stronger word reading ability in English. Similar to monolingual children with Down syndrome, this little girl did struggle with aspects of reading such as understanding what she was reading. In fact, when it came to understanding what she was reading, the little girl performed similarly to monolingual children with Down syndrome suggesting that this may be an area of difficulty for children with Down syndrome in general.  They concluded that learning to speak and read two languages in the presence of having a learning difficulty, does not necessarily lead to a detrimental effect on a child’s spoken language or word level reading.

Hot off the press is a review of 50 research studies which revealed that there’s little evidence to support view that being multilingual is harmful to the language or social development of children who live with developmental differences. The authors recommend that public policies should reinforce the fact that there is no clinical, linguistic, or cognitive evidence to support recommendations that multilingual families drop any of their languages.

Finally, a study that looked the potential cognitive effects on children with Down syndrome learning a second language. 41 children with Down syndrome aged 7-18 years of age took part. 28 were monolingual English speakers who also had Down syndrome. 13 children were bilingual and had Down syndrome. They were exposed to a language other than English for an average of more than 4 hours daily. The children were tested on things like navigating a virtual arena using a joystick to find a hidden object, sequences of numbers generated by tapping fingers, and working memory. The researchers wanted to find out what effect learning a second language might have on these cognitive abilities. What they found was that there was no significant difference between the two groups of children on any of the tests they did. This means that there were no cognitive costs to the children with Down syndrome who were learning a language other than English.  

So what does it all mean? Well, the available research indicates that children who have Down syndrome can and do learn two languages. Unfortunately though, this fact is not yet part of mainstream thinking. It’s important to remember that multilingualism is rarely a choice. It’s more a fact of life for your family. You need two or more languages to communicate at home, with family members, in your communities, at school, and so on. And your multilingual children with Down syndrome need to develop all of their languages. There are no scientific grounds for saying that it’s not possible and that families should stick to one language. That is wrong. And not supported by the best available evidence. It’s important to remember too that in some countries such as Canada where there are 2 official languages and Ireland where there are 3 (Irish, English, and Irish Sign Language), multilingualism is actually a legal right.

Of course, it’s important to remember that for children with Down syndrome, the level of language proficiency they attain in all of their languages will be affected by their level of cognitive functioning and developmental levels. Similar to any child, environmental factors such as the kind and amount of language input they receive and the opportunities to use their languages will also have an effect on the level of language skills they attain.

It’s important to give high quality language input and opportunities to use their languages. It’s important to support home languages especially as they’re vulnerable. They may have a lower social status and opportunities to hear and use them may be restricted.

As for speech and language therapy, recent research from Canada reports that the practice of language intervention in only one language (which is usually the language of the SLT/SLP) cannot be supported by the current research. Multilingual children with Down syndrome and speech and language challenges need intervention that takes all of their languages into consideration in order to help them achieve their potential and participate fully in society.


If you like this post, please pass it on to your friends and  be sure to sign up for my next post which will be about language intervention for multilingual children.


The research:

Kelly Burgoyne, Fiona Duff, Dea Nielsen, Anastasia Ulicheva, and Margaret Snowling. (2016) Bilingualism and biliteracy in Down syndrome: insights from a case study. Language Learning 66(4): 945-971.

Elizabeth Kay Raining Bird, Fred Genesee and Ludo Verhoeven (2016) Bilingualism in children with developmental disorders: a narrative review. Journal of Communication Disorders 63: 1-14.

Elizabeth Kay Raining Bird, Natacha Trudeau, and Ann Sutton (2016) Putting it all together: the road to lasting bilingualism for children with developmental disabilities. Journal of Communication Disorders 63:63-78.

Elizabeth Kay Raining Bird, Patricia Cleave, Natacha Trudeau, Elin Thordardottir, Ann Sutron, & Amy Thorpe  (2005) The language abilities of bilingual children with

Down syndrome. American Journal of Speech-Language Pathology 14: 187-199.

Elizabeth Kay Raining Bird (2016) Bilingualism and children with Down syndrome in Multilingual Perspectives on Child Language Disorders.  pp 49-73. Edited by Janet Patterson and Barbara Rodriguez. Bristol: Multilingual Matters.

Mirko Uljarević, Napoleon Katsos, Kristelle Hudry, and Jenny Gibson (2016). Practitioner Review: multilingualism and neurodevelopmental disorders- an overview of recent research and discussion of clinical implications. Journal of Child Psychology and Psychiatry 57 (11): 1205-1217.

Elizabeth Kay Raining Bird, Erin Lamond, and Jeanette Holden (2012) Survey of bilingualism in autism spectrum disorders. International Journal of Language and Communication Disorders 47(1):52-64.

Patricia Cleave, Elizabeth Kay Raining Bird, Natacha Trudeau, and Ann Sutton (2014). Syntactic bootstrapping in children with Down syndrome: the impact of bilingualism. Journal of Communication Disorders 49: 42-54.

Feltmate, K & Elizabeth Kay Raining Bird (2008) Language learning in four bilingual children with Down syndrome: a detailed analysis of vocabulary and morphosyntax. Canadian Journal of Speech-Language Pathology & Audiology 31(1) 6-20.

Stefka Marinova-Todd & Pat Mirenda (2016). Language and communication abilities of bilingual children with autism spectrum disorders in Multilingual Perspectives on Child Language Disorders.  pp 31-48. Edited by Janet Patterson and Barbara Rodriguez. Bristol: Multilingual Matters.

J.O. Edgin, A. Kumar, Spanò, & Nadel, L. (2011). Neuropsychological effects of second language exposure in Down syndrome. Journal of Intellectual Disability Research 55 (30): 351-356.



December 14, 2018
by Mary Pat
Comments Off on 6 Ways To Raise Multilingual Children

6 Ways To Raise Multilingual Children

So in your family, you speak two languages or more and you want the same for your children. What’s the best way to do it though? The truth is though that there isn’t one single best way. There isn’t one right way to do it. There’s no one definite way to guarantee your child will become an adult speaking fluently and reading and writing in all the languages. Language development just isn’t like that. By its very nature it’s variable. Why? Because we use different languages for different reasons and topics with different people and that affects language development. Other things that affect language development are the quality of exposure to each of the languages, the amount of quality exposure, the opportunity your child has to use the languages meaningfully, and the status of the languages in the place where you live. It’s a bit like gardening- you can only control how you prepare the ground, plant the seeds or bulbs, water them, weed and so on. You can’t fully control the quality of the seeds. You definitely can’t control the weather! And you can’t control things like the neighbour’s cat digging your seedlings while doing their poo- which is what I saw this morning on my way to work!

What can you do? You can focus on giving your child high quality input in the languages plus opportunities to use them. How do you do that? Have a look at these posts for specific language development tips:

8 Ways To Build Your Toddler’s Vocabulary

Two Small But Powerful Words That Affect Your Child’s Language Development

What Happens After Your Child Says Their First Words?


Consistent high quality input + opportunities to use the languages really help.


Let’s have a look at the options

#1 Have no plan. This is what my Serbian friend did with her little boy. They didn’t have a plan in advance but followed their instincts. She spoke Serbian with him when he was a baby because that’s what came most naturally to her when bonding with him. Her husband spoke English with him because that was his mother tongue. They lived in Germany so that was the language when they were out and about and in school. So initially they had two home languages and the community language. Then they came to Ireland so the community language switched to English. And they were now a minority language at home family. If she spoke Serbian to him and he responded in English, she didn’t pass any remarks. She just continued in Serbian. They spent summer holidays in Serbia. He’s now 19 and confident in Serbian and English. That’s what worked for them.


#2 Make a plan where you work out what you want and how you’re going to do it in advance. Only you can know what’s right for your family and your situation. Do you want to focus on listening and speaking and later reading and writing? How many languages? What ones? Why these? Once you’ve worked this out, then you have other options for how to go about developing your child’s languages. Still keeping in mind, that you only have control over yourself, what you do, and the meanings you attach to what your child is doing. Here are some more options:


# 3 Use the OPOL approach. OPOL stands for one person, one language and started out as a description for how some bilingual parents use their languages with their children. The research shows that this isn’t necessarily the best or most effective way to raise multilingual children. There are issues with it. For example it doesn’t support home language development enough. This is because community languages are so pervasive and have higher status that home languages need intensive support to have a chance. It also goes against a natural tendency in multilingual speakers to mix their languages and switch between them. Multilingual adults do this. Some people do it more than others. Some people do it less. But part of language learning for multilingual children is learning how to do it and when it’s okay to do it and when it’s not. There’s research to show that multilingual children work this out very early on- when they’re toddlers. They work out who understands which language and generally tend to be able to match the language to the listener. There’s also research that shows that in school for example they work out that it’s okay to switch and mix languages when chatting to friends but not when talking to the teacher.


This is something you can talk about with your partner and come to a decision. And it’s something only you will be able to know for yourselves. My attitude is, if it works for your family, that’s great. If it doesn’t feel right for your family, that’s fine too- your approach has to match your family circumstances and values. If you don’t use OPOL that does not mean your child will lose out when to comes to languages.


#4 Use the minority language at home. This is where both parents agree to use the minority language at home. Your child will then pick up the community language outside the home or in child care or preschool, playing with neighbours and so on. What if you’re worried about your level of ability in a minority language that’s not your strongest language? There’s mixed evidence about this. I read two papers recently where the advice was to speak your strongest language with your child because then your input is error free. However, my Serbian friend reports that her son never picked up any of her errors in English. Minority language at home does give your child a rich environment for developing that language. And is likely to be an effective way for them to develop language ability in the minority languages. They will pick up the community language easily as it is so pervasive. Another possibility is


#5 Time and Place where you choose a time and/or a place where you will speak each language. So you might decide to speak one language at dinner if you have family dinners. Ana Paula Mumy, a bilingual SLP has a lovely activity where you let your child pick the language – you put the flags for the country into a bag and they pick at random and decide for how long or on what topic. Doing it this way does require a lot of focus on your part but if that’s what works for you, then that’s great. You can only do this your own way.


#6 Mix it all up is where you use all of your languages with your child; whatever feels right to you at the time. No hard and fast rules here. One downside though is that your child might be more likely to use the community language as time goes on and lose ability in the home language(s). You can keep speaking the home language(s) so that their understanding continues to develop but home languages need more than occasional use in order to thrive.


So what works for you and your family? Be sure to leave a comment below. If you like this post, please pass it on to your friends.


What I read so you don’t have to!

Rosenback, R. (2014). Bringing Up A Bilingual Child. UK: Filament Publishing.

Cunningham-Andersson, U. & Andersson, S. (2002). Growing Up With Two Languages. London: Routledge

Paradis J. & Genesee, F. (2011) Dual Language Development & Disorders: A Handbook on Bilingualism & Second Language Learning (Communication and Language Intervention). USA: Brookes.

Baker, C. (2014) Parents’ & Teachers’ Guide to Bilingualism. (4th ed.) Uk: Multilingual Matters

October 25, 2018
by Mary Pat

How To Make The Most Of Screen Time With Your Child

So my last post was all about screen time. How much is enough? How much is too much? You can read that post here. Realistically, screens are here to stay so let’s look at ways that you can use them to help your child’s language development and to connect more closely through conversations. I know I resisted Peppa Pig for a long time! Couldn’t stand her! Eventually though, I just bit the bullet and started watching together with my little girl. I soon knew all the characters and plot lines. We had great chats about our favourite characters, ones we didn’t like, things that made us laugh, how characters were feeling and so on. Basically, we used the iPad as if it was a book. That’s the key to getting the most out of screen time. Watching together and discussing what’s going on, predicting what you think might happen, talking about clues in the episode title, goodies and baddies- the list is pretty much endless once you get into it. How to get started though?

There’s a research based approach with a fancy name of Dialogic Reading. It was designed originally for reading together but you can apply the strategies to screen time too. Two words to remember: PEER and CROWD

The general sequence for screen time together this way is by using PEER:

Here’s what you do:

Sit close to together so you can look away from the screen and at each other when you’re talking- just like in the photo.


P is for pause and prompt. Stop the video at least once a minute. Prompt your child to say something about the programme. You’ll use CROWD for the prompts. You’re going to vary the prompts. Keep reading to find out what the prompts are. Aim for 1-2 prompts each time you pause the video. Keep your questions fairly simple to start with like what’s that? What’s she doing? And you can make them more complex when you know your child knows the story line inside out after watching a lot!

E is for evaluating what your child says (in your mind- not aloud!). This means thinking about what they said and about how you can add something extra.

E is for expanding what they say so you add more information or make a longer sentence than they did.

R is for repeating- getting your child to repeat their response so you can check that they’ve learned from the conversation.


Here are the prompts to use when you’ve paused the video: CROWD


C is for completion: This is where you leave a pause at the end of a sentence for your child to fill in. So let’s say Peppa Pig is coming on and you sing Peppa and wait for your child to fill in Pig. This technique is often used where there’s a rhyme at the end of the sentences.  Can you finish this one? Somewhere hidden amongst thorny brambles is……..?


R is for recall so questions about what happened in a programme that they’ve already watched. What happened to Peppa in this one? When you ask these kinds of questions, it helps your child tune into story structure so they get the idea of a plot and a sequence to the story. You can use these at the start of a programme or at the end of the programme. You’re asking questions that get your child to recall details. We also love Peter Rabbit in our house. Mr Todd is one of the baddies and there’s an episode set at Christmas time and I can never remember if Mr Todd gets a present or not. So it’s a natural prompt to ask my little girl What happened with Mr Todd in this one? (You can use these with your child starting at age 4-5)


O is for open-ended questions that let your child talk about story ideas and use new words that they encounter in the programme. Say things like Tell me what’s happening in this part.


W is for Wh- questions like Who, what, where, how, and why? You can ask questions like what do you think Peppa should do? Or why does Mr McGregor hate the rabbits? What do you think will happen next?  You can use these at the start of new programmes to help your child focus on details. Using a question like what’s that?  can allow you to teach your child new vocabulary. Don’t overdo the what’s that? question though! It can kill the conversation! You can say Oh I wonder what that thing is?

D is for distance. This is where you ask your child to relate what they see in the programme to experiences outside of the book. Remember when we went to the pet farm? What animals did we see there? Do you ever jump up and down in muddy puddles?


 Here’s a quick video showing you what it looks like.


Two other ideas to consider are:

Change to educational content like Sesame Street as much as you can & Create unplugged times and spaces like meal times or no devices in the bedroom.

If you like this post, please share it with your friends!

Let’s get talking! MP



Flynn, L. (2011). Developing Children’s Oral Language Skills Through Dialogic Book Reading. Teaching Exceptional Children. 44(2): 8-16.


Fraide A. Ganotice Jr., Kevin Downing, Teresa Mak, Barbara Chan & Wai Yip Lee (2017) Enhancing parent-child relationship through dialogic reading, Educational Studies, 43:1, 51-66.


Towson, J.A., Fettig, A., Fleury, V.P., and Abarca, D.L. (2017) Dialogic Reading in Early Childhood Settings: A Summary of the Evidence Base. Topics in Early Childhood Special Education Vol. 37(3) 132–146


Towson, J., Gallagher, P., and Bingham, G. (2016) Dialogic Reading: Language and Pre-literacy Outcomes for Young Children With Disabilities. Journal of Early Intervention 38(4) 230–246.

October 11, 2018
by Mary Pat

How much screen time should you allow your child?

One day in the supermarket I noticed a couple buying groceries. Their little boy (a toddler) was sitting in the trolley seat playing with a smart phone. This little guy was playing with this phone like a pro- both hands, thumbs flying, totally engrossed. This led me to think about my family and our devices. We have no TV.  But we still have managed to accumulate two smart phones, two tablets, a desktop, and a laptop! Now don’t get me wrong, I love technology and I think the internet is brilliant. But I did notice myself getting irritated if I was checking something on my phone and my little girl interrupted. Oh I didn’t like how that felt! It wasn’t like I was checking any critical really.


So what does the research say about children and screen time? It’s complicated! First of all there isn’t a lot of recent research on this although TV has been around for a long time. And it’s hard to come to definite conclusions both because of the lack of research and because three factors tend to interact to affect children’s learning: # 1 characteristics of the child (like temperament and ability to self-regulate), # 2 features of what they’re watching, and #3 the variation in the social and cultural contexts of children’s lives.


Let’s have a look at what’s out there. Brace yourself! One study of 350 children aged 6 months to 4 years in Philadelphia found that by age 4, 50% of the children had their own television and 75% had their own mobile device!! By age 4! Their own television! That shocked me! Almost all the children (96.6%) used mobile devices, and most started using them before they were a year old. At age 2, most of the children used a device daily and spent similar amounts of screen time on both television and mobile devices. Most 3- and 4-year-olds in the study used the devices without any adult help. One-third of the children were able to operate the TV and a tablet at the same time. In adults this kind of media multitasking has been associated with task inefficiency, lapses in attentiveness, and safety hazards. But there’s not enough research yet to understand how it impacts on things like attention span, distractibility, time management, and social interaction in children.


Do babies learn from watching baby videos and DVDs?

One study looked at how many new words 12- to 18-month-old children learned from viewing a popular DVD several times a week for 4 weeks at home. Children who watched the DVD didn’t learn any more words from their month-long exposure to it than did a group of children who were not exposed to it. The best learning actually happened when parents tried to teach their children the same target words during everyday activities. The researchers also found that parents who liked the DVD tended to over-estimate how much their children had learned from it. Your child’s vocabulary growth is directly related to the amount of time you spend talking with them.


Children who’re younger than 24 months of age need hands on exploration of their environment and interaction with parents and caregivers to help develop their language, social-emotional, physical, and cognitive skills. They can’t learn from digital media before age 2. And they have trouble transferring any knowledge from digital media to real life. The key influence on toddlers’ learning from commercial media (from about 15 months of age) is parents watching with them and re-teaching the content. Television viewing in infancy is disruptive to play, reducing the quality and quantity of child-parent interactions. It has been associated with language delay, at least in the short-term.


It’s not all doom and gloom though. One review of research found that children learn better from screen time when the content closely resembles their real life experiences. Think simple stories, familiar objects, and routines. Repeated exposure helps them learn the format and content of screen media and can even offset the negative effects associated with watching particular content. Watching programmes together is also key. But it’s not just watching them together- it’s more about the conversations you have while watching. There are specific things you need to do to get the most from the screen time. I’ll show you how in my next post so be sure and sign up here to get the next post delivered directly to your inbox.


Well-designed programmes such as Sesame Street can improve literacy, social, and cognitive outcomes for children between 3 and 5 years of age. But for most apps that you find under the “educational category” in app stores, there’s no evidence that they actually work. They’re generally not based on any established educational curricula and they use very little if any input from educators or specialists in child development.  Most of them are not designed to encourage two people using them together. Skills that are essential for school success (like creative and flexible thinking, emotional regulation), are best taught and learned through unstructured social play which is much cheaper than a device + internet subscription!


Digital books or ebooks that can be read on a screen often come with interactive features. Research suggests that these features may actually decrease your child’s understanding of the content and interfere with your conversations with them while reading because they’re too distracting. It depends. So, if the ebook has hotspots (where your child clicks on a picture to activate animation) or game zones built-in, these may lead to poor performance on tests of vocabulary and story comprehension in 3-6 year olds. Using those features involves task switching, and like multitasking in general, seems to cause cognitive overload. But, if the ebooks include animated pictures, sometimes enriched with music and sound, that match the simultaneously presented story text at the same time that they’re seeing/reading it, these can help integrate nonverbal information and language and promote storage of those in memory. Or something like a dictionary function with word definitions can also provide useful on-demand help.


Bottom line? Multiple developmental and health concerns continue to exist for young children using all forms of digital media to excess. There’s enough evidence to suggest that children between 2 and 5 years should watch no more than 1 hour a day. This gives them time to do other things that are important for their health, weight, and development.

Here’s what the American Academy of Pediatrics currently suggests:

  • If your child is under 18 months, then video chatting via Facetime or Skype with relatives or friends with a parent present is okay but not anything else.
  • If your child is between 18 & 24 months, you need to choose high quality stuff and don’t let them use TV or tablets or phones alone
  • How to find good stuff? Check out Common Sense Media , PBS kids, and Sesame Workshop
  • If your child is older than 24 months: 1 hour a day max of screen time but only watching high quality programming and shared use with you to encourage conversations. Talk about what you’re watching, critique it, and help them make links between it and the real world
  • No screens during meals and no screens for 1 hour before bedtime


You can also check out the American Academy of Pediatrics’ advice on creating a family media use plan here.


Don’t worry- your child won’t miss out on anything by your waiting to introduce technology- everything is so intuitive and responsive now that it won’t take much time for them to get the hang of it.


How you talk about what you’re watching together is critical to helping your child’s language development. I’ll show you how to do it in my next post so sign up here to get the next post delivered directly to your email.


What programmes do you like to watch with your child? Why these? What programmes do you hate watching? And what apps do you like? Be sure and leave a comment below.

Let’s get talking!



What I read so you don’t have to

Bus, A., Takacs, Z, and Kegel, C. (2015) Affordances and limitations of electronic story books for young children’s emergent literacy. Developmental Review  35-79-97.


American Academy of Pediatrics  (2016) Media and young minds.  American Academy of Pediatrics 138(5).


DeLoache, JS, Chiong, C, Sherman, K et al (2010) Do babies learn from baby videos? Psychological Science 21(11):1570-1574.


Kabali, HK., Irigoyen, MM, Nunex-Davis R et al (2015) Exposure and use of mobile devices by young children Paediatrics 136:6:1044.1050.


Kostyrka-Allchorne, K., Cooper, N. & Simpson, A. (2017). The relationship between television exposure and children’s cognition and behaviour: A systematic review. Developmental review 44: 19-58.


Linebarger, L. and Vaala, S. (2010). Screen media and language development in infants and toddlers: an ecological perspective. Developmental Review 30: 176-202.

September 28, 2018
by Mary Pat

5 Amazing Facts About Your Bilingual Baby’s Brain

Prepare to be amazed! Babies are wired to acquire languages. Speech and language development takes time but babies start early and with a solid foundation before they are even born! Here are 5 Amazing Facts About Your Bilingual Baby’s Brain.

#1 Your baby starts to hear at around 26 weeks of your pregnancy. Now of course, this isn’t exactly like hearing on the outside! Sound has to pass through skin and muscle and amniotic fluid. But research shows that babies can tell the difference between sounds like /b/ and /z/ before they are even born. Distinguishing one language from another in a bilingual baby is robust at birth . They show language preferences at birth and shortly after for languages they heard while still on the inside! Your bilingual baby’s language journey starts before they’re born!

#2 New born babies show a preference for stories that were read to them before they were bornThey also show a preference for their mother’s voice at birth. Only a few days after birth, new born babies respond differently to language and to non-language sounds. Very young infants prefer to listen to speech over non-speech sounds.

#3 Babies are born with the ability to distinguish between and produce all of the sounds in all of the world’s languages! That’s around 600 consonants and 200 vowels! Starting at about 6 months of age, this ability gradually starts to narrow to the languages in their environment.

#4 Babies learn language rules earlier than you think! All languages have rules for what sounds can go together to make syllables and words. Like in English, we don’t have words that start with /nd/. But Swahili has words that begin with this combination of consonants. At 9 months of age, babies have been found to show a preference for what are called legal combinations of sounds in their languages.

#5 Babies don’t just learn languages by listening. Looking at your face is important too. There’s research to show that 6 and 8 month old bilingual babies could distinguish between French and English speakers just by looking at speakers on videos with the sound turned down.

If you want to read more about your bilingual baby’s brain, be sure and read this post that I wrote for Bilingual Kidspot.

If you like this post, please pass it on to your friends. And if you haven’t already signed up for email updates, be sure and sign up!

Let’s get talking! MP


Inspired by:

Byers-Heinlen, K., Burns, T., & Werker, J. (2010). Monolingual, bilingual, trilingual: infants’ language experience influences the development of a word learning heuristic. Developmental Science 12(5): 815-823.

Byers-Heinlen, K., Burns, T., & Werker, J. (2010). The roots to bilingualism in newborns. Psychological Science 2 (3): 343-348.

Byers-Heinlen, K., Morin-Lessard, E., & Lew-Williams, C. (2017). Bilingual infants control their languages as they listen. Proceedings of the National Academy of Sciences of the United States of America, 114(34): 9032-9037.

Werker, J., & Byers-Heinlen, K., & Fennell, C.  (2009). Bilingual beginnings to learning words. Philosophical Transactions of the Royal Society. 364: 3649-3663.

September 6, 2018
by Mary Pat
Comments Off on 4 Powerful Ways To Help Language Development When Your Baby Is Born Prematurely

4 Powerful Ways To Help Language Development When Your Baby Is Born Prematurely

In my last post, you found out about language development in babies born prematurely. (If you haven’t read that post already, you can read it here.) In today’s post, I’m going to share with you 4 ways to significantly improve your premature baby’s language development- in any language. Babies who are born prematurely are at risk for delays in language. The quality of your interaction with your baby is a key factor in their language development and how you do it can have a significantly positive effect on their language development. One study from Montana looked at adult talk in the NICU and how it related to premature baby’s development. They found that the more adults talked and took turns interacting with their preterm infants in the NICU, the higher the babies’ language and cognitive scores were at 7 and 18 month corrected age.

Another study (from Chicago this time) found that when there was high mutual responsiveness between mothers and babies (born between 29 and 34 weeks gestation), language development was positively affected even at 6 weeks corrected age. What does this responsiveness look like though and how do you do it? It’s when you respond consistently to your baby’s behaviour, when you reinforce desired behaviours, & when you communicate & use words and actions that support social, emotional, and cognitive development. (Don’t worry- I’ll give you tips on how to do this below.)

Mutual responsiveness is made up of:

  • Mutual attentiong. the total amount of time you and your baby spend looking at each other face-to-face
  • Positive affect– how pleasurable does your interaction seem? You can recognise it in facial expressions such as smiles, grimaces, frowns, raising eyebrows, making an ‘o’ with your mouth & vocalising (laughing , crying, copying what your baby says)
  • Mutual turn taking – where you get repeated cycles of reciprocal behaviour either in imitation or play in which one partner elicits and the other responds e.g you talk and your child mouths or verbalises a sound in response
  • Maternal pausing is where you wait and stop all stimulating behaviours in order to provide time for your baby to respond
  • How clear are your baby’s cues? How clearly does your baby let you know that she’d like the stimulation to continue or stop
  • How sensitive are you to your baby’s cues and responsiveness? Can you read them right and adjust what you’re doing accordingly?


An Australian study from (2017) involving 12 month old babies living with adversity found that the more fluid, balanced, and connected the interactions between mothers and their premature babies were, the stronger the positive effect. Mothers’ verbal imitations of their babies’ noises and movements and the amount of vocalisations the babies made had a positive impact on the total number of words the children produced and the number of different words that they produced in a 5 minute period.


Here are 4 things to do to help your premature baby’s language development:


Look at and listen closely to your baby for cues like their level of alertness, and are they looking at you while you are looking at them, do they vocalise to you? When they vocalise, that’s their turn. You can then take a turn by imitating them. Do they respond when you talk to them? Do they touch you?


Verbal Imitation

This is where you repeat sounds and words that your baby makes. So if your baby or toddler says ca whilst holding a toy cat. You respond by saying It’s a cat! With lively intonation and interested facial expression.


  Responsive questions for toddlers

  • You ask a wh question like What happened? When? Who? Your question must be dependent on what your baby has just done e.g. your baby reaches into a box and you say What’s in there? (Check out this blog post on the danger of too many questions)
  • You ask a question that requires a Yes/No answer. Again the question must follow on from something that your baby has just done. So, your baby pushes a toy figure down a slide and you say Is the boy going down the slide?



You label a toy or object or action which your baby is either looking at or doing. Make sure that your label is the last word in what you say. So, your child picks up a toy bunny and you say e.g. It’s a bunny.


Two blocks to language development. Avoid these when you can!


Too many commands

Your baby mouths a toy and you say Don’t eat it!  Mouthing is a normal stage of development where babies explore their world using their hands and mouth. Giving lots of commands gets in the way of having conversations that help develop language.


Redirecting their attention

One of the best things you can to do to help your baby’s language development is to comment on what they are currently looking at. If you redirect their attention to something they’re not currently looking at then that isn’t helpful for language development. It’s really important to notice what they’re interested in and follow their lead by talking about their focus of interest. (There is some disagreement about this in the research though).


Here’s a video I made to help you become a tuned in communicator with your baby and another one on how to sing with your baby. And one final one on being a good language model for your child.


Reading together is also an effective way of building your relationship with your child while building their language. You can find 18 ways to use books to build language here.

If you like this post, please pass it on to your friends!

Let’s get talking! MP

What I read so you don’t have to!

Caskey, Stephens, Tucjer, & Vohr. (2014) Adult talk in the NICU with preterm infants and developmental outcomes. Paediatrics 1(4): 579-584


Smith, Levickis, Eadie, Bretehrton, Conway, & Goldfield (2017). Concurrent associations between maternal behaviours and infant communication within a cohort of women and their infants experiencing adversity. International Journal of Speech-Language Pathology  1-12.


White-Traut, R. & colleagues (2018). Relationship between mother-infant mutual dyadic responsiveness & premature infant development as measured by the Bayley III at 6 weeks corrected age. Early Human Development 121: 21-26.


White-Traut, R. & colleagues (2013). Mother-infant interaction improves with a developmental intervention for mother-preterm infant dyads. Infant Behaviours and Development 36: 694-706.



August 23, 2018
by Mary Pat

What happens to language development in premature babies?

If you’re a parent of a child born prematurely you might be wondering how that might impact on language development and on becoming multilingual. I did a literature search and have chosen the most recent, good quality research I could find. It’s important to bear in mind that your experience might not fit with these studies and that doesn’t mean that there is a problem. You know your child best and if you’re worried that their speech and language development might be delayed, it’s best to check with a speech & language therapist. If you’re a multilingual family, I have two posts to help you if you encounter professionals who are not supportive of multilingual development. You can read them here and here.

What’s premature?

  • Pre-term generally means being born before 37 weeks (World Health Organisation). Rates are about 10-12% in the US and Africa, about 5-9% in Europe.
  • Other descriptions are late pre-term (34-36 weeks Rates of 60%),
  • moderate preterm (32-33 weeks Rates of 20%),
  • very preterm (28-31 weeks Rates of 15%) and
  • extremely preterm (less than 23 weeks 5%).

The survival rate of extremely preterm babies has increased to about 80% in the last 15 years due to medical and technological advances. And infants born very pre-term (VPT, <32 weeks), with a very low birth weight (VLBW, 1500g), or both make up about 1-2% of all babies born alive.


What does the research say?

A fair amount of research has looked at the developmental achievements and risks to development of very preterm children from preschool to kindergarten, primary school, and adolescence. However, research findings have been inconsistent. Some studies found no difference between VPT/VLBW groups of children and children born at full term (FT) but other studies report large differences. Why are the findings so different? Basically because each study tends to use different methods which complicates things when trying to come to definite conclusions. The variety makes the research hard to interpret in definite ways.

One of the more commonly affected areas of development is language. Language is fundamental to both communication and also for reading and writing and academic achievement. So it’s very important to understand language problems in these children so that they can get the intervention they need on time.

One Italian study found that about 1/3rd of very preterm children (average GA of 30 +/- 30 weeks) could be described as having a language impairment at age 3 and ½. The predominant predictor of language impairment was prior history of communicative and linguistic skills as reported at 2 and ½ years. (Sansavini & colleagues 2014- I’ve put the list of articles at the end of the post). But, when it came to language, both groups of children showed a lot of individual variation in language development. The extremely low gestational age children (ELGA) showed consistent language delays relative to full-term (FT) children but their language growth rate over time was not so different from FT children until the 3rd year. The greater individual variance suggests that some ELGA children might persist in their delay, some might gradually recover, and some might fall further behind showing an atypical pattern of development later (Sansavini and colleagues 2014).

Another Italian study (Ionio and colleagues 2016) found that at 24 and 36 months of age, preterm infants had significantly lower scores for language understanding and expression than those of full term infants. This was when corrected age and uncorrected age were used to score and interpret the test results.

A study from Finland found that in the 1st two years of life, even considering their corrected age, very preterm children shower lower scores than FT children on measures of vocabulary. (Vocabulary is thought of in terms of understanding/comprehension/receptive vocabulary– usually tested by the therapist saying a word and the child pointing to the corresponding picture. Expressive vocabulary then is where the child names pictures)

In that particular Finnish study (Stolt et al, 2009- listed at the end of the post), the comprehension vocabulary size of the FT children at 9-15 months were estimated to be 1.7 times larger than the pre-term children (GA 28 +/- 2 weeks). 32 children participated in that study. Expressive vocabulary was similar between the 2 groups from 9-18 months. By 24 months, FT children knew significantly more words than their pre-term peers, suggesting that differences in expressive language between preterm and FT children become evident around the end of the 2nd year.

Another Italian study of 104 very preterm Italian children (GA 29 +/- 2 weeks) showed a widening effect as time went on. This means that the more skilled children initially (FT) grow more rapidly over time than the less skilled preterm children. They found this effect for receptive vocabulary and gesture or action production from 12-18 months and in expressive vocabulary from 18-24 months. So the pre-term children showed slower gesture and language development to begin with and the gap widened in the 12-24 months period (Sansavini and colleagues 2011- listed below). At 24 months, 20% of the preterm children were delayed in word production and 14% did not yet combine words. Male gender, a diagnosis of broncho-pulmonary dysplasia and low maternal educational level increased the risk of language delay at 24 months. 


Stolt and colleagues in another Finnish longitudinal study from 2016, looked at 29 VLBW children and 28 FT children whose language development was followed intensively between the ages of 9 and 24 months. Their language was also tested at age 5 years of age. For the 1st time in VLBW children, the development of gestures measured between the ages of 9 & 15 months was shown to correlate significantly and positively with language development at 5;0. Also, both receptive and expressive language ability measured at 24 months was a clear and significant predictor of language skills at 5;0 in both groups. The findings particularly underline the role of early receptive language (understanding) as a significant predictor for later language ability in VLBW children. The results provide evidence for a continuity between early language development and later language skills.


Summary for up to age 5

  • At the end of the 1st year and at the beginning of the 2nd year of life, children typically communicate actively using gestures. And their understanding of words develops actively at this age.
  • Pre-term children have been shown to acquire early gestures at a slower pace than full-term children and the difference between groups of PT and FT has been shown to increase as children grow.
  • Early understanding of vocabulary has been reported to develop more slowly in PT children.
  • BUT there are also studies that do not find a significant difference between groups of preterm and FT in receptive vocabulary. Different studies, different methods.
  • At 24 months, PT children have been shown to have a smaller expressive vocabulary than FT children in different studies. Again, there are opposite findings.
  • Receptive and Expressive language ability at 24 months has been reported to be lower in PT at the group level. (This means when groups of children are compared)
  • At 5 years, children typically master all or nearly all of the speech sounds & the most typical grammatical structures of their native language.
  • Some PT children still have lower language skills at school age.
  • Complex language functions (e.g. expressing and comprehending complex sentences) in particular are difficult for at least some PT children up to age 12.
  • The proportion of VLBW children with weak language skills varies between 20% & 27% at 5; 0 depending on the method used whereas the respective value is 10% in FT children.


What about older children then?

One study from the University of Illinois found that in the absence of neurological problems, sophisticated vocabulary and grammar skills may be relatively intact in the conversation of children born prematurely. The 57 children in that study (Mahurin Smith et al 2014 in the list below) were assessed at average ages of 7, 8, and 10 and had been born at less than or equal to 32 weeks gestation of 1500g birth weight.

Finally, one paper that reviewed 12 studies of language ability in children who were very pre-term and/or very low birth weight reported that children born prematurely consistently scored at the lower end of the normal range on standardised language tests, with more pronounced differences seen in overall language skills and in particular in semantic abilities than in the grammar – both in terms of understanding and expression. (Barre et al, 2011 in the list). (Semantics has to do with word meaning- basically vocabulary). The findings to do with grammar were ambiguous.

It’s important to remember that these studies compare groups of children. So although as a group, children born prematurely are at increased risk of language impairment at school age, within those larger groups, many children do show an encouraging degree of resilience. Early outcomes may have limited predictive power for any one child. So what’s true for the group, may not be true for your child. One clear positive factor is where the child doesn’t have any neurological complications such as haemorrhage. And more studies are needed to fully understand the specific nature of language difficulties that these children have.


What about children who speak more than one language?

The children in these studies are all monolingual speakers of their respective languages. Unfortunately, research on that topic is very hard to find. But, there is research looking at children who have Down syndrome or autism or specific language impairment for example. This research shows that these children can and do become bilingual and multilingual. If your child needs two languages or more in their world, then that’s what they need. So don’t think it’s not possible for your child if they were premature. Each situation is different and depending on your circumstances, language outcome will differ. But being bring prematurely is no reason to drop a language.


What to do?

There’s good news here! There is research to show that when mothers are tuned into their premature babies’ unique communication signals, can perceive things from their babies’ point of view, can regard their child as a separate person by respecting their activity and avoiding interruptions, that this mind-mindedness as it’s called, plays a stronger role in supporting expressive language abilities than it does in full term babies. (In the Costatini study listed at the end, they found that high maternal mind-mindedness at 14 months had a significant positive impact on their babies’ expressive language development at 24 and 36 months of age.) An American study with more participants found that high mutual responsiveness between mothers and their premature babies was associated with significantly better language development and marginally better motor development.


What does this mean?   

You go through a lot when your baby arrives earlier than expected. And how you interact with your baby can be affected by what you’ve gone through and by seeing them in an incubator with tubes. What does it mean to be a responsive communicator with your baby? And what are the things you can say and do that will help your attachment develop and build your baby’s language? I’m going to share those tips with you in my next post so make sure to keep an eye on your inbox.


 What I read

Barre, Morgan, Doyle, Anderson (2011). Language abilities in children who were very preterm and/or very low birth weight: a meta-analysis. The Journal of Paediatrics 158(5): 766-774.

 Caskey, Stephens, Tuckr, and Vohr (2014). Adult talk in the NICO with pre-term infants and developmental outcomes. Pediatrics 133: 578.

Costantini, A., Coppola, G., Fasolo, M., & Cassibba, R. (2017). Preterm birth enhances the contribution of mothers’s mind-mindedness to infants’ expressive language development: a longitudinal investigation. Infant Behaviour & Development 49: 322-329.

Ionio, C. & colleagues. (2016) Paths of cognitive and language development in healthy pre-term infants. Infant Behaviour & Development 44: 199-207.

Mahurin Smith, Segebart De Thorne, Logan, Channell, & Petrill. (2014). Impact of prematurity on language skills at school age. Journal of Speech, Language, and Hearing Research 57: 901-916.

Sanavini, Pentimonti, Justice, Guarini, Savini, Allessandroni, & Faldella. (2014). Language, motor and cognitive development of extremely pre-term infants: modelling individual growth trajectories over the first three years of life. Journal of Communication Disorders 49: 55-68.

Sansavini, Guarini, Savni, Broccoli, Justice, Allessandroni, & Faldella. (2011). Longitudinal trajectories of gestural and linguistic abilities in very pre-term infants in the second year of life. Neuropsychologia 49:3677-3688.

Stolt, Lind, Matomaki, Haataja, Lapinleimu, & Lehtonen. (2016). Do the early development of gestures and receptive and expressive language predict language skills at 5;0 in prematurely born very low birth weight children? (VLBW). Journal of Communication Disorders 61: 16-28.

White-Traut, R. & colleagues (2018). Relationship between mother-infant mutual dyadic responsiveness & premature infant development as measured by the Bayley III at 6 weeks corrected age. Early Human Development 121: 21-26.

July 3, 2018
by Mary Pat
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7 Top Tips For Communicating With Your Internationally Adopted Toddler When They’re Just Home

Welcome to the 3rd (and final) post in our series for parents of children who were adopted internationally. In our first two posts, we covered what the research says about language development for your child (read it here.) and what questions to ask about your child’s early development before you bring them home (read it here). In this post, we’re going to give you 7 top tips for how to best develop your child’s new language when they come home. We’ll look at the question of multilingualism for children who were adopted internationally. And we’ll look at their mother tongue too.

 #1 Make a photo album

If you know you’ll be getting to meet your child a couple of times before she comes home, you can make a picture/photo album to leave with her. This way, she can become familiar with you and where she’ll be living and other family members like grandparents. You can have great interactions with the book; looking at the pictures and commenting on them using simple language and lots of pointing. Another option here are those books where you can record a message to go along with each picture so she’ll be able to hear your voice while you are away. (Tomy Discovery Forget Me Knot Photo Album is the one we had at home). You can also use the book for conversations once they are home.

#2 Find out as much as you can before she comes home

The information which you collected about your child’s language skills, her likes and dislikes, how she currently communicates etc., will help you feel confident when communicating with her. And as you get to know each other you’ll become more tuned into her style of communicating. The Hanen Centre in Canada have a handy tip called OWL. It stands for Observe, Wait, and Listen. This means that you pay close attention to your child in terms of what they’re looking at. What are they doing? If you say something in response to her, how does she respond? The Wait bit is important for her to take her turn. So you say something or do something while playing like put another brick on the tower. Then you wait to see what she does in her turn. Then you take your turn. The Listen bit then is where you pay close attention to the sounds she makes or the words she says and you say what you think she’s trying to say. You can find more great resources from Hanen here.

# 3 Remember that language development takes time

When your child comes home, she will be learning to adapt to many different things: a new home, new climate, new people, new culture, new routines etc. She’ll also being forming an attachment with you as her parents. In Bríd’s research, she interviewed parents whose children were toddlers when they came home so they had their mother tongue and were then immersed in English. Many of the parents she spoke with felt that communication and interaction occurred naturally in spite of the language barrier early on. At that age it’s often fairly obvious what your child may be trying to communicate. You can pay particular attention to what they’re looking at and what they’re reaching for or pointing to for clues.

# 4 Songs and nursery rhymes in your child’s mother tongue

Many parents in Bríd’s research found it helpful to buy a CD of nursery rhymes or songs in their child’s mother tongue.  They found that they often soothed children during times of upset in the early days after coming home.

#5 Learn some basic vocabulary in your child’s mother tongue

Other parents learned a couple of basic words from their child’s native language e.g. hello, bye-bye, words relating to their child’s regular routine e.g. bed, bath, food, drink, nappy etc. Being able to hear to her native language will act as a means of continuity and familiarity during the transition period.

 # 6 Keep it simple

Only have a small number of toys around to start off with. Get down to her level physically and encourage turn taking in simple games like building and knocking a tower of bricks. (These are going to depend on your child’s age and level of interest)

 # 7 Use gestures and facial expression as well as words

You want to give as many clues as possible to help your child understand what you mean so you can pointing to objects that you’re talking about, use animated facial expressions, varied tone of voice etc. Use natural gestures for things like sleepy/tired, hungry, no, yes and so on.

 Can your child become multilingual?

There’s very little research when it comes to this question but if we look at research on language development in children in general, we know that speaking two languages or more does not cause speech and language problems. And that children who have autism or who have Down Syndrome, for example, can and do become multilingual. (It’s important to remember that when we’re talking about language development, we need to think of listening, speaking, reading, and writing. Multilingual children’s abilities will naturally vary in each of their languages for each of these skills.) If your child was adopted internationally and now needs two or more languages in their new home environment, then the need is the important thing. And there’s no reason why they couldn’t learn two languages or more with high quality input and lots of opportunities to use their languages.


What about their mother tongue?

Children who were adopted internationally tend to make rapid gains in their new language in the early post-adoption period. Their mother tongue loses it significance as it’s not the language of their everyday lives any more. A recent Canadian study involved children who had been adopted from China at over 12 months of age and had not been exposed to their mother tongue for over 12 years. MRI scans showed that their brains had actually retained some representations of their mother tongue in spite of the lack of exposure.


Maintaining links with your child’s birth culture and language is a personal choice. In relation to language, your child’s perceived need for the language and her motivation will exert powerful influences on her development of that language. There’s no easy answer here. It does depend on your personal circumstances and choices. You have to do what works for you and your family. Here’s one woman’s account of her experiences of trying to maintain links to her child’s language and culture.


We hope this series has been helpful. Bríd would like to thank Mary-Pat for asking her to contribute to the blog! Delighted to work together Bríd!


Let’s get talking



Inspired by:

Pierce, L., Klein, D., Chen, J.K., Delcenserie, A., and Genesee, F. (2014) Mapping the unconscious maintenance of a lost first language. Proceedings of the National Academy of Sciences December 2, 2014, 111 (48): 17314-17319.