Foreign Language and Late Talkers
I just evaluated another two-year-old little girl who has language delays, both receptively (how she understands words) and expressively (how she communicates her wants and needs). Her parents are both highly educated professionals from another country. Naturally, they want to teach their daughter their native languages, as well as English. Yes, languages, since they are both from different parts of the same country. That’s 3 languages this little girl is trying to learn at one time. It’s enough to make MY head spin!
Not only does this little girl have delays in English, but she is not imitating or spontaneously saying words in ANY language. She’s not doing much better understanding language either. She doesn’t consistently follow many directions, no matter what language her parents use.
To her credit she is beginning to use some early gestures such as pointing and waving bye. Hmmmm….. could it be because these are the only consistent means of communicating in all of her languages?
I think the parents’ intentions were good. They wanted to expose their child to all of their languages hoping she’d become fluent in all of them. As educated parents, they have read that the best time to learn language is before age 3, so they have bombarded her from birth.
Her mother was careful to tell me that she talks to her daughter in her own native language most of the time and adds English words to label familiar objects. Her father does the same in his language and with English. In addition, the little girl loves television, and most of the shows she watches are American. They asked, “Shouldn’t this be enough to learn English?” My answer is obviously, “No.” If it were, she would have picked it up by now.
The mother cited that she learned English as a school-age child and knew that she didn’t want to wait that long to teach her English, but she also didn’t want her to have difficulty communicating with her grandparents and extended families during their yearly visits back home. She added that many of her friends advised learning only native languages at home and saving English for when she’s older and going to school.
The mother also was worried that their relatives might think they were neglecting their duty to continue to pass along their heritages. While I understand the concern, I can’t help but wonder, would you rather have upset grandparents who think you’re not doing a good enough job (and by the way, doesn’t that happen to most of us anyway?), or a daughter who can understand and use words to communicate in her home where she spends 11 months out of the year?
Now the question becomes, would this child have a language delay if her parents had chosen one primary language from the beginning? We’ll never know. She may have struggled with only English. Her system may have been compromised by who-knows-what that would have made learning any language difficult. Or not. We truly won’t know.
What I do know is that she is struggling now. Because of her challenges with language, she is at huge risk for cognitive and academic issues as well if things don’t improve for her and soon. Waiting to learn English in school is really not an option for parents who want their children to excel academically. Let’s not even talk about how she’ll do socially with no verbal way to initiate or respond to new classmates!
For her parents as well as all multilingual families I see, my number recommendation is to pick one primary language and stick to it. If your child is struggling to learn language, doesn’t it make sense that he’s more likely to succeed if he’s learning just one? That doesn’t necessarily mean that you won’t get to teach him other languages later. It means that we need to increase his odds of doing better right now. One language is easier to master than two (or three!).
Families who have chosen to fore-go their initial plans of raising a bilingual or trilingual child are often targeted by their friends or families. They are told that the SLP is trying to sabotage their child’s development or “doesn’t know everything” about language. Families also cite the research that tells us that bilingual children achieve milestones later. What they don’t say is that this research is relevant to expressive language, or what a child can say. It doesn’t address children who don’t understand or process verbal language. This indicates a larger problem than late talking.
While it is true that SLPs don’t know everything, we can certainly predict that a child who isn’t communicating well verbally by kindergarten is going to have an uphill battle learning to read and write. All of the academic concepts we learn, even math, are based on language. It’s a fact. The teacher talks to teach; kids listen to learn. It’s a mostly verbal system.
Educators who recommend teaching your baby several languages at once are not considering the effects on a child with language processing issues. While in theory it is a good idea to teach languages during this optimal learning time, it has done damage to children who weren’t old enough to be identified yet as language delayed or disordered. We don’t which kids are going to thrive with this approach and which ones are going to fail.
Granted it’s not a parents’ “fault,” but at the first sign of difficulty, I’d advise them to reevaluate their decision to teach multiple languages. If a child is having difficulty learning to understand and use language, I think it just makes sense to let him master (that is, catch up to his age level) in one language before moving on to another one. Then he’ll have a point of reference for “learning” the new one, and you’ll know you’ve done everything you can to help him learn to communicate his wants and needs in a consistent way that he and you understand. Isn’t that ultimately what all of us who love a child with language-delays want and hope for?
Comment by MaryAnn on 8 May 2008:
I was raised bilingual so I never thought learning two languages would be a problem. I have distinct memories of being able to speak Chinese and English and never had trouble distinguishing the two languages. According to my mother, I learned Chinese first and learned English from my uncles and television (I did not attend preschool and had no trouble understanding my kindergarten teacher and the kids in my neighborhood). I don’t remember having trouble academically and excelled early on in school and continued to excel through my entire academic career. But standards are most likely more rigorous now.
So when my two children were diagnosed with receptive and expressive language delays, it was at first difficult to accept that my children could possibly have difficulties learning two languages. When my childrens were diagnosed, we gave up on the second language and concentrated on English. My older child is doing very well in school in all subjects above his grade level (he’s in first grade). He has made much improvement in his speech issues after years of speech therapy and our constant work with him. He was diagnosed when he was 30 months and has received speech therapy since.
I’ve felt guilt about dropping the Chinese language. However, my parents were extremely understanding of the circumstances because they love their grandchildren and want what is best for them. Early intervention is best - that has been our experience.
Comment by Laura on 8 May 2008:
Mary Ann - Thanks so much for sharing your story with us! Best of luck to your family! Laura
Comment by Anonymous on 8 May 2008:
I am also an SLP and happen to have done a thesis on bilingualism. Your argument makes logical sense on some level… but unfortunately it does not fit with the research!!! Check out Fred Genesee and his book “Dual language development and disorders”… or the book “The bilingual edge”. Over and over again, studies show that introducing multiple languages does NOT confuse a child or cause language delay. Multiple languages is only a burden to the PARENTS, who are on the hook to provide enough rich exposure to each language (and no, TV does not count). A child who has language delay will show the same delay in all the languages… but it does not follow that taking away any of those languages will help him/her progress in the “primary” language. Language is abstract - it goes BEYOND any specific realization like English, or Chinese, or Czech. In a way, the words are just the details. The communicative intent, and the abstract concepts in the child’s brain… that is language! If there is a delay, it is in the formation of the concepts. The sooner parents and SLPs realize this, the better off the nation’s children will be. I think more spoken languages can only make a child richer.
Comment by Laura on 12 May 2008:
Thanks so much for your comment, even though you disagree with my position! Thanks too for the resources for parents so that they can do their own research when making decisions for their children. I will say that I have not read either of these resources, and I appreciate you sharing your expertise in this area of clinical interest.
However, I still stand by my advice to parents to reduce the complexity of language they are teaching children who have demonstrated that they are struggling to learn language. This would also be the same for parents who are teaching just one language. If mom and dad are constantly talking in ways that impede a child’s ability to understand and use words, then I ALWAYS recommend that they break it down to the level where their child CAN begin to process and imitate, again regardless of whether they are teaching 1 language or 3.
As unfortunate as it is, I can only help them facilitate English since I am not proficient in any other language, and I an entrenched in the belief that parents should be reinforcing what we’re working on in sessions. Otherwise, why bother with therapy?
I would like to reiterate that it has been my experience that reducing the complexity (aka - one language) has been successful in helping children progress vs. the families who were adamant about emphasizing the other language/s. While this is not confirmed in the research you cited, I have lived it many times from week to week in the homes of children I have seen.
Please know that I certainly understand that ALL language is abstract, and I appreciate you reminding our readers of this since they have not had the same educational benefits as you or I.
Again, I appreciate your insight and contribution to this topic, even if we disagree. Best regards - Laura
Comment by Marcela on 15 May 2008:
It’s hard to say… my oldest (7) was in the same environment like my youngest (24 mos) and yet, despite the fact that his round-the-clock caregiver did not speak a leak of English, his first five words were in English at 11 months… my 2 year old has five words now… and I’m not convinced either that the languages is the issue. However, I’m also thinking out loud - IF there are tendencies for language delays, then two languages in the house (or more, for that matter) would have to exacerbate such tendencies. But on the other hand, if the child would not have had a problem with speech from the get go, two or three languages at the house should really be piece of cake…
Comment by Jo on 2 July 2008:
I too grew up with two languages and learned a third when I entered school at six. Never had any problems. I could tell that they were different languages because the sounds were so different.
Most people in my country speak an average of 2-5 languages. If someone doesn’t have any developmental, hearing or auditory processing problem, being exposed to so many languages never causes any problems. For those who do have problems, they have problems in all the languages. They don’t even do that well (in school tests) in their first language.
Comment by Victoria on 1 August 2008:
We have been raising our daughter bi-lingual from birth. I speak English and my husband is from Mexico. He is a stay at home Dad and would speak Spanish most of the day, when we were together we would speak English. She has been in Early Intervention due to Global Developmental delays, including delays with her receptive and expressive language. When she was about 28 months (she is 32 months now) both my husband and I decided that we needed to concentrate on one language (English). This web-site was part of the reason, the other part was a gut feeling by both of us that the two languages was just too overwhelming for her. Since we cut back on the Spanish, both her receptive and expressive language have exploded. It’s really seems that it was just super confusing for her to be exposed to both languages, but without any real structure to it. We will continue to teach her Spanish so she can communicate with her family, but we will take a different approach. We starting to teach her, this is a ’spanish’ word, this is the ‘english’ word. Or ‘In spanish we say…’. It seems that putting this organization around it is helping.
Hopefully this comment will help other parents that are facing a similar issue.
Comment by Laura on 1 August 2008:
Victoria - I am so happy to hear about your daughter’s progress! I’m so glad I could help! Thanks so much for sharing your success story with us! You’ve made my day! Laura
Comment by Andrea on 2 September 2008:
hi Laura, I have an almost 20 month old daughter. My husband and I speaks spanish, but since we live in canada we decided to raise our daughter bilingual.
I’m a stay at home mom and all of our family is overseas, so is just the three of us here. My daughter says lots of words like animals and the sound they make (mostly in english), numbers 1-10 (spanish and english), body parts (mostly english), and the list goes on. The thing is that is more like we’re speaking to her in ’spanglish’ and we’re doing it because spanish flows easier to us, but still we don’t want her to feel lost when we are in the park and someone talks to her or when when we read books, which here we can only find in englih. She doesn’t respond yes or no, either in english or spanish and I find that she’s very echolalic, she constantly repeats songs, words or expresions from books and tv shows…oh and she sings lots of nursery rhymes, specially ‘ring around the rosie’, she would start to sing it out of the blue and makes the whole ‘we all fall down’ movement. Sometimes the expresions from books or tv shows come out of nowhere but most of the time is because she pretends she’s falling or something ‘bad’ is happening to some character on tv.
She started to point at things one week before she turned 18 months, but is mostly to show things she’s interested in or when I ask her to point at something on a book, but rarely to request something. I would really appreciate some advice.Thanks.
Comment by Andrea on 2 September 2008:
forgot to say that the expresion she uses the most is ‘oh no!’…she gaot it from a ‘go diego go’ book and in one part of the book diego says: “oh no, the rocks are falling!!”…sometimes she says exactly the same sentence, buy most of the time she uses the expresion “oh no” when she’s playing with her dolls or plush toys, or she just pretends she’s the one that fell, or sometimes she says it ‘just because’ and look at me or my husband with this surprised look and put her hands on her face or her head.
Comment by Laura on 2 September 2008:
Andrea - She sounds like she is meeting her milestones for her age and doing all of the great single word and phrase imitation we like to see 20 month olds do. This is the stage when all children with typically developing language sound like little parrots - that’s normal! The things you’re describing sound age-appropriate for a 20 month old. If she weren’t talking at all or not following directions, I’d be a little concerned about 2 languages, but it sounds like she’s doing fine. Many children don’t distinguish yes/no until closer to 2 1/2, so that sounds fine too. Keep working to help her build her vocabulary, understand more directions, and learn to ask for things in whatever language/s you choose. You seem like you are on the right track to me. Don’t worry unless she doesn’t continue to make progress. Laura
Comment by Andrea on 3 September 2008:
Thank you Laura for your help…how didn’t I find you before???? you are an oasis in the middle of the desert!!!…there’s still a couple of things that I’m worried about, so I’ll be back soon with more questions for you, for now, it’s time for me to get some rest after a busy day with a full of energy toddler…thanks again!
Comment by Laura on 3 September 2008:
Andrea - I’m glad you found the site! Thanks! Laura
Comment by Mamta Goyal on 9 March 2010:
hello,
I have a 25 month old son.we moved to USA 8 years back…I and my husband speak both english and our native language frequently and interchangebly at home and with our son.at the age of 25 months he really dosen’t have many words in his vocabulary…he barely speaks 4-5 words in english and couple of words in our language…he sings some english songs like I love you,you love me and twinkle twinkle…but not clearly….he counts in english till 10…he understand our language very well and will follow instructions if given in our language….understanding and following instructions in english isn’t that impresssive but it’s not too bad…he communicates with us in two ways…most common is pointing at things and second is speaking jargon and gibberish language which sounds like nothing to me.Also he seems soconfuse between yes and no…to be clear i doubt if he really knows when to use them…
Laura what would you suggest? do you thing there is a problem? what should I do?
Comment by Laura on 12 March 2010:
Mamta - Research tells us that toddlers who live in bilingual homes speak later than expected. However, I would be concerned that he only has a few words and he’s already two. Since you’re in the US, you can call your state’s early intervention program for an evaluation and free or low cost therapy. To get info, Google your state’s name, and then enter the phrase “early intervention.”
He does have some great strengths since he is understanding at least one language very well. Keep pairing your instructions with BOTH languages to help him make those connections and associations between words.
I would definitely follow up with the eval just to rule out any underlying language delay. You’d rather deal with this early and help him overcome any problems now rather than waiting.
In the meantime you can read articles here on the site for ideas with how to work with him at home. Also take a look at my DVDs so you can SEE the strategies in action. Often times changing your approach makes a world of difference! Hope these ideas help! Laura
Comment by Jennifer on 17 April 2010:
Hi Laura -
I’m an SLP and I just evaluated a 24-month old with only 3 words (mama, dada, byebye). His father is bilingual and his mother speaks only Arabic. His receptive language skills appear to be poor in both languages. Do you have any suggestions for working with a child whose primary caregiver does not speak English?
Thanks!
Comment by Laura on 18 April 2010:
Jennifer - Wow! That’s a tough one! I always recommend to parents that they really work in the language a child will need for school. If they live in the US, that’s English, so that’s what you should continue to recommend.
Are you doing therapy with Dad present, or just with Mom? If it’s just mom, that’s going to be very, very difficult, for you and for her. Can you get an interpreter for some sessions? If not, then you can still leave very detailed notes for Dad, or even videotape all or some of the session so he can see what you’re doing and then he can explain to mom what to do.
Many bilingual families try to tell a child everything twice - once in each language. However, if his receptive language isn’t strong in either, that’s obviously not working for him.
Hopefully mom can learn some English words along with her son during therapy so that she can reinforce those words - both receptively and expressively. I’d keep things really repetitive and really simple so that she also “gets” what you’re doing regardless of the language barrier you two have. Hang in there! This is a big challenge for you professionally!! You’ll learn some lessons from this one too! Laura
Comment by Dini on 10 March 2011:
Hello,
My son is 27 months and has been raised in a tri-lingual home. My husband and I speak mostly in English, my parents mostly in Gujarti (Indian language) and his caregiver only in Spanish. He speaks maybe around 30 words mostly in English though, he says some words in either Gujarti or Spanish. He is starting to form some two word sentences but his vocbulary is not where it should be.
He has been evaluated by two speech therapist who came up with different diagnosis. One is stating the problem is his receptive and expressive language skills are scoring around 19 months through his cronological age is 27 months. He has a mild to moderate delay. The other therapist believes he has a apraxia because he it seems like he takes in all that is going on around him, and gets confused and then, when he tries to execute a plan like completing a puzzle gets frustrated and will throw the puzzle piece when he can’t get it to fit. This therapist believes that is dyspraxia, but after reading your website I think it is being confused and unable to comprehend multiple languages and major frustration over that. My son is receiving speech therapy but are concerned why his frustration level is so high. Wondering if you could possibly shed some light on it. Also, where we can find other articles on your website that would be helpful to read. Last, of the three DVD’s that you have created which one do you think would be most helpful for us?
I shoudl also mention that excpet for his caregiver, we are mix languages (not realizing this maybe the problem).
We are very desparate for help and would appreciate any feedback!
Dini
Comment by Laura on 10 March 2011:
Dini - Is is possible to stick to one language for a little while? I think that would be a good start to see if you can bump up both his receptive and expressive language by simplifying the expectations?
If that’s not possible, and it sounds like it might not be, then you’ll have to bump up the English when you’re around him by spending more concentrated time time talking and playing with him.
If the extra focus doesn’t work, especially if his receptive skills improve, bu this expressive skills don’t, then, then he may be apraxic as well. (By the way, I use the terms apraxia and dyspraxia interchangeably.)
Even if I were seeing him and thought he could be apraxic, I’d be most concerned about the receptive language delay and would work on that as my #1 goal.
About the frustration level - it could very well be due to having to sort out all of the languages and feeling pretty darn helpless when he can’t even make the simple things, like a puzzle, work. Does he exhibit a low frustration tolerance for lots of activities? Does he get upset when you brush his hair or teeth or does he overreact to environmental challenges such as noisy places? Then it could be sensory processing differences. Have his SLPs mentioned that to you?
However, it could also be motor planning difficulties too. It may also be that he’s just short-tempered. Don’t we all know adults who have short fuses? Again - I haven’t seen him, so there’s no way I can even guess which one it is!
As far as DVDs go - I always recommend Teach Me To Talk first since it outlines the basic philosophy and introduces targeting language with a very play-based approach. For his receptive language, if that doesn’t move along in the next 2 to 3 months with therapy and this extra focus on English by you and Dad, I’d get Teach Me To Listen and Obey 2.
Read articles in the receptive and expressive section first. Use the yellow category bar on the top menu bar to get to those categories. Begin with the older entries first and read forward. The access those articles, scroll to the bottom of the page and click on Older Entries on the bottom left hand side until you get to the first entries I wrote back in 2008.
Thanks for your great questions! Keep up the good work at home with him! You realize what you and Dad do with him are essentially more important for his progress than anything else, right? Laura
Comment by Maestra on 10 March 2011:
I am a foreign language/ ESOL teacher and the mother of twin toddlers who are learning to speak in both English and Spanish. Your position towards raising children bilingually surprises me a great deal, since like a previous poster, the most current research I’ve encountered does not support your opinion. Children regularly learn multiple languages at once all over the world, without problems. The monolingual child is NOT the norm in many parts of the globe.
Bilingualism/ multilingualism simply does not result in expressive or receptive language delays in most children. Bilinguage children typically speak their first words around the same time as monolingual children. When their words in all their languages are combined, their total word count is equal to that of monolingual children. The newest research shows that infants being raised in bilingual environments can differentiate between the sounds of their two languages when they’re merely months old, an indicator that we come “equipped” for learning more than one language simultaneously.
Rather than just encouraging parents to switch to the language spoken in school (i.e. English, why not offer them additional options such as the one parent, one language approach or using only the minority language at home? Maybe instead of using only one language you could give them ideas for increasing comprehensible input in the languages they use with their children.
I worry that a parent raising a bilingual toddler might stumble across your page, as I did, and be scared into dropping one of their languages without need. There are likely many parents who read your site whose children don’t have delays severe enough to warrant taking such drastic steps (or they may have worried parents and have no true delay at all).
Comment by Laura on 10 March 2011:
Maestra - When a child exhibits receptive language delay, the first recommendation any SLP would make to parents is to simplify the language the child hears since he’s obviously not learning to understand words “the regular way” as a typically developing toddler would. This is the case for the mother you referenced who is concerned about her child. The delays were described as both receptive and expressive which is much more clinically significant than a child with only expressive delays.
It’s never been my position that the REASON a child is diagnosed with a language delay is due to learning more than one language. If that’s your impression, I urge you to re-read the articles and responses more closely. When children are typically developing, learning more than one language is not going to be difficult for them, and I’ve never said anything to contradict that position.
The research you’re citing is helpful for parents of typically developing children and for parents who are deciding how to raise their children, but unfortunately, it does not apply to children with language delays. Curent research points to language delays being present across the board in ALL languages a child is learning. Again, I think this supports my recommendation to reduce the complexity for what the child is trying to learn.
As you’ve noted, this is a website for parents of language delayed toddlers. Although you’ve found the site, most readers who’ve written to me over the last 3+ years have been parents of children with suspected or confirmed language delays. While parents of children who are typically developing or with even mild delays may end up here, after reading a few responses, my hope would be that they would be able to differentiate between their own situation with their own child and ones that readers are describing when a child’s language skills are delayed. If there’s no problem, why would a parent decide to change what they’re already doing? If they’re coming to linger on the site when they don’t need the information, then I’d have to question their motives for being here in the first place.
While I certainly appreciate your position as a parent raising bilingual toddlers and as an ESOL teacher, your experience and point of reference are completely different from mine. I’m sure your recommendations to this mom are well-intentioned, but from reading what she wrote, I think she’s essentially already tried what you’ve suggested without success. They already use the one language - one parent approach since this child’s caregiver is Spanish, his parents primarily speak English, and grandparents speak in another language. It also sounds like they try the minority language for only a portion of the day as well. My advice is to try something different to see if they can facilitate improvements.
As far as offering that mom suggestions to improve language input, this whole website is FILLED with examples for that, and I don’t restate the entire site in response to each individual question. I did refer her to categories of articles so that she could do further reading on her own, and I referred her to other materials as well.
Nevertheless, thank you for your contribution as I’m sure it could possibly alleviate concern for parents who have no need to be worried or have no reason to change their current approaches. But for parents of children who are struggling to learn language, I’m going to continue to offer the best practical advice I can from my perspective as a communication disorders specialist who’s worked with families with very young children with language delays for almost 20 years now. Laura
Comment by Jana on 1 May 2011:
Hi Laura,
First off - I’m a big fan and have recommended your website and materials to many parents. Your podcasts are taking up all the memory on my iPod! Thanks for providing such a wonderful resource.
I’m an SLP for my state’s early intervention program (0-3). I mostly do eligibility evaluations but also provide therapy when a provider cannot be found.
I’m struggling with evaluating monolingual NON-English speaking infants and toddlers - Children whose only exposure to English is what they hear on television, on the city bus, or while running errands. The state hires interpreters from a Language Resource center and I’m frequently working with families who speak Arabic, Twi, Karen, Spanish - You name it! I’m dependent on the interpreters, whom I’ve usually just met outside the family’s door, to help me administer tools which are not designed for use with these language populations. (Worse, I don’t have a tool for something like articulation concerns). On top of that, the children are often very shy and quiet during the evaluation because they’ve heard little English and are very confused. They’re also often unfamiliar with the testing materials. Sometimes I’m referred children who’ve been in the USA for only a few months! Because of our state guidelines, I’m never allowed to refuse to do an evaluation.
To make matters more complicated - if I determine that a child has a language delay and needs intervention - it will be me who becomes that child’s speech therapist (with an interpreter) because our community providers never accept these referrals. This means that I’m putting a language-delayed child (maybe? I’m never really 100% sure!) in the position of hearing everything said THREE TIMES as I’m coaching the parent - I say it in English, the interpreter repeats it and then the parent repeats it - defeats the purpose of simplifying language, right?
I’d love to hear your thoughts on this situation. It keeps me up at night!
Comment by Tallie on 2 May 2011:
Dear Laura,
I have been reading these posts and wondering to myself what to do. My son turned 2 last month and just started saying a few words - “bye bye” and “abba” (father in Hebrew) “sssso” (socks) and “shoo” (shoes) and “go” (dog in Mandarin) — and he hears 3 languages at home. We live in Beijing, both my husband and I work, and my son spends a lot of time with the Chinese nanny. I speak English to him, my husband speaks Hebrew and my nanny Mandarin Chinese.
He is very communicative with pointing and pulling and showing, very outgoing and playful, but I am concerned about his language delay. He makes a lot of babbling noises, talking a lot in his own “made up” language, but makes less of an effort to speak a “real” language. He is so expressive that he always gets what he wants without having to properly ask for it — he wants to go out? brings me the stroller and his shoes. He wants to eat? Takes me to the refrigerator. Etc. etc.
What can I do to prompt his language development - to provoke him to speak more and point less?
Which language, if any, should I eliminate? And we are relocating to Spain in the summer — any tips on how to make that move less difficult for him?
Any and all advice would be appreciated.
Thanks,
Tallie
Comment by Laura on 3 May 2011:
Jana - What a tough position you’re in!! I don’t envy you at all because I’m not sure there’s a great solution for you, or that there’s anything you can change about your cirmcumstances. The kids have to get services if they qualify, and you can’t eval any of them in their families’ languages, so you have to go with what your gut instinct tells you about the kid based on the information you gather. If you believe there’s a delay, you have to declare the child eligible.
Let’s look at it from the parents’ perspective too. Someone must be concerned about the child, or else he wouldn’t get the initial referral. The parents obviously care about their toddler’s development, or they wouldn’t have followed through with getting the assessment. If they’re allowing you to evaluate and then treat their kids, they’ve validated that they believe your information is important since they do allow you back into their homes. You have to use the interpreter so that parents get the info too.
I think my only advice to you would be to keep doing what you can to serve these families. Flawed as the system may be, if you didn’t do it, it doesn’t sound like the kids or their families would get services at all, and that’s no solution for anyone.
So… just keep doing the best you can to serve the families who are placed in your care. It’s not a perfect situation, but you are making a difference in their lives, even if none of them can tell you that!! Good luck!! Laura
Comment by Laura on 3 May 2011:
Tallie - Thanks for your question. First of all, your little guy is bright and communicative since he’s figured out a way to let you know what he needs even without words! Good for him!
I think the answer would be to simplify whatever language he’s hearing to help him link meaning with specific words and then attempt to imitate single words. He gets that he needs to talk, and he obviously understands directions and is social, so you’re going to go out of your way to help him learn to imitate single words in whatever language you choose. When it’s possible, give him the word you’re targeting in more than one language to help him link the languages. Encourage him to repeat the specific word.
Many SLPs disagree with eliminating languages for a child in this situation and many times, that’s not a possibility anyway. But if you can simplify to help him sort things out a bit, that’s going to help.
The best answer for him moving forward in Spain would be to have a nanny who is bilingual and somewhat fluent in one of the languages he already knows. Even though we have lots of evidence that birth to 5 is when children learn multiple langugaes best, it’s not happening yet for your little guy, meaning there’s an underlying problem learning language, so you will have to find ways to simplify so that he can learn to talk. It’s not going to be easy! Laura
Comment by Jana on 3 May 2011:
Thanks Laura!
I love serving these families and doing what I can do to help. Your comments are appreciated.
Just this morning I used an interpretor who spoke Burmese and broken English with a mother who spoke only Kareni and broken Burmese. I always feel concerned about billing for services and saying to Medicaid that there’s a medical necessity for speech therapy when I have such little faith in my scores.
Oh, and - the families do a great job of letting me know I’m appreciated! I’ve been served some delicious food and gotten plenty of hugs - some communication transcends language!
Thanks again for your thoughts.