Why and when to question your doctor’s advice about bilingual speech and language development

A hot topic for parents of bilingual kids, is the advice they receive from doctors and other medical professionals on their child’s bilingual speech and language development. I hear over and over again that parents have been advised by their family doctor to stop speaking their mother tongue, and instead speak the community language. Or that they need to drop a language at home because learning two or more languages is confusing for the child. Parents believe this advice because it comes from a medical professional.

But can doctors give advise on something so specialised?

If you haven’t already you check out these related articles:
Speech & Language Milestones for Bilingual Kids
Bilingual Kids and Language Development
Bilingual Kids and Speech Delay

Today I have Bilingual Speech Pathologist Scott Prath as my guest to answer the question of why and when to question your doctor’s advice about your child’s speech and language development, and who you should see instead.

Scott-prath-bilingual-speech-pathologistScott Prath, M.A., CCC-SLP is the Vice President of Bilinguistics in Austin, Texas and serves a diverse caseload in the schools and early childhood setting. You can find the books and apps he has authored and co-authored here. Scott is also the lead writer for The Speech Therapy Blog. You can contact him there or at Bilinguistics.  

Can general doctors give advice about bilingual speech and language development?

I have more respect for pediatric doctors than for almost any other discipline.  Dozens of times each day, they meet with parents and gently guide them in a direction that will help their child.  They hear our concerns and make decisions about vision, hearing, physical, fine motor, speech, language, cognitive, or even gastro-intestinal development.  It is truly an amazing amount of information that each doctor is responsible for.

To accomplish this, a pediatric doctor is armed with developmental norms from almost every discipline and needs to know when to reassure a parent and when to seek additional expertise.  So, it is not surprising that additional expertise is needed when dealing with a second language or when doctors reference developmental information that is outdated.

Ellen Kester, Ph.D., Bilinguistics
If I had a nickel for every time a parent has told me that their doctor or teacher told them not to speak their native language with their child,…

We are a group of bilingual speech-language pathologists who are frequently asked questions about bilingualism.
“Is it bad for my kids to hear two languages?”
“Will they get confused”
“Do bilinguals learn to talk later than monolinguals?”

Unfortunately, most of these concerns are generated by well-intentioned teachers and doctors who are not aware of current research and the truth about bilingual development.

Misconceptions about bilingualism

There are numerous misconceptions about bilingualism. Let’s address them here and then talk about what we can do if you are getting contradictory advice

Misconception #1 – Bilingualism is a problem. FALSE

Some believe that bilingualism is a problem that the medical or educational systems have to deal with.  It certainly makes things a bit more complex.  However, the truth is that over 51% of the world is bilingual and there are portions of Africa and India where Polyglots (at times 5 or more languages) are the norm.

Truly, monolingual development is the exception.  Retaining a second language often means retaining a second culture and educating the next business, social, and governmental ambassadors to the world.  Nearly every adult I encounter that finds out that I speak Spanish confesses a regret for not keeping up with whatever language they began in high school.

Misconception #2 – People who code-switch (mix two languages) have a language deficit and do not know either language well.  FALSE

Code-switching is used for a number of reasons but does not necessarily indicate a language deficit. Sometimes bilinguals code-switch for emphasis or to express a term that has a slightly different meaning.

In some regions, code-switching is the norm.  It is important to consider a child’s language model.  If they grow up in a code-switching region, they will likely code-switch.  What is important to determine is if they are able to use the languages separately after being sufficiently exposed to non code-switching models.

Misconception #3 – Children with language impairment should not learn more than one language at a time.  FALSE

There is no evidence that being raised with two languages will confuse children with normal language development or language impairment.  A recent study (Westman, Korkman, Mickos, & Byring, 2008) found that children with language impairment who came from bilingual backgrounds did not have more severe language problems than monolinguals with language impairment.

Read More : Bilingual Kids with Special Needs

Misconception #4 – Children learning two languages are at a cognitive disadvantage compared to monolingual children.  FALSE

In the past, bilingualism was often viewed as a source of problems in language development.  Many poorly designed studies provided support for this idea.  Conversely, a number of studies have found a wide array of cognitive benefits related to bilingualism.  Executive function, which is thought to aid in one’s organizational skills, attention, and inhibitory control, has been found to be superior in bilinguals as compared to monolinguals (Bialystok, 1999; Bialystok, 2009; Mezzacappa, 2004; Yoshida, 2008).

Additionally, bilinguals have been found to have greater cognitive flexibility in word learning than monolinguals.  Bilinguals were able to learn words with similar meanings more readily than monolinguals (Yoshida & Smith, 2007).

Read More: Benefits of Being Bilingual

Misconception #5 – Children who learn two languages at the same time confuse the languages and have difficulty communicating.  FALSE

In the same way that monolingual children sometimes overapply rules when they are learning their language (for example, “Daddy goed to the store”), bilingual children sometimes apply rules from one language in the other.  For example, in Spanish adjectives come after nouns.  You might hear a child from a Spanish-speaking background say, “I like the car white” instead of “I like the white car.”  It is common (AND NORMAL) for people to use patterns from one language when learning another.

Read More: Bilingual Kids Do Not Get Confused

So Who Should You See Instead?

Seek the Advice of a Trained Speech Language Pathologist (SLP)

Like any specialty, speech-language pathologists spend their entire career focusing on one specific area.  If your concerns are above and beyond typical development, an evaluation can:

1. Identify if your child is communicating like her peers.

If not,

2. Identify goals that will help her move in the right direction.

It is important to point out that not all speech pathologists are trained in the same areas.  Doctors are not the only ones who continue to increase their knowledge about bilingualism.  It is important to ask if a speech pathologist has experience or training in Culture and Linguistic Diversity.  Stated more directly:

“My child may be having difficulty communicating.  Will you be able to diagnose if he has a true disorder or if his difficulties are only due to learning a second language?”

We specialize in bilingualism and our website has tons of free resources to help you and/or your speech pathologist correctly identify areas of need and work with your child.  Simple click on the tabs that say PARENT or SLP at: www.bilinguistics.com

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References:
Bialystok, E. (1999).  Cognitive complexity and attentional control in the bilingual mind.  Child Development, 70, 636-644.
Bialystok, E. (2009).  Bilingualism:  The good, the bad, and the indifferent.  Bilingualism:  Language and Cognition, 12, 1, 3-11.
Mezzacappa, E. (2004).  Alerting, orienting, and executive attention:  Developmental properties and sociodemographic correlates in an epidemiological sample of young, urban children.  Child Development, 75, 1373-1386.
Westman, M., Korkman, M., Mickos, Annika, & Byring, R. (2008).  Language profiles of monolingual and bilingual Finnish preschool children at risk for language impairment.  International Journal of Language & Communication Disorders, 43, 6, 699-711.
Yoshida, H. (2008).  The cognitive consequences of early bilingualism.  Zero to Three, 29, 2, 26-30.
Yoshida, H. & Smith, L. B. (2007, March).  Different developmental trajectories for bilinguals and monolinguals:  Evidence from novel word learning.  In H. Yoshida & J. R. Johnston (Chairs)  Proactive interference in word learning for monolingual and bilingual children.  Symposium for Research on Child Development, Boston.