Top Ten Tips for Parents: Speech and Language Acquisition in Internationally Adopted Children

Parent Tips

So, what should parents of second first language learners expect in terms of speech and language development? When should we be concerned, and how do we go about getting professional help? Here are my Top Ten Tips for ensuring your child's speech and language needs are met:

1. Don't panic.

The odds are in your favor. Several recent independent studies of children adopted from China and Eastern Europe have found that although there is considerable variability during the early months post-adoption, after one or two years in their permanent homes the vast majority of children adopted as infants or toddlers are performing at or above age level on tests of English language proficiency. This good news suggests that given sufficient exposure to English in a stimulating, language-rich environment, most internationally adopted children will become competent speakers of English in a remarkably short period of time.

2. Be proactive.

Even though there is a good likelihood that your child will eventually achieve normal English speech-language abilities, most parents are not content to sit back and wait to see what happens. Many of us waited a long time to become parents, and are eager to give our children all of the support we can to help them compensate for any early deficiencies.

We also know that it is better to identify and address problems early than to waste precious time that could/should have been spent providing critical early intervention. You can do a lot by making your home a language-rich environment. For example, talk to your child about what you are doing and where you are going. Repeat and expand upon what your child says, and read to your child (at a level appropriate to their interest and attention span). Many parents have found baby signs (simple gestures used to represent words and ideas) useful as a way of reinforcing early communication skills and acting as a bridge to spoken words.

Parent training programs for enhancing children's language are also available in many communities. In addition, some families take advantage of opportunities for more structured early intervention programs. In most areas, our children qualify for early intervention because they are 'at-risk' for speech-language and other developmental delays. Most early intervention is family-focused, and will also provide you with techniques for facilitating and supporting speech-language development at home.

3. Get a hearing test.

All internationally adopted children should have their hearing tested as soon as possible after returning home. Consider it comparable to the newborn hearing screenings that are routinely done before children are sent home from the hospital. Good hearing is essential to speech and language development, and you want to know that your child is beginning this task with all of the necessary tools. In addition, the first step in any evaluation of speech-language concerns is a hearing test to rule out poor hearing.

Speech-language pathologists can 'screen' for normal hearing through a variety of conditioned behavioral response methods (such as turning towards a sound source, or dropping a block in a bucket in response to hearing a tone). But if your child does not respond to such methods, or if they do not pass the screening, follow up with more in-depth testing by a qualified audiologist. In the early months home, some children may not respond to behavioral testing methods, due to stranger anxiety or a lack of understanding of what is being asked. Audiologists have other objective ways of ruling out hearing loss that do not require a behavioral response.

4. Trust your instincts.

If you have concerns about your child's communication abilities, act on them. Don't be overly influenced by other parent's experiences, or put off by well-meaning physicians or family members who tell you to just give it more time. Parents are known to be very reliable reporters of their children's speech-language difficulties. After all, you know your child better than anyone else. If you have difficulty understanding their communication attempts, or think that their abilities are not up to par, seek professional help.

5. See a qualified speech-language pathologist for an evaluation.

Although you may want to first discuss your concerns with your child's doctor, recognize that not all pediatricians and medical personnel are familiar with or have experience in assessing speech-language development. If you have concerns, seek an evaluation from a qualified speech-language pathologist (SLP), more commonly referred to as a speech-language therapist (SLT) in the UK. You do not need a physician's referral to see an SLP although you may need to go through your local health care system unless you are paying with private funds. Ask for recommendations through your local school district or health authority, or use one of the searchable databases on the websites for national organizations of speech-language pathologists and audiologists (see page 94).

The type of evaluation the SLP conducts should vary according to both the age of your child and the length of his/her exposure to English. For example, assessments during the first month or two home should focus on universal (and not English-specific) aspects of communication:

• Does a newly arrived 10-month-old vocalize to get the attention of an adult?
• Does s/he babble repetitive strings of syllables such as ba-ba or da- da-da-da?
• Does a newly arrived 16-month-old imitate simple gestures, such as clapping hands, or push away unwanted objects?

These types of communication skills, which are not specific to the language being learned, are most predictive of newly arrived children's language development status. Over the next year, as the child has more and more exposure to English, it may be possible to estimate the number of different words the child understands or says and compare them to preliminary norms for children adopted at similar ages from Eastern Europe and China. Keeping a record of these vocabulary estimates over time will also give an idea of the rate of change, which may also be predictive. By two years (or perhaps even after one year) post-adoption, commonly-used speech and language tests developed for and 'normed' on monolingual English speaking children can be used, although they should still be interpreted with caution.

6. Be prepared to 'inform' the professionals.

Do not be surprised if you know more about speech and language development in internationally adopted children than your speech-language pathologist (SLP). This statement is not meant to insult my professional colleagues. Research on this population is still in its infancy, and most SLPs have not received any formal training in how to assess or treat 'second first language' learners. Results of early studies are beginning to appear in our professional journals, but best practice guidelines for assessment and intervention with our children are not yet widely available. Internationally adoptive parents are highly educated and dedicated parents who seek information from a variety of sources, and have an extensive network for sharing that information. So you may have access to new information before they do.

If your SLP does not have extensive experience with assessing internationally adopted children (and remember, they are different from bilingual and ESL children), share with them copies of articles on the topic, or refer them to the relevant websites. Armed with these additional resources, they will be able to work with you to properly interpret assessment results and make appropriate recommendations.

7. Learn as much as you can about your child's communication development.

One critical piece of information that is often missing when our children are brought to an SLP for an evaluation is what their communication abilities were like in their birth language. Not knowing how their development was progressing in the birth language makes it more difficult for SLPs to determine whether a child is likely to catch up on their own, or require speech-language therapy. If at all possible, try to get as much information as you can by interviewing their caretakers or sending a translated list of questions to their orphanage. Recognize that not all attempts to obtain such information will be successful, however, due to time constraints and/or level of cooperation of orphanage staff.

Another alternative might be to have an assessment conducted in the birth language after arrival. The feasibility of this option depends on the availability of a native speaker (in the child's local dialect) and the extent to which the newly arrived child is comfortable interacting with strangers. In addition, because attrition is rapid, in order to get an accurate picture of the child's abilities any assessment in the birth language should be conducted within the first few weeks home.

8. Don't assume that all problems are adoption-related.

No doubt many of our children are at risk for speech and language disorders due to less-than-ideal stimulation in orphanages or other related developmental delays or medical issues. But it is a mistake to assume that all of our children's difficulties with English are due to the fact that they were adopted. For example, I've been asked more than once if a child's difficulty with the /r/ sound is due to them not hearing /r/ during first year of life, because /r/ was not present in their birth language. I point out that difficulties with /r/ are also quite common in monolingual English-speaking children, and many do not master it until eight or nine years of age. In fact, most of the speech sound errors that internationally adopted children make are common developmental errors.

Internationally adopted children are difficult to assess because of their late onset of English exposure, but if all else is developing normally they should make the switch to English with relatively little difficulty. However, somewhere between two and eight percent of all children have developmental speech and language disorders, regardless of whether or not they were adopted or switched languages midstream. If your child is not progressing steadily, consider the possibility that there may be a problem and seek help.

9. Be prepared to advocate for needed services.

Our internationally adopted children are often caught in the cracks of eligibility for speech-language services. For example, I know of school-aged children who were denied speech-language services because they were viewed by the school system as ESL learners. Because a pre-adoption assessment in the birth language was not conducted, there was no proof that they had a more basic, underlying language deficit that would qualify them for speech-language services. Another common example are preschoolers who are too old for early intervention services, but whose problem is not severe enough to make them eligible for other special programs prior to entering the school system. Parents should be prepared to advocate for services, if necessary with the assistance of a private practitioner.

10. Take time to enjoy your child's development.

It's easy to get caught up in the day-to-day concerns about whether or not your child is progressing adequately, or if they are getting enough of the right kind of help. Too often we forget to sit back and watch the miracle of a young child discovering the joy of communication and its power. Jot down those cute little mispronunciations, made-up words, and ungrammatical attempts at sentences, and marvel at the adaptability and resiliency of our children, who really do 'say the darndest things!'

About the Author

Karen E. Pollock is a Professor and Chair of the Department of Speech Pathology and Audiology at the University of Alberta in Edmonton, Canada. She is also a single parent to a 7-yr-old daughter adopted from China and a 12-yr old biological son. For the past five years, she has been actively involved in the conduct of research on speech and language development in children adopted from China. Recently, she has expanded her work to include children adopted from other non-English-speaking countries, such as Haiti. Karen has presented the results of her work at both professional conferences and parent support group meetings, and published in academic journals as well as adoption support group newsletters.