Should infants be raised bilingually?

The Pediatric Insider

© 2013 Roy Benaroch, MD

Carla wrote in, “I speak only English, and my husband speaks Spanish and English. Will it confuse our child to hear both languages? Or is it better to start speaking Spanish with him when he is young?”

In the past, some authorities had advised against speaking multiple languages in a household. The thinking was that two or more languages would confuse a child who was just learning to speak, causing frustrating and delayed speech skills. It turns out that this isn’t true at all.

Multiple good studies, like this one, have shown that simultaneous bilingualism—raising children to speak two languages at the same time—doesn’t cause or contribute to speech delays or speech-language problems. This seems to be true for studies done in many different countries looking at different combinations of languages. While some studies do show that at first, children may learn fewer individual words (or learn their first clear words more slowly), within just a few months these kids catch up, often surpassing the speech skills of their single-language peers by kindergarten.

Babies and toddlers have a unique gift for language. They can learn human speech just by listening and copying, without “practice” or translation. The best way to help young children learn to speak is to speak with them. Talk about what you’re doing, and what they’re doing; discuss what you see and what you hear. Give them a chance to answer back, and reflect clearly back at them what they just said. Speak just a little slower and a little more clearly, but don’t exaggerate your speech. It’s also very helpful to read books, over and over, pointing things out and talking about what’s happening. The more live, interactive human speech developing children hear, the better and faster their speech development is likely to be.

I recommend that bilingual couples (or couples with one bilingual member) embrace their second, or third, or even fourth language. Speak it just as much, if not more, than English. Kids growing up here in the USA, even kids who have two non-native-English-speaking parents, grow up speaking English well. If you want your kids to learn a second language as well as a native speaker, the time to “teach” is when they’re too young to know they’re being taught!

Stuttering: That’s all, folks

The Pediatric Insider

© 2010 Roy Benaroch, MD

Lara wanted to know about stuttering: “My son is almost two and a half and started stuttering a few months ago. I thought it was getting better, but it seems lately that he is doing it a lot still. I have read that most kids go through this stage and grow out of it at some point. I am wondering at what point should I have him checked out in order to correct it early on and how long I should wait to see if he grows out of it.”

Stuttering is an involuntary repetition of sounds, usually at the start of a sentence. Almost all children have an occasional stutter, especially when they’re young and their language skills are growing quickly. Although the exact cause of stuttering isn’t known, It seems like stuttering occurs when the brain can thinks thoughts faster than the mouth can say them.

Most kids who stutter will stop on their own, without any sort of formal speech therapy.  Look out for some red flags:

• Stuttering most commonly starts between age 2 to 3. If stuttering starts after age 3 1/2, it is more likely to continue.
• Children with a parent or sibling who has chronic stuttering are more likely to continue to stutter.
• Most stuttering will stop within 6-12 months after it begins. If your child has been stuttering longer than this, more help might be needed.
• Children who have other speech problems– like substituting letter sounds, or dropping parts of words– are at more risk for long-term stuttering.

For parents of toddlers who stutter, the best way to help is to remain calm, reassuring, and unconcerned. Speak slower, and don’t rush. Do not complete your child’s sentences or urge him to slow down, but rather just show with body language that you are patient and will wait for her to finish. Do not interrupt. Don’t try tricks like getting him to sing or anything like that. Ask fewer questions, and keep them simple. Watch how you and your family communicate, and set a good example by listening patiently to one another and paying attention when someone else speaks.

Stuttering is common and usually disappears as children pass the toddler years. If your child has some “red flags” or your family can’t relax and be patient when your child talks, speak with your child’s doctor about a referral to a speech therapist.

Additional info: http://www.stutteringhelp.org/

Tongue tie

The Pediatric Insider

© 2009 Roy Benaroch, MD

Kelly has a six-year-old son who has tongue-tie, but there are “…no speech problems, no eating problems…he just can’t stick his tongue out and taking temp under tongue is a challenge. Our ENT is recommending to clip. This requires general anesthesia.”

This is one of those questions that could get you some different answers… but since you posted it to my blog, you’re stuck with my response!

Tongue-tie means that the little flap of tissue under the tongue (the “frenulum”) is kind of short, so the tongue can’t lift off the floor of the mouth easily. The doctor-word for this (God forbid we talk like normal people) is “ankyloglossia”. Most of the time, the tongue also can’t extend far past the gums or out of the mouth. I’m not sure I’ve ever seen exact data on how far out a tongue should stick out, but most people can easily poke their tongues at least past their lips, so that’s probably “normal.”

In the good old days, if a tongue was perceived as “tied”, the pediatrician would take a little scissors and snippity-snip right there in the newborn nursery, packing some gauze under the tongue. Simple, I guess. But is it necessary?

Most of us feel that tongues come in all sorts of shapes and sizes and stick-out-ability. Rather than fixate on what the tongue looks like, I think a more reasonable way to look at it is just how the tongue-tie affects the child. If it’s a newborn who genuinely can’t nurse well
or a child with a speech problem, that probably should be repaired. But I don’t see the need to fix a tongue just because it can’t be stuck out very far. Maybe it’s better for children to find other ways to express themselves!

Talk with your children

The Pediatric Insider

© 2009 Roy Benaroch, MD

Language skills are fundamental to success, and speech skills learned in early childhood are strongly associated with later cognitive development. There are many products available that claim to give a child a “leg up” on learning—special videos, interactive toys, flashcards—but a recent study supports an old notion that the best way to help your children learn to speak is to simply talk with them.

In the 2009 study, published in Pediatrics, researchers used small digital recorders worn by about 275 children to determine how many words they heard each day, how much television they listened to, and how many interactive conversations they had with adults in their lives. They also measured each child’s language performance. On average, the children in the study heard about 13,000 words each day.

The number of words spoken to the child was strongly associated with improved language skills, but an even stronger effect was seen with conversational turns—that is, the number of times adults spoke with the child, taking turns in a conversation. Television was a negative predictor of language skills. More time listening to TV correlated with fewer conversations, and poorer speech development.

Speaking to your child is good; speaking with your child is better. Tell stories, interrupt yourself for questions, and allow your child to make up the next few sentences. Encourage back-and-forth conversations. Give your child time to think and respond, and show with body language and patience that you want her to ask questions back. You’ll get some laughs, you’ll learn about your child’s world, and you’ll help your child grow.

Late-talking twins

Holly posted this on the suggestions thread: “My 21-month-old b/g twins were 6 weeks early, but have hit big milestones (eating solids, crawling, walking, etc.) generally on target. They are, however, a little slow on speech. We have always spoken/read to them as adults, and their speech comprehension is very good. Both have had some struggles with ear infections, and my daughter is scheduled for an adenoidectomy soon. I have read in various twin literature that speech delay is not unusual with twins, but at what point would you recommend having them tested for speech delay?”

It’s true that at least mild speech delays seem to be more common in twins—some believe they have each other to “talk to,” and don’t need to learn Mommy’s language! I’m not sure that’s necessarily true, but you should certainly see if your children are in the usual range of speech skills for their age.