From a practical standpoint, bilinguals can be defined as individuals who use more than one language in their daily communicative interactions (Grosjean, 1982). In the global village, more than half of all children learn at least two languages. In many cases, these children are from families in which one language is used at home, and another language is used in school and the larger community. In other cases, children live with bilingual parents in dual-language communities, with two languages coexisting and interacting across contexts. The point here is that bilingual children regularly function in environments in which two different languages are used. In order to be successful in these environments, both languages are needed.

Most bilingual children become extraordinarily skilled in speech and language, just as do most monolingual children. However, it is also clear that a small, yet significant subset of bilingual children will have chronic deficits in communication. These impairments are not due to environmental differences, but rather to some breach in the integrity of the childs internal speech or language processing system, as it interacts with the available input. Although there are currently no studies on the extent to which communication disorders, in general, and Childhood Apraxia of Speech (CAS) in particular, exist among bilingual children, we anticipate that the rates are similar in monolingual and bilingual populations. The general purpose of intervention in CAS is to assist children in achieving their full potential as communicators, considering both their capacity (e.g., current weaknesses relative to strengths) and the environmental demands that determine success (such as literacy or communicative competency in more than one language). Thus, the overall purpose of intervention for the bilingual child with CAS must be to affect positive change in their ability to communicate in both/all languages used in their home and community.

Well-intended clinicians and educators often advise parents of bilingual children with communication deficits to “pick a language.” This advice is based on the assumption that bilingual children with speech or language impairments fare worse than monolingual children with similar impairments. There is no evidence to support this claim (see Gutierrez-Clellen, 1999 and Paradis, Crago, & Rice, 2003 for counter-evidence). This advice fails to recognize the interrelated neurological representations of the childs two languages, built up over time and experience. Moreover, when we intentionally limit a childs opportunities to fully participate in all aspects of his home or community, we fail to recognize the fundamental links between communication, self-esteem, achievement and cultural identification that form the cornerstone of successful clinical intervention (see Kohnert & Derr, in press for additional discussion).

Is it more challenging to support two languages in children with speech or language impairment? Absolutely. The territory is generally unchartered and the waters are surely choppy. Is it worthwhile? Most definitely. Can competent clinicians who do not speak both of the childs languages support bilingual development Yes! There are many options culturally competent clinicians may use, including parallel programs implemented in each of the childs languages in collaboration with family members and bilingual paraprofessionals, or bilingual approaches that target speech skills common to both languages within structured tasks (see Kohnert & Derr, in press).

From this perspective, the critical clinical question becomes: How can we structure intervention to promote gains in both languages of the bilingual child with CAS? The best approach to intervention will depend on a number of factors, which include the severity of the disorder, the extent to which various languages are used in the home and other environments, and child-related issues such as physical impairment and/or learning problems. Even if production practice is focused more consistently in a single language, the child will benefit in significant ways from continued systematic exposure to all of the languages used in the home and community. In summary, professional understanding and respect for bilingualism and its relationship to all aspects of development is fundamental to successful intervention in children with CAS.

References:

Grosjean, F. Life with Two Languages: An Introduction to Bilingualism. Cambridge, MA: Harvard University Press, 1982.

Gutierrez-Clellen, V. “Language Choice in Intervention with Bilingual Children.” American Journal of Speech-Language Pathology 8 (1999): 291302.

Kohnert, K., & Derr, A. “Language Intervention with Bilingual Children.” Bilingual Language Development: A Focus on Spanish-English Speakers. Ed. B. Goldstein. Baltimore: Brookes, in press.

Paradis, J., Crago, M., Genesee, F., & Rice, M. “French-English Bilingual Children with SLI: Do They Compare with Their Monolingual Peers?” Journal of Speech, Language, and Hearing Research 46 (2003): 113127.

(Kathryn Kohnert, Ph.D., CCC is an Assistant Professor in the Department of Communication Disorders at the University of Minnesota. Her research investigates theoretical and practical issues related to effective assessment and intervention with culturally and linguistically diverse populations. Dr. Kohnerts publications include empirical studies on cognitive-linguistic processing in bilingual children and adults, and clinical intervention programs for Spanish-speaking children with phonological impairment. Ruth Stoeckel, MA, CCC-SLP from Rochester, Minnesota, has a breadth of experience working in the schools, private practice as both therapist and training consultant, private rehabilitation agencies and clinics. Ms. Stoeckel is a doctoral student at the University of Minnesota and is employed at the Mayo Clinic, evaluating and treating young children with a variety of speech-language difficulties, including children with motor speech disorders. She is also a member of the Apraxia Kids Professional Advisory Board.)