Wednesday, May 11, 2011

International Adoption and Language 1: When To Refer

Over five years ago now, my family became one of thousands of other families who have adopted internationally.  It was a decision that has forever changed me--so much so that I simply can't remember who I was before my beautiful baby boy entered my life. It was also a decision that made me wonder: how does being adopted internationally affect language development?

Until recently, our field didn't have a great answer to that question. We've studied the language development of children who grow up in bilingual homes for quite some time now.  Children who are adopted internationally, however, are generally not bilingual.  Unless their adoptive parents are fluent in their birth language, children who are adopted internationally do not usually speak two languages at one time. Instead, they start their language development in one language and then move into an environment where they lose access to their birth language and are suddenly surrounded by a brand new language.  Because international adoption was relatively rare until recently, we haven't had great information about what to expect out of children who go through a language transition like this.  Luckily, this is changing. Dr. Sharon Glennen, speech-language therapist, professor at Towson University, and fellow adoptive mom, has been studying the language development of young children who were adopted internationally and has put out some guidelines to help. Here's what she has found.

When To Seek Out a Speech-Language Therapy Evaluation

When a young child is adopted internationally, her language will undergo a transition. For a period of time, she will struggle to communicate effectively in her new language. This is expected. However, during this period of time, there are clues in other areas of development that can provide insight into her potential for language development.  Even when a child is making a transition in language, we can still take a peek at her use of eye contact, play, and gestures.  Children who are adopted internationally may struggle to use verbal words at first, but their use of eye contact, play, and gestures should not be affected by the switch in languages. And because these areas of development are closely related to language development, they can help us decide if a child is at risk for a language delay.  If you, as a parent, have recently adopted a child internationally, you can check out these posts to find out what your child should be doing with play and gesture use. Find your child's age, click on the post, and read the sections about gesture use and play.

If your little one isn't yet using gestures and play as expected for her age, you may want to consider talking to your pediatrician about a referral to an early intervention specialist.  Use your judgment, of course, in deciding how quickly to act. Your little one needs time to connect with you and feel comfortable in your home; unless something is really concerning you, there is nothing wrong (and probably a lot right) with giving her a bit of time to make the transition into your home.  Once she's comfortable with you, she may reveal whole new sides that you didn't know she had upon first meeting her. But do keep an eye on her eye contact, her use of gestures, and her play skills. Once she is comfortable with you, these areas of development should be at age appropriate levels pretty quickly. If they're not, a good early interventionist can teach you strategies to nudge those areas of development along a bit.

If your child is using eye contact and gestures and play as expected for her age, then there are some additional guidelines to consider to help you decide if she is learning her new language as we'd expect. The guidelines are different depending on the age that your little one arrived in your waiting arms.
  • If your child arrived home before the age of 12 months, you should seek out a speech and language evaluation using the same guidelines as a child who had spoken English all her life. You can review what to expect out of children at different ages here,
  • If your child arrived home between 13 and 18 months of age, you should seek out a speech and language evaluation if she's not using 50 words and/or two-word phrases by 24 months,
  • If your child arrived home between 19 and 24 months of age, you should seek out a speech and language evaluation if she's not using some English words by 24 months, 50 words by 28 months, and 2-word phrases by 30 months,
  • If your child arrived home between 25 and 30 months of age, you should see out a speech and language evaluation if she's not using 50 words and 2-word phrases by 31 months, and
  • If your child arrived home after 30 months, you should seek out a speech and language evaluation if she doesn't start to understand you pretty well within a few weeks of coming home. You can also expect her to develop a significant English vocabulary within 3-6 months.
Whew! Is your head spinning yet? Mine is! You'll need to use a bit of flexibility with these guidelines, of course. If your child arrives home at 30 months and 17 days, for example, it is probably a stretch to expect her to be using 50 words and two-word phrases in her new language by 31 months. And, since exact birth dates are often unknown in international adoption, you'll definitely need to take these guidelines with a grain of salt if you are unsure of your child's age.

For those very interested parents and speech-language therapists out there, Dr. Glennen has quite a bit more data to explore, too. You can find it here.  And, for more information on what to expect out of language development in children who were adopted, click here.

Also see:
Glennen, Sharon, (2009). Assessment and Intervention for Internationally Adopted Children: ASHA Self Study. Rockville, MD


  1. Thanks, Becca, for this post. I sure could have used it when my children first came home! And thanks for jumping over to my blog to answer the concerned parent in the comments!!!

  2. Our pediatrician and our dentist disagree about how close our daughter's estimated age is to the real one. We are just happy that her language abilities are improving steadily and that she seems to be catching up to her peers at daycare that have always spoken English.

  3. Our son came home at 10 months old, but our International Adoption Specialist was not worried about his language delays until he was 2, then she referred us to various groups for evaluation, but we discovered we can not get any assistance until our son is 3 years old. It is very frustrating. We are doing everything we can on our own. Your website is a great resource for helping us through! Thank goodness I found it!

  4. Just found your blog. I love it. I am an SLP in Utah. I'm relatively new to the field and I so appreciate all the blogs and thoughts out there. Thank you for posting. I just recently started a blog of my own to try to put together some of the ideas and resources I have found over the years. Feel free to visit whenever. I would love some feedback and collaboration.

  5. Very useful info and I'm sure it will help many thanks for visiting my blog and I'm returning the bloggy love.

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  8. Our son had some speech issues and one of them was that we spoke 2 languages at home. Speech therapist was a lot of help to us. Stumbled back

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  10. @Dancing Mama,

    How frustrating! I'm so sorry. Why can't you get help for your son until he is three?? Are they saying he doesn't qualify? Would it help to show them some of Dr. Glennen's data?

    Feel free to e-mail me at if you want to brainstorm how to access help for your son. Otherwise, just keep on using some of the strategies on this blog and others you might find. You really are his best teacher and you are probably doing a lot more than you think. :)