Stuttering and the Bilingual Child

According to the recent United States Census, one in seven, or 31.8 million, people in the United States speak a language other than English in the home. It is unknown how many people who stutter are bilingual, but it is safe to estimate that at least a half million people in the United States who are bilingual also stutter.

Research has shown that a child's language skills can affect his or her fluency. Many young children who are in the beginning stages of stuttering will show an increase in stuttering when they use:

• New or longer vocabulary words.
• Complex grammar, such as longer sentences containing words like and, but, or because.

Many treatment programs suggest that when young children are stuttering, it is best to simplify the language that's being spoken to them. But what if your child speaks more than one language?

What is Bilingualism?

Currently, there is no one way to define bilingualism. Although many definitions have been suggested, the following definition may be most appropriate for young children: Bilingual refers to those children who speak/have been spoken to in two (or more) languages in the home since birth and who are spoken to in only one or both of those two languages at daycare/school.

Also, some children are referred to as second-language learners. A child who speaks/has spoken only one language at home since birth and is then exposed to a second language after age 3 is a second-language learner.

How Does Bilingualism/Second-Language Learning Affect Fluency?

In young children who are bilingual or second-language learners, stuttering may be noticed when:

• The child is mixing vocabulary (code mixing) from both languages in one sentence. This is a normal process that helps the child increase his skills in the weaker language, but may trigger a temporary increase in disfluency.
• The child is having difficulty finding the correct word to express his/her ideas resulting in an increase in normal speech disfluency.
• The child is having difficulty using grammatically complex sentences in one or both languages as compared to other children of the same age. Also, the child may make grammatical mistakes. Developing proficiency in both languages may be gradual, so development may be uneven between the two languages.
• Adding a second or third language between the ages of three and five years of age may cause stuttering to increase (become more severe). However, this may be the case only when: (1) the child's first language is not strong and/or the child is experiencing difficulties in her first language, (2) One language is used more than the other or, (3) the child resists speaking the additional language.

Recommendations and Suggestions for Parents

Will speaking to my child in two languages at home make him/her more likely to start stuttering?

No evidence has been found to suggest that speaking two languages in the home since birth causes stuttering. In fact, this may be the best time and the best way to input a second language.

My child has been receiving two languages in the home since birth and now he/she has started to stutter. What should I do?

If your child is bilingual and he or she begins to stutter, we recommend the following:

1. Monitor the stuttering in the child's strongest language as that is generally where the most frequent stuttering would be noted.
2. Follow the recommendations for stuttering prevention outlined in previous publications of the Stuttering Foundation.
3. If stuttering persists for more than six months, see a speech pathologist specializing in stuttering.
4. Avoid mixing vocabulary words from both languages when speaking to the child. In other words, speak one language at a time to the child.
5. Allow the child to mix vocabulary in both languages, but then model the word in the primary language. Don't ask the child to repeat your model.

Will introducing my child to an additional (second, third, etc.) language between the ages of three and six years make him/her more likely to start stuttering?

There is no indication that teaching your child another language creates stuttering. Additional languages are often introduced around age four, which can be a critical age for both language learning and stuttering. If your child's strongest language is not developing appropriately for his/her age or you notice the beginning signs of stuttering, you may want to seek consultation with a speech pathologist and hold off on the introduction of an additional language until after age six. The literature suggests that introducing a second language as late as or even after grade six can result in proficiency.

My child has recently been introduced to an additional language and has also started to stutter. What should I do?

If your child is a second-language learner or a bilingual second-language learner and he or she begins to stutter, we recommend the following:

1. Help your child with new/difficult words by prompting the word when you know what it is. For example, you can prompt your child by giving the first sound of the word, or by providing a cue about the word's meaning.
2. When talking with your child, avoid mixing words from both languages in the same sentence or sentences.
3. Allow your child to use words from both languages when he is speaking.
4. When you notice your child having difficulty using vocabulary or grammar in the stronger language, it is important that you simplify your own language.

Recommendations and Suggestions for Speech Therapists

When treating a child who speaks two (or more) languages, we recommend the following:

1. Carefully determine the nature of disfluency to determine whether the child is stuttering or merely struggling with linguistic development in two languages. A good place to start would be in taking a language sample to differentiate between normal speech disfluencies (NSDs) which may characterize second-language learning rather than stuttering.
2. Compare the types and frequency of disfluency between the two languages spoken to see if the disfluencies noted are seen in both languages. If a high percentage of NSD occurs in only one language, this may be a result of limited proficiency in the language rather than from stuttering.
3. If you initiate direct treatment for stuttering, treat the child in his/her stronger language and monitor the weaker language(s) to determine whether the treatment effects carry over when the second language becomes more complex.
4. When the child is resisting speaking a second-language, try to find out the reason why. Often the child may have been asked to perform in the second-language and this may be the cause of the resistance. Never force, as this puts additional pressure on the child to speak.