Combatting Myths About Bilinguals With Language Disorders

By Kerry Danahy Ebert & Giang Pham
August 31, 2020

Speech-language pathologists and other communication professionals often perceive children and adults who speak more than one language to be a challenging population to serve. Yet in many parts of the world, speaking more than one language is the norm. Even in the United States, which has been considered a monolingual English-speaking country, nearly one in four children speak a language other than English at home.

Why are bilinguals seen to be a unique challenge for clinical practice in communication disorders? Bilinguals are a heterogeneous group, and the variability in experiences precludes a “one size fits all” approach. Beyond this inherent variability, however, a great deal of misinformation about bilinguals with language disorders persists. This misinformation may contribute to the perceived difficulty of serving this population. Here we debunk five commonly held myths about bilinguals with language disorders.

Myth #1: The first language a person learns will remain their strongest language.

Language proficiency is determined by several factors, not just the age of exposure to a language. The frequency with which a language is used and its importance to communication in the broader community are also both important to language proficiency. For children born into households that speak a language other than the majority community language (e.g., English in the United States), there typically is a shift to stronger proficiency in the majority language (i.e., the child’s second language) sometime during childhood. Even adults who immigrate or otherwise shift their language environment may develop stronger skills in a later-learned language. Clinicians should not assume a first language is strongest.

Myth #2: Treatment targets that we address in one language will improve in the other language, too.

The limited research on treatment of language disorders in bilinguals – both adults and children -- indicates that transfer of learning between languages is not automatic. This means that clinical language professionals cannot focus solely on a single language in treatment and simply assume that any learning in that language will transfer to the other. The good news, however, is that cross-linguistic transfer is indeed possible for both children and adults. Clinicians should carefully consider treatment targets and approaches to facilitate this generalization across languages.

Myth #3. In order to fairly assess two languages in a bilingual client, we should administer the same tasks in both languages.

It is true that bilingual individuals should be assessed in both languages in order to provide a complete picture of their language skills. Interpreting this recommendation to mean the same tasks should be done in both languages (and presumably compared to each other) is counterproductive for both clinician and client. Assessments should be matched to a client’s needs. To use an extreme example, it is clearly unnecessary to assess a client’s written language skills in a language for which they have never received reading instruction, simply because written language skills were assessed in their other language.  For clinicians, the assumption that formal and equivalent testing must be done in both languages may discourage any attempt at bilingual evaluation at all. Instead, clinicians should carefully consider what aspects of language are most important to assess in each language spoken by a client (e.g., the language modalities, vocabulary, and discourse formats that are necessary to meet communicative needs and environmental demands) as well as the different methodologies that can be used to gather assessment information (e.g. family interview; review of records; collaboration with interpreters).

Myth #4. A bilingual adult who acquires aphasia will experience a greater impact in their second language.

A “last in, first out” principle has long been assumed for bilinguals who acquire aphasia. This principle means that bilinguals will be more likely to lose a second or later language, and to have more difficulty regaining skills in this language, than in their first language. The roots of this myth are likely tied to Myth #1, and the response to this myth is similar: patterns of language loss and recovery in bilingual aphasia are influenced by factors beyond age of acquisition. Again, usage patterns – both pre- and post-injury – play a critical role in determining language outcomes in bilingual aphasia.

 Myth #5. Children with language delays can likely learn more than one language, but this isn’t a realistic goal for children with more severe disabilities.

The myth that children with language disorders cannot learn more than one language has been one of the most persistent and damaging in the field. After years of research on bilingual children with developmental language disorder (a primary or relatively isolated language disorder), there may finally be a shift in understanding that children affected by this disorder can indeed be bilingual. But what about children whose disabilities have more profound effects on their development, such as those with intellectual disabilities or autism spectrum disorder? These children, too, deserve the ability to communicate in all the settings of their daily lives. If this means they must learn more than one language, then that must be the overriding goal of language intervention. Evidence to date supports this goal: bilingual children with autism or with Down syndrome show comparable language skills to their monolingual peers.

Addressing the myths surrounding bilinguals with language disorders is a first step in improving clinical services to this population. Bilinguals are individuals who need two languages to communicate across home, school or work, and community contexts. Clinical professionals can prepare themselves to support this need in their bilingual clients with language disorders.