Transcript Speech and Language Development in Multiples

Marinet Brennan
Consultant Speech-Language Therapist
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Delayed communication development is the most
common symptom in children under 3 yrs,
affecting 5-10% of that population.
Numerous factors interfere with normal
environmental interaction and can increase the
risk for a delay.
Just like singletons and other typically developing
children, twins and multiples are at risk for
developing speech and language difficulties.
Twins have a greater risk (or are more likely to)
experience speech and language difficulties
because of specific biological and environmental
factors:
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Biological factors include: Low birth weight, Time of
Gestation or Prematurity, Apgar Score.
Environmental variables: speech to the children – (i)
receive less directed speech from their caretaker; (ii)
participate in fewer situations where their attention is
specifically and mutually engaged with the caretaker
– both necessary (to some extent) for language
learning & development. ‘Twin situation’ – each twin
receives relatively less individually directed parental
speech. Often participate in 3-way conversations
(parent & co-twin).
Researchers have concluded that environmental
variables are more important than biological
variables.
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Multiples vs Singletons: Compared on language
measures – twins tended to have shorter
sentences, less speech overall, less speech
directed towards mother, slight difference in
vocabulary (Mittler, 1970).
2.5 yrs - Reynell test (language comprehension &
expression) (Hay et al., 1986).
Expressive:
boys 2-6 months behind norm;
girls about normal.
Receptive:
boys 4 months delayed;
girls at/slightly above normal
Language delay in twins when compared to
singletons is mild yet prevalent, particularly in
males
 200 twins & 100 singletons (aged 4yrs)
– 6 month delay.
 Predictors of performance (other than ‘twinness’): birth weight & age at first word.
 Those producing their first word later than 18
months performed significantly poorer on Illinois
Test of Psycholinguistic Abilities than those
producing their first word before that age.
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Tendency to complete each other’s utterances
Syntactic or semantic adaptations to twin status,
e.g. Misuse of plurals and pronouns.
Twins less frequently use their own name
compared to singletons.
Twins more advanced than singletons: acquire
the ability to use of ‘I’ relatively quickly.
One multiple talk for another reducing need for
the quiet child to talk.
Personality differences & gender (girls = more
verbal than boys)
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Idioglossia - a unique system (private language)
that works only between twins.
Spoken language or language of gestures and
body language.
Rare - will generally disappear spontaneously.
Most often seen in twins with immature /
disordered language, especially when twins are
performing at the same developmental level.
Twins are less adventurous in their use of words
when playing with each other than when they are
with an adult.
They use simple language and fewer words when
they talked to each other.
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An early delay in language acquisition does
not necessarily mean a child will have
language or reading problems later in life
(Dale,2004).
“half of them won’t have problems and will
catch up with their peers; the other half will
have problems (temporary or enduring delay)”
Plomin & Dale, 1998.
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No words by 18 months.
Considered ‘late talker’ if less than 50 words at 24
months.
If your twins are late to talk it is important not to
assume that they will automatically catch up in time.
Realising early that your child may have a speechlanguage or developmental delay is key in increasing
the chances for improving communication skills down
the line, preventing him/her from falling further
behind.
Good precaution to see SLT: assess and monitor at
regular intervals.
Check your child’s hearing regularly.
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12-18months: say first words, understand
simple directions, know their own names,
give you a toy if you ask for it, look at picture
book with interest.
18-24 months: put 2 words together, learn
words quickly, copy adults, ask & answer
simple questions.
24-36 months: listen to stories, like to play
pretend games, why questions, use ‘no or
‘not’ a lot, enjoy naming objects in picture
books, answer yes-no questions.
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Language delay in twins relates to sociallanguage experience  appropriate
intervention and remediation of language
delay should focus on providing a more
stimulating language environment both
inside the house and outside the home.
Environment really matters!
The amount and the way parents talk to
children is very important and influences how
well they will learn language.
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Help reduce their risk by providing a language-rich environment.
Parents have a critical role in their twins’ speech and language
development.
You can never talk enough when youa re with your twins.
Talk about what you are doing and why you are doing it, e.g.
“Mommy is thirsty. Mommy is making a cup of tea to drink.
Mommy switches on the kettle ...”
Comment on what your twins are doing.
Expand on your twins’ utterances, e.g. “mmm”  “mmm, that
milk tastes good. The milk is cold.”
Avoid baby talk.
Incorrect pronunciation – repeat it back to them the correct way,
emphasizing the sounds in the words. Don’t expect them to
repeat it correctly back. Do praise any attempts.
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Encourage your twins to talk. Tell mommy, use
your words. Offer choices. Ask questions to
encourage words, e.g. “what do you want?”
Take time to sit down on the floor with your
twins and play with their toys. Play = great way
to build vocabulary, expand language, teach
social skills.
Reading! Turn book reading into a conversation –
talk about the pictures. Make comments. Ask
questions. Read with animation. Explain words.
Act out words. Use objects. Encourage
participation (finish a line, predict, name).
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Get into habit of talking to one child at a time.
Give instructions to each child individually &
praise individually.
Teach the importance of turn taking and good
listening behaviour.
Try to have 1 child finish their conversation with
you. Make sure you listen without interruption.
When 1 child asks a question, answer that child
directly.
Create opportunities to talk to 1 child at a time.
Family walks: 1 direction & 1 opposite direction
or leave earlier. Bath once a week separately –
special interactive time alone.
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Bilingual: experts recommend that each adult
stick to a designated language to avoid
confusing a child who is trying to become
bilingual.
Refer to SLT if your child:
 Lengthy meals – no longer than 30min
(45min max)
 Gagging, choking, coughing during / after
mealtimes.
 Pocketing food, spitting out lumps, food
refusal and avoidance.
 Wet gurgly voice.
 Chewing difficulties.
 Multiple swallows.
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NO! to baby bottles and soothers (after 2yrs) and
a word of caution about sippy cups
Young children learning to drink independently can
compensate by biting onto spouts during drinking.
Doesn’t help develop a good swallowing pattern.
Bite on the spout to stabilise the cup or put their
tongue underneath the spout thus reverting back to
an immature suckling pattern that can cause tongue
protrusion & can develop an incorrect swallowing
pattern.
Cause poor dental hygiene and dental cavities:
Journal of Dentistry for Children, nearly two-thirds of
toddlers with tooth decay problems used sippy cups.
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Mr Juice Bear or Honey Bear.
Straw drinking: target lip strengthening, lip
rounding and tongue retraction. Encourages a
more mature drinking pattern.
Special spill-proof lid.
A word of caution: use only lips during straw
drinking (no more than ¼ inch into the mouth).
Watch out for bite marks on the straw and
tongue is not under straw.
An alternative: Kids Smoothie cartons (e.g.
Innocent Smoothies).
Open-cup drinking = good!