Speech-Language Development in Children Adopted from China

Karen E. Pollock, Ph.D., CCC-SLP

University of Alberta

Background and Rationale

I am a Professor and the Chair of the Department of Speech Pathology & Audiology at the University of Alberta.  Prior to assuming this position in January 2003, I was on the faculty at the University of Memphis for 13 years and at the University of Northern Iowa for 3 years.  My primary research and teaching interest is children’s speech and language development and disorders. I have published research in refereed professional journals and some of my previous research was funded by the National Institutes of Health in the U.S.  [click here for more information about me and my research]

I am also the mother of a daughter adopted from China. Over the past several years, I have become increasingly interested in the speech-language acquisition patterns of children adopted from China. In my position, I have often been approached by concerned parents with questions about speech and language acquisition. Parents want to know whether or not their child is acquiring English at a normal rate and, if not, whether they should take a “wait and see” approach or seek professional services such as speech-language therapy or early intervention.

The biggest obstacle to answering these questions is that we simply don’t know much about the nature and course of speech-language acquisition in internationally adopted children. They face a unique learning situation, with (for most) loss of first language exposure and onset of second language exposure occurring abruptly and simultaneously. And this frequently occurs at a critical time for speech-language development – late infancy and early toddler years.  At the time I began this line of research, there were a couple of published reports on children adopted from Romania in the early 90’s, and a handful of more recent studies on children from eastern European countries (e.g., Glennen & Masters, 2002). But there were no comparable large group studies focusing on the speech-language abilities of children adopted from China. Anecdotal and personal experience suggested that most (but certainly not all) children began talking within several months following arrival in the U.S. (if not before) and were indistinguishable (in terms of their speech and language skills) from children born and raised in the U.S. within one or two years. However, some children did not acquire English within this time frame and required speech-language therapy.

It would not be surprising to find that children adopted from China had a high incidence of speech-language delays/disorders, given the lack of stimulation in the orphanages, developmental delays in other areas, and the abrupt switch from Chinese to English. Studies of children adopted from Romania in the early 90’s found that although about 20% thrived, 60% had long-term problems, and 20% showed little or no improvement.  A study by Miller and Hendrie (June 2000 issue of Pediatrics) of children adopted from China stated that 43% of their sample had language delays. But it is important to recognize that in this study, most (88%) of the children were evaluated less than two months post-placement, too early for them to have had much exposure to English. It is not reasonable to expect them to perform at the same level as American-born peers exposed to English from birth. Miller and Hendrie themselves stated that the long-term effects of the various medical problems and developmental delays were unknown, and suggested that they may be at risk for problems such as hyperactivity, attention deficit disorder, learning disabilities, and persistent language delays as they enter the school years.

Promising Recent Research

Recent studies of children adopted from China and Eastern Europe are finding very promising results for speech and language development in internationally adopted children.  Although there is considerable variability in the first several months home, by two or more years post-adoption the vast majority of preschool-aged children tested appear to do quite well with language (scoring within the average range for their age), and some are excelling (that is, scoring higher than average for their age).   However, there also appear to be a small percentage of children who have significant difficulties acquiring English, and require the assistance of early intervention, speech-language therapy, or other professional services.  The results of several recent studies are summarized on this web site. 

[click here to read more about recently Completed Projects]

Critical Need for Additional Research

Although we have learned a lot in the last several years about the remarkable abilities of many internationally adopted children to acquire English, many questions remain unanswered.  What is the typical course of language development for internationally adopted children?  How long should it take them to “catch up?”  Are there certain early behaviors that might predict later language skills?  Taking a “wait and see” approach might be fine for children who simply lack sufficient exposure to English, but such an approach can be devastating when there are true underlying problems because precious time is wasted.  Earlier identification of underlying speech-language problems could lead to earlier intervention and perhaps even the prevention of longer-term problems. 

Speech-language pathologists need normative data to be able to interpret the performance of our children on speech-language tests, especially during the early years post-placement.  In the absence of such data, they are left to compare a child’s performance to that of monolingual English-speaking children (obviously an unfair comparison) or to make subjective judgments based on past experience and anecdotal evidence. Thus, there is a critical need to collect normative data in order to develop guidelines for determining whether a child’s language skills are within normal limits or significantly delayed relative to their peers (that is, other children adopted from China).   

There is also a need for information about later language and academic abilities, such as reading and writing, as our children get older.  Children who appear to have adequate  English conversational skills during the preschool years may still be at risk for language-learning problems in the elementary school years and beyond, as more complex language skills are required.  It is important to continue to follow the children who participated in earlier studies as they reach school age.

[click here to read more about Ongoing Projects]