As a pediatric speech pathologist, I have had tremendous opportunity over the past few years to work with children adopted from many countries. The greatest number have come from China between the ages of 6 months and 3 years. In my opinion, all adopted children should receive both close professional observation for developmental milestones, and extensive medical evaluations.
The most important result of early assessments is to give adoptive parents extensive information about the well-being, health, and development of their child. This knowledge empowers families then to offer the best start in life. I have personally seen numerous children who, after being evaluated as developmentally delayed across the board, absolutely flourish following early intervention services. I have witnessed, for example, a 3-year-old adopted from Eastern Europe, whose usual verbal pattern with her family was to screech and scream. With the aid of speech and language therapy, she quickly adapted an appropriate sound level. As services progressed, this little pupil acquired other communication skills at a rapid rate. Once, she even picked up appropriate gesturing during the very moments the therapist was demonstrating them.
Parents must recognize that children who may not have been adequately nurtured will almost always show some form of developmental delay. This does not mean they then must suffer dramatic, lifelong difficulties. What it does mean is, such children need our help. They need an extra push -- a concentrated exposure to auditory feedback and reinforcement, particularly from a source outside the family -- from someone other than the emotionally associated primary caregiver. This experience enables many children to overcome whatever they missed in the earliest stages of their life.
Formal testing reveals that internationally adopted children often initially fall below age expectations in motor abilities, cognitive development, and language/communication skills. They then receive services to address those needs and "catch up." Whatever the combination of delayed skills, language delay is the most common. This makes sense, since these children have moved from one language environment to another during critical periods of development.
Evaluation for the youngest children examines factors that affect pre-language communication skills, such as facial response, an early cooing stage, and basic social interaction. Older children who lived in their native country beyond the customary age of language acquisition (generally 15 months to 2 years) require bilingual evaluation to check, for instance, if they can put two words together in their native tongue. Often these youngsters show delays in both languages, as their primary tongue possibly was not sufficiently nourished because they were institutionalized with little interaction, language exposure, or reinforcement to sounds.
Approximately 70 percent of the internationally adopted children I evaluate test significantly below age expectation for language skills. Speech and language therapy follows. This approach isolates and structures language in a very consistent, fun format. It infuses the child's auditory environment with the sounds that present difficulty, while providing a nurturing setting for practice and experimentation. This enables children to make language connections at a faster rate than would otherwise happen.
For most internationally adopted children, speech delays are transitional. Success rates are very high, following auditory stimulation therapy. Speech and language therapy often dramatically increases the rate of second language acquisition and eliminates emotional distress by setting up opportunities for early success. It affords children the social advantage and helping hand that they need to catch up with their peers. The developmental improvements that follow speech therapy, based on my experience, encourage both the individual children and their families as well.
If you would like more information on speech and language acquisition or other issues mentioned in this article, call SPARK at 212-360-0259 or e-mail firstname.lastname@example.org.