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Bilingual Family Intervention

By Dr. Brenda Gorman, CCC-SLP, Lingua Health Advisory Clinical Director and Marquette University Assistant Professor, College of Health Sciences Speech Pathology and Audiology

Dr. Brenda Gorman, CCC-SLP

Dr. Brenda Gorman, CCC-SLP

I recently received an inquiry from a father who was wondering about best intervention practices for children who are simultaneously learning two languages. His questions are so important, that, with his permission, I share his inquiry and my response with you.

“Dear Dr. Gorman,

I came across your work while researching treatment methods for language delays. My son is being raised in a bilingual household with a Portuguese-speaking mother and English-speaking father (me) in Brazil and has a language delay. Our therapist agrees that bilingualism is not the cause, but has suggested that we focus our attention on Portuguese, saying that learning two languages at the same time is more difficult and that English should be reduced to maximize Portuguese exposure.

I am my son’s main caregiver outside of daycare, and the therapist has asked me to not repeat or support the Portuguese exercises done in therapy in my own language. For example, if my son is learning colors in Portuguese therapy, I should wait at least a week to teach him colors in English. I was wondering if you would mind sharing your thoughts on these kinds of cases, and what the current research is showing about the best form of treatment for bilingual children.

Thank you so much for your time and consideration.”

“Thanks for your question.

There is no research evidence indicating that bilingual children with language delay do better if reduced to one language. Experts in speech-language pathology believe that parents should communication with their children in the language they speak best. The research does, however, provide very compelling evidence indicating cognitive benefits of bilingualism, among many others. Therefore, I would continue using the language in which you are most comfortable with your son.

Regarding vocabulary targets, I have observed that some children who are learning two languages simultaneously respond just fine when the therapy targets are similar in both languages. However, I have also noticed that some simultaneous bilingual children are more motivated in therapy when the activities and vocabulary targets differ by language. In other words, rather than repeating the same lesson in both languages, some children appear more motivated when the targets are selected to match the real language context in which they are more likely to use them.

For example, we saw a simultaneous bilingual child who had been receiving alternating-day intervention, in which the clinician presented the lesson in English on one day and then in his other language, Spanish, the next day. The child was making adequate gains in English but minimal gains in Spanish, and the clinician and parents were discussing giving up on the Spanish. When I was asked to consult, I recommended changing the plan to alternate the language and themes biweekly. We (the graduate student clinician and I) chose English language targets and activities that supported the skills he needed to be successful in his school setting (he attended school in English), and then the parents helped the clinician determine relevant Spanish targets and activities to help him be successful in his home setting (the parents spoke exclusively Spanish in the home). The child’s interest and progress was closely monitored, and his parents reported that this model was “mucho más efectivo” (much more effective) and motivating for him.

There is not as much research out there regarding bilingual therapy as we’d like, so sometimes it takes some creativity to figure out what works best for a particular child. The family is now thrilled they didn’t give up on the Spanish, which is very important for the child’s full participation in his family and community.

I would recommend that you and your clinician select targets that are most important and relevant for the language contexts in which your son is likely to use them. For example, what types of words/activities would help him communicate most effectively with you in English? Then, what targets/activities would help him best meet him communication needs in Portuguese? Sometimes these may be the same in both languages, but they do not always need to be. The key is for therapists and parents to work together to discuss the best approach to meet the child’s needs, to monitor the children’s response, and to modify the approach if needed.”

“Thank you so much.

Your informative reply is so helpful and will give me more confidence with this issue while working with our son and therapist. Most of the specialists we have met along the way have discouraged bilingualism, saying that as a child with a language delay he was “too fragile,” though the therapist we settled on is a bit more open. I will keep in mind what you wrote about using context-based learning targets for each language and see if the therapist can help me find targets for the English side as well as the Portuguese.

Thank you again for your kindness in taking the time to write; it’s a relief and a blessing to hear your more positive view on bilingualism based on evidence, and to have a sense that we are on the right track.”

I hope you find this helpful. See also “Language Intervention from a Bilingual Mindset” by Elin Thordardottir at

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