Season 1, Episode 20: Dr. Sharon Glennen describes her research examining speech language outcomes among adopted children. She discusses the complex interactions between genetic and environmental factors in language development and how they explain the variability of outcomes among adoptees as well as serve as predictors for resilience in children experiencing risk factors for poor language outcomes. Dr. Glennen describes the unique experience of international adoptees learning new languages post-adoption and how this is similar to and different from traditional bilingualism in non-adopted children. Dr. Glennen also outlines the typical trajectory of internationally adopted children’s learning of new languages, varying by age at adoption, and what factors should trigger a referral to a speech language pathologist for these children. She ends by discussing ways that parents, speech language pathologists, and school personnel can work as a team to provide relevant services and accommodations for adopted children who qualify for these supports.

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Routledge Handbook of Adoption

Transcript

Dr. Emily Helder: Hello, I’m Dr. Emily Helder, and I’m here with Dr. Sharon Glennen. Who is a Professor of speech language pathology and audiology at Towson University, and also the author of a chapter in the Routledge Handbook of Adoption, entitled “Speech and language development in adopted children.”

So thanks so much for being here.

Dr. Sharon Glennen: Well, thank you for inviting me.

Dr. Emily Helder: Yeah. So I wanted to talk about both some themes in the chapter that relate to wider things related to child development, as well as some practical issues. So starting out, one of the things that you begin with in the chapter is a discussion about how genetics and environment you know, the relative role of those, how they interact to impact language.

And it really made me think a bit about how we’ve moved away from more… a more simplistic idea of nature versus nurture. And so I wondered if you could talk a bit about that complex interaction.

Dr. Sharon Glennen: It’s definitely both. So, you know, we know even from non-adopted children that language abilities are a combination of the genetics you’ve received from your parents, but then also the environments that you’re raised in, and we talk about shared environments and non-shared environments.

Shared environments being the things that you and everyone around you have in common, being in that environment. And then non-shared would be the things that might be unique to you, like the birth order in your home, whether you’re the first born or second born or third born. And we know in really young children that about 50% of a child’s language development potential is based on that shared environment.

So how good is the caregiving environment? How much language stimulation is the child getting? You know, is it quality language stimulation, and unfortunately children who are raised in a foster homes and children who are raised in institutional environments tend to not get that quality language input during the early years.

And so we see a key factor of them, you know, already sort of starting behind… at the point where they might be adopted because that shared environment that they’re in – it’s just not a strong language quality environment. The good news is that when we move these kids into a good quality language home, where they’re really being enriched and getting life experiences is that we can make up part of that deficit.

And we see in kids who are internationally adopted, especially, that there’s huge, catch-up growth that occurs during the first few years after adoption. But unfortunately our research is showing that we can’t always fully close that gap. And while certainly there are some adopted children who do exceptionally well – you know, with the children I’ve worked with, I’ve seen children who are gifted and talented, but you know, as a group, they tend to not do as well as their peers. And I always, when I’m talking about this sort of, talk about, you know, if we take a normal distribution curve and draw it out, if we take the population as a whole, you know, that average is right at 100.

And when we have children who are growing up in environments that aren’t quality language environments, that curve is going to shift downwards. And so we’re still going to have kids at the upper end of the curve who are doing really, really well. We’re still gonna have those kids at the bottom of the curve who, you know, aren’t doing well, but that middle average is just shifted. And you know, the interesting research question is how much can we shift it back up – once we put kids back into a good environment. And I strongly believe we can shift it and we do shift it when children are adopted into good homes. But I think that there’s still some lost potential there because of that early environment of the children.

Dr. Emily Helder: Yeah, well, I’m glad you brought up that idea of the variability that’s present. Cause I see that so much in my clinical work, too. And I wondered if you could say a bit about maybe what sort of environmental factors even pre-adoption might be related to or predict some of that, you know, who’s gonna really recover well and who is going to struggle.

Dr. Sharon Glennen: Yeah. I think that’s the $50,000 question that a lot of researchers are trying to figure out, you know, which kids are going to be resilient and which ones are not. I mean, I know we have strong evidence that there’s certain environmental factors that strongly correlate with language and cognitive outcomes.

You know, the, the single strongest one is time spent in an institution or in a poor quality foster home. And, you know, it’s, it’s, not unexpected that the longer you spend in a poor environment, the less likely you are to have a quality outcome in the end. But again, I’ve seen children who were adopted at school age who come home and just, you know, you look at the background and you think, “Oh, this child just has every strike against them.” And yet they end up doing really, really well. And so, you know, in my mind, some of that is the genetics. You know, maybe that particular child through you know, their genetics just has more resiliency had stronger skills to be… the potential for stronger skills to begin with and are able to adapt and, and, and do well.

I still think that probably that adverse environment early on still takes away potential in every child, whether they have strong potential for good language skills or poor potential for good language skills that growing up in an adverse environment takes away some of that potential.

And we just, no matter what we do, we can’t give all of it back is how I explain it to parents.

Dr. Emily Helder: Yeah. As you’re thinking, you know, focusing a bit on the internationally adopted kids in particular. They have some really, some extra challenges because both, you know, they, they have the adverse environment, plus now they’re usually adopted into a country where they don’t know the language and have to learn it. I wondered if you could say a bit about how kids in that situation compare with non-adopted kids who are sequentially bilingual. So what’s similar, kind of what’s different between those two scenarios.

Dr. Sharon Glennen: Yeah. So my thinking on this has changed a lot over the years. Some of the  early research, was saying that internationally  children are, not sequentially bilingual. And I guess I’ll back that up and talk about the different types of bilingualism quickly just to define it for the audience.

We talk about children being simultaneous bilinguals, and that’s a child who’s born into a home where they’re immersed in two languages from day one and they grow up, maybe hearing mom talking one language and dad talking a different language. And those children usually end up very fluent in both languages.

Sequential bilingualism is what happens to most children and that is that they grow up in a home speaking one language and then at some point in time, usually when they start school, they get exposed to a second language. And especially if they’re living in a country where that second language is the dominant language, what tends to happen over time is that second language then becomes the child’s dominant language and that original first language while, while still strong is never quite as, as good as someone who grows up monolingual in that first language. Internationally adopted children, you know, understandably are speaking one language in their home, from birth.

And then at the point of adoption, the difference with them and sequential bilingual children is they completely lose that first language. I mean, every once in a while, I meet a family who you know, is originally from the child’s home country and can maintain the first language, but 99% of these kids lose that first language at adoption.

And so then they’re put in the process of learning their second language, but without what I call the scaffold of that first language to learn upon. So when I travel to a country where I don’t speak the language well if I don’t understand something in that country, in that language that I don’t speak really well, I can always fall back on my first language and try and ask someone who understands that language.

“All right. Well, what’s going on? What are they talking about? What is this I’m supposed to understand”, and then kind of figure it out and then go back into the second language again and try and converse about it. Internationally adopted children who come here, especially those who are adopted close to school age you know, maybe starting kindergarten or first grade or second grade, and they’re suddenly supposed to be learning these concepts, you know, math concepts and reading concepts and social studies concepts.

And they’re doing it in a new language. And unlike a child, who’s a sequential bilingual who, if they’re not understanding it in English can always revert back and have it explained in the first language. These kids don’t have a language to fall back on. And so what, what I see oftentimes, especially in the kids who are adopted at school age is their rate of learning the second language is way faster than sequential bilinguals, because they are immersed 100% of the time in this new language. Their original first language disappears very quickly and they very quickly become conversational in their first language in the new second language I mean and we call that basic interpersonal communication skills.

So within a year, I can have a simple conversation with a child who is say, adopted from China or Korea, or, you know somewhere else, and they will be able to converse with me. I might hear some grammatical errors in their speech, but they’re able to follow along as long as I’m talking about the here and now.

That tends to mask the fact that there’s still a lot of concepts they don’t know in the language. And so when they are listening to more academic concepts in school, they are missing a lot of information. And a lot of times families and teachers kind of miss this because the kids are so conversational and appear pragmatically to be doing really, really well.

And yet academically just whole subjects are just passing them by because they don’t have the language skills and they don’t have that fallback language, like a child who is a sequential bilingual.

Dr. Emily Helder: Yeah. I hear you talking a bit about the age at adoption piece. And I wondered if you could say more about how, you know, research that’s been done on critical and sensitive periods for language, how that sort of intersects with this idea of internationally adopted kids having to learn a new language.

Dr. Sharon Glennen: Yeah. So when children are learning language it’s an amazing process how the brain becomes specialized to listen to the language that you’re immersed in. And so prior to eight months of age we know through  research that, children pretty much, they prefer listening to the language that they heard in utero, but they can discriminate all sorts of different sounds.

Whether that sound is part of the language they’re hearing or not part of the language they’re hearing, but eventually we have to learn how to filter out things that aren’t important. If we don’t do that, it’s going to take us longer to learn a language, and so at about eight months of age, and this is true in children around the world, a process of attunement happens where they get really, really good at listening to the sounds of their language. And then they tune out listening to sounds that aren’t important to their language. And this process is important because once that attunement happens, they get really, really good at pattern detection.

“Oh, I’ve heard this pattern before and every time I hear it, this thing is in front of me. And maybe that’s what this thing is called.” And that’s how we start learning to comprehend the language around us, and then later to speak the language around us. Well, an internationally adopted child is going to go through that natural process of attunement at around eight months of age.

And what we know from looking at internationally adopted children after they get adopted to their home countries, their new countries is that when we analyze how their brains process language, they process their adopted language, much like anyone else learning a second language. And that is you’re not, you get highly specialized to listen to and comprehend and process that first language and the left temporal lobe is really, really good at doing that.

When you start learning a second language later in life, you have to use more of your brain and pay a whole lot more attention to that language, to listen to it and process it. And there’ve been a number of studies done on very fluent bilingual individuals who are sequential, you know, bilingual learners and then internationally adopted children that shows that, they simply don’t process language as well as someone who originally learned that first language from birth. And what I find interesting is that these internationally adopted children, when we’ve done research looking at their ability to process sounds and patterns from their original first language, those skills are still maintained. You know, they, they don’t understand a word of the language anymore, but their brain is still attuned to looking for and processing those patterns.

Which I find interesting.

Dr. Emily Helder: Yes. When I first saw that research come out, it, it just blew my mind. It was so interesting to read. Yeah. If we think too about some of the practical implications of, of what you wrote in the chapter, I guess one thing I want to really draw attention to is that the chapter includes some really helpful norms for practicing speech pathologists that look at, you know, what should be expected across different language measures, depending on age at adoption and how long kids have been in their adoptive home. But building on that one of the things I think that maybe adopted parents might encounter, especially if they haven’t been through this language learning process with a child previously is, you know, what’s actually within the normal range. And so I wondered if you could say a bit about what should trigger a referral for an assessment with a speech pathologist and maybe intervention you know, that just helps to guide parents and other professionals that aren’t as familiar.

Dr. Sharon Glennen: Yes. So what drove me to get into this line of work was I’m the parent of two internationally adopted children myself. And they were, 17 months one of them and 19 months, the other, and at the time there really wasn’t any research out there as to what the typical language learning process was for these children.

You know, what, what are the milestones for an internationally adopted child? When should we expect them to catch up? And in my own two children, I saw two very different early learning patterns, you know, one of my  children learned language really, really quickly. And the other ones struggled and I didn’t know what, what was typical and what wasn’t. And then other parents, when they found out I was a speech language pathologist started asking me, you know, to, you know, “what about my child? You know, I’m worried about them, should I be or not?” And so I started trying to collect data across a number of internationally adopted children to try and determine what are the typical patterns of language learning shortly after adoption, and then following them out over time to see how they did. And so the norms that are in the book and, and they’re not really norms, but it’s based on data that we’ve collected on children. Typically, I segment children by how old they are when they come home. So a child who is adopted prior to eight months of age and I actually round that up to one year of age, I would expect to meet every milestone in language learning as a non adopted child would. And, and so they catch up really quickly and by you know, six months after adoption, I see no difference in those children and, and the internationally adopted and children who were never adopted. For children who are adopted between one and two years of age typically within about a year, their comprehension skills should be where they should be expected to be for a child who has been speaking that language their whole life.

And then expressive language skills should still be within the normal range as well. Now they might not have reached fully caught up, but if we test these children, they fall in the normal range. So I always say within a year of adoption for a child adopted under the age of two. If you don’t think your child is talking as well as other children who are the same age you need to go get your child evaluated.

For the kids who come home at three and four years of age I’m always amazed at how rapidly they catch up as well. And so within a year of adoption children who are adopted as three and four year olds… if I assess them in the English language, still as a group fall in the average range, you know, it’s kind of on the low side, but they’re still average within a year.

And they’re still progressing and, and their skills keep growing and they keep catching up over the next first three years home. But again, if you have a child who was adopted as a three and four year old and within a year of adoption, you don’t think they’re sort of falling within that typical average range, then you really need to go have your child assessed by a professional and for the kids who are adopted at school age, the five-year-olds and up – I don’t have great answers there, and I don’t have a lot of data to let me feel confident about what I have to say, but based on the children that I’ve, I’ve seen professionally and the children who I’ve studied typically within a year, their basic conversational fluency skills should be pretty good. You should be able to, you know, have a conversation with them about what they did today, what they’re doing tomorrow, they’re going to make grammatical errors and they may have some pronunciation errors, but they still should have enough fluency that you’re able to have basic conversations with them.

Again, it’s all those concepts that they have to learn and learn quickly that are going to take years and years and years of learning to get them caught up. But if I see a child who’s not conversant at a functional level within a year of adoption, I start to get very concerned.

Dr. Emily Helder: Yeah. One of the things as I’ve, you know, when I do clinical assessments with kids and help families sort of navigate the school issues, I guess I should say I encounter this more with kids adopted at school age where they’re, they’re seen at school generally more through an English language learner lens so that they’re getting ELL services, but I suspect that probably overlaid on top of that are maybe some academic learning disabilities or perhaps, you know, communication deficit. And it becomes really challenging to get them access to services. Because a lot of the requirements are that, you know, the learning disability can’t be due to lack of exposure to English, but then I’m stuck because I can’t assess them in their birth language cause they’ve lost it. So I wondered if you had advice for professionals or families in this case?

Dr. Sharon Glennen: I, I wish I had the magic key to this because I’ve, I’ve sat at many tables at schools for children that I’ve assessed, advocating for them. And it’s just been a tough uphill road each time. Sometimes it’s not. I had one child who she was in my study adopted at age four and struggling with language. And at age eight, the school was still insisting that she was an English language learner and had to be assessed in her first language which she hadn’t heard in four years to determine whether she had a learning disability or not.

Luckily, somehow it got to the level of the head of the ELL within her particular system. And, and he immediately recognized that this was a dumb idea and we were able to qualify her for services eventually based on her abilities in English, but it’s just tough. And so what I’ve done is a lot of, sometimes it takes assessing and following the child over a period of time and having that trail of lack of progress.

So you know, in an initial evaluation sometimes I have difficulty qualifying the child to get them out of that English language learner box and qualifying them for an IEP and getting special services. But if I can see the child again in six months or a year and document that minimal progress is occurring, then I’m able to go back and argue more successfully.

And usually at that point, I’m able to get the child the services they need, but you know, then we’ve lost a year of, of getting special help. So I have sometimes gotten schools to not officially qualify a child for an IEP, but provide through title I and other mechanisms, getting the child extra help, you know, so, you know, I, in my mind, even if they don’t officially have that IEP, if the school is providing extra reading, tutoring and math tutoring and whatever, the child… one-on-one support the child needs you know, I feel pretty good about it.

And then once we sort of track over time that no progress has been made you know, maybe, you know, a year or two later, we can go back and get the child to qualify for an IEP, but it’s tough.

Dr. Emily Helder: No – no I just run into this all the time. And it’s just really challenging. I mean, I tend to just handle it on an individual case by case basis.

Dr. Sharon Glennen: And some of it is specific to the team working with that particular child at that particular school, I find some school educators and professionals are much more willing to be flexible. And then others are very unwilling. One little boy I worked with who really struggled and had some significant learning disabilities and his teacher was advocating for him, even the English language learner specialists were advocating for him and others in the school were advocating for him. But the particular speech language pathologist in this school didn’t want him on her caseload and wasn’t advocating for him to get services and finally said, well, okay, I’ll see him but only for articulation therapy to work on his pronunciation, which was the least of his issues. It’s like, “Oh my goodness.”

Dr. Emily Helder: Yeah. Yeah. Supporting families as they walk that line of being a strong advocate, but also needing to maintain relationships at schools is challenging. As you, as we wrap up can you say a bit about what you see as the broader implications of language difficulties for children in the school setting.

Dr. Sharon Glennen: Again, I think the, the broader implication, and especially for these kids who are adopted at older ages is just, they have to learn so much vocabulary so quickly. The good news is that vocabulary is typically a strength in these kids.

It’s, it’s the one language area that’s not affected neurobiologically as much by a change in language. But if you think about all the words that you need to learn to make sense of the world around you, they start day one in a rapid catch-up race, trying to learn all of those concepts. And there’s so many little nuances.

There was a little boy who I remember I was assessing and I needed a timer with a second hand and I looked up to see if the clock on the wall had one. And I said, “Oh, it doesn’t have a second hand. And he looked at the same clock and he goes, no, it has two hands. It doesn’t have a third hand”, you know?

It’s yeah. Yeah. Little nuances that take a long time for these kids to understand and comprehend and catch up because they haven’t learned the language for the first three, four, five years of their lives. We do know that these kids, from a more neuro-biological perspective as a group, tend to have more difficulty with verbal working  memory and with the syntax and grammatical elements of language.

And I think some of the verbal working memory probably stems from the fact that as we were talking earlier, they have to use more of their brain to process and use language in this new adopted language. And, so that means they have less to focus on whatever else it is they’re supposed to be learning.

Dr. Emily Helder: Yeah. Well, thank you so much. This was a great conversation, both about some of the practical implications of your work and how it connects with some broader themes in child development. So thanks so much both for writing the chapter and for spending a bit of time talking about the implications.

Dr. Sharon Glennen: Well, thank you for inviting me to be part of the book. So it’s been fascinating for me to read the other chapters in the book as well, and learn about some areas that are outside my specialty area to help broaden out what I know about this population.

Dr. Emily Helder: Yeah. Yeah. I’m biased, but I think it turned out pretty good.

Dr. Sharon Glennen: I agree with you.

Dr. Emily Helder: Well, great. Thanks so much.

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